Sunday, June 26, 2011

The latest threshold that psychiatry has crossed

Mommy, am I really bipolar? is the title of a Newsweek piece by Stuart L. Kaplan, M.D. Dr. Kaplan argues that there is no scientific evidence that bipolar disorder surfaces in childhood. Dr. Kaplan goes through the recent history of this diagnosis which began in the 1990s with the book The Bipolar Child, and he discusses how quickly psychiatry and the public rallied around this label. Judging from the force of the comments to this article, mainly all negative in regard to Dr. Kaplan's opinion, there should be a huge blow coming to psychiatry's credibility as it tries to backpedal on this diagnosis in children. Why should these parents believe psychiatry now?

As much as I agree with much of what Dr. Kaplan writes, there is a huge credibility problem that has been simmering along for the profession and could boil over. Since psychiatry has put all its efforts into magic bullets it has neglected to figure out how to relieve human suffering. In fact, it has gone out of its way to tell parents that it was dangerously old-fashioned to believe that maybe the family environment has a good deal to do with why the child is behaving in a certain way and that chemicals are the main solution. I would be all in favor of what Dr. Kaplan is saying, except that he undermining this position by further arguing that bipolar in children is most often ADHD, and psychiatry has chemicals to treat that. He also refers to ADHD as less trendy than bipolar. Maybe so now, but not so when my kids were in elementary school. ADD and ADHD was THE buzz with the mothers in the schoolyard. So, all Dr. Kaplan is doing is trading one diagnosis for another diagnosis that has the FDA 's blessing for the drugs that are used in children.

Many young parents don't know what they believe themselves, so they believe their doctor. They believed their doctor, perhaps after initially putting up resistance (or perhaps not), when the doctor told them their child was bipolar. Now, all of a sudden, the same doctor is telling them that the child is not bipolar? How is the doctor going to explain away the drugs and the fact that their kid is still messed up? Why should the parent believe this latest fad un-diagnosis? You would think that a parent would be delighted to hear that their child is inattentive and hyperactive, rather than the more ominous bipolar, but that doesn't seem to be what is happening with the parents who commented on this article. They are lining up behind the belief that their child is horribly, mentally ill and they don't want the label dropped. By giving parents this option, psychiatry has created a much bigger problem that has invaded every nook and cranny of family life and parents want to hold psychiatry to it. They won't be able, to, unfortunately.

Psychiatry should be in big trouble from these parents now that it is backpedalling on the bipolar diagnosis. Memories are short, however. The parents of under 18s now will not be the same group of parents of under 18s ten years from now. The bipolar label is going to be folded into a new label. I'll let Dr. Kaplan explain the new think:

The tide may be turning. The American Psychiatric Association is deliberating intensely on new criteria that would dramatically restrict this fad diagnosis. One step the association is recommending is a new diagnosis called temper dysregulation disorder, a more accurate way of describing extreme irritability in children. If mental-health professionals can be persuaded to consider these alternative diagnoses, many thousands of children could be spared an unwarranted, stigmatizing label that sticks with them the rest of their lives.

The controversy over bipolar will fade, since there is a good chance the current drugs won't get approved for use in children, anyway, and the next generation of parents will be snowed once again by the profession using new labels and different drugs.

For those who want off the merry-go-round, this latest controversy is all the more reason to rely on one's own intuition, to expand one's belief system, and look to emulate people who have cured themselves.

Friday, June 24, 2011

I'm tempted to report this guy as "inappropriate"

There has been a tremendous outpouring of positive response from New York Times readers to the self-outing of Dr. Marsha Linehan. Dr. Linehan is the creator of DBT therapy, whose story of recovery from a diagnosis of schizophrenia appeared in yesterday's paper.

Perhaps you can spot the problem in Mark's take on mental illness. (Well, there are two actually.)

Providence, RIJune 24th, 20119:41 am

Dr. Linehan has done a great service to all people who suffer from emotional and mental problems, and she deserves tremendous praise for having the courage to reveal her personal story. Her story gives hope to those who read it, but the story is more complicated than the Times reports.

