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Chances are you probably know someone who suffers from some form of mental illness.
Whether it's anxiety depression post TV or bipolar disorder he can put an incredible strain on the patient and the family.
Fortunately there are ways to cope.
Welcome to a document.
Nearly sixty million Americans are living with mental illness.
While most cases are manageable with therapy and medication others can be quite severe.
Schizophrenia -- -- -- one of the most difficult disorders for both patients and their families.
And in our first story you'll meet two women who have been divided since -- -- -- -- I am.
If I do anything good in this world.
It is -- at home.
Being born you -- But it doesn't work it's -- -- -- two time for.
It's one of medicines great mysteries schizophrenia.
Pamela Wagner has been living with the illness for most over 57 years.
There's a divided consciousness between what I'm supposed to believe -- -- And when you hear things.
They can be very dangerous.
If you're apt to act.
You know they're called command hallucinations and if they tell you to do things and you listen to them here -- tropical.
Hallucinations and hearing voices that are not really there.
Our common symptoms of paranoid schizophrenia in -- case the voices are delivering a dangerous message.
Tell me to do things like fittingly like on fire and a half cent while I can't fire because as -- -- whole -- -- And I work.
I work because the whole point.
Is mark of Cain is supposed to keep people away from.
So why won't hurt anyone out.
So -- won't cause any more evil in the world.
Psychiatrist doctor -- -- can't quite wrap her head around -- -- Perhaps that's because they're identical twins.
It was very difficult to have my -- twin sister telling me these things it's very hard to get around that.
Have as a strange for me you -- by.
-- -- -- -- -- It is hard for anyone to comprehend.
-- are genetically identical and yet as adults the want a psychiatrist the other crippled by mental illness -- and Caroline were born in 1952.
They were inseparable from the moment -- arrived just five minutes after her sister.
I don't know what it's like not to have somebody that's my best friend always there.
They have always been able to feel close to her even when I know there's something wrong with her.
Like many twins the -- shared everything.
From their looks to their live experiences.
But things change as the girls grow and by the time they got to middle school they were noticeable differences between the two.
She started hearing voices happening in sixth grade I had this identical -- and she's not washing our hair she's not trying to Wear the right clothes she's not taking shower.
And the trouble is -- knew something was wrong that my parents.
You know they thought -- she's just growing up later.
Then in 1963.
When the girls were just eleven years old the nation suffered a monumental tragedy.
The assassination of president Kennedy but -- illness and her reeling with a different kind of grief she believed she was responsible.
I was devastated.
And not just devastated I.
And those things.
People told me.
And I felt somehow but I killed.
I'm never told anyone how she was feeling.
To the outside world her future seem to be full of promise in 1971.
That she and Caroline enrolled at Brown University.
But -- life soon began to unravel.
I was very to crafts.
I was hearing things but I was also parent time I believe mind.
Roommate went she wore -- red -- it meant that she and her friends were plotting against me.
College -- almost impossible for -- Did in 1975.
Both ways graduated.
Two years later they started med school.
-- at the University of Connecticut and Caroline at harbor.
Not long after -- classes began administrators became concerned with her behavior and asked her to leave.
Once medical school -- basically.
We lost touch with.
In the sense that they didn't know what to do it didn't know how to help.
Caring for a loved one -- mental illness can drain and even destroy a family.
Unable to hold down a job because of her deteriorating mental health.
Pam found herself shaking in and out of hospitals.
Caroline was focused on building her own life as a -- I needed to get to just get away from her.
I I needed my own identity.
Then in 1981 while on call -- Massachusetts mental health center Caroline got an urgent phone call from a hospital in Connecticut.
Only this time the patient was her sister.
Pam was finally diagnosed with paranoid schizophrenia and put on medication.
I didn't even.
Believe that I haven't LS.
Until I taking medication that made me feel father.
And then I began to say you could say to myself.
These pages now.
Pam and Caroline had an autobiographical novel -- divided minds and just this here.
-- published her first book of poetry it is -- sheet there's like these that -- contradict the stigma so often linked to schizophrenia.
The incidence of violence with schizophrenia is is no more violent than the general public is just gets the media.
That's usually when most people here it's -- premiums when there's some violent crime committed.
Today she spends most of our time writing painting and making jewelry.
But even with medication she still has a lot of old demons to overcome -- Often.
-- have to burn myself that I do.
-- myself but I have to.
This is -- good.
This illness is really quite.
Draining in spite of all the treatment and she's incredibly -- had.
And it's got a break her hard to realize how.
Much more she might have been able to do.
Patients like Pam are not without hope.
