Frequently Asked Questions (FAQs)
About Peer Support

"How is Peer Support different than DRADA's support groups?"

DRADA's support groups meet in person at a designated time and place on a regular basis. All the members in the group provide mutual support. In Peer Support, mutual support is also provided, but on a one-to-one basis with your partner. You can call or email your partner when you need support, as they can do with you. There is no need to wait for the next meeting. This program is great for persons who are unable to attend support groups or for those that already attend groups and would like additional support.

"How do I make the most of my Peer Support relationship?"

The most important recommendation I can give is to give it time. Giving it time means that you do not let differences in each other turn you away from the match. A different person's viewpoint on experiences with the illness can be very helpful to hear. You may not be able to tell from the first conversation whether or not the two of you will make good support partners. The first couple of conversations can feel awkward and stilted. Keep trying and you will feel much more comfortable as details of each others lives and sharing feelings about depression and bipolar illness come up. Establish a regular time with each other that you will talk and agree on who's turn it is to call. Also, let it be okay for either of you to call the other at any time in between in case you need support right away. Make sure that you respect the other person's need for support as well as receiving support from him or her. Ask about how they have been feeling lately. Also, respect their needs and responsibilities away from the Peer Support relationship. Most people have families and commitments, which may mean that they are not always available to talk. This does not mean that they do not want to talk with you. Ask when is a better time to call back. All relationships take work to develop, including Peer Support. And if, after giving it some time to work out, you do not feel that it is a good match for you, please call to give it another try with someone else.

What do I do if I do not think that my peer support partner is a good match for me?

Please call the coordinator to talk about your particular situation. We can either help you work it out or look for a new match for you. Sometimes it takes a couple of tries before you find a match that works well for you. The coordinator wants to help you find the support you’re looking for, no matter how long it takes. Let us help you to keep trying. Peer support can be an important adjunct to medical treatment. Other mechanisms include a support group, one or more peer support partners, spiritual support systems, as well as family and friends. It is best to receive support from a variety of sources.

“If I sign up for Peer Support, does that mean that I can stop seeing my therapist?”

A Peer Support partner can be a great addition to the treatment that you receive from your therapist. We encourage you to continue seeing your therapist because Peer Support is not professional treatment. It is a form of self-help, enabling you to form friendships with other people with mood disorders. You and your partner will give each other encouragement and someone to share experiences with. So, please continue to see your therapist and physician and continue with any treatment plan that is in place and enjoy the extra support that Peer Support can give you and that you can give to your partner as well.

Please check back periodically for new FAQs about Peer Support!

Contact DRADA’s peer support coordinator, Chantal Abukutsa at 410-616-2820 or DRADAPeerSupport@jhmi.edu for more information.

Undercurrents: A Life Beneath the Surface, Martha Manning, San Francisco: HarperCollins, 1995. (Hardback, 197 pages, $20.00)

In Undercurrents, psychotherapist Martha Manning, Ph.D., uses revealing excerpts from a personal journal to tell the story of her own experience with a severe and medication-resistant depression. Dr. Manning's writing is sparked by her candor, sharp wit, and uninhibited sense of humor. Fascinating and sometimes surprisingly intimate scenes from her daily life propel the narrative. Also included are musings about her work as a professor of psychology and clinical psychologist; her religious and spiritual life; and her relationships with family members, colleagues, and friends. A forthright description of electroconvulsive therapy (ECT), the only treatment that relieved Dr. Manning's near-suicidal depression, demystifies this much-maligned technique. Undercurrents has something to say to everyone whose life has been touched by depression—not only patients, but also family members, friends, and mental health professionals. Patients will find much to identify with, for Dr. Manning captures the experience of depression with a vividness reminiscent of William Styron in his book Darkness Visible.

The emptiness of the depression turns to grief, then to numbness and back again. My world is filled with underwater voices, people, lists of things to do. They gurgle and dart in and out of my vision and reach. But they are so fast and slippery that I can never keep up. . . . All escapes are illusory—distractions, sleep, drugs, doctors, answers, hope. . . . (p. 99)

Family and friends of someone who has had a severe and lengthy depression will recognize her husband's frustration and despair over his wife's condition.