Having practiced psychiatry, child psychiatry and primary care medicine for 20 years, I have been impressed that mental illness is a concept that is not as simple as it is often portrayed, and that by oversimplifying it, in tends to stigmatize many people. To begin with Borderline Personality is not a unitary concept, but an aggregate of behaviors and mental and emotional experiences that varies in its intensity and characteristics from one person to the next. There may be 20 or more variants of borderline personality. Many patients who do not meet the DSM criteria are diagnosed with "borderline traits". Many diagnoses in the DSM are probably best not viewed as mental "illnesses" but rather problems that have complex social, cultural and economic contexts. Among these should probably be adjustment disorders, learning disabilities and substance abuse disorders. While I would agree that Schizophrenia and Bipolar Disorder are true mental illnesses, we must recognize that sometimes these terms have been used to describe borderline patients and other patients out of countertransference more than because the patient truly met the criteria, out of an expression of anger and frustration at the process of treating people with provocative behavior.
Personality disorders have a strange place in the pantheon of mental disorders (By the way, what is a disorder? Is it equivalent to an illness or something different). As Dr. John Oldham has written in his books on Personality Disorders, these conditions reflect a spectrum of personality traits that range from the normal to the pathological. The pathological is largely defined by the extent of the traits.

Recommend Recommended by 0 Readers Report as Inappropriate.

Thursday, June 23, 2011

A recovery story

Expert on Mental Illness Reveals Her Own Fight. About Marsha M. Linehan, from the New York Times.

How we arrived at the mess we are in

I say "we" because even though the references here are mainly U.S.-centric, psychiatry in developed countries has been heavily influenced by the pharmaceutical industry. Here is an excerpt from the second installment of Marcia Angell's three part review of The Emperor's New Drugs; Anatomy of an Epidemic; and Unhinged. Dr. Angell is the first woman to have served as editor-in-chief of The New England Journal of Medicine.

One of the leaders of modern psychiatry, Leon Eisenberg, a professor at Johns Hopkins and then Harvard Medical School, who was among the first to study the effects of stimulants on attention deficit disorder in children, wrote that American psychiatry in the late twentieth century moved from a state of “brainlessness” to one of “mindlessness.”2 By that he meant that before psychoactive drugs (drugs that affect the mental state) were introduced, the profession had little interest in neurotransmitters or any other aspect of the physical brain. Instead, it subscribed to the Freudian view that mental illness had its roots in unconscious conflicts, usually originating in childhood, that affected the mind as though it were separate from the brain.

But with the introduction of psychoactive drugs in the 1950s, and sharply accelerating in the 1980s, the focus shifted to the brain. Psychiatrists began to refer to themselves as psychopharmacologists, and they had less and less interest in exploring the life stories of their patients. Their main concern was to eliminate or reduce symptoms by treating sufferers with drugs that would alter brain function. An early advocate of this biological model of mental illness, Eisenberg in his later years became an outspoken critic of what he saw as the indiscriminate use of psychoactive drugs, driven largely by the machinations of the pharmaceutical industry.

In addition to the money spent on the psychiatric profession directly, drug companies heavily support many related patient advocacy groups and educational organizations. Whitaker writes that in the first quarter of 2009 alone,

Eli Lilly gave $551,000 to NAMI [National Alliance on Mental Illness] and its local chapters, $465,000 to the National Mental Health Association, $130,000 to CHADD (an ADHD [attention deficit/hyperactivity disorder] patient-advocacy group), and $69,250 to the American Foundation for Suicide Prevention.
 And that’s just one company in three months; one can imagine what the yearly total would be from all companies that make psychoactive drugs. These groups ostensibly exist to raise public awareness of psychiatric disorders, but they also have the effect of promoting the use of psychoactive drugs and influencing insurers to cover them. Whitaker summarizes the growth of industry influence after the publication of the DSM-III as follows:

In short, a powerful quartet of voices came together during the 1980’s eager to inform the public that mental disorders were brain diseases. Pharmaceutical companies provided the financial muscle. The APA and psychiatrists at top medical schools conferred intellectual legitimacy upon the enterprise. The NIMH [National Institute of Mental Health] put the government’s stamp of approval on the story. NAMI provided a moral authority.

Growing numbers of for-profit firms specialize in helping poor families apply for SSI benefits. But to qualify nearly always requires that applicants, including children, be taking psychoactive drugs. According to a New York Times story, a Rutgers University study found that children from low-income families are four times as likely as privately insured children to receive antipsychotic medicines.

Read the NYR article here.

Wednesday, June 22, 2011

The definition of short

So, if we still don't know what is meant by "short term" use of antipsychotics, is there a doctor in the house or out in cyberspace who can shed some light on this? If I don't get an answer, shall I assume that nobody is looking seriously at this issue?

