Living on her own and not finding much success with singing, Gaga admits that “I was very depressed when I was 19. I would go back to my apartment every day and I would just sit there and it was lonely and it was still. It was just my piano and myself. And I had a television that I would leave on all the time to feel like there was someone hanging out with me.”

The type of depressed mood Germanotta describes aligns with key symptoms of clinical depression, including depressed or down mood most of the day persisting for at least two weeks and a loss of interest in normal relationships and activities.

Rather than seek help or mental health treatment at the time, Germanotta says she turned to cocaine as a way to self-medicate, “When I was doing cocaine, it was like the drug was my friend. I never did it with other people.”

Individuals suffering from untreated depression may use drugs or alcohol, often secretively, as a way to ease feelings of loneliness and isolation. As Lady Gaga now realizes looking back on this time, cocaine just ended up making the underlying problem of depression that much worse. “It’s such a terrible way to fill that void, because it just adds to that void, because it’s not real,” she admits.

Germanotta managed to pull herself out of her depression and put an end to drug use after she realized that cocaine was taking her further and further away from her goal of music stardom: “I sort of … woke up one day and was like, ‘You’re not an artist. [If you were], you’d be focused on your music…’”

It’s not clear whether Germanotta sought treatment for depression at the time, or has continued with treatment, especially since the star still cops to bouts of serious melancholy. As Gaga recently told a UK magazine, “I have a chronic sadness that recurs… I was overwhelmingly sad, and I didnt know why, because I had all these things to be happy about.”

Sources:

- Lady Gaga on “The Conversation with Amanda de Cadenet”

http://www.theconversation.tv/episodes/missed-this-weeks-episode-of-the-conversation-watch-episode-2-in-full/

- Lady Gaga ‘cherishes’ loneliness

http://www.torontosun.com/2012/05/04/lady-gaga-cherishes-loneliness

New Jersey mom Patricia Krentcil is facing child endangerment charges stemming from accusations that the 44-year old took her young daughter to a tanning salon. Krentcil denies charges that burns on her 5-year old’s legs came from a tanning booth session and instead says her fair-skinned daughter simply spent too much time in the sun.

In New Jersey, state law prohibits children under 14 from using tanning booths; anyone under 18 must have parental permission. However, it may be Krentcil’s own appearance that is raising the most questions in this case and keeping it in the media spotlight. Dubbed “Tanning Mom” due to the extreme tan she showcased during an interview on NBC’s Today Show and her 20-visit per month habit at the local tanning salon, Krentcil has many wondering whether she suffers from body dysmorphic disorder, a condition frequently expressed through “tanorexia”, or compulsive tanning.

Thought to affect 1%-2% of the U.S. population, body dysmorphic disorder (BDD) is a body-image disorder characterized by a persistent and intrusive preoccupation with defects in one’s physical appearance that are, in reality, very slight or completely nonexistent. Individuals with BDD typically feel great distress over these perceived imperfections; it is not unusual for those with BDD to miss work or school, avoid social situations, and otherwise physically and socially isolate themselves out of an intense fear that others will notice their flaws.

Skin is a common focus of compulsive body-related thoughts, with as many as 73% of individuals diagnosed with BDD admitting to fixations with acne, scars and marks, uneven skin tone, wrinkles, and other perceived defects. As more research emerges on the subject, it is clear that a sizable percentage of individuals with BDD compulsively tan as a way to “cover up” their skin problems and self-medicate negative emotions associated with BDD, including anxiety and depression.

In one recent study of 200 individuals affected BDD, 25% of participants reported past or current compulsive tanning behaviors. Among this group of so-called tanorexics, the majority also displayed symptoms of an eating disorder and over half admitted to substance abuse. All compulsive tanners had experienced some level of problems related to social functioning as a result of BDD’s negative self-perceptions; one quarter had attempted suicide.

Going to a tanning salon five days a week, as is the case with Tanning Mom, could be viewed as compulsive tanning related to BDD. It may also be a sign of an addictive personality. As a small 2006 study found, UV rays in tanning beds enhance the production of endorphins, chemicals released from the brain that produce a euphoric-like “high” Tanorexics may begin to crave this boost, especially if they suffer from depression. According to the study, when participants stopped tanning, many experienced withdrawal symptoms similar to those experienced among those quitting nicotine use.

Krentcil herself has not given too many specifics about why she tans. She does admits that she “really likes to tan” and that it is something she has done for “at least twenty years.” Krentcil has not discussed BDD or even confirmed that she understands chronic tanning bed use is linked to skin cancer risk.

As for her daughter, Krentcil admits to taking her daughter Anna to the tanning salon, but insists she left the little girl in the waiting room with her father and brother. As Tanning Mom told the Today Show, “I am not going to bring my little daughter into a 90-degree tanning bed. Now, that’s not normal.”

