heal
A publication of the Sheppard Pratt Health System • WINTER 2015
Learning to Cope For 12-year-old Bryce Greenberg and his family, The Frost School has been a ‘special’ gift.
PLUS CONCUSSIONS: A SERIOUS CONCERN NEW LEADERS AT THE RETREAT FINDING SUPPORT FOR EATING DISORDERS
In this issue.
WINTER 2015
4
13 4
3 Road to Recovery from Eating Disorders Is Shorter with Family Involvement
Learning to Cope For Bryce Greenberg and his family, The Frost School has been a ‘special’ gift.
12 12
Philanthropy: You give. They heal.
14
Informing Ourselves About E-cigarettes
15
eet Our Doctor: M Edward Zuzarte, M.D.
7
Calendar
8
In The News
10
Questions for Our Medical 3 Director of the Trauma Disorders Program
On the cover.
Concussions: A Serious Concern
Photo by David Stuck
11
Bryce Greenberg, 12, is now thriving, thanks to the comfort of The Frost School and his constant companion, Griffin.
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heal. is published four times a year by the Marketing Department of the Sheppard Pratt Health System, a private, nonprofit health system with one of the nation’s leading mental health programs. Information provided is general in nature and should not be substituted for the medical advice of a physician. Please consult your health care provider for recommendations specific to your personal health, medical treatment, and medical conditions.
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Contributing Photographers
Brian Glock and David Stuck
EATING DISORDERS
Road to Recovery from Eating Disorders Is Shorter with Family Involvement WHEN A FAMILY MEMBER DEVELOPS AN EATING DISORDER, THERE ARE MANY VARIED REACTIONS How did this happen? Where did I go wrong? Why won’t you just eat? These questions, while quite common, have no simple answers and can easily distract from the ultimate goal of recovery. When questions have no easy answers, many family members find themselves bewildered by the illness and frustrated with the afflicted individual. As an alternative, families are often encouraged to ask a new set of questions: How do eating disorders affect the body and the brain? What can I do to support you in recovery? Family involvement in the treatment of eating disorders can play a critical role in an individual’s recovery and is considered absolutely essential for children and adolescents. Family-based treatment (FBT) is a type of family outpatient therapy in which parents are coached to help their child to eat normally, end unhealthy behaviors, and regain weight. FBT helps parents understand what an eating disorder is and how it affects their child, both emotionally and physically. It views parents as the best experts in the refeeding of their son or daughter. The focus is on behavioral change, nutritional rehabilitation, and weight restoration. FBT is a “no blame” approach. During weekly sessions, the therapist serves as a coach to the family, and assists the family in supporting their child to eat what they need to in order to meet the body’s nutritional requirements. While the therapist may be quite active in treatment, most decisions are left to the parents. It is firmly believed that most families CAN help their child recover. A key principle in FBT is a therapeutic technique known as externalization of the illness in which the child and the illness are viewed as two separate entities. For example, when a child is struggling and resisting a meal, parents learn to direct their frustration at the anorexia and not at the child. This allows parents to remain aligned with their child, working together as a team against a common enemy, the eating disorder, instead of battling each other.
Family-Based Treatment Promotes Success The Center for Eating Disorders at Sheppard Pratt (CED) recently participated in a multisite NIH-funded study to assess the efficacy of family-based treatment (FBT). This five-year, international study found that parental involvement promotes success in treatment and recovery. CED offers FBT as a first-line approach for families of children and adolescents with eating disorders. Because FBT is an outpatient therapy, the individual needs to be medically stable to utilize this approach. At times, an individual may require hospitalization to ensure safety during the beginning stages of recovery. Family involvement remains critically important at these higher levels of care as well. The benefits of family support for recovery are not just for children. Changing deeply ingrained eating disorder behaviors is very difficult for individuals at any age. During treatment, adult patients are encouraged to identify people who are supportive and can help them while they work toward recovery.
Support People Need Support, Too The process of recovery is difficult for an individual as well as for his or her support network. To assist support people and families, CED offers free Collaborative Care Workshops for families and friends of individuals with an eating disorder. These workshops are tailored to address the needs of care providers, offering education and therapeutic communication techniques. They provide a space for caregivers to seek
STEVEN CRAWFORD, M.D., co-director, The Center for Eating Disorders Dr. Crawford has been in a leadership role at The Center for Eating Disorders for more than 20 years. He also serves on the faculty of the University of Maryland School of Medicine, where he teaches how to
support while also learning self-care strategies for themselves. For more information on The Center for Eating
identify eating disorders, and is also a lead investigator in federally
Disorders, visit eatingdisorder.org or call
funded research grants.
410-938-5252. sheppardpratt.org • heal
3
FEATURE/SPECIAL EDUCATION
Learning to Cope
BY DAVID HOLZEL
FOR THIS 12-YEAR-OLD AND HIS FAMILY, THE FROST SCHOOL HAS BEEN A ‘SPECIAL’ GIFT
N
ot so long ago, Tracy Greenberg
“Everything was driven by what
than not, Tracy was the victim of Bryce’s
often looked like a battered wife.
