feeling unable
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Not to be believed; incredible: unbelievable luck.


1: beyond belief or understanding; "at incredible speed"; "the book's plot is simply incredible" [syn: incredible] [ant: credible]


2: having a probability to low to inspire belief [syn: improbable, unconvincing, unlikely]

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What Is Bipolar Disorder?

Bipolar disorder, which is also known as manic-depressive illness and will be called by both names throughout this publication -is a mental illness involving episodes of serious mania and depression. The person's mood usually swings from overly "high" and irritable to sad and hopeless and then back again, with periods of normal mood in between.

Bipolar disorder typically begins in adolescence or early adulthood and continues throughout life. It is often not recognized as an illness, and people who have it may suffer needlessly for years or even decades.

Effective treatments are available that greatly alleviate the suffering caused by bipolar disorder and can usually prevent its devastating complications. These include marital break-ups, job loss, alcohol and drug abuse, and suicide.

Here are some facts about bipolar disorder.

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Manic-Depressive Illness Has a Devastating Impact on Many People.

  • At least 2 million Americans suffer from manic-depressive illness. For those afflicted with the illness, it is extremely distressing and disruptive.

  • Like other serious illnesses, bipolar disorder is also hard on spouses, family members, friends, and employers.

  • Family members of people with bipolar disorder often have to cope with serious behavioral problems (such as wild spending sprees) and the lasting consequences of these behaviors.

  • Bipolar disorder tends to run in families and is believed to be inherited in many cases. Despite vigorous research efforts, a specific genetic defect associated with the disease has not yet been detected.

  • Bipolar illness has been diagnosed in children under age 12, although it is not common in this age bracket. It can be confused with attention-deficit/hyperactivity disorder, so careful diagnosis is necessary.

D/ART: A National Educational Program

The National Institute of Mental Health (NIMH) has launched the Depression/Awareness, Recognize, and Treatment (D/ART) campaign to help people:
  • Recognize the symptoms of depressive disorders, including bipolar disorder

  • Obtain an accurate diagnosis

  • Obtain effective treatments

D/ART Also:

  • Encourages and trains health care professionals to recognize the signs of manic-depressive illness and utilize the most up-to-date treatment approaches

  • Organizes citizens' advocacy groups to extend the D/ART program

  • Works with industry to improve recognition, treatment, and insurance coverage for depressive disorders

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Bipolar disorder involves cycles of mania and depression.

Signs and symptoms of mania include discrete periods of:

Signs and symptoms of depression include discrete periods of:

  • Persistent sad, anxious, or empty mood

  • Feelings of hopelessness or pessimism

  • Feelings of guilt, worthlessness, or helplessness

  • Loss of interest or pleasure in ordinary activities, including sex

  • Decreased energy, a feeling of fatigue or of being "slowed down"

  • Difficulty concentrating, remembering, making decisions

  • Restlessness or irritability

  • Sleep disturbances

  • Loss of appetite and weight, or weight gain

  • Chronic pain or other persistent bodily symptoms that are not caused by physical disease

  • Thoughts of death or suicide; suicide attempts

It may be helpful to think of the various mood states in manic-depressive illness as a spectrum or continuous range. At one end is severe depression, which shades into moderate depression; then come mild and brief mood disturbances that many people call "the blues," then normal mood, then hypomania (a mild form of mania), and then mania.

Some people with untreated bipolar disorder have repeated depressions and only an occasional episode of hypomania (bipolar II). In the other extreme, mania may be the main problem and depression may occur only infrequently. In fact, symptoms of mania and depression may be mixed together in a single "mixed" bipolar state.

Descriptions provided by patients themselves offer valuable insights into the various mood states associated with bipolar disorder:


I doubt completely my ability to do anything well. It seems as though my mind has slowed down and burned out to the point of being virtually useless....[I am] haunt[ed]...with the total, the desperate hopelessness of it all...

Others say, "It's only temporary, it will pass, you will get over it," but of course they haven't any idea of how I feel, although they are certain they do. If I can't feel, move, think, or care, then what on earth is the point?


At first when I'm high, it's tremendous...ideas are fast...like shooting stars you follow until brighter ones appear...all shyness disappears, the right words and gestures are suddenly there...uninteresting people, things, become intensely interesting.

Sensuality is pervasive, the desire to seduce and be seduced is irresistible. Your marrow is infused with unbelievable feelings of ease, power, well-being, omnipotence, euphoria...you can do anything...but, somewhere this changes.


The fast ideas become too fast and there are far too many...overwhelming confusion replaces clarity...you stop keeping up with it--memory goes. Infectious humor ceases to amuse. Your friends become frightened...everything is now against the grain...you are irritable, angry, frightened, uncontrollable, and trapped.

