Stigma isn’t the issue – mental health is

Politicians are human. Some of them receive psychiatric labels due to the ups and downs of career and life. A psychiatric label is less likely to derail a politician’s career than it once was.

The media likes to downplay the matter. According to an article, Mental health isn’t the issue – stigma is, in the St Paul Minnesota Star Tribune:

“It’s just a disability,” said Dr. Steve Miles, a bioethicist at the University of Minnesota and former candidate for the U.S. Senate who has bipolar disorder. “I take medicines. I show up for work. If depression disqualified people, we’d have to put 20 percent of [the population] on welfare.”

When Dr. Miles claims to have a disability, I don’t imagine that means he shows up to the office in a wheelchair. Dr. Miles doesn’t feel he can shake his sadness and his euphorias without help, er, or even with help.

Mental illness is not the political kiss of death it once was, partly because it’s now more widely recognized as a treatable brain disease. Depression is now regarded as one of the most common medical conditions, affecting as many as one in five people at some point in their lives, by some estimates.

One point I want to make is that brain disease is in the expertise of the neurologist. Since mental illness is in the expertise of the psychiatrist, it is not brain disease. We don’t find mental illness through lesions and tumors of the brain, we find it through behavior which might be described as different or aberrent. We are dealing with actions that stem from a disorder of the thought processes and, therefore, perhaps it is more of a self-control issue.

Elvis Costello released an album/CD a few years back entitled “Get Happy”. I would think in a sense that listening to this sort of music might be conducive to good mental health.

I understand 7% of the US population are taking SSRI antidepressants. I had read 10% somewhere, but that would be excessive in anybodies book. A lot of people would be very sad then if it were not for their chemical make overs.

Then the question becomes…or would they? Antidepressants have been found to often work no better than an enhanced placebo. Sometimes in clinical trials a placebo beats the antidepressant drug, and then the drug company execs start complaining about the placebo effect. What is the placebo effect? It’s the notion, given studies supposedly proving such, that the mind given a sugar pill, due to the power of suggestion, can heal itself as well if not better than the mind given a drug. Uh, right.

Common sense would take us down a different pathway; for instance, I have heard of a study in which exercise alone beat both drug treatment with exercise, and drug treatment alone, as a solution to what is characterized as depression. Feeling blue? Get out of the house, and do something exciting. I hear that can help.

The theory now current is that there are all these fruitcakes out there who aren’t being given the drugs they need because they are afraid to step into a psychiatrist’s office and be stigmatized.

Perhaps, but just consider, if some of those already labeled ‘mentally ill’ individuals were able to lose their labels, their ‘mental illnesses’, that ‘stigma’ they had been given goes with it, doesn’t it?

Problem. If you increase the population of the country taking antidepressant drugs, you are not having more people losing their ‘mental illnesses’. Technically, the illness is synonymous with the drug. Likewise, if you encourage more people to enter into treatment, it may be good for people in the mental health profession, and for people in the pharmaceutical industry, but it’s not so good for the nation as a whole that then finds it’s mental illness rate is on a sharp incline.

I tend to be a serious disbeliever in the religion of mental disorders. I don’t think any advertisements for serious mental disturbances are going to make mental disorders mentally healthy. I don’t think any such advertisements are likely to make it socially or environmentally healthy either for that matter. I think the best way to maintain your mental well being is by staying away from the psychiatrist office. Why? If you don’t want to be a good Catholic, you don’t consult a priest. If you don’t want to be a good jew, you don’t consult a rabbi. The same principal applies to serious mental illnesses.

The question that then arises, at a certain level, is should it be more socially acceptable to be labeled psychiatrically disabled, or mentally ill, than it is not to be so labeled? If so, then before long we will have to be leaning on our ‘mentally disordered’ majority to make things right in this country, and how we are going to manage to pay for this ‘mentally disordered’ majority would defy logic. Just consider the ‘social security’ debacle it is predicted we will be having to contend with in the not so distant future.

You can walk away from your ‘mental disorder’, too, and you don’t have to be a politician to do so. You call yourself recovered. You just take the door out of the ‘in recovery’ building, and you enter the much wider world beyond the parenthetical world of mental health treatment. My feeling, based on actual experience, is that that is sometimes the best course of action a person in such a situation can take.

Mental Health Recovery Without Psychiatric Drugs

One of the greatest secrets of our time is the fact that people can and do fully
recover from serious mental illnesses. Those serious mental illnesses
that affected people have fully recovered from include major depressive disorder,
bipolar disorder and schizophrenia. Much of the information published today,
chiefly by the mental health profession, on the subject that indicates
otherwise is frankly misinformation.