Bryce’s moods were going to be,” Tracy
fury. “With children like Bryce, they tend
said. “Even going out to dinner or to a
to take out their aggression on their
She was a battered mother.
friend’s house — I didn’t want to push him
mother,” she said.
Her son Bryce, now 12, was often
because I didn’t know what his reaction
She wasn’t one though.
It hadn’t always been that way.
uncontrollably violent. Diagnosed with
would be. We had to cancel a vacation
Bryce was “a fabulous baby,”
attention deficit hyperactivity disorder
because he had to be hospitalized.”
remembered Tracy, who with her
(ADHD) at age 5, and later with bipolar
Something as seemingly innocuous
disorder and anxiety, Bryce’s rages, prior
as being asked to do his homework
to treatment, controlled family life.
could lead to an outburst. More often
husband Terry adopted Bryce at birth. “He hit all his milestones.” The couple knew that the birth parents struggled with drugs and mental illness. “But when you want a baby, words
Bryce Greenberg, with his pet dog Griffin.
like bipolar and schizophrenia mean nothing,” she said. She hoped nurture would overcome nature. But when Bryce was 18 months old, Tracy and Terry “started to notice things weren’t right. He had night terrors. They were like nightmares on steroids,” Tracy said. In the following years, Bryce developed new, violent behaviors. When it was time for kindergarten, the Greenbergs enrolled Bryce in a public school. “For the next four years, our life was awful,” Tracy said. “In kindergarten and first grade he was restrained more than 10 times. He had
i 4
Taking Action
of the Sheppard Pratt ED day school programs.
Emotional disability (ED) is not so much an illness as it is
“It overlaps with the child’s medical definition such as
a diagnosis category that allows patients to access
depression, anxiety, psychosis.”
benefits available through the Individuals with Disabilities
The bottom line is that emotional disability
Education Act (IDEA). It governs how states and public
“impairs the child’s ability to get an education. It impairs
agencies provide early intervention, special education,
their ability to engage in satisfying interpersonal
and related services to more than 6.5 million eligible
relationships,” she said.
infants, toddlers, children, and youth with disabilities.
That was certainly true in Bryce Greenberg’s case.
“Emotional disability defines what a child is entitled
There were long periods before he began attending The
to in services. It defines the parents’ rights in requesting
Frost School when “he wasn’t learning at all,” his mother
evaluations,” said Ayanna Cooke-Chen, medical director
Tracy said.
heal • Sheppard Pratt Health System
Bryce Greenberg, shown here with father Terry, mother Tracy, and brother Cole, has made tremendous progress at The Frost School.
“He’s no longer violent. I can challenge him now. I can discipline him. He knows how to use his coping skills, and he comes out of [an episode] quicker.” — Tracy Greenberg
fits. He was violent. He was aggressive
again had to be restrained at school.
toward the staff and himself.” That’s when
“He was banging his head for an hour
Bryce was hospitalized for the first time.
on cement walls,” Tracy said. The Greenbergs had an
The extent of Bryce’s illness isn’t
At The Frost School, which Bryce began attending in the middle of fourth grade, he is reminded every day of the
apparent on a recent fall afternoon at
Individualized Education Program (IEP)
coping skills he has learned. It has made
the family’s home in the Maryland
for Bryce beginning in second grade;
a difference. “He’s no longer violent.
suburbs of Washington, D.C. Bryce,
however, it did not cover the level of
That’s the hugest thing,” Tracy said. “I can
is eager to show off his bedroom,
services Bryce needed to be successful
challenge him now. I can discipline him.
where his pet gecko, Echo, has run of
in school. Eventually, the Greenbergs
He knows how to use his coping skills,
the place. He rough houses with the
were able to get another IEP for Bryce,
and he comes out of [an episode]
Greenbergs’ good-natured golden
where it was recommended that he
quicker. He recognizes it.”
retriever, Griffin.
attend The Frost School, one of
“We found out Bryce is sensory seeking,” Tracy said. “He wants to feel
Rather than explode in anger,
14 special education schools in the
Bryce is more likely to tell his mom,
Sheppard Pratt Health System.
“I have homework. I need a break first.”
