Dear everyone,

Yesterday I started a blog about my experience with having depression, PTSD, OCD, an eating disorder and being borderline borderline. I type everything on my typewriter and then take pictures of the cards and post them online. I think it's a pretty cool format, so if anyone wants to read it, I'll be posting there more than here.

 The URL is beautifulborderline.blogspot.com. 

       - Kelley 

Here's what's happening on the HealthyPlace site this week:

• Addicted to Food
• Why is Food Addictive
• "The Emotional Pain of Food Addiction" On HealthyPlace TV
• Immaturity and Your Child
• Self-Help For Your Mental Health

Addicted to Food

I came across an interesting article on food addiction by psychiatrist and author of "Living the Truth," Dr. Keith Ablow. In it, Dr. Ablow says increasing numbers of men and women are turning up in his office unable to lose weight despite diet and exercise.

"I'm talking to more and more patients who are deeply ambivalent about giving up food. Eating has become one of their primary sources of pleasure; for all intents and purposes, they're as addicted to food as other people are to smoking or alcohol."

Why is Food Addictive?

Food, like tobacco and alcohol, also contains substances that are mind-altering, says Ablow. Fats can be mood stabilizers; carbs can increase energy and many nutrients are linked to levels of serotonin and other brain chemical messengers that basically determine whether we feel content and happy -- or anxious and depressed.

• What is Food Addiction?
• Signs and Symptoms of Food Addiction
• Characteristics of Binge Eating Disorder
• What Causes Food Cravings (Food Addiction)?
• Food Addiction Test
• Videos on Food Addiction, Binge Eating

"The Emotional Pain of Food Addiction" On HealthyPlace TV

Caryl Ehrlich was a compulsive overeater. She used food to change her moods. She ate because of good news, bad news, no news, or during the news. How it started and how the food addiction ended is the subject of this Tuesday's HealthyPlace Mental Health TV Show.

Join us Tuesday night, August 4. The show starts at 5:30p PT, 7:30 CT, 8:30 ET and airs live on our website.

• TV Show Blog with this week's show info

In the second half of the show, you get to ask HealthyPlace.com Medical Director, Dr. Harry Croft, your personal mental health questions.

Coming in August on the HealthyPlace TV Show

• The Psychological Process of Changing Your Gender
• The Stress of Being an Alzheimer's Caregiver
• Being in a Relationship with Someone Who Has Dissociative Identity Disorder

If you would like to be a guest on the show or share you personal story in writing or via video, please write us at: producer AT healthyplace.com

Click here for a list of previous HealthyPlace Mental Health TV Shows.

More Information on Food Addiction

• Understanding Compulsive Eating
• How to Handle Food Cravings
• How Do You Treat Food Addiction?
• Triumphant Journey: A Cyberguide To Stop Overeating and Recover from Eating Disorders

We also have many transcripts from previous chat conferences on food addiction, compulsive overeating and binge eating with excellent information.

Immaturity and Your Child

We had a parenting problem at my house several years ago. Like most kids, my 13-year old son wanted to be treated like a 16-year old. Unfortunately, many times he acted like a 10-year old. It was a very frustrating time during this period in our "parenting lives."

Maybe you're facing the same issue? If so, this article, Coaching The Emotionally Immature Middle Schooler, by the Parenting Coach, Dr. Steven Richfield, may shed some light on the problem.

Self-Help For Your Mental Health

Sure, therapy and psychiatric medications, can help improve a mental health condition.   But there are also things you can do to help yourself get better and stay better.

• Self-Care When Parenting an ADHD Child
• Managing Your Anxiety
• Bipolar Recovery: Reconstructing A Balanced Lifestyle
• Self-Help Stuff That Works

back to: HealthyPlace.com Mental-Health Newsletter Index

Learn about Bipolar psychosis. Includes examples of bipolar psychosis along with symptoms and treatments of psychosis in Bipolar Disorder.

Psychosis is thinking in which there is a break with reality. Common types of psychotic thinking include:

• thoughts which are not consistent with reality called delusions
• sensory experiences that are not real such as hearing, seeing or smelling things that are not there called hallucinations
• misinterpretations of reality, such as imagining that the announcer on TV is directly talking to the person suffering the psychosis called illusion

Psychosis can be present in those with schizophrenia, depression, or bipolar mania.