Krentcil is due back in court on June 4.

Sources:

- TANNING IN BODY DYSMORPHIC DISORDER http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1622896/

- Today Show: http://www.hulu.com/watch/356853/nbc-today-show-mom-charged-for-allegedly-taking-daughter-tanning

- ABC News: Does Tanning Mom Have Tanorexia? http://abcnews.go.com/US/tanning-mom-jersey-woman-suffer-tanorexia/story?id=16267543#.T6hNRev-_K0

“What I can say is that I was depressed,” Lovato reveals about her state of mind. “I would come off stage in front of 18,000 people and suddenly be alone in a hotel room. I’d come crashing down and would try to find a way to recreate that feeling, to stay up.”

Demi attempted to alleviate her depressive symptoms by using a combination of alcohol and illicit drugs, reportedly cocaine, as a way to self-medicate. She also admits to struggling with bulimia. The eating disorder, marked by bingeing, typically on high carbohydrate foods, and then purging foods through vomiting, use of laxatives, or excessive exercise, is a condition that is strongly associated with depression; as recent research has shown, a history of depression may be present in approximately half of all people diagnosed with an eating order.

In another attempt to “block the pain” of depression, Demi then turned to self-mutilation, in the form of cutting.

“You do it because you feel so bad inside. You don’t know how to take it out other than on yourself,” she recalls. “It started with my wrists. People saw that, so I cut in places they couldn’t see.”

Cutting is a common form of non-suicidal self injury (NSSI), or self-injurious behavior with the intent to inflict physical harm as a way to relieve emotional distress, but not to end one’s life. Other methods of NSSI include burning, biting, scraping or scratching skin, hitting, interfering with wound healing and skin picking. NSSI frequently co-occurs with depression or can be considered a maladaptive behavior associated with borderline personality disorder. As studies show, approximately 4% of the U.S. population engages in NSSI, with teen girls and women most likely to self injure.

Precipitating Demi entering rehab was a backstage “meltdown” that led to a fist fight with one of the show’s dancers. Rather than go on with the tour, the singer opted to finally seek a way out of the cycle of depression and self-destructive behavior.

After three months of in-patient rehab beginning in November 2010, Demi says the experience helped her learn how to manage her emotions through more positive means, a process she is working to perfect.

“I’m learning how to cope with issues, and cope with urges, and things like that, in healthy ways,”” she told ABC’’s Good Morning America last year. “Like, I’ve picked up knitting. I like, who would ever thought that, like, I knit on a Saturday night, like. Watching TV.  I totally do. I’m a knitter.”

In her most recent 2012 interview, Demi seems to have developed perspective on what contributed to her problems in the past — and what she can do now to take care of her mental health.

“I thought I was having fun,” she tells Fabulous. “Being a celebrity can be dangerous. Nobody says no”.

“That’s why so many end up overdosing and dying. It could definitely have happened to me.”

Sources:

http://www.fabulousmag.co.uk/fabmag/_fabulous/celebs/nolfabulous_celebfeatures/1375741/Demi-Lovato-talks-Disney-rehab-and-self-destruction.html

http://abcnews.go.com/blogs/entertainment/2012/04/demi-lovato-opens-up-about-depression-hollywood-drug-scene/

NSSI: http://www.psychologytoday.com/blog/two-takes-depression/201202/depression-and-non-suicidal-self-injury

“Patients who come to ECT are in a crisis and often functioning at a low level due to the severity of their depression. Since almost 4 million people with major depression in the United States are treated ineffectively each year, this could potentially help hundreds of thousands of patients,” said lead author Scott Tadler, MD, assistant professor of anesthesiology at the University of Utah.

Anesthesiology News
JANUARY 2012 | VOLUME: 38:01
Volatile Anesthetic Shows Promise for Treating Major Depression
Small study hints at benefits of isoflurane over electroshock
by Jennifer Hanawald

The expletive-laced rant features an angry Gibson screaming out accusations targeting Eszterhas and his frustrations with a film project the two were working on (“The Macabees”, which Eszterhas was to write), and then takes aim at ex Oksana Grigorieva in a string of ugly characterizations.

According to Eszterhas, motivation to release the tape came from his concern that Mel “badly needs help,” he told The Wrap. “My interest isn’t to damage him with this tape but to prevent damage being done to others… I strongly believe that unless he seeks and receives some kind of psychiatric help, someone is going to get hurt.”

Gibson has acknowledged in the past that he suffers from bipolar disorder (manic-depressive illness), a mood disorder characterized by unusual or extreme shifts in mood, energy, and activity levels, ranging from periods of intense sadness and depression to manic episodes marked by hyperactive, creative, and grandiose behaviors and poor impulse control. Mood changes related to bipolar disorder often interfere with an individual’s ability to carry out work and family responsibilities; in some cases, bipolar disorder can be a trigger for aggressive or even suicidal behavior.