With small classes, individual
“Frost has a way of holding the
support, daily therapy where he learns
students accountable, but it also allows
hospitalized at the Sheppard Pratt Health
coping skills, and the freedom to take
them to know that if they need support,
System during fourth grade when, after
a break when he needs one, Bryce “is
the support is there for them,” she said.
making some behavioral progress, Bryce
doing fine,” Tracy said.
everything all over him.” The family learned this when he was
The process for requesting testing and evaluation typically begins with a letter to the school principal. “If you suspect a psychological issue or emotional
Continued on page 6.
such as Frost. Donor contributions make it possible. Since mental illness touches almost everyone in some way, “people are hopefully beginning to recognize that
disturbance, go to your general practitioner and get
we need to have these resources for young people,”
a referral to a psychiatrist and get it documented,”
Cooke-Chen said.
she said. “Documentation gives you a basis for talking to schools and what the next step is for getting special education in the current school or finding a place like The Frost School.” Success for children like Bryce comes through
For information regarding giving to the Sheppard Pratt Health System, including our Special Education Fund, contact Marguerite Kelley, director of philanthropy, at mkelley@sheppardpratt.org or 410.938.4018.
the heavy investment Sheppard Pratt makes in schools sheppardpratt.org • heal
5
FEATURE/SPECIAL EDUCATION
Bryce even tolerated the school’s
would have been out of the question.
tie and dress slacks when he breaks the
So would have been the sight of
rules. “For a kid with sensory issues, this is
his younger brother Cole bringing
not easy,” Tracy said. “But he did it.”
his friends over to play, now a
Bryce’s progress has allowed the Greenbergs to live more like a family. But Bryce still has a long way to go. “His moods fluctuate constantly, and
b. This is a 10- to 14-week study.
As she watched Bryce and Griffin playing tug of war with a chew toy, Tracy said she “used to sit waiting for that phone call every day” from school saying that
live in the same world that we all live in all
Bryce had had another violent episode.
and struggles in groups.”
Major Depressive Disorder Study (NCT02153502, NCT02158533) a. Adults 18-plus with unresolved symptoms of depression.
common occurrence.
he is sad, confused, and doesn’t really of the time,” Tracy said. “He doesn’t sit still
Volunteers needed for research studies at Sheppard Pratt Health System.
synagogue. Only two years ago, it
“dress code consequence” — putting on a
Bryce made it through three swim
Now Bryce is doing so well at The Frost School that he made the honor roll. After receiving the award, Bryce told
practices last summer. “Next year, we
his therapist that he needed to talk to him
hope for five.”
“because he had never won anything
Tracy and Terry are discussing whether they want Bryce to begin preparing for his bar mitzvah, the
before,” Tracy said. Bryce cried, telling the therapist that they were “happy tears.” “It’s important for people to know
Jewish rite of passage celebrated at age
how hard it was,” she said, “and how much
13 that draws family and friends to the
better it’s gotten.”
c. We will evaluate an investigational medication designed to work with antidepressants to help address unresolved symptoms of depression. Unipolar & Bipolar Depression Study (NCT01562184) a. Adults 18-plus who are currently experiencing an episode of depression. b. This study will last up to 12 weeks. c. This study will evaluate the safety and effectiveness of transcranial direct current stimulation (tDCS) versus sham stimulation as an antidepressant treatment. Tardive Dyskinesia Study (NCT02274558) a. Adults 18 to 85 who suffer from schizophrenia, schizoaffective disorder, bipolar disorder, or mood disorder and are experiencing involuntary movements in their face or other parts of their body. b. This study will last up to 46 weeks. c. The purpose of this clinical research study is to evaluate the effectiveness, safety, and tolerability of an investigational oral medication for tardive dyskinesia. FOR MORE INFORMATION OR TO VOLUNTEER FOR ANY OF THESE STUDIES, PLEASE CONTACT:
Jennifer Sklar, study coordinator, at 410-938-3136 or jsklar@sheppardpratt.org Principal investigator, Scott T. Aaronson, M.D.
6
heal • Sheppard Pratt Health System
Making Education Accessible BRYCE GREENBERG is in a class of four kids. That’s the kind of student-teacher ratio The Frost School in Rockville, Md., employs to successfully educate its students. Frost is one of the Sheppard Pratt Health System’s 14 special education residential and day schools located throughout Maryland. Sheppard Pratt’s Special Education Program provides compassionate, nurturing care and individualized attention to children with autism, as well as emotional and behavioral disorders, to help them lead successful lives. The Special Education Program is recognized as the largest provider of nonpublic, special education programming in Maryland and serves nearly 700 students with special needs from the state and surrounding areas, more than 50 percent of whom have been diagnosed with autism. “Our purpose is to provide an educational environment that gives students the opportunity to access tools to make education accessible for them,” said Ayanna Cooke-Chen, medical director of the Sheppard Pratt ED day school programs. For more information about Sheppard Pratt’s Special Education Program, visit sheppardpratt.org/special-education-services or contact Jim Truscello, director of day school programs, at 410.938.4747.
Mark Your Calendar! For a complete listing of events, continuing education classes, and lectures, visit sheppardpratt.org/calendar-events.
PHILANTHROPY
Upcoming Wednesday Lectures:
Annual Care for Kids Benefit This year’s Care for Kids Benefit will
The Pathetic Past But Hopeful Future of Schizophrenia
be held on Saturday, March 21, at the
January 7
Four Seasons Hotel Baltimore. Presented
Fuller Torrey, M.D., executive
by Morgan-Keller Construction, it will
director, The Stanley Medical
feature a ‘70s disco theme, with all
Research Institute; professor of
proceeds benefiting Sheppard Pratt’s
psychiatry, Uniformed Services University
pediatric patients and students.
of the Health Sciences
Call 410-938-4020 for tickets and information.