Talk therapy and new medications have proven their value.
There's so much out there.
If the medications work.
And if the medications work they are lucky.
Because then his whole life -- they gave me.
A life worthless.
And -- and cry.
It gave me smile.
He really did it.
Coming up you send us your mental health questions on doctor -- -- -- has your answers.
But first we talked to a season psychiatrists who spend years working at one of the busiest psychiatric wards in the world.
-- -- it all and she's here to share her experience that's next.
If anyone knows about schizophrenia and -- toll can take on people it's my next guest got to have the -- it.
As a psychiatrist you spent seven years treating patients in the psychiatric emergency unit.
A New York city's Bellevue hospital.
-- -- thank you for being here let me ask you this question this story of -- and Caroline is in the fascinating but is it rare.
While schizophrenia is not a rare illness that occurs in about 1% of the population and that's worldwide regardless of social class culture.
Everywhere in the world.
And it does have a heavy genetic component so that if -- an identical twin of someone with schizophrenia.
There's about a 48% chance that you might develop the illness yourself.
However that means -- 52% of people with an identical -- schizophrenia.
Will not develop schizophrenia.
I would say that it's rare that that identical twin goes on to become a psychiatrist and I think that both women need to be commended for sharing their story.
Right so we know that schizophrenia has a very significant genetic component but what else do we know about schizophrenic.
Well in terms -- bit of the ideology of schizophrenia and that being the causes of schizophrenia.
There does seem to be a genetic predisposition.
As I mentioned -- 1% of the general population.
It's about 9% if you have a sibling -- schizophrenia and when it's an identical twin sibling it's about 48%.
Because we know there's a genetic component it.
They've done a lot of research on the different genes that might contribute in that come up with some suspects but nothing clear.
And we also know that there must be some other type of developmental or environmental factors that contribute to the development of this -- But those factors we don't know yet which -- You know we don't know until.
That's a very big deal of research and -- -- but so schizophrenia -- not only impacts the patient but the entire family unit.
-- the so what advice would you give the family of the patient you know with skits for me.
Well I would advise family is number one to become educated about the illness they need to find out as much as they can.
And they need to be trying to communicate with mental health professionals.
You know we have to protect the confidentiality of the patient themselves.
But perhaps a family member.
Can find a support group perhaps they can find other ways of educated themselves.
And -- it creates some support around themselves and trying to deal with this illness and what it means for the individual and the family.
Now -- as we mentioned -- you have spent seven years.
Working in -- -- hospital which is one of the leading hospitals I think in the country from mental health.
So I wanna I wanna know what was it like being in the front lines.
For almost two years tell me some stories from from your past.
Well it definitely is a very very intense place to work has a very high rate of burnout among our staff and is I think that outside of the operating room it's the place in the hospital where we have the most reliance on teamwork.
My nurses my tax my social workers my -- everybody on the team is critically important.
I need to know that they have my back and they need -- that I have -- You know we have.
Episodes almost on a daily basis of agitated patients patients who come in we -- -- in a body bag by EMS which means they're already restrained in the field and really out of control.
That could be mental illness could be substance abuse issues could be somebody high on PCP or cocaine something like that.
So every day we're dealing with a very.
Intense and complex patient population the carry a lot of issues with them medical illnesses.
Family issues social issues that we have to deal with.
And -- an SS for every patient confidence.
Working -- -- did you think that there was an increase over the years in the cases that you saw in the emergency room you know for mental disease.
We did have an increase in our patient flow a lot of that had to do with changes in the way the city mental health services are structured for example.
We used to get.
Anyone under arrest who -- a psychiatric attention.
For the boroughs of Manhattan the Bronx and Staten Island.
But for Brooklyn and queens they would go to Kings County than they consolidated -- thinks about the use of we seeing more and more patients under arrest and we -- before Bristol.
About research there's a lot of new research being done for schizophrenia and one of the things that you mentioned in the pre interview has a lot to do with.
And you know in -- diagnosis of schizophrenia.
I'm a little bit about that.
Well we certainly can't diagnose and -- around however one of the interesting fields of research and schizophrenia -- a field -- at -- genetics.
And that's the idea that if you take your basic genetic code that that's kind of a prescription for a certain.
You know constellation of physical factors you know it -- position.
Illnesses that you might develop and that and that what FB genetics does this -- study's other factors that might -- gene expression.
So for example they've looked at.
In countries where there's been -- a war or famine increased rates of things like diabetes and heart disease.
Among the children whose mothers were pregnant at that time.
So while we can't predict certainly.
In a baby your fetus.
There is -- and it really burgeoning field of of research now about how.