One of the biggest cover-ups of our time concerns the drugs so often used
to treat these conditions. Many of these drugs may seem to help in the
short term, but ultimately these drugs end up hindering, if not actually preventing,
recovery efforts in the long term. This is not all. Not only can these
chemicals sometimes impede the recovery process, but they are also
know to cause physical damage to those people taking these drugs
for predominately psychological or psychiatric reasons.

When people in mental health treatment are dying at a rate of on average 25 years earlier than the rest of the population, and the predominate cause of this earlier death
can be shown to be the drugs used ostensibly to treat the illness,
obviously the treatment is worse than the disease. Doctors are killing
people with the same substances these same doctors are claiming alleviate
the symptoms of those people’s illnesses. Unrealistically perhaps the façade of
normalcy is worth sacrificing 25 years of one’s life for, realistically this is an
incredible, outrageous, and completely unnecessary waste of humanity.

There are many safer and more humane ways to treat these fellow members of the human species than that of doping them into oblivion and death. Finding these better methods of treating the afflicted involves taking a few risks, and breaking out of habitual, customary, and often ineffective ways of dealing with them. When people in mental health treatment are given a wide array of treatment options, including nondrug options, then the
chances that lives will be saved in the process are much better than probable.

The DSM Inclusion Debate

The psychiatrists working on the upcoming 2013 update of the Diagnostic Statistical Manual of Mental Disorders are currently debating whether to include parental alienation syndrome among its growing list of disorders.

According to an article in The Tennessean, Therapist’s split on ‘parental alienation’:

Parental alienation, as defined by [William] Bernet and more than 50 colleagues around the country and the world who are pushing for its inclusion in the reference tome, is a form of brainwashing that occurs only in a small number of highly contentious breakups.

A small number he says. I imagine it would occur in a growing number of households if the DSM made it a treatable disorder. Sure. Staying together for the sake of junior can be a good idea, or it can be a bad idea. If this sounds weird to you, not to worry, it sounds weird to me, too. Sometimes grownups have a hard time growing up. That’s life, that’s not medicine.

The concept has vocal critics who fear some decision-makers may not be able to distinguish parental alienation from genuine danger. But the scenario of one parent attempting to turn children against another is familiar to anyone who works in family law or counseling.

The fear is that mommy or daddy could really be a danger to the kids. This happens, and there is no need to dreg up the ghost of Robert Ripley to confirm. All you have to do is open up a newspaper.

You’ve got alienating parents, sure, but what about your alienating siblings? Shouldn’t we also have a sibling alienation designation? Can’t siblings also be a danger to other siblings? Sibling rivalries develop, and family scapegoats occur. I’m sure there must be some alienation involved in this matter, too.

Also, alienation is hardly restricted to the nuclear family. Why don’t we make social alienation an official disorder as well? Add social alienation syndrome as a DSM disorder, and the over all medicalization of modern society should be nearing completion. Of course, the question then becomes who is doing the brainwashing? Is it society at large, or is it the American Psychiatric Association membership behind each additional expansion of the DSM?

Cure alienation then, if it’s all a matter of brain washing. Uh huh, but is the brain washed brain the alienated brain, or is it the non-alienated (think smiley) brain? You will have to answer that one for yourself.

I haven’t gotten to psychiatric alienation yet, but just give me time.

Editorialist Gets It Wrong

Some of these would be mental health experts don’t know what they’re talking about. One case in point is that of Anne Ziegler writing in the editorial corner for the Fierce Healthcare website, No drug reform, no relief for the poor.

Mrs. Ziegler would take two seemingly disparate news stories, 1. Seroquel is being sold as a street drug, and 2. Senator Grassley investigating a certain Miami doctor for over prescribing prescription psychiatric drugs, and she would try to unite these two stories into a single story with a single message. This story being that these drugs are priced so high that the poor can’t afford them.

She even goes so far as to suggest that Seroquel is a life saving drug. That Seroquel can also be a life destroying drug seems to be a bit of information that hasn’t entered her consciousness yet.

Is Grassley target Dr. Fernando Mendez-Villamil an overprescriber? I don’t know, of course; but I do know that it’s likely some poor people got at least some of what they needed. Should street drug users buy and sell Seroquel? Definitely not, but if they’re too poor to buy it at retail, don’t have insurance and don’t have access to a psychiatrist, they’re going to do it anyway, particularly given that many are the untreated mentally ill.