In Mel’s case, documented episodes of intense rage followed by apparently normal periods could be construed as symptomatic of bipolar disorder (should be documented episodes of irritability or rage followed by normal periods or periods of depression….). The star has also owned up to a longstanding substance abuse problem which, on its own, can trigger mood swings or play a role in worsening existing symptoms of bipolar disorder.

Gibson talked about his bipolar diagnosis for the first time in “Acting Class of 1977,” a documentary made in 2008. “I had really good highs but some very low lows,” Gibson said in the film. “I found out recently I’m manic depressive.”

It is unclear what treatment Gibson has pursued in light of his bipolar diagnosis. As ABC News reports, Gibson was interviewed for the documentary in 2002, four years before his now infamous 2006 DUI arrest, in which he spat anti-semitic slurs that he later said were “blurted out in a moment of insanity.” In 2010, several tapes were released online of the actor/director verbally abusing Grigorieva, the mother of his two-year-old daughter, Lucia; Gibson is still on parole stemming from a 2011 no-contest plea to domestic abuse involving Grigorieva.

Sources close to this latest incident speculate that the star may have recently stopped taking medication to treat his bipolar depression. On his part, Gibson maintains his “colorful language” was simply due to irritation over the stalled film project. In an open letter to Eszterhas, Gibson writes, “I will acknowledge like most creative people I am passionate and intense. I was very frustrated that when you arrived at my home at the expense of both Warner Brothers and myself and you hadn’t written a single word of a script … I did react more strongly than I should have.”

Sources:
Mel Gibson: Mentally Ill or Maybe Just a Jerk?

http://abcnews.go.com/Entertainment/mel-gibson-mentally-ill-jerk/story?id=11155332#.T5Xjwqv–xV

Joe Eszterhas: Why I Released the Mel Gibson Rant
http://www.thewrap.com/movies/column-post/joe-eszterhas-why-i-released-mel-gibson-rant-exclusive-video-37122

“I have OCD, which is not fun,” she told an Australian radio show during a recent press tour. “I have to be incredibly tidy and organized or it messes with my mind and switches off on me.”

In another interview, Charlize candidly talks about her “…problem with cabinets being messy and people just shoving things in and closing the door. I will lie in bed and not be able to sleep because I’ll say to myself: ‘I think I saw something in that cabinet that just shouldn’t be there.’”

What Charlize describes is not uncommon for someone with OCD, an anxiety disorder that affects approximately 1 in 50 adults. Typical symptoms associated with OCD include intrusive or unwanted thoughts that evoke anxiety (obsessions); and behavioral or mental rituals performed to neutralize the anxiety (compulsions). At its root, the disorder is based on a fear of one’s thoughts, whether it is a fear of messiness, germs, or some other perceived danger. To relieve the anxiety produced by these fearful thoughts, someone with OCD may feel compelled to take certain actions, such as cleaning out their cabinets before going to sleep.

When it comes to parental OCD, limited research tells us that children being raised by an obsessive-compulsive parent may be more likely to experience social, emotional and behavioral disorders, though it is still unclear what specific genetic vs. environmental factors may be in play; children with an OCD parent are also more likely to become obsessive-compulsive themselves when they grow up.

We also know that parenthood can worsen OCD symptoms in adults, especially if the obsessions associated with OCD begin to focus on the child (i.e., health anxiety may lead an OCD parent to check and recheck a child at night to make sure he or she is still breathing). Worsening OCD symptoms in parents may also be the result of over-accommodation on the part of family members. In their quest to please their parent, for example, children may get up in the middle of the night with a mother or father to check locks on windows and doors or participate in unnecessary cleaning tasks. A major danger with this is that having a child act as a kind of helper or accomplice may give a parent enough of a mental “green light” to continue the behavior unchecked.

However, for Charlize and other moms who appear to have mild form of the disorder, there may be an upside to mixing OCD with parenthood. Ample anecdotal evidence shows that parenthood may lesson OCD symptoms in some adults, likely because the focus required by children diverts attention from obsessive-compulsive thoughts. Besides, what better way is there to come to grips with fears about germs or disorganization than by living with a messy toddler? The arrival of a new baby can also function as a motivator for OCD parents to finally reach out for treatment and the help they need to overcome obsessive-compulsive thought patterns.

As for Charlize, the new mom seems to be adjusting well to life with her adopted infant son, Jackson. “I think that by the journey I decided to go on, it’s evident that I really wanted to be a mom, so I’m just overjoyed and very happy that it worked out,” she told E! News.