The question is quite deliberate on my part. Since most of us don't get a dress rehearsal for a schizophrenia diagnosis (60% of new "cases" apparently do not have family history), we will find ourselves on medications because we haven't got a clue that there are other ways of dealing with trauma.

I have heard that the most recent research says (patients have been saying this for years) that medications, if used at all, should be short term. If this is so, then people ought to know what short term is so they, and their doctors, can agree on an end date while bolstering their recovery with alternative therapies. Many doctors will claim that the patient has to be "stable" in order to go off them, while many patients claim that they shouldn't be on meds in the first place and don't function well on them. Doctors (pharma) have been getting a free pass up until now because the specifics, if there are any, are cloaked in mystery. I am not referring to how to go about withdrawal (there's lots of information here), I mean how short is short?

Thanks to Robert Whitaker's book, Anatomy of an Epidemic, we now know that the "medication is to schizophrenia just like insulin is to diabetes" argument was an falsehood (or misconception, depending on how you look at it) that was not clarified by the pharmaceutical companies until the author put the question directly to a pharmaceutical company executive.

If we are starting to hear that drugs, if used at all, should be short term, what is meant by short term?

Tuesday, June 21, 2011

Best practice for short term use of neuroleptic medication

Here's a question that's been puzzling me. There is a growing consensus that says that neuroleptic medication, if administered at all, should be of short duration and used only when and if necessary during periods of acute psychosis.

My question is, where is the best practice that defines "short term?" Are we talking one month, three months, one year maximum? What is meant by "short term?"

Does anyone out there have some information on this topic?

Friday, June 17, 2011

Horses and humans

It never ceases to amaze me that we still fail to recognize and treat trauma in the "mentally ill" human.


The story of Buck Brannaman and, by extension, the documentary is on the surface that of a man who turned hurt into grace operating from a reservoir of patience and profound love of horses. It’s also, as his quiet stories and those of friends who also pay witness to his cruel history make vividly, at times mistily clear, a look at the lines connecting parent to child, man to beast. Mr. Brannaman’s childhood was a horror, and while the movie includes chilling reminiscences, the most revealing moment comes in an old film clip that Ms. Meehl smartly tucks in and that shows the older Mr. Brannaman leading his small, blindfolded boys toward the front of a stage, his grip digging so hard into Buck’s shoulder that you may wince.

Thursday, June 16, 2011

Schizoaffective disorder: More junk science

Here's a telling quote (and audience reaction) from the APA 2009 convention.

William T. Carpenter, Jr., MD, from the University of Maryland in Baltimore and head of the psychotic-disorders work group, which includes schizophrenia, outlined several main changes being considered in this area that might be controversial.

One of these questions is whether to retain schizoaffective disorder as a diagnostic entity. "We had hoped to get rid of schizoaffective as a diagnostic category because we don't think it's valid and we don't think it's reliable," he said. "On the other hand, we think it's absolutely indispensable to clinical practice," he added wryly, drawing a laugh from the audience.


A righteous dude

"The lack of insight in modern psychiatry is more extreme than the lack of insight in patients."

Lawrence Albert "Al" Siebert, (January 21, 1934 - June 25, 2009)

What I like about Al Siebert is that he is on "your side." He will agree that you're all right, which, to my way of thinking encourages patients to "become all right." I don't get the same feeling from most psychiatrists.

NIMH table spreads cheer at NAMI convention

Or, this is what your government wants you to believe about mental illness. It's strictly brain-based.

The NIMH (National Institute of Mental Health) invites you to visit our table at the NAMI 2011 Annual Convention

Chicago, IL July 6-9, 2011
Exhibit Booth 106 – Southeast Exhibit Hall
Location: Chicago Hilton
720 S. Michigan Avenue, Chicago, IL60605Now available to view on the NIMH website:

Brain Basics

A self-guided education module that uses images and animation to show how the brain works, how mental illnesses are disorders of the brain, and ongoing research that helps us better understand and treat disorders.

Mental Health Statistics

A resource that represents an extensive collection of our best statistics on the prevalence, treatment, and costs of mental disorders. Equally important are sections that have been included on mental health-related disability and on suicide.

Featured below are several publications that may be of interest. All NIMH publications are available at no cost.

Suicide in America: Frequently Asked Questions

A brief overview of the statistics on depression and suicide with information on depression treatments and suicide prevention.

Learn more about this publication.

Brain Development During Childhood and Adolescence (Fact Sheet)

A fact sheet that describes the past, present and future of research on brain development.

Learn more about this publication.

About Us

The mission of NIMH is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery and cure.