The people buying these drugs off the street are not the labeled mentally ill as a rule. Seroquel is being peddled for its qualities as a sleeping pill. We may need to look more closely at just who would purchase street drugs, but these drugs are not being sold for their ‘medicinal’ qualities to people who are looking for a cure to their ills. They are also not being sold to people who need Seroquel. You have doctor’s to do that. If these ‘poor people’ had a diagnosis, believe me, paying for the pills wouldn’t be such a big problem.

But thanks to some bought and paid for legislators, we get no cheap drug reimportation, no strong price controls for drugs given to Medicaid patients, no significant pressure to curb “pay-for-delay” schemes bypassing generic competition; in sum, the poor are largely on their own.

‘Bought and paid for legislators’? By whom? By Astrazeneca, the maker’s of Seroquel? Does she have no idea as to whose bank accounts are feeding these legislators? If she does, she doesn’t go into it, laying the blame entirely on the legislators instead.

Then there is this ‘no strong price controls for drugs given to Medicaid patients’. Is this a slip of her typing finger? Her conclusion would be that ‘the poor are largely on their own’. Not those poor who are on Medicaid, our public insurance policy. This Medicaid is paying for their prescription drugs. The poor don’t pay for this insurance, and the drugs it buys for them, the taxpayers pay for it all. The very same taxpayers who are paying the saleries of those legislators she mentioned earlier.

She would make Dr. Fernando Mendez-Villamil an exception, and perhaps even an exception to be commended. Her assumption is that Dr. Mendez-Villamil is alone in his zealous over use of the prescription drug. He isn’t. The Chicago Tribute, conducting it’s own investigations, has been looking at one Dr. Michael Reinstein who has been overprescribing these drugs to patients in the Chicago area.

Dr. Mendez-Villamil and Dr. Reinstein I feel certain are only the tip of the iceburg. First you need someone in any area who cares intensely enough to launch an investigation into the matter. Dr. Reinstein is being investigated not only because he is quick to prescribe pills, but because some of the people under his care who had been prescribed these pills have died, undoubtably as a result of the drugs they were on.

Dr. Mendez-Villamil and Dr. Reinstein are definitely not the only people in the overprescription of the psychiatric drug business. The British are investigating the overprescription of psychiatric drugs in their nursing homes now. I have commented more than once about ongoing investigations into the overprescribing of psychiatric drugs to foster children and the elderly.

Sometimes two disparate stories, dealing with what’s going on in two different and distant locations, are not so related after all. Sometimes the facts of the matter are not so simple as one might have imagined them to be. Sometimes one needs to take a good long and hard look at all the facts before one jumps to an erronious conclusion. I suggest that Mrs. Ziegler should study the subject of the over prescription of psychiatric drugs more closely before she makes any more preposterous statements on the subject.

Stumping The Mad Science Network

Re: Is psychiatry hard science or is it psuedo-science, junk science?

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More Alternatives To Conventional Psychiatry

A body of evidence has been growing for some time on the harm that is done to people through the use of neuroleptic drugs. Neuroleptic drugs, also called antipsychotic drugs, are the drugs most often used in the treatment of schizophrenia, often used in the treatment of bipolar disorder, and sometimes used in the treatment of depression. Neuroleptic drugs cause changes in brain structure. Neuroleptic drugs shrink the frontal lobes, and swell the basal ganglia. The effects neuroleptic drugs have on the thought process resemble that of a lobotomy. In short, these drugs damage the brain, our organ of thought.

The newer atypical neuroleptic drugs, developed to be less irritating to the taker than the original neuroleptic drugs, have been found to cause metabolic changes in the body. These metabolic changes can be responsible for the development in the taker of a number of serious and potentially fatal health complications from diabetes to heart disease. This newer class of neuroleptic drug has been credited with contributing to the average age at death for people in mental health treatment being 25 years younger than the general population as a recent study has revealed. 25 years less of life on this planet is not the kind of improvement I would look for in my medicine cabinet.

People, from federal penitentiary inmates to one’s next door neighbor, should not be forced to take these damaging drugs against their wishes and will. When a person’s life is cut short, his or her human right to life has been violated; when a person has been given these poisons by force, and against his or her will and wishes, that person’s human right to liberty has been violated. People should be entitled to good health, at least, and harming that health, in opposition to an individual’s expressed wishes, should neither be tolerated nor legally sanctioned. Criminal offenses can be taken care of by the criminal justice system; predicting criminal offenses remains in the realm of science fiction.