Historical Trauma, Losses, and Separations: A Pilot Study to Evaluate the Psychological Problems of Exiles January 21 Eugenio M. Rothe, M.D., professor of psychiatry, Herbert Wertheim College of Medicine, Florida International University; professor, Robert Stempel
EDUCATION Dick Prodey Lecture Series Sponsored jointly by The Kolmac Clinic, the Sheppard Pratt Health System, and
School of Public Health, Florida International University; adjunct professor, Cuban Research Institute, Florida International University
Culturally Competent Assessment and Treatment of Abused, Suicidal African-American Women March 4 Nadine J. Kaslow, Ph.D., professor, Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences Sleep Disturbances in PTSD: Rational Use of Prazosin and Other Treatment Modalities March 25 Murray A. Raskind, M.D., professor, vice chair, director, Mental Health Services, VAPSHCS
COMMUNITY National Eating Disorders Awareness Week February 23-March 1 Please stay tuned for events hosted by The Center for Eating Disorders at Sheppard Pratt, including a community
the National Council on Alcoholism
The Changing Face of Autism
art exhibit featuring student artwork from
and Drug Dependence of Maryland
February 4
the annual Love Your Tree Campaign.
(NCADD-Maryland).
Fred R. Volkmar, M.D., director, Child
Learn more at loveyourtree.org.
A FREE, eight-class series held Wednesday
Study Center, Yale University School
evenings at The Conference Center at
of Medicine; chief of child psychiatry,
Sheppard Pratt from 7 p.m. to 9 p.m.
Yale New Haven Hospital; Irving B. Harris
Call 410.938.3900 for more information.
professor of child psychiatry, psychiatry, pediatrics, and psychology, Yale University
Continuing Education: Wednesday Lectures at Sheppard Pratt We offer a lecture series at The
National Drug Abuse Treatment Clinical Trials Network: Research and Dissemination Accomplishments
Conference Center at Sheppard Pratt
February 18
most Wednesdays from noon to 1 p.m. to
Maxine L. Stitzer, Ph.D., professor of
support continuing education of medical
behavioral biology, Department of
and mental health professionals. Visit
Psychiatry and Behavioral Sciences, Johns
sheppardpratt.org/education-training
Hopkins University School of Medicine
CONFERENCE EXHIBITING American Psychoanalytic Association 2015 National Meeting January 14-18 New York City Psychotherapy Networker March 26-29 Washington, D.C.
for more information.
sheppardpratt.org • heal
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IN THE NEWS
Neuropsychiatry Program Welcomes 3 New Clinic Heads HELP US WELCOME three new faces to the Neuropsychiatry Program at
Robert
Sheppard Pratt, an outpatient program that treats patients with developmental
Wisner-Carlson,
disabilities, traumatic brain injury, age-associated cognitive impairments, and
M.D., director of
related mental health problems.
The Developmental Neuropsychiatry
Margo Lauterbach,
Crystal Watkins,
M.D., director of
M.D., Ph.D., director
offers specialty care for adults with
The Concussion
of The Memory
intellectual disabilities, autism spectrum
Clinic, which treats
Clinic, which treats
disorder, and genetic conditions who
individuals who
individuals who
are also experiencing behavioral
have sustained
have started
and/or neuropsychiatric problems.
Clinic, which
a concussion or multiple concussions
experiencing mild memory problems,
Dr. Wisner-Carlson trained in psychiatry
and have been impacted by the
as well as those who have memory loss
at The Henry Phipps Psychiatric Clinic
neuropsychiatric consequences.
and/or confusion related to medical
at Johns Hopkins Hospital and at
Dr. Lauterbach completed a residency
conditions, and those suffering from
Maudsley Hospital in London.
in psychiatry and fellowship training in
dementia. Dr. Watkins completed her
He is also service chief for the
neuropsychiatry at the University of
psychiatric training as well as a geriatric
Adult Inpatient Neuropsychiatry
Massachusetts Medical School.
fellowship at Johns Hopkins University.
Program at Sheppard Pratt.
For more information on the Neuropsychiatry Program at Sheppard Pratt, call 410.938.4981.
Trauma Disorders Unit Staff Nurse Receives Caul Grant JOIN US in congratulating Briana Snyder, MSN, RN-BC, CNE, a registered nurse on the Trauma Disorders Unit, for being selected for a David Caul Research Grant at the International Society of Trauma and Dissociation’s 31st annual meeting for her ongoing research study, “Views of Women with Dissociative Identity Disorder on Intimate Partner Violence.”