Psychosis in Bipolar Disorder

We usually think of a person suffering from bipolar disorder as having:

• distractibility
• rapid thought or speech
• not needing sleep
• being grandiose or irritable
• often taking unnecessary risks or being reckless (spending too much money, driving too fast, having reckless sex)

Most patients suffering from manic episodes will have several of these symptoms at the same time, and for a prolonged period of time. But some with bipolar mania can also suffer from psychotic thinking. In bipolar mania, these psychotic thoughts are usually related to the person's manic state.

Examples of Bipolar Psychosis

Some, during their mania, believe they are more important, gifted or capable than they really are. As a result of their inflated thoughts, they often behave in ways that are not usual for them, and represent a severe change from the non-psychotic state. For example, people during a manic psychosis might believe:

• they are capable of superhuman feats (can fly, drive at excessive speeds, gamble excessively though they are broke).
• they have God-like qualities, and begin to "preach" to others.
• they are about to receive large amounts of money (eg, will win tonight's lottery) and so begin to spend excessively.

In depression, the psychosis is usually consistent with their depressed state (eg, thinking they have a terminal disease and are about to die). In schizophrenia, these thoughts are more bizarre and disorganized or paranoid. In mania, however, the psychotic thinking is usually grandiose, reckless, or about hyperactive or pleasurable or angry events.

Psychosis during a manic episode is a very severe symptom and needs to be treated. Today, we use drugs called atypical antipsychotics to treat manic episodes with and without psychosis. Some of these medicines are: Zyprexa (olanzipene). Risperdal (risperidone), Seroquel (quetiapine), Abilify (aripiprazole) and Geodon (ziprazedone). Other older antipsychotics (such as thorazine, haloperidol, thioridazine, perphenazine and others) can be used for the psychotic thinking but are not as effective for use in longer term prevention of bipolar symptoms.

Watch HealthyPlace TV Show on Bipolar Psychosis

Psychotic thinking during a manic episode is usually an indicator of the need for hospitalization to protect the patient as well as to get more rapid control of the manic state. On the HealthyPlace TV show, we will talk with author (and bipolar sufferer), Julie Fast, about this unusual symptom. You can read her special section on Psychosis in Bipolar Disorder written exclusively for HealthyPlace.com. She also discusses bipolar psychosis in videos (numbers 9 and 10).

Join us this Tuesday, September 15. You can watch the HealthyPlace Mental Health TV Show live (5:30p PT, 7:30 CT, 8:30 ET) and on-demand on our website.

Dr. Harry Croft is a Board-Certified Psychiatrist and Medical Director of HealthyPlace.com. Dr. Croft is also the co-host of the HealthyPlace TV Show.

next: Living with Dissociative Identity Disorder
~ other mental health articles by Dr. Croft

Learn about the signs, symptoms and treatments of dissociative identity disorder and what it's like living with DID.

What is Dissociative Identity Disorder?

Most of us have heard of the movie Sybil or Eve, movies (based upon books) about those with dissociative identity disorder (the condition that used to be known as multiple personality disorder). DID is a psychiatric disorder which is characterized by "the presence of two or more distinct identity or personality states...that recurrently take control of the person's behavior." There is also an "inability to recall important personality information". The condition is generally the result of early childhood trauma that is so severe that the child developed a "coping strategy" that involved psychologically dissociating - that is, in their minds, "not being there" and having the abuse dealt with by another part of their psychological selves. These different parts of the person eventually become distinct personalities. Usually the main day-to-day personality is not even aware of the existence of the other personalities. These other personalities often "come out" during a time the main personality is "blacked out." Thus the person does things under the control of the other personalities, (that are called "alters") that the person is not aware of, and will often deny.

Being a Partner of Someone with Dissociative Identity Disorder

In my 35 years of clinical practice, I have treated several patients with DID, but my first patient with the disorder is the one I remember the most. She was bright, capable, married, ran a successful business, and was quite reserved in her demeanor. During periods she did not remember, she would curse, have angry outbursts, mess up the house, and behave in ways she later denied , and called her husband a "liar" for imagining that she had been responsible for this behavior.

While it is difficult for the patient suffering with Dissociative Identity Disorder, it often even more problematic for the person living with the DID patient. Imagine what it must be like to see the person you live with behaving in a way that is totally foreign to their usual personality, and then denying that it ever happened.