Things -- wrestlers infections.
Famine -- warm -- -- Impact of baby -- in the womb at that time.
So you know there's a lot of stigma when it comes to the you know being tagged with the diagnosis for mental illness.
Hobby you think we can break down.
That way of think.
I think it we need to understand that people need to understand the mental illness as well as addiction do have a very.
Hi genetic component they are multi fact Torino but they are strongly inherited.
So you can see that there's clearly a biological basis for these diseases and even though the impact someone's behavior.
And the behavior can be difficult to manage that really the person themselves.
Is not responsible for the development of this illness and I think it's it's some it's really a call to have compassion for these patients rather than scorn.
And to help work with them where they are.
And to help improve their lives in any way possible.
What do you think the future goes from here.
I think there are a lot of exciting developing fronts on first of all the medications are getting.
-- Fewer side effects.
And working out toward the effectiveness that we have with the on medications particularly for schizophrenia.
We also know at this point that it's critically important that other types of support are available for a patients so -- best social worker.
Possibly a nurse on the team I think that the more support and structure people have the better that.
The chances that they'll do well I think some of those areas in terms of new types of psychotherapy.
New interventions in terms of meeting someone in their home rather than making them -- the hospital.
Are really some of the the forefront of treatment at this time.
Well thank you so much for coming eventually -- for the program I think everybody should see mental health professional because you know it was have to check your head and -- -- Thank you so much they -- -- Coming up when you think about bipolar disorder -- necessarily think Broadway musical -- you will.
Speaking about mental illness can be difficult.
Knowing that we decide to give you the opportunity to ask what ever you want it.
-- now to help answer your questions as New York Times best selling author and psychiatrist.
Got to keep -- K thank you coming off man we have several emails.
And let's start with the first one.
-- have depression and have been taking many anti depressants and all of them.
Make me feel bad either more depressed or extremely anxious to -- I wonder if there is an anti -- for every one or if some are just better off without.
Any kind of medication when he said that.
Well here's what I say it's maybe a little more complicated and answer then someone might have expected with such a simple and direct question.
There isn't an antidepressant for everybody that's why Psycho pharmacology the prescribing -- Madison's is as much an art.
As psychotherapy is.
You need to to match the -- to the individual.
And look if many of these medicines have creative side effects for this individual.
Fine but it might be that lowering the dose makes one more effective or combining them together so that you get the best of each.
With -- triggering side effects from anyone that might be the answer to.
I also have to say this that if somebody has had side effects that are intolerable.
From more than one antidepressant it's time to look at this new therapy.
Called RT MS.
Trans cranial magnetic stimulation.
-- you may have to lean on your insurance company to pay for but basically it involves exposing the part of the cortex that is thought to be involved in depression.
The powerful magnetic energy.
And it turns out that for people who haven't done well on more than one antidepressant this may be more effective than any anti depressant.
So people who have quote unquote failed I don't like to use the word failed but failed antidepressant treatment.
This is really something to look at our TMS Google it go online look at Fox News I think I may have had a -- An essay about it a blog about it take a look at that and also don't neglect psychotherapy because one thing we keep hearing.
As many studies as they do about all the new technologies.
Is that psychotherapy is really still the gold standard and as much as medicines -- question as to their effectiveness.
Effective psychotherapy nobody's ever said that doesn't work -- let's go to the next question.
-- fifteen year old daughter suffers with anxiety.
At ten years old after a viral illness should begin to -- germs and to wash her hands compulsively.
We've been dealing with life dominating anxiety issues -- then.
She's taking medications but we are wondering.
If she will ever be medicine -- this comes from -- and again.
It it's very important to take a look at these things and say.
Arrows in our quiver of errors therapeutic we can we employed.
Of course you want your child to be medicine -- if possible but first let's find the ideal medicine for him or her.
In combination it might work better to take more than one medicine.
At the proper dosages and I think that the lesson here Manny is never settle for less than an ideal or.
Therapeutic result there are a lot of clinicians.
And patients who stop short.
And -- will take a B minus but we feel relieved to some extent.
You'd never except that in internal medicine or cardiologist right if you're dealing with cholesterol you'd never see OK great it's a see through right.
You got it down to two girls they have -- our psychiatrist.
I want to be as close to you thought I make.
Of ideal mood as possible I want my daughter or son symptoms to be relieved I don't want them lessons and so tell me what do we need to do.
Is it that we haven't Neil Diamond diagnosis very often people say oh it's OCD well what are we sure work.
But we sure that's the entirety of it or is there an element to depression present it's also creating anxiety because depression can.