Our Location

6001 Executive Boulevard, Room 8184, MSC 9663
Bethesda, MD20892-9663
Phone: 301-443-4513
Toll-free: 1-866-615-6464
TTY: 301-443-8431
TTY Toll-free: 1-866-415-8051
Fax: 301-443-4279

We also invite you to view NIMH Science News about mental health.
For the latest NIMH research news and funding opportunities, subscribe to a NIMH e-mail newsletter or RSS feed.

Haven't registered yet for the NAMI Convention?


Just come to the on-site registration desk located on the lower level of the Chicago Hilton.You can register for the full convention or just for one day. On-site registration will be open Wednesday – Saturday.
Visit for details on registration fees. You can also download a complete program schedule to help you plan your time at the convention.

Wednesday, June 15, 2011

The church's attempts to hide its mental illness

Part II of Personal problems as just another consumer commodity

Thomas Szasz famously wrote: "If you talk to God, you are praying; If God talks to you, you have schizophrenia. If the dead talk to you, you are a spiritualist; If you talk to the dead, you are a schizophrenic."

If a belief in God is evidence of a mental illness, then the church is mentally ill.

I listened to the audio version of the Fifth Avenue Presbyterian Church (FAPC) Pentecost sermon entitled Prophets Wanted: Apply Within. The minister was saying that prophets often make the church feel uncomfortable. It became very clear to me just how uncomfortable mentally ill people make the church feel, if the FAPC sermon is any example. There was not one mention, not one, of the mentally ill*, in the list of people the minister was inviting to be prophets. The minster said that prophets were, inter alia, gays* and lesbians, women, people of different nationalities and races. These groups of people may have a welcome, different perspective, but prophets are in a category of their own.

I am hugely ashamed of my church for failing to acknowledge where the real prophets are located. The church continues to play it safe by making sure that its prophets don't get anywhere near the church to challenge its cherished notion that prophecy was something Biblical, not modern. There they are, these prophets, babbling to themselves in tongues outside the church while inside the church we are treated to sermons about Pentecost. If there was ever an example of mental illness in action, the celebration of Pentecost would fit the bill. "The first scientific study into glossolalia, that is, speaking in tongues, took place in 1927 when psychiatrist Emil Kraepelin, while studying schizophrenic patients, linked glossolalia to schizophrenia and hysteria. He observed that glossolalists tended to have more of a need for authority figures and appeared to have more crises in their lives."

If there is a link between glossolalists, schizophrenia and the founding of new religions, then William J. Seymour (Pentacostalism), L. Ron Hubbard (Church of Scientology), and George Fox (Quakers), are only a few outstanding examples.

So, there is no huge expectation on my part that the church will actually take me up on my challenge to advocate for the mentally ill. I suspect part of the reason is the close association between religion and mental illness, that the church knows about, but finds too uncomfortable to deal with. Real prophets upset the status quo. I am going to go out on a limb and say something as opinion that I have noticed all my life: There are lots of borderline mentally ill people in church. They try to disguise it, as best they can, but the closer you get to the altar, the more fervent and unusual are the people attracted to that sacred ground. It can be manifested as a love of symbols, rituals and reading the Bible. Put another way, these people's chakras are open at the higher levels. So, perhaps it is no wonder that mental illness frightens the church because it risks exposing the fervent. It is like a politician going out of his way to vilify homosexuality, only to be exposed later as a practicing homosexual.

As a mother of a son who got labelled "schizophrenic," I sure could have used the help of the church early on to see so-called mental illness in a positive light. The church is a potential ally, given what it is built upon. I'm not talking about the rock that the early Christian church is supposedly built upon, I'm talking about the church's intimate affiliation with prophecy/mental illness/spirituality. Everywhere I turned when I was most in need, psychiatry and public ignorance ramped up my fear. I began to catch on relatively early that the church was merely echoing psychiatry because it is convenient for it to do so. Psychiatry practices social control. (I'm beginning to sound more like Thomas Szasz every day.) The church should ask itself if it is helping psychiatry practice social control when it advocates for supportive housing instead of supporting the individual in his quest to get answers to spiritual questions.

Shouldn't the expectation of society be that "mentally ill " people become well again and resume their rightful place in the community? Statistics for the mentally ill population show a different picture, that their numbers are increasing and their illnesses are becoming chronic.