Dickerson: A Doctor on the Move
Autism Research Collaborative
FAITH DICKERSON, PH.D., director of psychology and the program
THE SHEPPARD PRATT HEALTH SYSTEM’S Child and
been traveling the world presenting research updates. Among
Adolescent Neuropsychiatric Inpatient Unit is one of six
other talks, she has presented “Infections, Inflammatory Markers,
inpatient sites in the country to join the Autism &
and Schizophrenia” at several conferences this year, including the
Developmental Disorders Inpatient Research Collaborative
PsychoNeuroImmunology Research Society’s (PNIRS) 21st Annual
(ADDIRC) in an effort to characterize the severely affected
scientific meeting in Philadelphia, the 21st Multidisciplinary
autism population. The goal of this collaborative is to develop
International Neuroscience and Biological Psychiatry Stress and
a comprehensive registry of clinical and biological data on
Behavior Conference in Russia, the Fourth Biennial Schizophrenia
severely affected children and adolescents with autism.
International Research Society Conference in Italy, and the 12th
director for the Stanley Research Program at Sheppard Pratt, has
Psychoimmunology Expert Meeting in Germany.
8
heal • Sheppard Pratt Health System
Meet the New Leaders of The Retreat at Sheppard Pratt Thomas Franklin,
candidate at the Washington Center
M.D., was recently
for Psychoanalysis. He is board
appointed the new
certified in Addiction Medicine
medical director
and Psychiatry and has extensive
of The Retreat at
experience in psychotherapy,
Sheppard Pratt, a
psychopharmacology, addictions,
premier residential
and co-occurring disorders.
treatment program on Sheppard Pratt‘s Towson campus. Dr. Franklin previously
We also welcome Miles
served as medical director of Ruxton
Quaytman, M.D.,
House, The Retreat’s transitional living
as the new
program designed for residents who
associate medical
need more time before transitioning
director for
back into the community.
The Retreat and
Dr. Franklin is also a clinical
the medical director of Ruxton House.
assistant professor of psychiatry at
Dr. Quaytman has been an integral part
the University of Maryland School
of The Retreat’s treatment team for
of Medicine and an advanced
eight years.
Visit our YouTube channel at youtube.com/user/SheppardPrattHealth to watch our Q&A session with Dr. Thomas Franklin.
About The Retreat WITH JUST 16 LUXURIOUS BEDROOM SUITES, The Retreat is a private-pay program that is host to a select group of patients from all over the world. The treatment team has extensive expertise in working with professionals at a crossroads, young adults desiring increased independence and personal responsibility, and adults facing retirement and loss, problems in marriage, and other interpersonal difficulties. It treats the full spectrum of mental health disorders including depression and treatment-resistant depression, addictive disorders, anxiety disorders, and borderline
Expert Psychiatric Care in a Residential Setting The Retreat at Sheppard Pratt, our premier residential unit, offers patients seeking a private-pay, intensive, and highly personalized assessment and treatment program, a chance to make meaningful progress toward recovery. We offer an intermediate length of stay of three weeks to several months in a therapeutic milieu and provide nationally renowned expert care for depression, anxiety, personality, and addictive disorders. Our 12-year anniversary marks a new era for The Retreat with a new medical director, Thomas Franklin, M.D., a more intensive co-occurring disorders treatment track, and a recently renovated facility that provides unrivaled comfort. • Experienced psychiatrists lead treatment teams and are involved in patient care. • Our expertise is in working with professionals at a crossroads, young adults, and adults facing life-changing events. • Residential treatment takes place in an open, unlocked setting.
personality disorder. For more information about The Retreat, call our program director at 410.938.3891.
6501 N. Charles Street Baltimore, MD 21204 410.938.3891 • retreatatsp.org
sheppardpratt.org • heal
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TRAUMA DISORDERS
3 Questions for Our Medical Director of the Trauma Disorders Program
2.
What is unique about the Trauma Disorders Program at Sheppard Pratt?
Our Trauma Disorders Program is unique in that it is designed to treat individuals with the types of complex trauma and complex trauma reactions described in Question 1. Our program emphasizes highly intensive individual and group psychotherapy. All of our psychiatrists, psychologists, social workers, rehabilitation services, and nurses are specifically trained to work with individuals with trauma symptoms. We have success in treating patients who have failed treatment in community settings or have not responded to treatment at other trauma treatment programs.
1.
3.
What is a complex trauma disorder, and when is it considered complex vs. non-complex?
What is the single most pressing need facing mental health care today?
The single most pressing need is the shocking and
“Complex” trauma is a term that means that an individual has experienced multiple traumatic events, and/or types of
scandalous lack of resources and funding for treatment of
traumatic events over multiple developmental periods, usually
psychiatric disorders. Because of this, there are more than
childhood maltreatment and/or exposure to domestic violence.