"No, Martha . . . I don't think you know what it's like to have to manage everything alone. Keara [their 12-year old daughter], the house, the families, the friends. I dread calling you. I dread coming home to you because I don't know how you'll be. You are receding every day. I'm living with a ghost. And I don't know how much longer I can take this." (p. 92)

Months passed. As Dr. Manning's depression deepened, she consoled herself with thoughts of death. First her therapist and then her psychiatrist suggested that her best hope for recovery might be ECT. This suggestion was not well received. After another month of deterioration, a still dubious but desperate Dr. Manning checked into a local hospital for ECT. After only two treatments, two days apart, Dr. Manning's sleep improved. That seemingly slight change marked the beginning of her halting climb out of depression. Treatments and improvement continued. Although ECT, like other treatments, is less than perfect, Dr. Manning readily affirms its effectiveness. "I will never be the ECT postergirl. I am the first to admit the downside—confusion and memory loss. But damn it, it worked." (p. 166) Other mental-health professionals may be surprised at Dr. Manning's reaction to life on an inpatient psychiatric unit.

Being shepherded from one stupid group to the next is my punishment for all those times my patients bitched about life on inpatient units and I told them [to] "cooperate" and "get as much as you can out of it." We in mental health . . . have positive intentions, . . . but benign tyranny is no less oppressive than malevolent tyranny. (p. 133, 134)

Her insight about a therapist's role, however, is a tribute to all "care professionals" worthy of that name.

[My] memories of my own doctors remind me that the process of just walking the road with someone is so important. The communication of hope, the administration of gentleness, and the sharing of some part of self can make a long lonely journey, in all its circuitousness, almost bearable. (p. 151)

As Undercurrents draws to a close, Dr. Manning movingly describes the joys and fears of returning to a full life. It will never be the one she had before, but she treasures its blessings in a new way. Readers will long remember Dr. Manning's story—told in her own marvelous voice—and wish her well.

by Anne Heasty, M.S.
DRADA Book Committee
Smooth Sailing: Spring 1995

Click here to order the book Undercurrents: A Therapist's Reckoning with Her Own Depression, by Martha Manning

BIPOLAR ILLNESS: WHAT IS DIFFERENT ABOUT YOUNG PEOPLE - A report on a presentation1 by Gabrielle A. Carlson, M.D.,2 Smooth Sailing, Spring 1998

Dr. Gabrielle A. Carlson stated that children and adolescents with bipolar disorder warrant special attention, since 20 to 30 percent of bipolar patients experience the onset of their illness before the age of 25. Also, she cautioned that diagnosing adolescents can be particularly challenging because 1) they often have had no prior episodes, and 2) their symptoms of mania or hypomania [relatively mild mania] are clearly associated with other psychopathology, such as ADHD/ODD [attention deficit hyperactivity disorder/oppositional defiant disorder]. Symptoms shared by mania and ADHD/ODD include hyperactivity, impulsivity, distractibility, and emotional lability. Adolescents who have externalizing disorders [conduct/behavioral disorders] or who are substance abusers are particularly vulnerable to bipolar illness, and substance-abusing patients with bipolar illness have four times the usual rate of conduct disorders. In the adolescent population, uncomplicated bipolar illnesses are rare.

Studies suggest that rates of mixed mania [symptoms of mania and depression appearing simultaneously] and comorbid mania [mania coexisting with another disorder] are higher in young people than in the adult population. In about 80 percent of the adolescent/young adult group, the illness first occurs as depression, with mania following as long as three to four years later. A psychotic depression often indicates that a bipolar illness will follow, and there is often a family history of mood disorders.

Not surprisingly, Dr. Carlson observed, outcomes are worse in adolescents than in patients first diagnosed with bipolar illness after age 30. Adolescents with comorbid disorders fare worse than adults in terms of their ability to get along in the work environment, even though they can return to their former level of functioning. Not only do these early-onset patients have more persistent substance abuse, but they also have more recurrence of mood episodes.

There are several important considerations in treating this population of adolescent bipolar patients who have comorbid externalizing disorders and substance abuse. These patients need comprehensive treatment planning and special education. Medication alone is unlikely to eliminate the patient's psychopathology, since the mood disorder and the externalizing disorders and the substance abuse need to be treated. Not surprisingly, medications for mood disorders are also used to treat aggression. The medications, then, are likely to be needed all the time, not just during a mood disorder episode. Since bipolar illness runs in families, it may also be necessary to treat the parents.

In summary, adolescents with bipolar illness deserve special attention because they truly have special needs.

1Presented at a DRADA/Johns Hopkins symposium, Baltimore, MD, April 30, 1998.

2Professor of Psychiatry and Pediatrics, Director of Child and Adolescent Psychiatry, State University of New York at Stonybrook.

by Ann M. Bain, Ed.D.
Smooth Sailing: Spring 1998

When diagnosing a mood disorder, adolescents can be at a disadvantage. The symptoms of depression and bipolar disorder (manic-depressive illness) in young people can differ from adults. Symptoms can be missed if you don't know what to look for.

