James Hicks, M.D., 50 SIGNS OF MENTAL ILLNESS (Yale University Press)

Dr. James Hicks
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Disclaimer: The facts and opinions provided in this Web site are for informational purposes only. They do not constitute medical or psychological treatment. If you have a concern about psychiatric symptoms, there is no substitute for receiving an individualized personal examination by a licensed health professional. Dr. Hicks cannot respond to clinical questions on an individual basis. See Resources for links to professional organizations which can help you find a health care provider in your area.

July 2006:

The paperback edition of "50 Signs of Mental Illness" is now available in bookstores. The book continues to reach an expanding audience of readers through positive reviews on the internet and in publications like Health Magazine. I especially appreciate the recognition of the National Alliance on Mental Illness which reviewed the book and selected it as one of the best books of 2005. The New York City chapter also recognized "50 Signs of Mental Illness" for its "substantial contribution to the public's awareness and better understanding of mental disorders."

April 2005:

It is spring, and "50 Signs of Mental Illness" has just begun to arrive in bookstores. Several people have asked me how I came to write a book about mental illness and what I hope to accomplish by it.

I decided to write the book several years ago when I realized how little people know about psychiatric illness. Nearly everyone has experienced depression, anxiety, stress, trouble sleeping and other symptoms of mental illness. But almost everyone thinks of these as personal failings or existential problems rather than as health issues with potential treatments. We are afraid that if we have a mental illness, we might be "crazy" and have to see a "shrink." But effective treatments exist, and you can feel much better after a simple trip to a doctor or counselor. We should be able to recognize the signs of mental stress in our lives in the same way that we monitor our blood pressure and cholesterol.

There are other books about mental illness available, but most of them are organized around disorders. You have to know whether you have depression, panic attacks, schizophrenia, or bipolar disorder in order to know what to read. "50 Signs" focuses instead on the signs and symptoms that you experience. The symptoms of mental illness overlap, and most people have more than one mental health concern. I wanted to write a book that would help readers understand the full range of their concerns and guide them to the most effective treatments.

My other goal in writing "50 Signs" was to emphasize the perspective of the patient. Even the mildest mental concerns can be frightening, and I wanted to explain that these experiences are common and understandable. You should be able to talk about them with your doctors and loved ones without feeling embarassed or afraid.

Updates to "50 Signs of Mental Illness"

Several new antipsychotic medications have been approved by the FDA for the treatment of schizophrenia: paliperidone (Invega), iloperidone  (Fanapt), and arsenapine (Saphis). Paliperidone is also available in a long-acting injectible formulation (Invega-Sustenna). See the chapter Psychosis for more information about the treatment of schizophrenia and related conditions.

Eszopliclone (Lunestera) and ramelteon (Rozerem) are new medications for the treatment of insomnia. Like zolpidem(Ambien) and zaleplon (Sonata), they do not appear to be addicting. Ramelteon is the first sleep medication to mimic the effects of the hormone melatonin, and it is not considered a controlled substance. Zolpidem is also available in a longer acting form (Ambien CR). See the chapter Sleep Problems for more information about coping with insomnia.

The Substance Abuse and Mental Health Services Administration (SAMHSA) of the federal government has created a national toll-free suicide prevention line: 1-800-273-TALK (8255). This hotline has been added to the Resources section of this Web site, and you may wish to pencil it in on p. 359 of the book for future reference. See the chapter Suicidal Thoughts for more informations about how to prevent suicide.

The FDA has approved two new medication for addiction. Varenicline (Chantix) appears to help smokers to stop smoking by easing withdrawal and blocking the effects of nicotine. Naltrexone is now available in a once-monthly injection (Vivitrol) to reduce cravings for alcohol. See the chapter Cravings for other methods of treating addiction.

Methylphenidate for the treatment of attention-deficit hyperactivity disorder is now available in a skin patch (Daytrana) that children can wear for nine hours during the day rather than taking pills by mouth. See the chapter Hyperactivity for other information about the treatment of ADHD.

An old antidepressant medication, selegiline, is now available in a skin patch (Emsam). Since the medication is absorbed through the skin, it does not appear to block the effects of enzymes in the gut as other MAOI antidepressants do. The other MAOI medications are effective but rarely prescribed because they can cause dangerous elevations in blood pressure when certain foods are consumed during treatment. The selegiline skin patch offers a safer alternative. See the end of the chapter Depression for more information about the MAOI and other antidepressants.

A medication for dementia, galantamine, is now being marketed under a new brand name, Razadyne, due to confusion of the old brand name, Reminyl, with a similarly sounding medication for diabetes. See the chapter Memory Loss for treatments for dementia.

The advocacy organization known for years as the National Alliance for the Mentally Ill (NAMI) has changed its name to the National Alliance on Mental Illness, in order to avoid appearing to define anyone by their illness. See Recommended Resources Mental Health Advocacy and Support for a link to NAMI's Web site.


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