10 times the number of mentally ill individuals in prison cells
In general, these traumas also involve a betrayal at the hands of
than in state hospital beds. This was the condition of American
someone who should be trustworthy and on whom the person
mental health “care” in the 1830s, when the movement for
depends: parents, teachers, clergy, coaches, et al. However,
humane mental health treatment began, exemplified by our
complex trauma may also describe multiple adult traumas
founder, Moses Sheppard.
under conditions of captivity and imprisonment such as victims
These imprisoned individuals receive virtually no
of sexual trafficking and political torture and prisoners of war,
treatment. Many other severely mentally ill individuals spend
as well as soldiers subjected to multiple combat experiences,
days in emergency departments because no psychiatric beds
particularly if they involve committing or witnessing atrocities.
are available for them. Additionally, large numbers of mentally ill children are unable to find services due to a lack of child
Complex trauma reactions cut across diagnostic categories and describe individuals who have problems with
mental health providers, the lack of funding for adequate child
attachment and relationships or regulation of their mood and
mental health at the state level, and insurance companies’
emotions; have a damaged sense of self or identity; have a
policies that prioritize profits over mental health treatment.
sense of alienation from their bodies; or have a core set of
Similarly, most public and private insurance does not provide
beliefs that see the world as dangerous and untrustworthy.
reasonable reimbursement even for adult inpatient and
But also these individuals see themselves as blameworthy for
outpatient services.
the traumas they have suffered and frequently have problems with reckless behavior, suicidal and/or self-harmful behavior, anger and aggression, and substance and/or alcohol abuse.
For more information on the Trauma Disorders Program at Sheppard Pratt, call 410.938.3584.
RICHARD J. LOEWENSTEIN, M.D., medical director, Trauma Disorders Program Dr. Loewenstein is a senior psychiatrist and founder of the Trauma Disorders Program. He lectures frequently and has received numerous awards for his contributions to clinical studies of trauma and dissociation. He is a clinical professor of psychiatry at the University of Maryland School of Medicine.
10
heal • Sheppard Pratt Health System
NEUROPSYCHIATRY
Concussions: A Serious Concern
Studies have shown that sadness or depression, irritability, and mood swings may follow a concussion and that concussions may also be linked to difficulty concentrating, recalling, or absorbing information.
THANKS TO a settlement with the
and fatigue. You don’t need to be
National Football League, every football
playing sports to suffer one; car
player today knows about the dangers of
accidents, assaults, falls, and being
a concussion, an all-too-common brain
struck by a hard object can also lead to
injury that can result any time the head
a concussion or traumatic brain injury.
is subjected to a sudden acceleration of
Concussions have been linked to sleep
forces. Untreated or repetitively inflicted,
disturbances such as too much or too
concussions can even result in death as
little sleep or difficulty falling asleep. But
in the high-profile tragedies suffered by
when emotional symptoms or difficulty
several high school football players in
thinking or remembering things are also
problems that result after brain
the past couple of years.
present, recovering from a concussion
injury, illness, or disease.
All of the media attention is helpful, but because reporters tend to focus on
may be even more challenging. Studies have shown that sadness
The Concussion Clinic at Sheppard Pratt embraces a team-based
the consequences, too few people can
or depression, irritability, and mood
approach to care for patients who have
recognize the signs and symptoms of a
swings may follow a concussion and
sustained brain injuries and are suffering
condition that, according to Centers for
that concussions may also be linked
emotionally and/or physically. The clinic
Disease Control statistics on sports and
to difficulty concentrating, recalling, or
is available to patients at all stages of
recreation-related injury, affects millions
absorbing information, which can cause
healing from a brain injury or concussion,
each year. The sooner a concussion or
serious issues for people in a school
whether the concussion was a recent
head injury is diagnosed, the better the
or work environment.
occurrence or was incurred several
person’s chances of recovery, so it’s
Who can help someone recover
weeks, months, or even years prior to
important to know what a concussion is
from a concussion after the immediate
seeking treatment. The clinic also
and what to look for should you suspect
trauma or emergency has passed?
collaborates with other medical providers
that you or someone you know may be
While physicians of varying specialties
in an effort to facilitate rehabilitation from
suffering from a concussion.
may be helpful, you may also want
a concussion in a way that works best
to consider seeking treatment from
for the patient.
A concussion is a type of brain injury broadly defined as a bump, blow, or jolt
a neuropsychiatrist who specializes in
to the head that can lead to a variety
the assessment and treatment of
MARGO LAUTERBACH, M.D.,
of physical symptoms, including
patients with emotional or cognitive
neuropsychiatrist and
headaches, dizziness,
director of The Concussion Clinic, part of the Neuropsychiatry Program
To make an appointment at The Concussion Clinic, contact the Neuropsychiatry Program at 410.938.4762.
sheppardpratt.org • heal
11
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You give. They heal. You make great things happen when you give to the Sheppard Pratt Health System.
Our Largest Individual Donation Ever to Benefit Child, Adolescent Programs THE SHEPPARD PRATT HEALTH SYSTEM recently received a donation of $2 million from Mildred Kern of Baltimore, the largest individual donation to the health system since its doors opened in 1891. For more than a century, the largest donation to mental health and the health system came from benefactor Enoch Pratt, a well-known American businessman and philanthropist from Baltimore who donated $1.6 million in 1896. Mildred, a Baltimore resident and New York native, was six days shy of her 105th birthday when she died on June 9, 2013. Her donation will support child and adolescent programs at Sheppard Pratt, with the intent to improve To honor and commemorate Mildred’s generosity, a plaque was dedicated in the lobby of the Weinberg Building on Sheppard Pratt’s Towson campus on September 17, 2014.