Any and every place needs alternatives to the conventional mental health treatments that employ the use of these powerful psychiatric drugs. Soteria type houses, safe houses, crisis respite centers, holistic treatment facilities—the world is not without examples of alternative environments for people in crisis that have been successful, in some cases much more successful than conventional treatment facilities where non-drug methods of treatment are virtually unheard of. These residents and environments should be established everywhere it is possible to do so. We need to make it possible for people to live full, eventful, and productive lives rather than further limit, debilitate, and destroy those lives through paternalistic treatment methods, and the excessive use of harmful chemical agents that goes along with those methods.

The Latest On The Mad Gene Chase

Before anyone gets too excited about the supposed genetic links to schizophrenia and bipolar disorder that have been bandied about by the media of late, a few relevant pieces of information might help to temper that enthusiasm.

Schizophrenia according to the National Institute of Mental Health afflicts 2.4 million adults, or 1.1% of the population of the United States. Bipolar disorder according to the NIMH statistics affects 5.7 million people, or 2.6% of the overall population.

The latest genetic research on the subject seems to be that pertaining to the ABCA13 gene which would be linked to both schizophrenia and bipolar disorder. According to a Times of India article on this research, Gene linked to schizophrenia discovered:

“We found that the gene was involved in 4 per cent of individuals with bipolar and 2 per cent of people with schizophrenia. This is quite significant, since we think that these disorders are caused by hundreds or even thousands of genes,” he [Dr. Allan McRae] said.

Wait a minute! Who does this doctor think he is fooling?

Apparently we’re talking 4% of 2.6% of the population, and 2% of 1.1% of the population. These are incredibly shrinking odds if you ask me. Certainly these fractions of fractions are by no means any smoking gun.

What this research seems to be saying is that 98% of the schizophrenic population and 96% of the bipolar population remain completely unaffected by this particular genome.

I don’t see in this research anything having to do with environmental factors, social factors, self-control, nor resilience and recovery. Just think, maybe other factors play a much more significant role in the development of both schizophrenia and bipolar disorder than the gene these researchers are looking at.

1/2 The Children Given Psychiatric Labels Don’t Need Treatment

Mental health authorities once more find themselves alarmed over the number of children and adolescents stricken with the disease of growing up who are not in treatment. According to a report in Medical News, fully half of the children with a diagnosable mental illness are going untreated. I suspect the figures could be a little higher than that when you consider that many of these diagnosable childhood diseases are like modern art, this is to say that any behavior that offends a member of the grown up world can now be construed a disease. Got an imperfect kid, take him or her to a psychiatrist or a school counselor, and you can pin a disease diagnosis on him or her. Got a perfect kid, send her or him off to an Ivy League school before the matter requires any further scrutiny.

Data from the National Health and Nutrition Examination Survey from 2001 to 2004 indicated that 13% of 8- to 15-year-olds had a recognized mental disorder, but only 51% of them had sought professional help, reported Kathleen Ries Merikangas, PhD, of the National Institute of Mental Health in Bethesda, Md., and colleagues

First, I’m thinking 13% is better than 10%. I know you don’t mean a serious mental disorder, that stays way down there, and as you don’t mean serious mental illness, what’s all the bother about? These kids are way up there with the unemployment and homeless rates in these depressed times. Given double digit unemployment rates, and homelessness rates approaching that figure, irritating kiddies are a very little matter.

They reported the following 12-month prevalence of disorders in the 8- to 15-year-old population:

• Attention deficit-hyperactivity: 8.6% (SE 0.7%)
• Mood disorder: 3.7% (SE 0.6%)
• Conduct disorder: 2.1% (SE 0.3%)
• Anxiety disorder: 0.7% (SE 0.3%)
• Panic disorder: 0.4% (SE 0.1%)
• Generalized anxiety: 0.3% (SE 0.1%)
• Eating disorder: 0.1% (SE 0.1%)

I think the most telling disorder of the bunch is conduct disorder. There was a time when conduct was not a disorder, it was a grade. Students had the choice of being good students or bad students, and being a bad student didn’t mean you had a ‘sick’ student on your hands. It could all be taken care of in special education classes. Kotter had his Sweathogs, for instance.

Merikangas and colleagues also reported the prevalence of mental health services usage within the previous year among those with mental disorders:

• Any disorder: 50.6% (SE 3.4%)
• ADHD: 47.7% (SE 4.4%)
• Conduct disorder: 46.4% (SE 8.0%)
• Mood disorders: 43.8% (SE 6.0%)
• Anxiety disorders: 32.2% (SE 14.3%)

Do you really think that students who cause disorder in the classroom are handled any better by the school psychiatrist than by the school dean? I don’t know. I imagine it depends on what sort of a dean you have. And, with regard to the untreated, if it isn’t broken, why fix it? They should, after all, be adult in a few years time. Most children are cured of the struggles involved in their growing up by becoming adult.

