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September - December 2010 Providing Education, Support and Hope How the Right Drugs Can Treat Bipolar Disorder Bipolar patients need drugs to keep them even, not up. downside of the drugs against having a life in an institution,” she says. Drugs for bipolar disorder don’t cure the condition, psychiatrists say. “They only suppress the symptoms,” says Michael Thase, MD, professor of psychiatry at the University of Pennsylvania. “Because of this, people who take them are temporarily at increased risk for relapse when they stop the medications, particularly if they stop them abruptly.” Once you’re taking a mood stabilizer, you may not need an antidepressant, which can trigger manic phases. John Markowitz, MD, a psychiatrist at the New York State Psychiatric Institute and clinical professor of psychiatry at Weill Medical College of Cornell University in New York City, adds: “One episode of mania, you’re on a mood stabilizer for life. Mania with severe depression can have catastrophic consequences.” But the drugs themselves are no easy solution for people suffering from bipolar disorder, says one woman who says she experienced “cognitive dulling” on lithium, so much so that switched to another medication when she wanted to try to go to graduate school. “You have to weigh the IN THIS ISSUE President’s Message............................ p. 8 Ways to Help Someone.................... p. Clues Help ID People at Risk............. p. Depression and Belly Fat.................... p. Learn to Manage Mania..................... p. Exercise and Depression..................... p. Don’t Overschedule............................ p. Helping During an Episode................ p. Disorders Treated with Drugs............ p. 2 2 3 3 4 5 5 6 6 Results of the multicenter Systemic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study support the notion that antidepressants like Prozac may not be appropriate for bipolar patients. In this rigorously controlled study, people with bipolar disorder were treated for up to 26 weeks with either a mood stabilizer paired with an antidepressant or a mood stabilizer plus a placebo. Of the 179 subjects, 42 (or 23.5%) who were taking a mood stabilizer plus an antidepressant had a durable recovery. Of the 187 subjects taking a mood stabilizer plus a placebo that looked like the antidepressant, 51 (or 27.3%) had a durable recovery. The statistical analysis confirmed what a quick look at the numbers suggests: The antidepressant didn’t add anything to the benefits of the mood stabilizer. In fact, the people taking only a mood stabilizer plus placebo did a little better than the people who took an antidepressant plus a mood stabilizer. Mary, a middle-aged woman living in Massachusetts who has bipolar disorder, says that the mood stabilizer Lamictal keeps her from spinning off into manic episodes. A low dose of Zoloft keeps depression at bay, and she takes a benzodiazepine tranquilizer occasionally. But Mary faces a big Gina Minns-Burford and Melanie Malcuit did a great job organizing DBSA’s recent bowling fundraiser. The next bowling event will be on September 18th. Information about it can be found at our website (dbsatampabay.org). pitfall: “I do periodically miss my old life, with its creative, productive highs. I have thoughts like, ‘How can I get back there?’” Sometimes she convinces herself that she can go off her meds, and that strategy has landed her in the hospital several times because she felt strong suicidal impulses. The last time she went off her medications, in early 2007, she slid into a crisis so fast “that even I didn’t see it coming,” she says. “I went running to the hospital because I felt that I might kill myself. I can’t do that to my family.” Article from Health.com A Message From Our President Again we have gone through the summer season, time passes so fast. We hope you were successful this season and made great efforts to improve your overall health and mental health recovery. DBSA Tampa Bay Speaker’s Bureau Would you like to have a speaker at your group or organization? Members of our DBSATB continues to offer the tools to improve the lives of people living with mood disorders. With the variety of tools please reveal and share information with support persons and families. The volunteers that facilitate, responds the phone messages, responds to the email requests, the web site and the lecture series. Without their services theses tools could not be provided. Those that have attended the support groups can appreciate the time, efforts and sacrifice the facilitators make each week. There is always a need for new facilitators and co-facilitators. We would request that if you would like to volunteer, please email or leave a message on the phone. You can also discuss with the facilitators the necessary program to complete to become a facilitator. There are many ways to become a volunteer with this organization. Each volunteer strives to offer the best service, if you have suggestions for improvement we encourage your response. As we enter the fall season may we all strive to improve our lives on our way to recovery. Those locations that let us use your facilities thank you so much. Sincerely, Neil Bush President DBSA TAMPA BAY NEWSLETTER organization volunteer to give informal talks about depression and bipolar illness. For more information, please email us at [email protected] 8 Ways You Can Help Someone With Depression • Remember that they cannot help being affected by depression. Educational Resources American Psychiatric Association 888-357-7924 • www.psych.org American Psychological Association 800-964-2000 • www.apa.org Advocacy Center 800-342-0823 www.advocacy center.com Child & Adolescent Bipolar Foundation 847-256-8525 • www.bpkids.org DBSA (National) 800-826-3632 www.DBSAlliance.org dbsa.invisionzone.com facingus.org Military Veterans Suicide Hotline 1 800-273-8255 National Alliance for the Mentally Ill 800-950-6264 • www.nami.org • Encourage them to talk and listen to what they are saying. National Association for the Dually Diagnosed 800-331-5362 • Let them know that you care about them. National Family Caregivers Association 301-942-6430 • Stay in contact with them. Send a card, give them a ring, visit them in their home. Remember that depression can be a very isolating experience. National Foundation for Depressive Illnesses 800-248-4344 • Help them to feel good about themselves by praising daily achievements. National Institute of Mental Health 800-421-4211 • www.nimh.nih.gov Panic Disorder Line: 800-64PANIC(7-2642) • Encourage them to help themselves by adopting self-help techniques. Anxiety Disorder Line: 800-888-8-ANXIETY(26-9438) • Find out about support services available to them and to you (self-help groups, out-of-hours emergency support, help lines, etc). National Mental Health Association 800-989-6642 • www.nmha.org • Encourage them to visit their doctor, and ensure that they take any prescribed medication as directed. The Fly lady flylady.net 2 Confidential Depression Screening www.depression-screening.org September - December 2010 Clues Help ID Depressed People at Risk of Bipolar Disorder Aug. 17, 2010 -- Researchers have discovered clues that may help identify which people with depression are at risk of developing bipolar disorder. The new findings appear in the online version of The American Journal of Psychiatry. Bipolar disorder is a serious condition characterized by the extreme highs of mania and devastating lows of depression. Nearly 40% of people with a history of major depression also report recurrent episodes of low level, subtle hypomania, the new study showed. Less intense than mania, hypomania is marked by bursts of increased energy, activity, and less need for sleep. The episodes reported by nearly 40% of the study participants were not fullblown mania or even full-blown hypomania, but more mild and dubbed “sub-threshold hypomania.” “People with a history of depression who have recurrent episodes of a day or two of increased energy, activity, and decreased sleep and then go back to their usual level of function may be more likely to develop bipolar disorder in the future,” says study author Kathleen Merikangas, PhD, a senior investigator and chief of the genetic epidemiology branch in the Intramural Research Program at the National Institute of Mental Health in Bethesda, Md. “The earlier bipolar disorder is recognized and treated, the less consequences there are of manic episodes such as substance abuse and trouble with the law,” she says. “These people should be monitored carefully, not just put on antidepressants.” DBSA TAMPA BAY NEWSLETTER Depression Could Play a Role in Added Belly Fat New research provides more evidence of a link between depression and extra pounds around the waist, although it’s not exactly clear how they’re connected. The study raises the possibility that depression causes people to put on extra pounds around the belly. The opposite doesn’t appear to be the case: researchers found that overweight people aren’t more likely to become depressed than their normal-weight peers. These findings come from researchers at the University of Alabama at Birmingham, who examined data from the Coronary Artery Risk Development in Young Adults Study (CARDIA), a 20-year longitudinal study of more than 5,100 men and women aged 18-30. (Longitudinal studies look for a link between cause and effect by observing a group of individuals at regular intervals over a long period of time). Among other things, the researchers wanted to figure out if depressed DBSA Tampa Bay Website: www.dbsatampabay.org The place to learn more! Research back issues of our newsletter. Discover documents of interest. Link to other resources. The study included information from members of more than 5,000 households across the U.S. who participated in face-to-face interviews between February 2001 and April 2003. The interviews focused on having a history of mood disorders, their symptoms, and the severity of their symptoms. (WebMD.com) 3 people were more likely to have larger waist circumferences and a higher BMI, and how that changed over time. They found that over a 15-year period, all the subjects put on some pounds, but those who were depressed gained weight faster. “Those who started out reporting high levels of depression gained weight at a faster rate than others in the study, but starting out overweight did not lead to changes in depression,” said study coauthor Belinda Needham, an assistant professor of sociology, in a university press release. Since the stress hormone cortisol is related to depression and abdominal obesity, Needham speculated that elevated levels might explain why depressed people tend to gain more belly fat. “Our study is important because if you are