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Questions Regarding ‘Brain Change’ Study

A worrisome article has appeared in The Chicago Tribune on a Dr. John Csernansky and his colleagues of Northwestern University’s Feinberg School of Medicine in Evanston, Illnois, conducting a study to help better diagnose schizophrenia.

“Diagnosing schizophrenia is more of an art than a science,” said Csernansky, who heads Northwestern’s psychiatry and behavioral sciences department, “but by using a computer to chart subtle changes in the brain from [magnetic resonance imaging], we can create brain maps. We still don’t know why the disease is degenerative, but we can now see patterns. Even in the absence of obvious deterioration of behavior, we can see biological progression of the disease.”

Had this doctor said of his research, as he says of diagnosis, that it is more of an art than a science, I would feel even more queasy about the article than I do now, and I find this approach to research very disturbing.

A woman, Mrs. Gertie Rodig, hopes it will help other people deal with situations such as that which took the life of her son.

Many patients go undiagnosed and/or untreated, such as Don Rodig, who died four years ago at age 50 after a tumultuous few years with the disease, said his mother, Gertie Rodig of Arlington Heights. “He tried to commit suicide four times and had a mental breakdown,” Rodig said, “but when we took him to the hospital, he would check himself out.”

Though he had symptoms such as hearing voices and believing the FBI was watching him, Rodig said her son never received medication.

My concern is that unless this research team includes people diagnosed schizophrenic who aren’t on psychiatric drugs (medications) in its study, it will not be able to rule out whether the ‘deterioration’ that takes place in its subjects is due to the use of these psychiatric drugs, or ‘the progression of the disease’ as Dr. Csernansky puts it.

Much evidence exists to support the conclusion that the drugs used to treat schizophrenia actually cause much of the damage attributed to the disease itself.

When psychiatrists have only one primary method of treatment, drug maintenance, it becomes very difficult to find any patients who have not at one time or another been maintained on psychiatric drugs. Until such time as some portion of the patients used in such a study are not being maintained on psychiatric drugs, we cannot rule out the drugs as the source of the damage seen in the MRI scans.

Treatment of schizophrenia includes antipsychotic medications and psychotherapy. By comparing the disease progression with treatment, Csernansky said, the study will help show how medications affect or do not affect the schizophrenic brain.

Okay, but not unless it includes ‘the disease progression’, if any, without treatment.

Another question I have regards the ties Dr. Csernansky might have to the pharmaceutical industry. Is his research heavily industry funded? The US Senate is currently investigating the financial links a number of prominent researchers in this country have to the pharmaceutical industry. It is always possible that Dr. Csernansky’s scientific curiosity is tainted with self interest, and that it is somewhat less impartial and unbiased than it would appear to be from any merely cursory examination.

Pardon me if I don’t recognize the seriousness of your condition but

Philip Dawdy, author of the Furious Seasons blog, just celebrated the second anniversary of his going off psychiatric drugs. This is 2 drug free years following 18 years on psychiatric drugs.

Way to go, Philip! A whole lot of people, judging from the comments, sympathize, support, or just plain react to your anniversary, and your very successful blog.

I could say I was suffering from pangs of envy here and there, and I wouldn’t be lying.

He says his case establishes 1 of 4 things. A conclusion I’m much less sure about.

1. He had a bad diagnosis, and he was never bipolar. (Is that anything like a misdiagnosis?)
2. Bipolar disorder burns out over time.
3. He is a medical miracle of some kind.
4. He is sick, delusional, soon to be hospitalized.

Given the forty fold increase in the diagnosis for bipolar disorder reported a few years back, I don’t think Philip’s case can be very unusual in the least. A lot of people must have some kind of imaginary disorder these days.

I remember when I was taking a Psychology course in college, and Bipolar Disorder was described as a rare genetic disorder. Robert Schumann, the musician, was seen as the primary example of somebody who may have been suffering from this disorder.

