ALPIM Anxiety-Laxity-Pain-Immune-Mood

Many of us living with mental illness have other chronic illnesses. Often we are not treated for our “physical” illnesses, as many doctors dismiss them as psychosomatic. “Mental” illnesses ARE “physical” illnesses, and “physical” illnesses affect our “mental” illnesses. We are not just our brains, just our bodies, just our minds, just our feelings, or just our souls. The more we learn, the more we understand interconnectedness and comorbidities.

The ALPIM Spectrum

In the Spring 2015 issue of the Journal of Neuropsychiatry and Clinical Neurosciences, researchers proposed The ALPIM Spectrum:

  • A = Anxiety disorder (mostly panic disorder);
  • L = Ligamentous laxity (joint hypermobility syndrome, scoliosis, double-jointedness, mitral valve prolapse, easy bruising);
  • P = Pain (fibromyalgia, migraine and chronic daily headache, irritable bowel syndrome, prostatitis/cystitis);
  • I = Immune disorders (hypothyroidism, asthma, nasal allergies, chronic fatigue syndrome); and
  • M = Mood disorders (major depression, Bipolar II and Bipolar III disorder, tachyphylaxis. Two thirds of patients in the study with mood disorder had diagnosable bipolar disorder and most of those patients had lost response to antidepressants).

Study Conclusion

We conclude that patients with ALPIM syndrome possess a probable genetic propensity that underlies a biological diathesis for the development of the spectrum of disorders. Viewing patients as sharing a psychological propensity toward somatizing behavior essentially denies patients access to care for the diagnosable medical conditions with which they present.

– J Neuropsychiatry Clin Neurosci. 2015 Spring;27(2):93-103. doi: 10.1176/appi.neuropsych.14060132

Download the Study

Should you want to read the journal article, I purchased the pdf version: A Novel Anxiety and Affective Spectrum Disorder of Mind and Body—The ALPIM (Anxiety-Laxity-Pain-Immune-Mood) Syndrome: A Preliminary Report (J Neuropsychiatry Clin Neurosci. 2015 Spring;27(2):93-103. doi: 10.1176/appi.neuropsych.14060132). No copyright infringement intended.

Associations in ALPIM Domains

ALPIM SYNDROME FIGURE 5. A Schema Demonstrating Significant Associations Within and Between ALPIM Domains. Anxiety - Pain Attacks (included in Phenotype). Laxity - Joint Laxity Syndrome (Beighton), Mitral Valve Prolapse. Hernias. Scoliosis. Double-Jointedness. Easy Bruising. Pain - Fibromyalgia (included in Phenotype), Headache, Prostatitis and Cystitis. Immune - Asthma, Rhinitis, Irritable Bowel Syndrome, Chronic Fatigue Syndrome, Hypothyroidism. Mood - Major Depressive Episode (included in Phenotype), Bipolar II Disorder, Bipolar III Disorder, Tachyphylaxis. This schematic diagram depicts, via line connections, significant associations within and between the ALPIM domains (see the Results for a description). Table 2 repors corresponding significant probability levels, odds ratios, confidence intervals, and Wald statistics. ALPIM, anxiety, laxity, pain, immune, mood.
J Neuropsychiatry Clin Neurosci. 2015 Spring;27(2):93-103. doi: 10.1176/appi.neuropsych.14060132

Diagram of Comorbidities

FIGURE 7. The ALPIM Syndrome: A Neuropsychosomatic Spectrum Disorder. Schematic Venn diagram showing the hypothesized spectrum of comorbidity in patients having a core anxiety disorder with laxity, pain, immune, and mood disorders. The overlapping circles demonstrate that comorbidities exist along a spectrum, in which a patient might have anywhere from just one disorder under one domain to multiple disorders under multiple overlapping domains. ALPIM, anxiety, laxity, pain, immune, mood.
J Neuropsychiatry Clin Neurosci. 2015 Spring;27(2):93-103. doi: 10.1176/appi.neuropsych.14060132
Bipolar III is cyclothymia, a “milder” form of bipolar than bipolar II.