I 'm of the opinion that the tragedy that is playing out daily on the streets and in the current housing solutions, is connected to psychiatry's insistence up until now that favors medication over understanding. Harvard professor Marcia Angell raises doubts about these drugs: "And what about the drugs that are now the mainstay of treatment? Do they work? If they do, shouldn't we expect the prevalence of mental illness to be declining, not rising ?"

In addition to doctors and hospitals, there is a vast network of social service housing projects that oversee management of the mentally ill. The mentally ill who reside outside of the influence of doctors, hospitals and projects, meaning, on the streets, either cannot or will not take their medication. As it happens, recent research is on their side. The medications are increasingly being challenged as ineffective, and their grotesque side effects are evident. But, who actually listens to the "mentally ill?" Apparently not the church.

We, as a society uplift freedom of choice, except for the mentally ill. We say "the customer is always right," except when it comes to the mentally ill. We are supposed to value a person's opinion, except when it comes to the mentally ill. We instead put down the mentally ill by saying that they have agnosognosia, the inability to recognize that they have a mental illness.

Mental illness is understandable if you view it as a response to psychic pain or trauma. The problem is, psychiatry has abandoned getting to know its supposed customers in favour of the much more lucrative diseased brain model of mental illness. You hear the mantra everywhere: Medications will help the mentally ill. Except, by and large they don't. The side effects overwhelm any supposed benefits the drugs are supposed to deliver and lead to a life span that is twenty-five years shorter on average**. The false claim that medication is the best way to treat mental illness has been exposed on many fronts, most recently in Robert Whitaker's book, Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs and the Astonishing Rise of Mental Illness in America. Psychiatrists has been so focused on pretending they are real doctors (able to prescribe) that they hardly even pay lip service to psychotherapeutic interventions.

If the church really wants to help the mentally ill, a positive perception about what mental illness is may go a longer way to helping the mentally ill than cleaning up the streets and putting people in housing where medication is mandatory. I am asking the church to re-examine whether institutional solutions are helping or hindering recovery of the individuals who are sleeping on the church steps.

There is an old Chinese saying, "Be Careful What You Wish For," which means that what you get may be exactly what you didn't want to happen and/or have unintended consequences. Churches profess to help the mentally ill in ways that can more cynically be interpreted as wanting the mentally ill off the streets as a social service to everybody else. They have convinced themselves they are doing God's work, but are they? In the case of the mentally ill, it may never even occur to the church that the mission they were really put here to do is to listen to and uplift their own, which today would include the so-called mentally ill. Ask any minister, priest or rabbi how many mentally people they come across on a yearly basis who are lurking around the church entrance or creating disturbances in or around the building. They're there because they are on a spiritual quest. When my son Chris was wandering around the streets of our city, looking dishevelled, fully medicated, living with his family and attending a psychiatric program, he often was seen hanging around a different church than the one we go to. Street prophets like Chris have not been welcomed at church since organized religion began to stamp out pagan beliefs and issue edicts about how the Bible is supposed to be interpreted.

Churches should rethink where their real expertise lies. Rather than align itself with mainstream psychiatry today, which it is doing by supporting the institutions over the individual, the church could be a leader as an advocate for the dignity of each individual.

The Village Voice has a sad story about two individuals who live together in a privately run adult care home for the mentally ill in Coney Island, New York. Churches, if you are reading this, ask yourselves, are you helping the people or are you helping to clean up the streets for the rest of us so we don't have to pick our way over vagrants on our way to church? Put yourself in their shoes. If they are there because they refuse to take medication, then they have a point that needs to be listened to. If they are there because the family has abandoned them, then help families to appreciate and support their family members. Does it ever occur to someone to ask the customer what he or she would like? I doubt their solution would be a warehouse for the mentally ill in Coney Island. A great way to help would be to become the people's advocate, to advocate along with the therapy and skills that they need to lead independent lives.

Here's what the church can do to advocate for the mentally ill. I'm not asking it to do anything other than begin to change its perception of what mental illness is:

Read the words of the prophets and then ask why those guys were different than these guys today.

Ask how come Jesus cured the demon possessed, and yet psychiatry claims there is still no cure for schizophrenia or bipolar, only management.

Ask yourselves who you are serving.

Respect what the supposedly mentally ill person is telling you.

Learn more about mental illness by reading books written by people who disagree with the status quo. Do not take the view of mainstream psychiatry at face value. They are not your constituents.