interested in controlling obesity, and ultimately eliminating the risk of obesity-related diseases, then it makes sense to treat people’s depression,” Needham said. “It’s another reason to take depression seriously and not to think about it just in terms of mental health, but to also think about the physical consequences of mental health problems.” The study appears in American Journal of Public Health. DBSA Tampa Bay is an all volunteer non-profit organization September - December 2010 How a Bipolar Patient Learned to Manage Mania If someone had told me when I was in my teens that one day I’d be a spokesperson for a mental health group, I wouldn’t have believed them. Chances are, I wouldn’t have understood them either. When I was 18, I was drowsy on antipsychotics and hospitalized for my first manic attack. But a lot has changed since then, and over the last 36 years I’ve learned how to manage my health. And, as a member of NAMI (National Alliance on Mental Illness), I help other people understand mental illness for themselves and their loved ones. Today I talk openly about my bipolar disorder, but for a long time I didn’t tell anyone about it. First of all, I didn’t really understand the illness, let alone want to share this big secret with people. Though, at times, it was hard to conceal. Whenever I was stressed or overtired or feeling enormous pressure, I was at risk of going through another manic episode. That’s what happened when I started college at a reputable liberal arts women’s school—which will remain nameless. The unfamiliar surroundings, the irregular class schedule, and the unlimited opportunity offered me too many choices. And it resulted in unmanageable stress. I couldn’t sleep, I would forget to eat, and I would talk incredibly fast. I even thought I had ESP—when a song would come on the radio, I thought, “Hey, I predicted that song.” I sensed something was wrong, but I didn’t know what it was. So I visited the college’s infirmary. During the first few visits, the college doctor focused on my insomnia. He gave me medication to sleep and sent me home. But when the sleep medication didn’t work, and I was getting more hyper and my energy was peaking beyond control, the doctor sent me to a hospital. To my surprise, they had me stay in the hospital for six weeks. Imagine: I had just started college, a bright-eyed, ambitious student and then, three weeks later, I was a patient in a mental ward of a DBSA TAMPA BAY NEWSLETTER hospital. It was hard to understand, even harder to accept. Back then there was very little medical consensus on bipolar disorder— and there was very little patient consultation on which treatment would be preferred. The medication I was given snowed me. I couldn’t function. I was sleeping during the day, wide awake at night. It was horrible. My family was extremely supportive, but it was a very confusing time. My condition was not officially called bipolar at this time because I hadn’t had enough episodes for a clear diagnosis. At the end of the six-week period, my energy levels stabilized, and I felt like myself. When I was ready for school, the college wouldn’t accept me— something about me not being an ideal student. I went to a different college while my father appealed for my reentry. The following year I returned to my original college of choice, and I eventually graduated. Stigma about mental illness was very common then, and it remains a challenge now. I think the best way to combat this stigma is to talk about it, its symptoms, the genetic component, and also how lifestyle choices can influence your susceptibility to more manias. My next manic episode happened when I was 25. I have since had seven or eight episodes, and they usually happen when I undergo a major change: my mother’s death, a new job, or a longer commute to work. Although I find it hard to remember my behavior during my manic stages, I know I have a bundle of symptoms: I tend to lose my sense of humor, I find it hard to follow directions, I can be unreasonably suspicious, and I cry easily. I am happy to say that my episodes have grown less frequent as I’ve aged and become more aware of my personal triggers. Bipolar can be different for different people and come on differently at different times in their lives. 4 Today, I manage my bipolar condition by keeping a regular schedule. Routines. Without them, I’d be far less healthy. I try to exercise regularly, I don’t drink alcohol anymore, and I eat “happy” foods like raw fruits and vegetables. But even with the most discipline, there’s always a chance that I could slip back into a manic state. Sometimes my mental illness is in the foreground, sometimes it’s in the background. The genetic component of bipolar is something that I cannot control. And like many families, I didn’t even know that mental illness was in my family until much later in life. A few years ago, a genealogist contacted me while he was researching my family for another individual. He told me that my great-grandmother had killed herself and that she likely suffered from some mental illness. This came as a complete shock to me, and I’m certain that my father (he passed away years ago) didn’t know about this either. Knowing this information about a relative—although tragic— somehow helped me understand and accept my condition a little more. It also reminded me of the importance of managing my condition. My family didn’t