Recognition of the various mood states is essential so that the person who has manic-depressive illness can obtain effective treatment and avoid the harmful consequences of the disease, which include destruction of personal relationships, loss of employment, and suicide.

Manic-depressive illness is often not recognized by the patient, relatives, friends, or even physicians.

  • An early sign of manic-depressive illness may be hypomania--a state in which the person shows a high level of energy, excessive moodiness or irritability, and impulsive or reckless behavior.

  • Hypomania may feel good to the person who experiences it. Thus, even when family and friends learn to recognize the mood swings, the individual often will deny that anything is wrong.

  • In its early stages, bipolar disorder may masquerade as a problem other than mental illness. For example, it may first appear as alcohol or drug abuse, or poor school or work performance.

  • If left untreated, bipolar disorder tends to worsen, and the person experiences episodes of full-fledged mania and clinical depression.

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Most people with manic depressive illness can be helped with treatment.

  • Almost all people with bipolar disorder--even those with the most severe forms--can obtain substantial stabilization of their mood swings.

  • One medication, lithium, is usually very effective in controlling mania and preventing the recurrence of both manic and depressive episodes.

  • Most recently, the mood stabilizing anticonvulsants carbamazepine and valproate have also been found useful, especially in more refractory bipolar episodes. Often these medications are combined with lithium for maximum effect.

  • Some scientists have theorized that the anticonvulsant medications work because they have an effect on kindling, a process in which the brain becomes increasingly sensitive to stress and eventially begins to show episodes of abnormal activity even in the absence of a stressor. It is thought that lithium acts to block the early stages of this kindling process and that carbamazepine and valproate act later.

  • Children and adolescents with bipolar disorder are generally treated with lithium, but carbamazepine and valproate are also used.

  • Valproate has recently been approved by the Food and Drug Administration for treatment of acute mania.

  • The high potency benzodiazepines clonazepam and lorazepam may be helpful adjuncts for insomnia.

  • Thyroid augmentation may also be of value.

  • For depression, several types of antidepressants can be useful when combined with lithium, carbamazepine, or valproate.

  • Electroconvulsive therapy (ECT) is often helpful in the treatment of severe depression and/or mixed mania that does not respond to medications.

  • As an adjunct to medications, psychotherapy is often helpful in providing support, education, and guidance to the patient and his or her family.

  • Constructing a life chart of mood symptoms, medications, and life events may help the health care professional to treat the illness optimally.

  • Because manic-depressive illness is recurrent, long-term preventive (prophylactic) treatment is highly recommended and almost always indicated.

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Getting Help

Anyone with bipolar disorder should be under the care of a psychiatrist skilled in the diagnosis and treatment of this disease.

Other mental health professionals, such as psychologists and psychiatric social workers, can assist in providing the patient and his or her family with additional approaches to treatment.

Help can be found at:

  • University- or medical school-affiliated programs

  • Hospital departments of psychiatry

  • Private psychiatric offices and clinics

  • Health maintenance organizations

  • Offices of family physicians, internists, and pediatricians

People With Manic-Depressive Illness Often Need Help To Get Help.

  • Often people with bipolar disorder do not recognize how impaired they are or blame their problems on some cause other than mental illness.

  • People with bipolar disorder need strong encouragement from family and friends to seek treatment. Family physicians can play an important role for such referral.

  • If this does not work, loved ones must take the patient for proper mental health evaluation and treatment.

  • If the person is in the midst of a severe episode, he or she may have to be committed to a hospital for his or her own protection and for much needed treatment.

  • Anyone who is considering suicide needs immediate attention, preferably from a mental health professional or a physician; school counselors and members of the clergy can also assist in detecting suicidal tendencies and/or making a referral for more definitive assessment or treatment. With appropriate help and treatment, it is possible to overcome suicidal tendencies.

  • It is important for patients to understand that bipolar disorder will not go away, and that continued compliance with treatment is needed to keep the disease under control.

  • Ongoing encouragement and support are needed after the person obtains treatment, because it may take a while to discover what therapeutic regimen is best for that particular patient.

  • Many people receiving treatment also benefit from joining mutual support groups such as those sponsored by the National Depressive and Manic Depressive Association (NDMDA), the National Alliance for the Mentally Ill (NAMI), and the National Mental Health Association.

  • Families and friends of people with bipolar disorder can also benefit from mutual support groups such as those sponsored by NDMDA and NAMI.

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My Story

Sara Brew

It's one of those things you think will never happen to you. It happened so suddenly. Without any warning I dropped the telephone and slumped in my chair. The right side of my body was completely paralyzed and I couldn't speak.

The next few hours were a complete blur. Words can't say how terrified I was. What was happening to me? I kept shaking my dead arm and leg with my other hand, trying desperately to bring it back to life. I felt as if my body was dying, bit by bit, in slow motion, before my eyes.