From left: Dr. Steven Sharfstein, president and CEO of the Sheppard Pratt Health System, joins Morris Roseman, Mildred Kern’s friend and representative, Marguerite Kelley, director of philanthropy, and Byron Forbush, chairman of the board of trustees, at the Weinberg Building to honor Mildred’s generous gift.
Thank You for Your Generosity DR. STEVEN SHARFSTEIN, president and chief executive officer of Sheppard Pratt Health System, hosted
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opportunities for education and care for children in need.
Sheppard Pratt’s annual donor reception at the picturesque Sagamore Farm House on October 15. More than 70 of Sheppard Pratt’s most generous donors enjoyed networking, refreshments, and a short program at the historic Vanderbilt family farmhouse now owned by Kevin Plank, CEO and founder of Under Armour. For more information on supporting Sheppard Pratt, contact Marguerite Kelley, director of philanthropy, Dr. Steven Sharfstein (center) thanks honored donors, from left: Stan Goldman of the Weinberg Foundation; Hosanna Asfaw-Means of CareFirst BlueCross BlueShield; Donn Weinberg of the Weinberg Foundation; and Pedie Killebrew of the Women’s Hospital Foundation who is also a Sheppard Pratt trustee.
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at mkelley@sheppardpratt.org or 410.938.4018.
PHILANTHROPY
Sheppard Pratt Stride Debuts as Family-friendly Fundraiser more than 350 participants, many of whom were Sheppard Pratt employees and friends. More than $40,000 was raised. Additionally, as a result of the Stride, Sheppard Pratt connected with more than 500 new donors. In addition to the one-mile walk around Sheppard Pratt’s main campus in Towson, there were many familyfriendly activities, including moon
Tracy Greenberg, the top fundraiser, and her family attended the Stride.
ON SEPTEMBER 27, the Sheppard Pratt
“The first Sheppard Pratt Stride
bounces, face painting, balloon animals,
united our employees, patients, and
a pre-walk warm-up routine, and zumba
Sheppard Pratt donors and reinforced
lessons. Musical entertainment for the
support for mental health in Baltimore,”
day was provided by four Sheppard
said Dr. Steven Sharfstein, president
Pratt employees.
and chief executive officer of the
The Stride’s top fundraiser was Tracy
Sheppard Pratt Health System. “It is
Health System held its first Sheppard
Greenberg, a member of the Sheppard
with great eagerness that we look
Pratt Stride, a one-mile walk and family
Pratt Health System’s Consumer Council
forward to hosting the Stride next year
fun day that raised awareness and
who raised more than $4,000. A former
on October 3.”
funds to support the many Sheppard
Dallas attorney, she moved to Maryland,
Pratt programs that help patients and
so that her son, Bryce, could receive
students, their families, and those
better care. Bryce is a fifth-grade student
affected by serious mental illness. The
at The Frost School, which is part of the
event surpassed all expectations, with
Sheppard Pratt Health System.
Special thanks to Sodexo, the 1st Sheppard Pratt Stride presenting sponsor.
Walkers of all ages helped raise more than $40,000 in the first-ever Sheppard Pratt Stride.
sheppardpratt.org • heal
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ADDICTIONS
Informing Ourselves About E-cigarettes WHAT ARE THE BENEFITS? WHAT ARE THE RISKS?
refers to the part of the e-cigarette that heats the e-liquid for vaporization. E-cigarettes either use refillable cartridges or a refillable tank. (Adding more e-liquid is called “dripping.”) Proponents of e-cigarettes feel that they are a viable harm-reduction strategy, which can reduce morbidity and mortality. This reduction, if achieved, could be vital, as our existing methods have yielded limited success. They also feel that the amount of toxicants found in CIGARETTES cause more than 480,000
larger and sport different colors;
e-cigarettes is significantly lower than
deaths annually in the U.S. Seventy
while others look very different from
in cigarettes. Opponents, however, are
percent of smokers say that they
traditional cigarettes.
not convinced of their safety. They
would like to stop smoking, yet only
The e-cigarette market has
4 to 7 percent of people are able to
expanded exponentially to the point
evidence-based strategies. They
actually quit. E-cigarettes have now
where it has become a $2 billion industry.
also think that e-cigarettes will act as a
emerged in the market, bringing with
There are now close to 500 brands of
“gateway” and that youth can get hooked
them new promises and questions.
e-cigarettes and 8,000 unique flavors.
on nicotine from their use. Poison centers
Time will tell, however, whether they
There are substantial differences among
have received more than 200 calls a
will actually be able to break the
these varieties, so one needs to be
month this year for nicotine-related
stronghold of combustible tobacco
cognizant before one chooses to use
poisoning, and more than half of these
products and become a true
them or advise others to use them.
cases involve children in accidental
“breakthrough technology.”