Is there an element of attention deficit problems because frankly if you can't focus you're going to be highly anxious checking out the environment.
That can contribute to a two.
We have an email from Steve.
From Texas and he says I think I may have -- DD.
But I'm not sure I have a hard time paying attention when someone is trying to communicate verbally.
I seem to a dream daydream a lot my mind seems like it's running a hundred miles an hour while I'm still sitting still.
What may I half wore on my options well and here's the -- we to this.
We say this.
It's certainly possible that attention deficit disorder is the root of those symptoms.
But it it's very important to be elegant and specific in diagnosis what else could explain -- I don't know the full case correctly you'd say boy if someone were.
Well hypo manic.
That could mimic those symptoms to and what is that that's when your mood is elevated.
When you're a bit euphoric.
When you might be dream but what's the contents of the day dreams -- -- psychiatry needs to get quite specific.
Is it expansive content where you have grandiose thinking.
That may go more with the mood disorder.
Than it does with attention deficit disorder and you only you know you find these diagnosis of the kind of sit for a while with the patient just trying to get a description of -- absolutely absolutely rule things in and you ruled them out and part of the elegance here.
Is that you use medicines in fact.
As part of that processor there's a bit of trial and error.
You might find that you prescribe a stimulant medicine that would be useful for EDD for attention deficit disorder and a person.
Has worsening symptoms as has now I'm daydreaming more and it's more elevated and my wife tells me that I'm grandiose and my thinking -- -- wait a second.
I think now we know we're up to hear it it looks like a mood disorder and we've pushed you too high.
Now -- we do a mood stabilizer.
Whether it's -- a code words tegra tall or she can see because you know I mean Madison is partly an art.
-- what we need is a Doctor Who says we're not giving up.
We're gonna find out what this -- and defeat it and get -- well thank you so much for with -- -- And all the help and you have also have -- knowledge.
When it comes to mental illness.
And coming up bipolar take center stage on Broadway as the musical next to normal tackles the -- ups and downs of this disorder.
It's a Tony award winning many plus one you know one of -- What does it mean to be normal it's typically define as conforming to the standard or common type.
But that's so black and white to me there -- many shades of -- And some days just being next to normal is the perfect variation.
Ever since it opened on Broadway in the spring of 2009.
The musical next to normal.
Has -- electrifying audiences with -- unforgettable songs.
And it's one of the kind story.
I caught up with Tony award winning writer and literacy is bright your key to talk about what inspired him to write this play with his longtime friend composer Tom -- You know -- and I have both had people relies too close to us who struggle with mental illness we wanted to write something.
That you know starting just not Ferraro -- help us better understand what we're going -- Suffered from mental illness and the people around on the net where we started really.
-- -- -- -- -- Which is when it comes with -- the amazing -- -- disease that you chose to fight Holmes.
It's a very complex disease in her diagnosis I think is not the clearest diagnosis of bipolar disorder I think that that's primarily what what -- her.
Throughout the process for example -- psychologist psychiatrist consulting with thoughts on it.
And the horror.
Strayed beyond I think it typical bipolar diagnosis.
But we chose that sort of central problem for her because.
We wanted to chart ups and downs gets me to the question is a beautiful.
So I wish -- good thing it would -- -- went -- Which is sung by -- which is.
I miss the mountains right.
And I miss the mountains and as I can thing I can't think I try.
-- news DEC.
Well this is a woman at this stage in her life she has been.
Some doctors did their very best to level out her her eyes.
And they've helped her manage her disease but she realizes that means that cost of feeling some things she wishes.
That she enjoys them.
But she enjoys the network part of her life.
Next to normal not only tackles what bipolar does to an individual it also heartbreak -- demonstrates that whole takes on an entire family unit.
Tony award nominated actor.
An experience that has for -- change the way he looks at -- I think that there should be any team involved with it and that it's in this shows incredibly therapeutic.
That's what's crazy about it and that's what -- -- amazingly beautiful impact it has.
It's a therapeutic aspect but.
You don't have to.
Have a family member who or yourself have this particular issue to not understand or get the show.
And you can click with the because everyone has a family whether it's a good -- -- they're not there's love there's loss there's hope there's light involved with.
Believe me this show is a must see if you get a chance to come to New York put it on your list.
As we -- throughout the show living with mental illness and loving someone baffling disorder can be frustrating.
-- -- and devastating all of the same time.
And as typical as they can be the key to surviving is to have understanding patience and most of -- compassion.
Remember to check out Fox News health dot com for more on the next topic.
That's all for now thank you so much for joining us -- Dr.
Manny Alvarez I don't see you next week.
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