Although I couldn't speak, I was able to scream. I was totally aware of what was going on around me; my horrified colleagues, the panic, the confusion, the ambulance, the sirens, arriving at the hospital, lying there while people just stared at me.

In the most unusual way, a wave of peace seemed to pass over me and I became the observer, helpless and detached from my body. I wanted Mum and Dad so much. It breaks my heart to think of the desperate fear that they would now be going through as they got the call from work, but I knew that whatever was happening to me was very serious and they had to be with me. I felt like a child again, totally stripped of everything.

In those few moments I thought about my life; how Mum and Dad would have a disabled daughter needing constant care, how I'd never get married and have my own children, how I'd never succeed in my career, how I'd never climb a mountain or swim in the sea again. It really is true when they say your life passes in front of your eyes. This just couldn't be happening. I simply wanted the chance to be able to say that I understood the world around me, my thoughts and feelings were still there, and maybe life wouldn't be quite so bad after all, even like this. Please don't give up.

This was ten months ago. The feeling hasn't fully returned to my hand and my voice sometimes slurs when I'm tired. I look normal but the emotional scars go a lot deeper. I've cried until I can't cry any more. I've suffered flashbacks to those awful hours. I've felt anger and pain. But overriding all of this I have the most unbelievable feelings of love and closeness to my family and those who have supported and helped me along this difficult journey.

Although the doctors could not find a definite cause for what happened, I've had my heart operated on and feel like a different person; something definite has been done in a battle against something that felt so much out of my control. I have my spark back and can finally try to move on. One day I like to think I will look back on this period in my life and see a reason for it happening. Maybe it was sheer bad luck. Or maybe it was a warning and has saved me from something much worse later on in my life.

I used to think I was invisible and now I know I'm not. I think it's only when you stare death in the face that you experience that sense of pure fear and I don't think I'll ever get over that. When you realize you could loose something you want it even more. I love life and want to live it, more than ever before.

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10 People with Unbelievable Medical Conditions


'Trust Drug' Oxytocin Unbelievable For Now

Researchers Balk at Media Reports Hyping 'Love Drug' Hormone's Effects

ABC News Medical Unit
June 25, 2008

For the past few days, Paul Zak's phone has been ringing off the hook.

Normally, this would not be a problem. Zak, a professor of economics and the founding director of the Center for Neuroeconomics Studies at Claremont Graduate University in Claremont, Calif., is generally happy to talk about his research, which focuses on the effect of the hormone oxytocin on mood and emotion.

But lately, the phone calls have been less about his research and more about media reports that have elevated the status of the oxytocin nasal spray his team devised to that of a truth serum, a trust drug -- even a love potion.

"I have gotten an enormous number of calls from patients," says Zak, adding that one e-mail he received was from a woman whose social phobia had confined her to her house for the past 10 years. She hoped the oxytocin spray would help her overcome her fear of socializing.

"What do you write back to that kind of message?" Zak says.

The impetus for these calls and e-mails, he says, is his being quoted in a story that ran in the U.K. press. The article sported the provocative headline "Scientists Find Childbirth Wonder Drug That Can 'Cure' Shyness."

"They were very much too hyperbolic," Zak says of the piece. "I think media around the world have started to use the word 'cure.' … This hormone does not cure anything."

But that might not always be the case.

Zak says that more than a dozen studies at his lab, as well as several other projects at other institutions, are taking aim at the hormone with the hope of teasing out therapeutic benefits in the years and decades to come.

But to some Internet marketers, news of the sprayable hormone's development in 2005 already carried the sweet smell of success.

Improved Social Live, Career

A Google search reveals at least two proprietary formulation nasal sprays containing oxytocin. One spray, OxyCalm, is touted as a relaxation aid that helps users kick the smoking habit. The other, marketed under the name Liquid Trust, purports to improve users' social lives and careers.

Nowadays, however, the "love drug" manufacturers don't seem to be feeling the love. Mike Delaney, a spokesman for OxyCalm, says pressure from the U.S. Food and Drug Administration caused his suppliers to shut down oxytocin production. And a call to the makers of Liquid Trust went quickly to voice mail.

But that hasn't stopped consumers from seeking out what they believe is a miracle emotion potion.

Anatomy of a 'Love Potion'

Like certain other hormones, oxytocin is produced naturally in the brain. While oxytocin's reputation as a love potion is relatively new, the hormone has been the subject of study for decades.

In animal studies, researchers have found that the hormone does play a role in social attachments and behavior. And in humans, oxytocin has been detected in elevated levels in the bloodstream during orgasm, childbirth and breast-feeding. Some have suggested that this means the hormone is instrumental in human trust and bonding as well.

Not all about oxytocin is a matter of scientific speculation. Dr. John A. Seibel, past president of the American College of Endocrinology, notes that the hormone is used as a medicine as well.