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Walking the Line

Living with Bipolar Living with bipolar is like walking on a tightrope, trying to maintain my balance, fearful of each step I take. KittOMalley.com

Living with bipolar is like walking on a tightrope, trying to maintain my balance, fearful of each step I take.

As a young adult, I didn’t understand what triggered my highs and lows. I saw depression as a problem, but I didn’t fully understand the role of workaholism, overachievement, and perfectionism, even as I crashed over and over.

After my training as a clinician, when I finally turned to medication for help, I understood and described myself as cyclothymic (experiencing highs and lows less extreme than bipolar) even as I was diagnosed and treated for dysthymia (persistent depression).

At almost 54, I’m still learning about myself. I used to consider myself extroverted. I threw parties, loved to be on stage and the center of attention. When I look back, though, I performed at parties. I did not really feel comfortable. I danced and laughed loudly, or I shrank back into a corner, wanting to leave.

Now social stimulation overwhelms me. Sounds bombard me.

This summer, first the long days challenged me with too much sunshine. My thoughts raced at bedtime. I found it hard to sleep, had to take benzodiazepine to turn off my thoughts and allow slumber. I started to ramp, to take on more and more tasks.

Recently, I signed a three-month private trainer contract at a Pilates studio. The training itself overstimulates me. Too much social interaction. The exercise has aggravated forgotten knee and hip injuries. I know that Pilates should help, but for now, I’m in pain.

Responding to the pain, I’ve scheduled appointments with an orthopedist and a physical therapist.

Picture of sun shining through evergreen forest of coastal redwoods (I believe).

Escape is what I yearn. I want so badly to be in a less stimulating place, quieter, slower, surrounded by trees on one side to shelter me and an open vista on the other so I can look at the horizon and feel free. It’s a place I’ve had in my imagination a long time. My husband and I have been talking, but it’s not yet time to retire. Our life is here for now.

Multicultural Mental Health Facts #MHM

Multicultural Mental Health Facts 1. Mental Health Facts MULTICULTURAL Prevalence of Adult Mental Illness by Race 16.3% 19.3% 18.6% 13.9% 28.3% Hispanic adults living with a mental health condition. White adults living with a mental health condition. Black adults living with a mental health condition. Asian adults living with a mental health condition. AI/AN* adults living with a mental health condition. www.nami.org Follow Us! facebook.com/NAMI twitter.com/NAMIcommunicate Ways to Get Help Talk with your doctor Visit NAMI.org Learn more about mental illness Connect with other individuals and families LGBTQ Community Use of Mental Health Services among Adults (2008-2012) Fact: Mental health affects everyone regardless of culture, race, ethnicity, gender or sexual orientation. 1 in every 5 adults in America experience a mental illness. Nearly 1 in 25 (10 million) adults in America live with a serious mental illness. One-half of all chronic mental illness begins by the age of 14; three-quarters by the age of 24. 11.3% 21.5% 6.6% 10.3% 16.3% 15.1% 4.4% 5.3% 5.5% 9.2% Hispanic White Black Asian AI/AN* Male Female *American Indian/Alaska Native Critical Issues Faced by Multicultural Communities Less access to treatment Less likely to receive treatment Poorer quality of care Higher levels of stigma Culturally insensitive health care system Racism, bias, homophobia or discrimination in treatment settings Language barriers Lower rates of health insurance *American Indian/Alaska Native LGBTQ individuals are 2 or more times more likely as straight individuals to have a mental health condition. 11% of transgender individuals reported being denied care by mental health clinics due to bias or discrimination. Lesbian, gay, bisexual, transgender and questioning (LGBTQ) youth are 2 to 3 times more likely to attempt suicide than straight youth. 2X 2-3X 11% 1 This document cites statistics provided by the National Institute of Mental Health. www.nimh.nih.gov, the Substance Abuse and Mental Health Services Administration, New Evidence Regarding Racial and Ethnic Disparities in Mental Health and Injustice at every Turn: A Report of the National Transgender Discrimination Survey.