talk about my greatgrandmother’s illness, but they were the only ones who knew about my mental illness for a long time. The privacy was comforting, but it also limited my social support network. That changed when I was in my 30s. I started to branch out socially. I discovered that I loved ballroom dancing, and it became my favorite hobby. I traveled with a dancing tour group and we went as far as Australia. In addition to learning new steps, I made lasting friendships. And my closest friends know about my bipolar diagnosis. When I told them, more often than not, they would always respond by telling me they knew someone else in their family or network of friends who also had bipolar. (courtesy health.com) September - December 2010 Exercise and Depression Don’t Over Schedule Feeling stressed and overwhelmed is a common trigger for depression symptoms. If you’re struggling with depression, it’s important not to over schedule your time and take on more than you can manage. If you have complicated tasks to perform at work or at home, break them up into manageable pieces. Depression is draining. It can make any type of exertion -- going to the grocery store, cleaning up the yard, or exercising -- seem daunting. “Energy loss is one of the key characteristics of depression. Some people feel that it’s the key characteristic of depression,” says Robert E. Thayer, PhD, a psychology professor at California State University, Long Beach, an expert in managing mood, and the author of Calm Energy: How People Regulate Mood with Food and Exercise. Edvard Munch, The Scream (1893) has been widely interpreted as representing He points to exercise as one of the best ways for depressed people to lift their mood. “Exercise generates energy,” Thayer says. Here are Thayer’s answers to questions about exercise and depression. Can depressed people get into a vicious cycle if they feel stressed and overeat and don’t exercise and then become more depressed? “Definitely. People self-regulate with food, and I think that’s one of the reasons for the obesity epidemic that’s occurring – the combination of increased stress and depression going on for a long time and people needing to self-regulate, using food and other substances for doing that.” If depressed people begin to exercise instead, what happens physiologically? “There’s a whole series of things that happen when we begin to exercise. As we get up and begin to move and exercise, there’s a general bodily arousal state that occurs. It includes many different systems of the body -- everything from metabolism to cardiovascular activation, various kinds of endocrine changes in the brain, various kinds of hormonal changes and shifts.” DBSA TAMPA BAY NEWSLETTER the universal anxiety of modern man And remember: It’s OK to slow down a bit. “Maybe you can’t work at 100% capacity,” Raskin says. “Maybe you can work at only 75% capacity. Still, that’s an accomplishment.” But, he adds, “if you really can’t function, you have to be compassionate with yourself. You deserve a break; take a sick day, whatever you need.” Thank You to all of you who have paid your dues, subscribed to our newsletter, or made donations to our organization, we truly thank you. Without this monetary support, we would not be able to provide educational materials, literature, newsletters and a website to those that need our help. What happens psychologically when people start to exercise? “It depends on the degree and level of exercise. With moderate exercise, [in our research] we’ve been working with short, brisk walks [of] five or 10 minutes. The primary mood effect in that situation is increased energy. Secondarily, sometimes -- but not always -- there’s a tension reduction.” “With more intense exercise -- for example, an hour of heavy aerobic exercise -- there is a reduction in energy and a reduction in tension. But oftentimes, after recovery [from the workout], there’s an energy resurgence that occurs.” Do depressed people have to exercise intensely to get a mood boost? “No, it actually can occur fairly quickly. One of the things about our ‘short, brisk walks’ studies really 5 illustrates this point. People can think about ... how tired they’re feeling, then get up and begin to walk -- walking moderately, maybe quickly down the street for a short while. Immediately, they will begin to feel differently. As we’ve found with short, brisk walks of five to 10 to 15 minutes, there’s a significant increase in energy. They begin to feel it almost immediately.” “When people are seriously depressed -- with clinical depression, of course -it may be not as efficacious as it would be for people in a normal state, but it still will have an effect.” If depressed people lack motivation to begin exercising, how do they get started? “It’s a significant problem because when you’re depressed, you have no energy. When you think about exercising, you have no energy to try it. What I suggest is to start out very minimally, just getting up and walking a few steps. September - December 2010 Helping a Person During a Manic Episode You may feel frustrated around a person with bipolar disorder during a manic episode. The high energy level can be tiring or even frightening. The person may also actually enjoy the mania and may not take medications, which can prolong the episode. In addition, the person may say and do unusual or hurtful things. You can help during a manic episode by