"It is a medicine that, traditionally, we use to induce labor in women," he says. "But a lot of people feel that besides inducing labor in women, it may also lead up to the nurturing nature of these women toward their children."

"I think this, in turn, has been turned into a 'trust effect.' After all, who doesn't trust their mother?"

Research in the past several years that looked into the possible connections between the hormone and levels of trust sparked a wave of interest in the clinical community and the public alike.

First, a Swiss study published in the journal Nature in 2005 -- in which Zak was a co-researcher -- suggested that the use of a nasal spray containing the hormone could increase generosity in a game using imaginary money. In another study, published last year in the online Public Library of Science journal PLoS ONE, Zak and his colleagues found that study subjects receiving the hormone were more generous when asked to split a sum of make-believe money with a stranger.

Other research suggested the hormone might have modest but positive effects in mitigating the repetitive behaviors seen in those with autism.

And animal studies continue to suggest anti-anxiety effects of oxytocin. Larry J. Young, professor in the department of psychiatry at the Emory University School of Medicine in Atlanta, has published many of these animal studies. But while the effects of the hormone when administered to voles, mice and other creatures is quite well known, he notes, "the place it gets a little bit dicey is in humans."

Young says this is because it is simply impossible to experiment on humans in the same way one would experiment on rodents. And the social behaviors of humans -- the ones that everyone is interested in, anyway -- are far too complex to nail down without extensive research.

Seibel, too, urges caution when it comes to interpreting the effects on humans.

"It is very difficult to quantify how much of an effect this actually has," he says.

And while Zak says such excitement over the potential of oxytocin is heartening, there are more ways than a nasal spray to increase the amount of the hormone that courses through one's veins.

"Massage, for example, primes the brain to release oxytocin," he says. "There are many more ways than having a drug to have trust behaviors develop … there are lots of ways to get the brain to release this stuff."

Love Potion Biz Evaporating Online

Still, when studies on oxytocin became common knowledge a few years ago, some companies couldn't resist marketing their versions of trust in a bottle. And many consumers couldn't resist trying it out.

Fast forward to today, and the supposed wonder drug looks more like a formula for disaster. The root of the problem could be the fact that oxytocin is already used as a drug in the medical setting, which makes it the object of scrutiny from federal regulators when marketed for nonmedical purposes.

Companies selling a pharmaceutical -- any drug with an application in a clinical setting -- off label and without permission to sell the drug, could be subject to FDA penalties or sanctions, including forced shutdown.

"We haven't had any product available this year," OxyCalm's Delaney says. "We can't find any contract manufacturers to make any more of it due to potential perceived liabilities."

Delaney says the troubles began when the FDA contacted a seller of the product in Florida about two years ago. Soon, even Internet-based sales of his vanilla-scented version of the oxytocin spray could not be sustained.

But in the year or so that his product was available, Delaney says sales were "decent."

"We sold about 6,000 bottles," he recalls. "We always had a money-back guarantee. Only two to three customers asked for their money back. For one, it was because he didn't like the vanilla scent."

Calls to the Vero Labs, the Boca Raton, Fla.-based makers of Liquid Trust, were far less conclusive. As an automated voice in a distinctively clipped British accent ushers callers through mailbox options, they learn that Liquid Trust is "The world's first and only trust-enhancing spray, specially formulated to increase trust in you."

Messages left at the number were not returned.

Zak says the last time he encountered a representative of Vero Labs, it was on a morning news show on which he and a spokesperson for the company were both guests. Zak says he took this opportunity to point out that the company could face trouble from the FDA for marketing its product in the way it had.

"We really laid into them," he says.

No Magic Bullet for Trust

Could the time come when a shot of oxytocin into the sinuses has therapeutic value? Some experts think it might. But even if such a treatment comes to pass, experts agree that boosting the hormone can only go so far when it comes to treating such complex issues as social anxiety and lingering psychological trauma.

"Social dysfunction and other antisocial behaviors are often very difficult to treat," Zak says. "There is often some trauma in these people's lives; these are hard patients to treat."

Plus, Seibel notes, oxytocin taken without a doctor's guidance can be harmful.

"You might be putting yourself at a significant risk," he says, adding that the drug could lead to miscarriage in pregnant women or heart problems in those predisposed to such conditions.

Young agrees.

"I don't think that it's a good idea for the public to go out and get oxytocin on their own," he says. "I don't think there's enough evidence for us to know how powerful an effect this actually has."

So when it comes to Liquid Trust, do people need a dose of liquid skepticism instead? Zak says perhaps.

"There's probably a big placebo effect. ... It's not a crutch for people who are nervous," he notes. "Having said that, our findings are very exciting. Hopefully, people will just get the straight story and not the hype."

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The American Red Cross