Challenge the cosy relationship between pharmaceutical companies, doctors and research institutions through letter writing campaigns and other means.
*From Wikipedia: Following controversy and protests from gay activists at APA annual conferences from 1970 to 1973, as well as the emergence of new data from researchers such as Alfred Kinsey and Evelyn Hooker, the seventh printing of the DSM-II, in 1974, no longer listed homosexuality as a category of disorder. But through the efforts of psychiatrist Robert Spitzer, who had led the DSM-II development committee, a vote by the APA trustees in 1973, and confirmed by the wider APA membership in 1974, the diagnosis was replaced with the category of "sexual orientation disturbance".

Thursday, June 9, 2011

Personal problems as a just another consumer commodity

Part I

Prophets Wanted. Apply Within is the title of the upcoming sermon posted on a sign on the front entrance of the Fifth Avenue Presbyterian Church (FAPC) in New York City. I debated with myself about whether to march in and ask to speak with the author of the sermon or if I should just walk by. This was too good an opportunity to pass up, so in I went. The young woman at the reception table said the minister was not available so I opened the door to the main area of the church and found a pew to sink into. The cool interior of the church was a welcome respite from the rising heat wave in the city. I grabbed a visitor's card and scribbled a short message to the minister.

It went something like this:

Hello - I am sorry I will miss your upcoming sermon on Prophets Wanted: Apply Within. Would today's church recognize a prophet if one walked through the door or would it urge this person to see a psychiatrist and get on medication?

That was the abbreviated message because I had to hurridly sketch my point on the back of the visitor's card. I ran the risk of looking like a bit of a nutter myself with handwriting crudely scratched from the pencil I found in the pew. I signed off with my pseudonym Rossa Forbes and added as an afterthought "mother of a prophet," in case it looked like I was making a personal job application. I added my e-mail address and URL.

So, in case anyone from FAPC is reading this post, here's what I am fumbling to say: We all know that churches are at the forefront of community outreach programs, and your church newsletter The VOICE has an excellent issue this month devoted to all the work your members are doing at shelters. But I think your church and the church at large has forgotten or suppressed something very fundamental -- the prophets of yesterday, the Jonahs, the Elishas, the Ezekiels, would today be locked up and heavily sedated. Today's prophets are devalued. Their gifts of hearing voices and seeing visions frighten people. Given the church's longstanding affiliation with The VOICE of prophecy, shouldn't the church be at the forefront of changing the public's perception? The so-called mentally ill have messages and few people are listening. A simple shift in our collective thinking, to value, laud and encourage people who are struggling with forces from God that are very distressing when not properly understood, would go a long way to help people do on earth what they were put here to do. In this population you will find the poets, writers, artists and musicians, a.k.a. our prophets.

Instead, churches are preoccupied with the problem of "homelessness," a word which has become synomymous with mental illness. To quote from The VOICE:

"Permanent supportive housing is the most cost-effective and lasting way to address homelessness," Rev. (Kate) Dunn says. .........By supporting temporary shelter options for local street homeless, while advocating for permanent supportive housing, we have an opportunity to create a powerful witness in our backyard."

I disagree that homelessness can be addressed by permanent supportive housing. That is an attitude that everything can be fixed if you buy the right product. I know that permanent supportive housing has great appeal to people because "homelessness" seems like a social wrong that throwing housing at will fix. But does it fix the real problem? People are homeless because they have personal and family problems that have manifested themselves to the breaking point. Many are on the streets because they refuse to take medications that pharma and psychiatry at one point in time managed to convince the public would keep them out of institutions! Many of these people have received the label "schizophrenic" because they hear and see things that we do not as we go about our consumer driven lives. Modern psychiatry has embraced the "consumer" at the expense of the individual and no longer wants to hear about anybody's existential or spiritual crisis. They have convinced people they have a brain disease, one manifestation of which is to believe you are a prophet. Nobody believes in prophets anymore, least of all the church, which is weird, frankly, given the longstanding affiliation between the two. After all, it is probably safe to say that schizophrenics have founded most of the new charismatic Western religions, e.g. George Fox (Quakers), William J. Seymour (Pentacostalism), L. Ron Hubbard (Church of Scientology).

Part II of this two part story will look at supportive housing for the mentally ill run by a church community on Long Island. My point is not to criticize FAPC and all the other churches for doing what is popularly thought of as a good work. Rather, it is to look at where the reality of treating the so-called mentally ill has led us in the absence of holistic support to the individual. Here is a link to the article Two Flew Over the Cuckoo's Nest, that is in this week's The Village Voice.

Friday, June 3, 2011

Medications' unintended side effects as seen by the parent

These are just a few side effects that come to mind.