Boy, have times changed! Now all sorts of people from Sir Isaac Newton to Lord Byron to Abraham Lincoln are thought to have had undiagnosed bipolar disorder.

I have had all sorts of people introduce themselves to me as bipolar. I ignore such indiscretions as much as I am able to do so. I’ve never seen a bipolar disorder up close. I have only seen people somebody claimed were bipolar.

I’d ask for it on a microscope slide, the way you could do with syphilis, but I know better than to do so. Psst. They haven’t really found it yet.

It doesn’t happen so much with people who have other bogus diseases. I don’t find people introducing themselves as schizophrenic, or depressed, or, heaven forbid, ADHD so much. It’s just people who have been tagged bipolar seem to think this makes them special.

I could say come back after it clears up, I just don’t think that would work.

The Doctors’ Error, or A Matter Of Focus

A generally good article here on the possibility that some late bloomers are people with mental illness who recover. The author of this article, Dr. Lloyd Sederer, is looking at an article writen by social commentator, Malcolm Gladwell, on the place love holds in blooming late professionally. He, Dr. Sederer, uses Paul Cezanne as an example of someone who, although never accused, could have been seen as mentally ill early in his career. Alright, and later in his career Paul is the artist whose art so impressed his contemporaries and continues to impress people to this day.

(Also consider that he is calling such people as Cezanne and the ‘mentally ill’, ‘awkward outsiders’. Hmmm. Maybe someone should consider inviting a few people in for dance lessons?)

Later he uses the example of Roy, real name hidden to protect his identity. Roy was characterized as mentally ill earlier in his life, but Roy didn’t let this stop him from succeeding at a health technology business venture.

Cut to the end of the piece, and I have to object. I think the author is slipping a little.

Recovery, making a life of contribution despite and with a mental illness, is about hope and belief and patience and persistence.

…and with a mental illness…

Hold on, partner! Check your dictionary! Recovery is not making a contribution despite, recovery is recovering from. The past tense of recover, to put it another way, is recovered.

I checked a couple of dictionaries, and this is what I got.

Recovery

n. pl. re·cov·er·ies
1. The act, process, duration, or an instance of recovering.
2. A return to a normal condition.
3. Something gained or restored in recovering.
4. The act of obtaining usable substances from unusable sources.

The American Heritage® Dictionary of the English Language, Fourth Edition copyright ©2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved.

recovery

Noun
pl -eries
1. the act of recovering from sickness, a shock, or a setback
2. restoration to a former and better condition
3. the regaining of something lost
4. the extraction of useful substances from waste

Collins Essential English Dictionary 2nd Edition 2006 © HarperCollins Publishers 2004, 2006

Perhaps he is implicitly suggesting that full recovery is less common than partial recovery. Maybe, but that doesn’t excuse him from obscuring the fact that people actually do recover, and making it something less than it actually is. Full and complete recovery is possible, and actually happens. Psychiatrists in general tend to dwell on the percentage of the people who fail in treatment rather than the percentage who show real improvement. Given those percentages, when they are as high as they are, these psychiatrists are likely to discount the possibility that a person can recover. Well, people do fully recover, and they go on to accomplish some truly amazing things.

Comparisons by the World Health Organization have found recovery rates nearly twice as high in developing countries than they are in the developed world. When these psychiatrists focus on rates of failure at the expense of rates of success, generally they are thinking about success rates in developed countries. If they looked at rates in the developing world, their perspectives might change, as might their approaches to treatment. When recovery is seen as a distinct possibility, and it is not discounted out of hand, I imagine that recovery is then more possible than it would be were it thought of as next to impossible.

Normality Screening In San Francisco

nscreeningapa

As I’m on my way to the west coast, and I don’t know when I might have another opportunity to post, I thought I’d leave people with a few pictures of recent events.

MindFreedom International and the California Network of Mental Health Clients co-sponsored a protest of the annual convention of the American Psychiatric Association at the Moscone Center in San Francisco that took place in May of this year. You can read about the protest, attended by yours truly, here.