They are highly variable in quality,
poisoning. Both proponents and
appeal, and efficiency.
opponents, however, agree that there
E-cigarettes are designed to emulate the experience of smoking
They have also added some new
argue that smokers should use current
is a need for better regulations.
and usually deliver a certain amount
terms to our lexicon. “Vaping” denotes
of nicotine but without exposing the
the inhalation of the vaporized solution.
writes, “We have to accept that it will
user to the highly carcinogenic tar and
“E-liquid” or “juice” is the liquid solution
probably be more than 30 years before
harmful carbon monoxide gas that
vaporized by e-cigarettes; it usually
we would have a chance of being able
cigarettes emit. Many of them look
contains water, propylene glycol or
to use epidemiology to quantify risks
very similar to cigarettes but are often
glycerin, nicotine, or flavorings. “Atomizer”
from e-cigarette use.”
Robert West, an epidemiologist,
SUNIL KHUSHALANI, M.D., service chief of the co-occurring disorders inpatient unit and the adult day hospital Dr. Khushalani is a clinical assistant professor at the University of Maryland School of Medicine and serves as a physician adviser to the Stanley Research Program at Sheppard Pratt. He has co-moderated a monthly “Addiction Forum” at Sheppard Pratt since 2010.
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MEET OUR DOCTOR
Catching Up with Dr. Edward Zuzarte PROVIDING COMPASSIONATE CARE IN A SAFE ENVIRONMENT
Dr. Edward Zuzarte, service chief of the Psychotic Disorders Unit, has worked at Sheppard Pratt for more than 15 years, specializing in helping those with psychotic disorders, such as schizophrenia and bipolar disorder, heal and recover. He also offers outpatient services through Mosaic Community Services, Inc., and is NAMI Metropolitan Baltimore’s 2014 Frances J. Lentz Mental Health Professional of the Year.
Q. What is a psychotic disorder?
Q. What is unique about the
A. A psychotic disorder is when a person
Psychotic Disorders Unit?
starts to lose touch with reality and loses
A. For our patients, we’re not just a unit,
the ability to function. They may believe
we’re a setting where they can receive
things that aren’t true or have unusual
innovative treatment in a safe, effective
sensations such as hearing things or
environment. The continuum of care
seeing things that impact their behavior.
we are able to provide our patients is
We don’t know why it happens, but it
unique to Maryland. On our unit, we
is a medical problem in the brain.
provide 24/7 intensive and acute care.
These types of mental illnesses
Once a patient is stabilized, they are
usually manifest in a person in their late
able to move directly into Sullivan
teens and 20s. Because there is such a
Day Hospital and can reside at night
strong hereditary component, people
in a halfway house run by Mosaic,
should be particularly cognizant of any
one of our affiliates, also on our
changes in behavior among family
campus. Our nurses and doctors
members in this age group who have a
are all extremely dedicated to the
history of mental illness in their family.
work we do and have been
Frequently, early symptoms such as the
providing compassionate care to
person starting to smile to themselves
our patients for a very long time.
or mumbling under their breath are overlooked by family and friends — but
Q. If you could spend a day
these symptoms should not be ignored.
with any influential person, who would it be?
Q. What should someone do if they are concerned about a loved one?
A. That’s easy: Steve Jobs. My favorite [Jobs] quote: “The only way to do great
A. The earlier a person is diagnosed
work is to love what you do.” This is what
and receives treatment, the better the
I always remember as life throws me
person’s prognosis. You don’t want to wait
hurdles — I love what I do, my colleagues
until a person experiences a nervous
love what they do, and we come here
breakdown to seek help. If you suspect
each day to treat our patients and help
that something might be wrong, the best
them get well.
thing you can do is talk to a health care professional, whether a primary care
Visit our YouTube channel to hear more
doctor, pediatrician, or school counselor.
from our interview with Dr. Zuzarte:
You can also reach out to a reputable
youtube.com/user/SheppardPrattHealth
mental health organization, like NAMI [the National Alliance on Mental Illness].
6501 N. Charles Street Baltimore, MD 21204 410.938.3000
GARRETT
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ALLEGANY
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FREDERICK
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CARROLL
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BALTIMORE
HOWARD MONTGOM
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CECIL
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BALTIMORE CITY
KENT
ANNE ARUNDEL
PRINCE GEORGE’S
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QUEEN ANNE’S
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TALBOT CHARLES
CAROLINE
CALVERT
THESE FOUR SHORT, SIMPLE WORDS succinctly and powerfully sum up exactly what we try to do for each and every person we touch and can be applied to all programs and departments that comprise our vast health system throughout Maryland.
HARFORD
DORCHEST
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ST. MARY’S
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WICOMICO
SOMERSET
focused on helping you sheppardpratt.org
★ WORCHESTER