1. Continously nagging an adult to take something that makes him/her feel bad
2. Worrying constantly about him/her not taking the meds
3. Being dismayed at the weight gain
4. Disagreeing with your spouse about whether medication is the way to go
5. Getting confused about behavior you are seeing. Is it the person or is it the medication?
6. Continously buying new clothes (on the way up and on the way down)
7. Not being able to tolerate alcohol when everyone else is able to
8. Fighting with the psychiatrist over the efficacy of the medication

There is no chemical imbalance, nor has there ever been

The Epidemic of Mental Illness: Why?
Marcia Angell
New York Review of Books

Excerpt from review of
- The Emperor's New Drugs: Exploding the Antidepressant Myth (Irving Kirsch)
- Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America (Robert Whitaker)
- Unhinged: The Trouble with Psychiatry - A Doctor's Revelations about a Profession in Crisis (Daniel Carlat)

Second, none of the three authors subscribes to the popular theory that mental illness is caused by a chemical imbalance in the brain. As Whitaker tells the story, that theory had its genesis shortly after psychoactive drugs were introduced in the 1950s. The first was Thorazine (chlorpromazine), which was launched in 1954 as a “major tranquilizer” and quickly found widespread use in mental hospitals to calm psychotic patients, mainly those with schizophrenia. Thorazine was followed the next year by Miltown (meprobamate), sold as a “minor tranquilizer” to treat anxiety in outpatients. And in 1957, Marsilid (iproniazid) came on the market as a “psychic energizer” to treat depression.

then yada yada yada ..... But over the next decade, researchers found that these drugs, and the newer psychoactive drugs that quickly followed, affected the levels of certain chemicals in the brain.

more yada yada yada ... Thus, instead of developing a drug to treat an abnormality, an abnormality was postulated to fit a drug.....That was a great leap in logic, as all three authors point out. It was entirely possible that drugs that affected neurotransmitter levels could relieve symptoms even if neurotransmitters had nothing to do with the illness in the first place (and even possible that they relieved symptoms through some other mode of action entirely). As Carlat puts it, “By this same logic one could argue that the cause of all pain conditions is a deficiency of opiates, since narcotic pain medications activate opiate receptors in the brain.” Or similarly, one could argue that fevers are caused by too little aspirin.

But the main problem with the theory is that after decades of trying to prove it, researchers have still come up empty-handed.
Psychiatrist and author Carl Jung would not subscribe to the biochemical imbalance theory were he alive today.

These forces did not originate in our patient out of nowhere. They are most emphatically not the result of poisoned brain cells, but are normal constituents of our unconscious psyche. They appeared in numberless dreams, in the same or a similar form, at a time of life when seemingly nothing was wrong. And they appear in dreams of normal people who never get anywhere near a psychosis. (1939)

Misunderstood and then misdiagnosed

I do most of my thinking for this blog while I'm walking to and from work. The motion and fresh air stimulate my thoughts. As I walk, I ruminate about something I heard or saw the day before.

 The bipolar disorder satire that has been seen on so many blogs, the one where the computer animated woman keeps telling the shrink how crummy she feels on the medication and he keeps repeating that she needs the medication because she has "the bipolar disorder," and it goes round and round from there. She tells him that she was feeling very upset because of a family tragedy when she was admitted to hospital and he says "that's the bipolar disorder."

What interested me recently about this clip was that the patient says she is on 10 mg of Abilify for "the bipolar disorder." A few months ago I half jokingly told Chris (on 5 mg Abilify) he was depressed, not schizophrenic, because I discovered that Abilify was now being prescribed as an add-on treatment for depression. But he can also be bipolar, if that's what he prefers, because Abilify is also for bipolar disorder. (A real wonder drug!) Who's to say Chris isn't bipolar? When he was first admitted to hospital, the doctors gave him only a 25% chance of being bipolar, but, as we know, doctors are often wrong, especially when it comes to psychiatric diagnoses.

Of course, I am being facetious, because the labelling is meaningless in the first place, but the blurring of diagnoses logically comes about because the same drug is used to treat supposedly different conditions. This is an open invitation to pick the diagnosis you would prefer to have. If a choice has to be made, wouldn't a patient want to join the higher status group of people like Britney, Catherine and Mel, who supposedly don't have schizophrenia, they have "the bipolar disorder." Is it logical to claim that if you are no longer on Abilify, you no longer have the bipolar disorder/schizophrenia/depression?