The day after this protest, David Oaks, director of MindFreedom International, dissident psychologist Al Galves, Laura from Texas, and myself, Frank Blankenship, conducted normality screenings in San Francisco.

The picture above shows David Oaks, Laura from Texas, and myself in front of the Moscone Center.

Screening The People

nscreeningha

After screening for normality in front of the Moscone Center, we took the bus to Haight Street, and conducted further screenings there.

In this picture Al Galves, myself, and Laura from Texas are screening for normality somewhere near the corner of Haight and Ashbury Street in San Francisco. Between Laura and myself you see anonymous pedestrian, definitely abnormal.

On Haight Street

hanscreening

Needless to say no normality was found.

In this picture you see Laura from Texas, Al Galves, David Oaks, and myself.

Exit Janie

What gets me about people in the mental health/illness system is how thoroughly so many of the people who are in that system have been brainwashed. Alright, brainwash is a strong word, and perhaps I need to take a moment to explain.

I used to volunteer with the Virginia Organizing Project, a social justice organization, and a couple I met who also worked with that organization had a relative in the mental health/illness system, and they were telling me how once a person entered that system all forms of behavior were interpreted in terms of disease.

Yes, no, or maybe? Isn’t it a yes?

The only people buying mental health are the so called mentally ill. This is a fraction of the total population. The mentally healthy have no need to buy mental health as it comes with the territory. The mental health/illness system sees itself as selling mental health to the mentally ill. The mental health/illness system isn’t sustainable without people who are convinced they are mentally ill.

There are causes for actions besides disease unless, of course, you get caught up in this system where so much behavior is seen as the symptom of a disease that must be suppressed and managed as it can’t be eradicated. In the mental health/illness system there are two types of behavior, legimate behavior and diseased behavior. Folks in the mental health/illness system are dismissive of anything tainted with the disease.

We will skip the preliminaries…Janie came into conflict with her family, her boyfriend, her husband, her neighbors, her associates, the law, etc., and got thrown into the Looney Bin…but you get the idea.

Janie absorbs the propaganda, and Janie discovers she is sick. Janie has a chemical imbalance. This sickness is, like, a physical disease. Although there is no cure, it can be managed through medications. Janie is going to have to take these medications for the rest of her life due to the seriousness of Janie’s condition.

Anybody who questions this line of reasoning can’t be right because it came from an expert source. This expert source is an expert source because it repeats the words of other expert sources. All the experts behind these expert sources have had many years of ideological indoctrination (if they use the word experience, think error), and so, of course, they can’t be wrong.

If she read the propaganda and followed it, Janie will die 25 years earlier than her neighbor will die. There is also a high likelihood that before Janie kicks the bucket entirely she will develop debilitating involuntary and uncontrollable twitches of her face and limbs. Her state of mind may also deteriorate (whatever that means) under the effect of the pills she has been popping.

Oh, and if the doctor says Janie is mentally ill, and Janie disagrees with the doctor, Janie is either in denial, or Janie lacks insight into the seriousness of her condition. The doctor can’t be in denial, nor can he lack insight, he’s the expert.

Where was Janie before all this began? Was she standing ln the railway station? A lot of excess baggage comes with a serious mental illness. Maybe Janie should have second thoughts, and just walk on.

Changing The System

A curious piece here:

In 2005, psychologists Belinda Board and Katarina Fritzon at the University of Surrey, UK, interviewed and gave personality tests to high-level British executives and compared their profiles with those of criminal psychiatric patients at Broadmoor Hospital in the UK. They found that three out of eleven personality disorders were actually more common in managers than in the disturbed criminals:

  • histrionic personality disorder: including superficial charm, insincerity, egocentricity and manipulation.
  • narcissistic personality disorder: including grandiosity, self-focused lack of empathy for others, exploitativeness and independence.
  • obsessive-compulsive personality disorder: including perfectionism, excessive devotion to work, rigidity, stubbornness and dictatorial tendencies.

They described the business people as successful psychopaths and the criminals as unsuccessful psychopaths.