doing the following: Spend time with the person, depending on their level of energy and how well you can keep up. People who are manic often feel isolated from other people. Spending even short periods of time with them helps them feel less isolated. If the person has a lot of energy, walk together, which allows the person to keep on the move but share your company. Answer questions honestly. However, do not argue or debate with a person during a manic episode. Avoid intense conversation. Don’t take any comments personally. During periods of high energy, a person often says and does things that he or she would not usually say or do, including focusing on negative aspects of others. If needed, stay away from the person and avoid arguments. Prepare easy-to-eat foods and drinks (such as peanut butter and jelly sandwiches, apples, cheese crackers, and juices), because it is difficult for the person to sit down to a meal during periods of high energy. Avoid subjecting the person to a lot of activity and stimulation. It is best to keep surroundings as quiet as possible. Allow the person to sleep whenever possible. During periods of high energy, sleeping is difficult and short DBSA TAMPA BAY NEWSLETTER naps may be taken throughout the day. Sometimes the person feels rested after only 2 to 3 hours of sleep. Call a health professional if you have questions or concerns about the person’s behavior. Always call a health professional (or 911 or other emergency service) if you think the person with bipolar disorder is in danger of causing any harm to himself or herself or others. DBSA Tampa Bay does not endorse or recommend the use of any specific treatments or medications mentioned in this newsletter. For advice about specific treatments or medications, individuals should consult their physicians and / or mental health professionals. More Mental Disorders Treated with Drugs Only More Americans with psychiatric conditions are being treated with drugs alone compared with a decade ago, while “talk therapy” -- either by itself or in combination with medication -is on the decline, a new study finds. The implications of the trend, as well as its underlying causes, are not fully clear, according to researchers. But they say the findings indicate that outpatient mental health care in the U.S. is being redefined. The results, reported in the American Journal of Psychiatry, are based on data from two government health surveys conducted in 1998 and 2007. Over that period, the percentage of Americans who said they’d had at least one psychotherapy session in the past year remained steady -- at just over 3 percent in both 1998 and 2007. 6 However, among Americans receiving any outpatient mental health care, the proportion being treated with drugs alone rose from 44 percent in 1998 to 57 percent in 2007. Meanwhile, combined treatment with drugs and psychotherapy declined from 40 percent to 32 percent, and the use of psychotherapy alone slipped from 16 percent in 1998 to about 10 percent in 2007. National spending on psychotherapy also declined -- from an estimated total of $11 billion in 1998 to $7 billion in 2007. Overall spending on mental health care remained fairly steady, however -- at $15.4 billion in 1998 and $16 billion in 2007- suggesting an increase in the proportion of mental health spending devoted to drug therapies. “This represents a fairly dramatic shift in mental health treatment, and it is not necessarily good news for many patients,” said Dr. Daniel Carlat, an associate clinical professor of psychiatry at Tufts University School of Medicine who was not involved in the study. “What concerns me most,” he told Reuters Health in an email, “is that there was a 20 percent drop in treatment combining therapy with medication.” Such “integrative” treatment, Carlat said, is often the most effective. “I think there are some reasons for concern,” agreed Dr. Mark Olfson, a professor of clinical psychiatry at Columbia University in New York and one of the study’s authors. He said that with depression, for example, there is evidence that combination therapy is superior to medication alone. In an interview, Olfson pointed out that the largest investigation so far of depression in teenagers found that September - December 2010 combined therapy was generally more effective than either drugs or talk therapy alone. In that study, known as TADS (Treatment for Adolescents with Depression Study), combination therapy was better at reducing teens’ suicidal thoughts, for example. Yet the current study of trends in psychotherapy use found that among Americans treated for depression, the proportion on medication alone rose from 41 percent in 1998 to 51 percent in 2007. The percentage receiving combination treatment dipped from 50 percent to 42 percent. On the “positive” side, Olfson said, the trend toward greater medication use means that some people who might not have received any mental health care at all in the past are now getting treatment. “Mental health care,” he said, “is evolving in a way that means more people are receiving treatment, but are not necessarily getting the most effective therapy.” The study was not designed to weed out the reasons for these trends. But one potential factor, Olfson said, is the increased marketing of psychiatric drugs not only to doctors, but to the public as well. Olfson recommended that people who are being newly prescribed a psychiatric