On the HealthyPlace.com website, there are several videos which describe the effect of living with someone with DID. One of the most memorable is that of the ex-wife of football great, Herschel Walker, someone who has admitted the presence of his DID.

Watch HealthyPlace TV Show on Experiencing Dissociative Identity Disorder

On the HealthyPlace TV show, we will talk with someone with DID and talk in more detail about the origin, symptoms and treatments for dissociative identity disorder. We will also focus on what it is like for family members to live with someone who has DID. I believe it will be a fascinating show. (Read show blog post on Life with Dissociative Identity Disorder.)

Join us this Tuesday, September 1. You can watch the HealthyPlace Mental Health TV Show live (5:30p PT, 7:30 CT, 8:30 ET) and on-demand on our website.

Dr. Harry Croft is a Board-Certified Psychiatrist and Medical Director of HealthyPlace.com. Dr. Croft is also the co-host of the HealthyPlace TV Show.

next: Stress of Being an Alzheimer's Caregiver
~ other mental health articles by Dr. Croft

It's stressful being an Alzheimer's caregiver. Learn about the symptoms of caregiver stress and how Alzheimer's caregivers can address that stress.

Over my years of psychiatric practice, I have dealt with many patients suffering from Alzheimer's disease. Fortunately for them, especially in the latter stages of their disease, they are usually unaware of the impact -- or even the presence of their disease. However, family members and other caregivers are keenly aware of the symptoms of their loved one's illness. Over time, the disease begins to have a profound effect upon the Alzheimer's caregivers. Recent studies on Alzheimer's caregivers show that THEY are likely to develop stress related problems, including high blood pressure, heart disease, intestinal conditions , headaches and other psychological problems including anxiety and depressive disorders.

As the population ages, dementia becomes more common, with almost one third of those age 85 and older expected to be affected. The average lifespan after the diagnosis is between 8 and 20 years. Since family members are usually the caregivers for those suffering with Alzheimer's Disease, it is anticipated that over the course of time, many of the caregivers will suffer stress related symptoms as well.

Common symptoms of stress found amongst caregivers include: anxiety, depression, insomnia, irritability, social withdrawal, depression, anxiety. There's a variety of stress related physical symptoms as well, such as: headaches, exhaustion, lack of concentration, despair and others.

The Alzheimer's Association recommends the following for caregivers:

• Know what resources are available
• Become and educated caregiver
• Get help
• Take care of yourself
• Manage your stress level
• Accept changes as they occur
• Do legal and financial planning
• Be realistic
• Give yourself credit, not guilt

On the HealthyPlace.com TV Show, we will talk more about symptoms of caregiver stress, and ways to manage it. We will also describe the symptoms of Alzheimer's disease and the various treatment options available.

Watch HealthyPlace TV Show on The Stress of Being an Alzheimer's Caregiver

On our show, this Tuesday, August 18, our guest will be discussing the trials and triumphs of being an Alzheimer's caregiver to his father. You can watch it live (5:30p PT, 7:30 CT, 8:30 ET) and on-demand on our website.

Dr. Harry Croft is a Board-Certified Psychiatrist and Medical Director of HealthyPlace.com. Dr. Croft is also the co-host of the HealthyPlace TV Show.

next: Psychological Process of Changing Sex
~ other mental health articles by Dr. Croft

Some people feel they were born the wrong sex and desire a sex change. Learn about the psychological aspects of changing sex, sex reassignment.

Defining Transexualism, Gender Identity Disorder

Transexualism is the condition that generally results in a desire for a person to "change their sex." In transexualism the person sees themselves as truly having been born "the wrong sex" -- ie, a man in a woman's body or vice versa. In the psychiatric manual DSM IV the transexualism is defined as:

• A desire or insistence that one is of the opposite biological sex
• Evidence of persistent discomfort with, and perceived inappropriateness of the individual's biological sex
• The individual is not intersexed due to a biological condition
• Evidence of clinically significant distress or impairment in work or social life.

At present, many professionals call the condition "gender identity disorder." It does not mean that the person is simply a "cross dresser" who dresses as the opposite sex due to psychological factors. Instead, these individuals have a feeling they are truly psychologically more of the opposite sex rather than their present physical sex. Transsexuals may be either heterosexual or homosexual after sex change treatment, but usually they prefer sex with members of the opposite sex than they are AFTER THEIR SEX CHANGE.