Personality disorder

Having helped to conduct a few normality screenings, I’m hardly surprised that some of these business people would not be perceived as normal. The organization MindFreedom International, of which I am proud to say I am a member, has done a number of these normality screenings in the past, and we haven’t found a normal person yet. This is not what concerns me so much here. What does concern me is this social division into successful for business people and unsuccessful for criminals. Also note that the criminals we are dealing with are not only people convicted of crimes, but people who have been labeled mentally ill.

I have long thought that what is in large measure wrong with today’s mental health system (and the same argument might be extended to prisons) is that it is perceived as a way of managing societies’ failures rather than as a way of helping unfortunate people enter the world of achievement. When bathos governs the operation of your treatment facilities, the revolution in lowered expectations has already proven fully triumphant, and every hope thereby is rendered a false hope. No wonder, given this situation, that what you get is less the brilliant blaze of a raging bonfire than it is the shameful blush of a dying ember. When it comes to the hopes, dreams and aspirations of the people stumbling about in this system of errors, they’ve been as good as stamped out.

How do we revive those hopes, dreams and aspirations? Well, first you get rid of that paternalism that would treat fully adult humans like children for as long as they live. Children are not especially equipped to deal with difficult and stressful situations, and the same can be said for people who have been treated like children. Part of this end of paternalism would involve paying people wages for work done, even if that work was done in a rehabilitation setting. Second, you provide good training opportunities and decent paying jobs. When a portion of the population is exiled from a middle class existence, as much of this population often is, that portion of the population becomes a problem population. Third, this provision also involves giving these people opportunities that are not available to the rest of the population. These opportunities would be provided not because this group had gained a monopoly of businesses through commercial predation. These opportunities would be provided because we realise, due to certain social barriers, some people need an edge if they are ever to advance, and to reach a situation on par with certain others of their species.

Not mentioned among these 3 steps was the step of providing other treatment options to putting people on powerful brain numbing drugs that result in near total disability, but this step is implicit throughout. We have a situation now where mental health professionals routinely ignore research results that have more positive outcomes than their own because those results disagree with their preconceptions. Negative results have a way of replicating themselves when change is not instituted. Negative outcomes in turn have a way of reinforcing ineffective practices, and ultimately, the resulting pessimism can become a kind of self fulfilling prophesy. Institute a few changes, here and there, and you will have a vastly different prospect for those people in treatment. Put these three steps I mention above into effect, for example, and I guarantee you, you are going to see an improvement in outcomes.

When Sickness Is Your Bread And Butter

Eureka! There’s Gold In Them Thar Children!

ADHD (Attention Deficit Hyperactivity Disorder) as a diagnosis hasn’t been around even 50 years, and already psychiatrists think they have found a genetic base for it. Try again, doctors. All kids are problem kids, they call it growing up. In the medieval period children were painted as miniature adults, but we all know they weren’t miniature replicas of their parents, they were children. Still they had no ADHD then. I wonder what they were doing right that we are doing wrong. Better luck next time. I don’t see any real Rococo angels and cherubim flying around your room. I don’t see any flying pigs or pink elephants either. Write your thesis on Barbie, Ken, and Skipper. Maybe if you keep at them test tubes you will come up with the perfect Mother, Father, and Child. Ah, forever! Not to be put off, if you find any flaws in your pursuit thereof, you can give it a diagnosis, develop a drug for it, and make a bundle of greenbacks selling that drug. Look at how successful ADHD has been!

Uh, right. You are sooo correct. The above mentioned article does have to do with the adult variety of ADHD. Well, as you must know, ADHD children, if they are lucky, grow up to become ADHD adults. Many sufferers of the adult variety of ADHD came by this disease through first being diagnosed as children. Incidentally, before ADHD was an adult disease, it was a child disease. Gee, I guess it’s growing up. I wish I could say the same for some of its sufferers.