Sources:

Charlize Theron and 8 More Stars with OCD: http://abcnews.go.com/Entertainment/charlize-theron-stars-obsessive-compulsive-disorder/story?id=15972302#.T4pGLqv–zI

Charlize Theron: ‘I have OCD, which is not fun’ http://www.independent.ie/lifestyle/independent-woman/celebrity-news-gossip/charlize-theron-i-have-ocd-which-is-not-fun-2994068.html#ixzz1sEyNwF00

Have we forgotten the children who have a parent with OCD?:
Accommodation and early intervention http://www.ocfoundation.org/EO_parent_with_OCD.aspx

He’s her little star: New mother Charlize Theron steps out with her son Jackson for the first time in public:http://www.dailymail.co.uk/tvshowbiz/article-2121338/New-mother-Charlize-Theron-steps-son-Jackson-time-public.html#ixzz1sEwKlC69

DSM IV Obsessive Compulsive Disorder (OCD) Criteria: http://www.biologicalunhappiness.com/DSM-OCD.htm

The Cedars Sinai psychiatry and behavioral neurosciences department has a rich tradition dating back to Dr. Franz Alexander. Known as the Father of Psychosomatic Medicine, Dr. Alexander established the Department of Psychiatry at Mount Sinai Hospital in 1957 and was its first chairman.  The Cedars Sinai psychiatry department has had a long association with The Thalians, a charitable organization founded by Hollywood movie stars.  In 1973, The Thalians inaugurated The Thalian’s Mental Health Center at Cedars Sinai with an opening gift of $75,000.  Over the years, the Thalians have amassed a 22 million dollar endowment to support mental health care at the Cedars Sinai Medical Center.

While it is unfortunate that Cedars Sinai is closing their inpatient and outpatient psychiatry services, community and local providers are optimistic that treating less urgent mental health problems may get easier.  A major overhaul of the way California deals with mental health is underway, partly in response to safety issues at mental hospitals, partly in response to Department of Justice oversight, in anticipation of federal health care reform and because of a major realignment shifting management and funding for many mental health services from the state to counties.

PCH Treatment Center is an immersive psychological treatment center that offers a full day treatment program, intensive treatment program with residential options, a partial day dual diagnosis program and a full psychological assessment clinic.  PCH Treatment Center is available to offer guidance and support to Cedars Sinai inpatient and outpatient clients who need further care.  Our intake services can help direct families and persons suffering from mental health issues to the proper facility or treatment program, whatever their condition or resources.  While the loss of the Thalians inpatient and outpatient programs and psychiatry residency program at Cedars Sinai is profound, new opportunities are available, such as PCH Treatment Center, and will become available, such as the new direction the state of California is taking towards treating mental illness.

“The most common disorders were attention deficit hyperactivity disorder (1.9%), oppositional defiant disorder (1.8%), conduct disorder (0.7%), anxiety disorders (1.5%), and depressive disorders (2.0%). Comorbidity among disorders was common. More emotional and behavioral disorders were seen in children whose parents did not live together and in those of low socioeconomic status. Boys more often had attention-deficit/hyperactivity disorder (ADHD) and depressive disorders than girls.”

What are most commonly reported as adult psychiatric disorders, typically have their onset in childhood and adolescence.  Often a parent or teacher will readily identify behavior problems that are indicators of underlying psychological dysfunction.  Depression, anxiety disorders and attention deficit/hyperactivity are identifiable even down to four years of age.  Previous studies typically evaluate children around ages 8 to 9 and older. This Norwegian study finds a somewhat lower incidence of mental health issues in children when compared to studies in the United States, which report a 10-20% incidence.  Some disorders may have onset in childhood, and then wax and wane throughout life.  Others may have a later onset.  For example, depression more typically arises in older children, predominantly in females, at the age of adolescence when hormonal changes are occurring.  Some psychological problems may also occur later in life and not be apparent in preschool children.

This study shows there are important opportunities to identify and even diagnosis psychological illness in preschool children. This would allow early implementation of therapeutic strategies and family psychoeducation, to help modulate these children, and minimize the effects of underlying psychological dysfunction as they grow into adolescence and adulthood.

Prevalence of psychiatric disorders in preschoolers
Lars Wichstrøm, Turid Suzanne Berg-Nielsen, Adrian Angold, Helen Link Egger, Elisabet Solheim1, Trude Hamre Sveen

Journal of Child Psychology and Psychiatry, 29 DEC 2011, DOI: 10.1111/j.1469-7610.2011.02514.x

Preschool psychopathology: lessons for the lifespan
Journal of Child Psychology and Psychiatry 48:10 (2007), pp 961–966 doi:10.1111/j.1469-7610.2007.01832.x  Adrian Angold and Helen Link Egger
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, USA

Prevalence and Development of Psychiatric Disorders in Childhood and Adolescence

E. Jane Costello, PhD; Sarah Mustillo, PhD; Alaattin Erkanli, PhD; Gordon Keeler, MS; Adrian Angold, MRCPsych
Arch Gen Psychiatry. 2003;60:837-844.