Psychological Evaluation Before Undergoing a Sex Change, Sex Reassignment

Not all transsexuals attempt to actually change their sex - many chose to live as the sex they were born; although they often have a sense of severe discomfort being of that sex throughout their lifetime. Others chose to undergo sex change (or sex reassignment treatment including the use of hormones, and ultimately sex reassignment surgery). Before getting to that point, however, most treatment programs require at least a year's worth of psychological evaluation or treatment.

Over the years, I have personally participated in such treatment. In fact, I helped with the sex reassignment program at my medical school when I was a psychiatric resident. I have evaluated many with the condition. The first step involves making certain that there are no other psychological or psychiatric co-existing conditions that cause severe distress for the person, and in some cases may be the true cause of the desire to change sex. Examples might be: schizophrenia, substance abuse, homosexuality that is not psychologically acceptable to the person, and borderline personality disorder.

Next in the psychological treatment is to determine the emotional stability of the person with Gender Identity Disorder. While many have experienced extreme emotional discomfort from having to appear as a member of the sex opposite of the one they believe themselves to be psychologically, it is important that there be basic emotional stability present before the medical procedures can begin.

Watch HealthyPlace TV Show on Psychology of Changing Sex

On our show, this Tuesday, August 11, our guest will be discussing her sex change and the psychological aspects behind it. You can watch it live (5:30p PT, 7:30 CT, 8:30 ET) and on-demand on our website.

Dr. Harry Croft is a Board-Certified Psychiatrist and Medical Director of HealthyPlace.com. Dr. Croft is also the co-host of the HealthyPlace TV Show.

next: Reality of Food Addiction, Compulsive Overeating
~ other mental health articles by Dr. Croft

Causes and psychological impact of compulsive overeating. And compulsive overeating vs. food addiction?

Is Food Addiction a Real Addiction?

It has become common to talk about a variety of compulsive behaviors to be, in fact, an "addictive disorder." Whether it is sex, shopping, gambling, binging and vomiting, internet usage - the term "addiction" is frequently used to describe the cause and the process. The same is true for compulsive eating as well - as some refer to it as food addiction. While, clearly, compulsive overeating is problematic and injurious to health and dangerous to life itself, it is still unclear about the "true underlying cause" of this behavior. Although scientists at the NIMH and academic universities argue about the issue of whether this behavior represents a true "addiction," the reality is that compulsive overeating is a significant problem, both for the sufferer as well as for society in general.

Why Do People Overeat?

Scientists do agree that the cause of compulsive overeating is generally not simply the result of "weakness of will - or flawed character." Only now are we beginning to understand the significance of imbalances of chemicals that control the feelings of the desire for food (hunger) and fullness (satiety). There also seems to be a genetic predisposition for becoming obese. This is in addition to the role that watching parents compulsively overeat may itself lead to inappropriate eating behavior in the child.

We know that some overeaters engage in the behavior due to the sense of psychological relief it provides. Some overeat due to depression, guilt, shame, anxiety, or stress. Others have little idea why they overeat - they just do so out of habit, or boredom. They feel compelled to overeat, anxious if they do not give in to the compulsion, and guilty at the end result. The result of compulsive overeating is the promotion of further negative emotions including embarrassment and shame, as well as the obvious deterioration of good health, and often the "solution" experienced by the compulsive overeater is to repeat the behavior.

During our Tuesday (Aug. 4) HealthyPlace TV show on food addiction, we will discuss the scientific controversy, as well as practical ways of controlling the undesired behavior of compulsive overeating as well.

You can watch it live (7:30p CT, 8:30 ET) and on-demand on our website.

Dr. Harry Croft is a Board-Certified Psychiatrist and Medical Director of HealthyPlace.com. Dr. Croft is also the co-host of the HealthyPlace TV Show.

next: Narcissism and Narcissistic Personality Disorder
~ other mental health articles by Dr. Croft

Brand Name: Actos
Generic Name: Pioglitazone Hydrochloride

Actos, pioglitazone hydrochloride, full prescribing information

Why is Actos prescribed?

Actos is used to control high blood sugar in type 2 diabetes. This form of the illness usually stems from the body's inability to make good use of insulin, the natural hormone that helps to transfer sugar out of the blood and into the cells, where it's converted to energy. Actos works by improving the body's response to its natural supply of insulin, rather than increasing its insulin output. Actos also reduces the production of unneeded sugar in the liver.