Antipsychotic Drug Is A Misnomer

I have been using the language of the oppressor too often for convenience and communications sake, and now I have to publish a retraction of sorts.

I’m not going to refer to neuroleptic drugs as medicine because there is nothing medicinal about these drugs. Not only are these drugs not medicine, but antipsychotic is not an adjective that describes these pills at all. Not only do these drugs not cure schizophrenia, but these drugs have been credited with impeding the actual process of recovery from any psychosis that a person may have developed.

Neuroleptic is the older term. Neuroleptic comes from the Greek, and means ‘take control of’ and specifically ‘the nervous system’. These drugs then take control away from the person who takes them. When it comes to the newer atypical neuroleptic drugs, this lapse in personal self-control translates into those metabolic changes—resulting in obesity, heart disease, etc.—that have contributed to the average age at death for mental health consumers being 25 years younger than that for the rest of the population.

Let’s look at what these drugs do. Neuroleptic drugs block receptors of the neurotransmitter dopamine. Doing so, these drugs impair the functions of the brain. The functions of the brain that these drugs impair are:

1. Motor function—the drugs make people uncoordinated, and the drugs make their bodies shake.
2. Emotional function—the drugs mute or blunt the emotions, numb the patient, and bring about what is described as a lack of affect.
3. Cognitive function—the drugs make people stupid, disrupting the higher thought processes that separate humankind from beasts.

Although the doctors say they are trying to target the emotions with these drugs, the drugs themselves are not so discriminate.

Much research has accumulated over the past few years to indicate that these drugs change brain structure. Long term use of neuroleptic drugs has been found to shrink the frontal lobes, that area of the brain that makes us human, and to enlarge the basal ganglia, an area of the brain thought to have much to do with psychosis. Animal studies reveal that much of the damage found in autopsies and MRI scans, and often attributed to mental illness, is in all probability a result of these drugs being given to treat the disease.

Mental health consumers and the general public are being deceived when they are not told about these matters. No consent is informed consent if it is consent given without perusal of all the facts. People as a rule are not informed when it comes to the damage done by these neuroleptic drugs. You are not likely to find the truth about these drugs in pharmaceutical company advertising literature, but you can get some idea that things are a little off kilter just by reading the fine print on the so called side effects. The list of things that can wrong with these drugs, even the companies selling them admit, goes on and on.

Studies have found these drugs to be effective as anti-schizophrenic drugs only in the short term. Long term use of these drugs is always detrimental. These drugs have addictive qualities, and to quit cold turkey could lead to serious withdrawal symptoms, including rebound psychosis. The longer an individual has been maintained on neuroleptic drugs, the less promising that individual’s chances become to ever make a complete recovery. Given the facts, there is very little about neuroleptic drugs that can be said to be at all antipsychotic.

More Children On Medicaid Taking Psych Drugs

Poor children, specifically children covered by Medicaid, are more likely to be on antipsychotic drugs than children in the general population according to an article in today’s New York Times. This disparity has been revealed in recently federal financed research studies.

Those findings, by a team from Rutgers and Columbia, are almost certain to add fuel to a long-running debate. Do too many children from poor families receive powerful psychiatric drugs not because they actually need them — but because it is deemed the most efficient and cost-effective way to control problems that may be handled much differently for middle-class children?

4% of the children on Medicaid are being given antipsychotic drugs while the rate is only 1% for children and adolescents covered by private insurers. While conditions associated with poverty may double the amount of children with serious disturbances, this ratio is way too high.

As a result, studies have found that children in low-income families may have a higher rate of mental health problems — perhaps two to one — compared with children in better-off families. But that still does not explain the four-to-one disparity in prescribing antipsychotics.

Children on Medicaid are also more likely to be prescribed antipsychotic drugs for less serious conditions than those for which the drugs were designed as a result of “off label” marketing.

This development must also add fuel to the health care debate raging in Congress. When you have more kids on a public insurance plan, is this going to mean even more kids on antipsychotic drugs? This public health care package may lessen the effect of having two health care systems, one for the rich and another for the poor or, on the other hand, it may increase this disparity. No crystal ball is going to resolve this matter sufficiently. Only when people care enough to make a difference is that difference likely to be made.