Online Mental Health Test

Are you worried about whether you might have a mental illness or not? You can now resolve the issue by taking a test for mental illness on line, and as this article says, self diagnose yourself. According to the Doctor who developed this test, 90% of the people who take this test have been shown to have some kind of emotional disorder, and should seek immediate help. I’ll bet!

Question. Where can a person go to take this test, and receive his or her very own mental disorder diagnosis?

Answer. If you are really desparate to have a mental illness, you might find the website below helpful:

Mac Anxiety

On Eccentricity and Madness

British Psychologist David Weeks has been studying eccentric people. The encouraging news is that some people who were thought to be mentally ill may actually be eccentric. It is a well known fact that some people have been locked up in mental health facilities because they did not conform, because they kept pace with a different drummer to paraphrase Henry David Thoreau. This fact alone shouldn’t make these people ‘crazy’, but some people find all sorts of excuses for frowning on their neighbors.

The following is from the wikipedia page on eccentrics.

Characteristics

Psychologist Dr. David Weeks mentions people with a mental illness “suffer” from their behavior while healthy eccentrics are quite happy. He even states eccentrics are less prone to mental illness than everyone else. This may be related in the same way that introverts (introversion) suffer more from their mental illness than do extroverts (extroversion), who tend to make those around them suffer instead by their actions or deeds (outward expression of their illness rather than inward).

According to studies, there are fourteen distinctive characteristics that differentiate a healthy eccentric person from a regular person or someone who has a mental illness (although some may not always apply). The first five are in most people regarded as eccentric:

• Nonconforming attitude
• Creative
• Intense curiosity
• Idealistic
• Happy obsession with a hobby or hobbies
• Known very early in his or her childhood they were different from others
• Highly intelligent
• Opinionated and outspoken
• Noncompetitive
• Unusual living or eating habits
• Not interested in the opinions or company of others
• Mischievous sense of humor
• Single
• Usually the eldest or an only child

http://en.wikipedia.org/wiki/Eccentricity_(behavior)

To this list Dr. Weeks has added a fifteenth characteristic that eccentric people are found to have. He says they also tend to be bad spellers.

Before one grows giddy with jubilant celebrating over the fact that one has found oneself to be merely odd rather than completely bonkers, I have found a couple of criticisms that can be made of this view.

If you look at the initial paragraph in this section on these characteristics you may find the thinking a wee bit fuzzy. People with mental illness, we read, suffer more from their behavior than do people who are healthy but eccentric. Then we are reading about sick introverts suffering, and sick extroverts making other people suffer, as a part of their respective mental illnesses. Alright, nothing was said about making other people suffer being a symptom of any mental illness. Without this little slip, sadists are healthy, masochists unhealthy. The claim is then made that introverts tend to have more severe mental health problems than extroverts, and so I guess the implication here is that it is healthier to make other people suffer than it is to suffer oneself. I imagine that people living under oppressive totalitarian regimes would find the thought itself offensive, and then there is the much touted ‘golden rule’. Could it find itself any more tarnished than it is in this discourse where good is rewarded with bad?

A second criticism of Dr. Weeks findings on eccentrics is that unhappiness in this view is equated with mental illness. People in the USA are supposedly guaranteed the right to pursue happiness by virtue of their Declaration of Independence, but there is no guarantee in this Declaration that any person will actually catch this happiness. Simply put, people who are unhappy are not sick, they are unhappy. People may also find themselves in negative unwanted situations, and if their unhappiness compels them to change their situation, this change would not have taken place if they had pretended their unhappiness was actually happiness. Adding mental illness to the afflictions that beset the impoverished is not going to improve their social station either. When a racial component is added to impoverishment, as one looks at external causes for unhappiness, this sort of perspective may actually represent an almost unconscious current of racist thought pervading the social sciences.

Is the greed that would sell the entire world for personal profit more healthy than the philanthrophy that would leave a pennyless preacher begging for alms? I leave this little snippet with you as I have other matters of import that I need to get around to addressing, and an eternity is more time than I’ve got to waste on any subject.