Actos (and the similar drug rosiglitazone maleate) can be used alone or in combination with insulin injections or other oral diabetes medications such as glipizide, glyburide,or metformin hydrochloride.

Most important fact about Actos

Always remember that Actos is an aid to, not a substitute for, good diet and exercise. Failure to follow a sound diet and exercise plan can lead to serious complications, such as dangerously high or low blood sugar levels. Remember, too, that Actos is not an oral form of insulin, and cannot be used in place of insulin.

How should you take Actos?

Actos should be taken once a day with or without meals.

• If you miss a dose...
  Take it as soon as you remember. If you miss a dose on one day, skip it and go back to your regular schedule. Do not double your dose the following day.
• Storage instructions...
  Store at room temperature in a tight container, away from moisture and humidity.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Actos.

• Side effects may include:
  Headache, hypoglycemia, muscle aches, respiratory tract infection, sinus inflammation, sore throat, swelling, tooth disorder

Why should Actos not be prescribed?

If Actos gives you an allergic reaction, you should not take Actos.

continue story below

Special warnings about Actos

In very rare cases, a drug similar to Actos has proven toxic to the liver. The manufacturer therefore recommends that your doctor check your liver function before you begin taking Actos and periodically thereafter. If you experience symptoms of liver problems such as jaundice (yellowing of the skin and eyes), nausea, vomiting, abdominal pain, fatigue, loss of appetite, or dark urine, report them to your doctor immediately. You will probably have to stop using Actos.

Because Actos works by improving the body's response to its own supply of insulin, it is not for type 1 diabetics, who are unable to produce any insulin at all. For the same reason, Actos can't be used to treat the condition known as diabetic ketoacidosis (excessively high sugar levels due to the lack of insulin).

In rare instances, Actos causes swelling and fluid retention that can lead to congestive heart failure. If you already have this problem, you should avoid Actos. If you develop symptoms that signal the problem—such as shortness of breath, fatigue, or weight gain—you should check with your doctor immediately; the drug will probably have to be discontinued. The problem is more likely when Actos is taken in combination with insulin.

Actos, by itself, will not cause excessively low blood sugar (hypoglycemia). However, when you combine it with insulin injections or some other oral diabetes drugs, the chance of hypoglycemia increases. If you begin to feel symptoms of hypoglycemia—shaking, sweating, agitation, clammy skin, or blurred vision—take some fast-acting sugar, such as 4 to 6 ounces of fruit juice. Let your doctor know about the incident; you may need a lower dose of insulin or oral medication.

To make sure that your blood sugar levels stay within the normal range, get regular tests of your blood sugar and glycosylated hemoglobin (a long-term measurement of blood sugar). Contact your doctor during periods of stress due to fever, infection, injury, surgery, and the like. Dosage of your diabetes medicines may need to be changed.

Possible food and drug interactions when taking Actos

It is possible that Actos may reduce the effectiveness of birth control pills containing ethinyl estradiol and norethindrone. To guard against an unwanted pregnancy, be sure to use some other form of contraception.

If Actos is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Actos with the following:

Ketoconazole
Midazolam

Special information if you are pregnant or breastfeeding

The effects of Actos during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, tell your doctor immediately. He may switch you to insulin during your pregnancy, since normal blood sugar levels are very important for the developing baby.

It is not known whether Actos appears in breast milk. For safety's sake, do not use Actos while breastfeeding.

Recommended dosage for Actos

ADULTS

The recommended starting dose of Actos is 15 to 30 milligrams once a day.

If this fails to bring your blood sugar under control, the dose can be increased to a maximum of 45 milligrams a day. If your blood sugar still remains high, the doctor may add a second medication.

When Actos is added to other diabetes medications, your doctor may need to lower their dosage if you develop low blood sugar. If you are taking insulin, the dose should be lowered when blood sugar readings fall below 100.

Overdosage

The effects of a massive Actos overdose are unknown, but any medication taken in excess can have serious consequences. If you suspect an overdose with Actos, seek medical attention immediately.

Last Updated: 08/09

Actos, pioglitazone hydrochloride, full prescribing information

Detailed Info on Signs, Symptoms, Causes, Treatments of Diabetes

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