Well meaning parents or teachers may think that a young person is unhappy or moody because it's a natural part of being young. This is especially true for adolescents, who are expected to be "hormonal" and rebellious. Persistent unhappiness or moodiness is not normal for anyone.

One way to overcome this problem is to educate teenagers themselves. This is why DRADA created the pamphlet:

I wish I was never born. I really hate myself.

Hey! You don't have to feel this way!

Teenagers, if you or someone you know often has feelings like these, read this pamphlet. You can also read the answers to Free single copies of our pamphlet are available. If you would like to receive one by regular mail, or if you would like to order this pamphlet in bulk quantities, you can e-mail Paula at paula.drada@erols.com or call her at 410-987-7447. Please include your name and post office mailing address.

You can find additional information on depression and teenagers below.

ADDITIONAL INFORMATION

Helpful Resources For Young People

Let's Talk About Depression.
From the National Institute of Health (NIH).

What to do When a Friend is Depressed: Guide for Students.
From the National Institute of Health (NIH).

A Helpful Resource For Parents

A highly recommended book for parents is Lonely, Sad and Angry: A Parent's Guide to Depression in Children and Adolescents, by Barbara D. Ingersoll, Ph.D. and Sam Goldstein, Ph.D. The authors provide a readable overview of symptoms, diagnosis, and treatment of depression in the young. Read a complete review of the book.

A Helpful Resource For Everyone

Day for Night: Recognizing Teenage Depression
A video produced by DRADA.

Teenagers relate their own experiences with depression and/or bipolar disorder (manic-depressive illness), their treatments and recovery, and encourage other teens to seek help. Also, professional explanations and tips about recognizing and treating these illnesses are provided by Paramjit Joshi, M.D., Chairman, Department of Psychiatry and Behavioral Sciences, Children's National Medical Center and formerly associate professor of Child and Adolescent Psychiatry at the Johns Hopkins University School of Medicine.

For more detailed information on depression and bipolar disorder (manic-depressive illness), be sure to visit our Reference Shelf. Supplemental information can be found in our First Person Experiences, Books, and Videos sections.

To read a review of the book (if available) click on the link below the book's summary. Many of the books listed here can be purchased from DRADA. To order a book from DRADA, click here.

Darkness Visible: A Memoir of Madness, Styron, William. New York:Vintage Books, 1990. (Paperback, 84 pages, $10.00)

When this Pulitzer Prize-winning author wrote about his personal experience with depression, this small, powerful book became a national best seller. Speaker at the DRADA/Johns Hopkins Mood Disorders Symposium in 1989 and again in 2002, Styron's words are chilling, yet hopeful.

Understanding Depression: What We Know and What You Can Do About It, DePaulo, J. Raymond, Jr., M.D., and Horvitz, Leslie Alan. New York: John Wiley & Sons, Inc., 2002. (Hardback, 304 pages. List price $24.95; DRADA price $20.95.

A comprehensive primer for patients, family members, and others seeking detailed, clear, and up-to-date information about the illnesses of clinical depression (unipolar depression), and bipolar disorder (manic-depressive illness), and related disorders. Understanding Depression discusses genetics and hormones and reveals the devastating effects the illnesses have not only on the patient, but also on family members and loved ones. Covers treatment, conventional and alternative.

Electroshock: Restoring the Mind by Max Fink, M.D. (Hardback, 157 pages, DRADA price $20.

Thoroughly covers modern electroconvulsive therapy (ECT), dispelling common misconceptions and fears about it and detailing its benefits.

Mood Genes; Hunting for Origins of Mania and Depression by Samuel H. Barondes, M.D. (Paperback, 237 pages, DRADA price $14.28.

Exceptionally clear and well written; explains pertinent genetic concepts and research techniques in lay readers' terms.

How You Can Survive When They're Depressed: Living and Coping with Depression Fallout by Anne Sheffield. (Paperback, 306 pages, DRADA price $13.33.

Offers good sensible advice on self-help for those living with a person who has depressive illness.

Night Falls Fast: Understanding Suicide. Jamison, Kay Redfield, Ph.D. New York: Knopf, 1999.
Now in paperback (Paperback, 432 pages, $14.00) DRADA price: $13.33

Covers general information about suicide, its history, the psychological patterns that underlie suicide attempts, suicide's biological component, and suicide prevention. It also includes stories about persons who attempted or committed suicide.

Read a review of this publication.