Along the same lines of my muddled thinking on Abilify, here is an excerpt from Pamela Spiro Wagner's blog, which relates how her friend  assumed that he was schizophrenic, based solely on the fact that he was prescribed Trilafon. The doctors never questioned this diagnosis once Joe told them what he was. They accepted what Joe told them as fact, without doing their own thinking. This is a very sad story, and unfortunately, it's an all too frequent one.

I believe that Joe was misdiagnosed for many many years with schizophrenia, when in fact he had had Asperger’s from childhood. Now, that’s a long story in itself and though I could make a case for it, I cannot prove it. But I am not the only one who knew him well to notice that he never once exhibited signs of psychosis or even real delusions or true paranoia. Furthermore, from what I gather, the only reason the diagnosis came about or “took” was because he was put on Trilafon by a well-known psychiatric incompetent who was later “defrocked” and when Joe looked the drug up in the PDR and read what it was used for, he concluded that that meant he must have schizophrenia. From then on, so his story was, he told subsequent doctors this diagnosis, and apparently they simply took it on faith. In fact, for all the years thereafter until his terminal illness of ALS, the one doctor he saw not only never questioned this, but also never even reconsidered his absurd concomitant Dx as bipolar, even though Joe clearly had one of the most placid temperament possible and certainly wasn’t the slightest bit moody. No one so far as I know ever even considered that there might be something else going on. Even when I once went with him to see his non-medical therapist, did she really seem even to want to think about the possibility, as if it might be too much trouble…Perhaps, though I cannot recall, it was too late, if in fact this was after Joe’s ALS diagnosis.

But as I said, that is a long story, and not being a doctor, I suppose I can’t make the diagnosis, except that as his closest friend, I do and I feel that a great injustice was done. Not only was he saddled with a serious psychiatric diagnosis, and a stigmatizing one at that, but that particular neuroleptic medication rendered him much too tired to work as an engineer. All his adult life that was what he really wanted to do. Work. But the drug sapped his stamina…Worst of all, although eventually on Zyprexa which helped what might have been poor social skills due to Asperger’s, after he had been on it for years it caused the diabetes that ultimately cost him his life.

So what is schizophrenia? I'll let Jung have the last word here. These are actually two quotes. I have added the second shorter quote to show how to cure a schizophrenic. (I like how he adds "provided one's own constitution holds out." How true!)

But even so one can bring about noticeable improvements in severe schizophrenics, and even cure them, by psychological treatment, provided that one’s own constitution holds out [in my own experience, I have had situations where I continued the long-term psychotherapy of several patients in inpatient state hospital settings, later transferred into my practice, in which I was physically attacked, reported to have sexually molested the patient , etc, to very positive outcomes, e.g., to the point where family thought their family member was originally misdiagnosed as schizophrenic, never having to return to the state hospital after many years of residing there, etc]. This question is very much to the point, because the treatment not only demands uncommon efforts but may also induce psychic infections in a therapist who himself has a rather unstable disposition. I have seen no less than three cases of induced psychoses in treatments of this kind.

A schizophrenic is no longer schizophrenic... when he feels understood by someone else.

- Carl Jung

Wednesday, June 1, 2011

Where are the holistic schizophrenia mommy bloggers?

Faithful reader Duane has pointed out to me that I seem to be unique in my being parent of an adult child with a schizophrenia diagnosis who has such a postive view of schizophrenia while holding a highly critical view of the medication approach. It's lonely being me. Don't get me wrong. There are people like Becky and Stephany, but they belong to a sub-group of mothers fighting the good battle against childhood psychiatric labelling and drugging. Most of the others (we tend to be women) appear to endorse NAMI and the finding the right drug approach.

Where are the others like me who are blogging? Not just mommy bloggers but daddy bloggers, too. One day I would like to join the "in-crowd" of my own choosing. I have a long history of rejection. Even as far back as high school I never made it to the "popularity table" in the cafeteria. When I moved to that school district, the table with the cool kids was full, and I sat with the rejects, as I termed them (not me). I knew it was not cool to be there. One girl wore a hair net. Why a hair net, I had no clue, not that I bothered to ask. I just sat there eating my baked beans and Vienna sausage and fluffy white roll, just a table away from all the fun.

So, if you are willing to step up to the plate and begin your own blog, or you can twist someone else's holistic arm to start one, I'm all for it. We'll become the in-crowd, for once. It's only a matter of time. Check out Blogger or Wordpress. You can be up and ranting in about half an hour.

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