medication ask their doctors if any alternative treatments are available for their particular condition. Other factors, he speculated, could include patients’ increased acceptance that mental health disorders have biological underpinnings and, for some people, a perception that medication may be the simpler approach -- requiring less time and effort and potentially offering quicker results. This is especially relevant for people with milder symptoms. In general, Olfson said, psychiatric drugs have been shown to be most effective for patients with more severe disorders. In addition, primary care doctors can prescribe psychiatric medications, while psychotherapy requires a referral to a mental health specialist -- a psychiatrist, psychologist, social worker or mental health counselor. The National Institute of Mental Health estimates that one in 10 American adults experiences depression in any given year, and that 18 percent of adults suffer from some form of anxiety disorder. Primary care doctors now account for the large majority of psychiatricdrug prescriptions issued in the U.S., Olfson and colleague Dr. Steven C. Marcus note in their report. One of the most common and beststudied forms of psychotherapy is cognitive-behavioral therapy, which involves examining how thoughts affect emotions and learning ways to change behavior patterns that may be negatively affecting a person’s mental well-being. What all of this means for Americans’ mental health is not entirely clear. But Someone with relatively mild depression symptoms, for example, might respond to some form of mental health counseling alone. OUR MISSION The Depression and Bipolar Support Alliance Tampa Bay’s mission is to provide education, self-help, fellowship and other direct services to people with Affective Disorders and to their relatives and friends. This organization is a non-profit, 501(c)(3) organization operated by it’s members. DBSA Tampa Bay is affiliated with the national organization DBSA. Contributions are non-taxable as provided by law. 2010 Membership Application DBSA TAMPA BAY NEWSLETTER 7 September - December 2010 Depression and Bipolar Support Alliance Tampa Bay SUPPORT GROUPS Please be on time in consideration of others. Times and locations may change due to circumstances beyond our control Brandon (Tampa): Monday 7:00 PM - 8:30 PM Brandon Christian Church 910 Bryan Road (at Lumsden) Tampa (Northdale): First and Third Thursdays, 6:30 PM - 7:45 PM Jimmie B. Keel Regional Library Room Number 1 2902 W. Bearss Avenue James Haley Veterans Hospital First and Third Thursdays 7:00 - 8:30 PM. 13000 Bruce B Downs Rm 1C-104 Town and Country Hospital: Wednesday 7:00 PM - 8:30 PM 6001 Webb Road Meeting in Cafeteria Private Room 1 USF Area (Tampa): Tuesday 7:00 PM - 8:30 PM USF Department of Psychiatry and Behavioral Medicine. 3515 East Fletcher Ave. Directions: From Fletcher Ave, turn south at Magnolia Drive. The Psychiatry Center is the first building on the left. Multiple Copies? DBSA Tampa Bay members, affiliates and supporters may order multiple copies of our newsletter via Priority Mail for $24/year (3 issues). A packet holds about 25 newsletters DBSA Tampa Bay PO Box 340572 Tampa, FL 33694 DBSA Tampa Bay Board of Directors 2010: Professional Advisor: Michael F. Sheehan, M.D. Founder: John C. Massolio, Jr. Executive Board: President: Neil Bush 1st Vice President: Vicki Robey 2nd Vice President: Mary Watkins Treasurer: Carol Yaros Secretary: Janne Ketrow Editor: Rich Sessums Support Group Guidelines * We are here to support mental health and your prescribed treatment. Family and friends are welcome. * We maintain confidentiality: What is said in group stays there. * As volunteer facilitators, we help guide your discussions. We share experiences, wisdom, successes, and common problems. * We limit the discussions to depressive, bipolar, and other effective disorders. * We are not mental health professionals. We do not diagnose, advise or recommend specific treatments or doctors. * Our participants respond with compassion, not judgment. Sharing is encouraged, how ever you are not required to. You may remain silent if you wish. * We are support groups and not therapy groups. We are here to give and receive support. National Suicide Hotline: 1-800-SUICIDE Project Return Community Center: Friday 10:00 AM - 11:00 AM 304 W. Waters Ave., Tampa St. Petersburg (West side): Thursday at 7:00 PM - 8:30 PM Pasadena Community Church The Life Enrichment Center Room 3A ( Behind the Church ) 227 70th St. S. St. Petersburg: Monday 7:00 PM - 8:30 PM Lutheran Church of the Cross 4545 Chancellor St., NE From 4th Street turn East on 62nd Ave N. Turn right on Bayou Grande Blvd. NE. Turn left on Shore Acres Blvd. NE. Turn right on Chancellor St. NE. St. Petersburg Baptist Church Tuesday 7:00 PM - 8:30 PM 1900 Gandy Blvd. N. Rooms 9 and 10 - Regular Support Group - Group for spouses and significant others only Zephyrhills: Monday 7:00 PM - 8:30 PM Florida Hospital (formerly EPMC) 7050 Gall Blvd. (Use Hwy. 301) Meeting is in the Speech Therapy Room near the Wellness Center. Would You Like To Reach Us? Would you like to become a member of the DBSA Tampa Bay? Call 813-878-2906 Would you like to receive our newsletter? Please refer to the application on page 7. We also appreciate any donations which help to defray the cost of our services or you can also email us at: [email protected] Thank You.