Bipolar Disorder: A Guide for Patients and Families. Mondimore, Francis Mark, M.D. Baltimore: The Johns Hopkins University Press, 1999. (Paperback, 277 pages, $16.95) DRADA price: $16.19

Focuses on information that patients and families really want and need about the illness more commonly known as manic depression. The comprehensive and authoritative coverage in the 277 page book ranges from brain imaging to practical ways to reduce the risk of relapse.

Read a review of this publication.

Overcoming Depression. Papolos, Demitri F., M.D., and Papolos, Janice. New York: Harper Collins, revised edition, 1997. (Paperback,413 pages, $15.00) DRADA price: $14.28

Covers various neurological/biological research approaches to causes, research on medication (maintenance, combinations), and hospitalization.

Depression: The Mood Disease. Mondimore, Francis Mark, M.D. Baltimore: The Johns Hopkins University Press, 1990 (revised 1993). (Paperback, 237 pages, $15.95) DRADA price: $16.19

Focuses on scientific knowledge about mood disorders in easy-to-understand style. Illustrates the difficulty and importance of accurate diagnosis and treatment.

How to Cope with Depression. DePaulo, J. Raymond, Jr., M.D., and Ablow, Keith Russell, M.D. New York: Ballantine Books, 1989. (Paperback, 216 pages, $12.00) DRADA price: $11.43

Considers depression from the perspectives of disease, personality, behavior, and life history. Discusses causes and treatments of mood disorders.

Undercurrents: A Life Beneath the Surface. Manning, Martha. San Francisco: HarperCollins, 1995. (Paperback, 201 pages, $13.00) DRADA price: $12.38

Uses episodes from the author's personal and professional life to portray the course of her severe depression. Includes a detailed account of successful use of electroconvulsive therapy (ECT).

Read a review of this publication.

An Unquiet Mind. Jamison, Kay Redfield. New York: Vintage Books, 1995. (Paperback, 224 pages, $12.00) DRADA price: $11.43

Tells vividly, with candor and wit, the story of Dr. Jamison's illness and how it shaped her personal life and her work. Also discusses symptoms and treatment.

Read a review of this publication.

You Mean I Don't Have to Feel This Way? Dowling, Colette. New York: Bantam Books, 1993. (Paperback, 320 pages, $14.95) DRADA price: $14.28

Focuses on the biochemical causes, treatments, and interrelationships of depressive illness, eating disorders, anxiety, panic attacks, alcoholism, and addictions. Highly readable.

SEASONAL AFFECTIVE DISORDER (SAD)

Winter Blues: Seasonal Affective Disorder: What It Is and How to Overcome It. Rosenthal, Norman E., M.D. New York: Guilford Publications, Inc., 1993. (Paperback, 325 pages, $14.95) DRADA price: $14.28

Updates this expert's previous book, an invaluable resource for seasonal affective disorder (SAD) patients. Covers light treatment, medication, psychotherapy, diet, and exercise.

ADOLESCENTS

New book in inventory!
Adolescent Depression: A Guide for Parents, Mondimore, Francis M., M.D. Baltimore: The Johns Hopkins University Press, 2002. (Hardback, 287 pages, list price $45.00, DRADA price $33.33; also in paperback, 287 pages, list price $17.95, DRADA price $15.24)

Thorough, compassionate, and comprehensive guide containing vital information for parents and those working with teenagers about the signs and symptoms of clinical depression and bipolar illness. Includes the multiple and varied signals of depression and ways it can appear in young people. Answers parents' questions about how mood disorders are diagnosed; how medications work; benefits of talk therapy; and how depression relates to other problems such as drug and alcohol abuse, ADHD, eating disorders and other self-injurious behavior.

(Prices above do not include Maryland Sales Tax or shipping and handling. Call Paula at 410-987-7447 to order by credit card.)

ARTISTS AND CREATIVITY
Touched with Fire: Manic-Depressive Illness and the Artistic Temperament. Jamison, Kay Redfield, Ph.D. New York: The Free Press, 1993. (Paperback, 371 pages, $15.00) DRADA price: $14.28

Presents evidence for a link between the illness and artistic creativity, featuring quotations from the artistsí writings. Also covers biochemical and genetic information. Beautifully written.

DRADA PUBLICATION
The Manual for Affective Disorder Support Groups. Resnick, Wendy Miller, R.N., M.S. Baltimore: DRADA, 1988. (Paperback, 73 pages, $23.81)

A comprehensive guide providing an organizational framework for the development and maintenance of a mutual-help support group.

Note: Materials offered for sale include books authored or coauthored by members of DRADA's board of directors (J. Raymond DePaulo, Jr., M.D., Francis M. Mondimore, M.D. and Kay Redfield Jamison, Ph.D.).