Childhood Bipolar Disorder: A Disturbing Trend

Perhaps some of my readers have heard about the recent 40 fold increase in childhood bipolar disorder that our nation has experienced. I’m not sure you are aware how this translates statistically. I just came across an alarming figure in a CNN story, Growing up bipolar: ‘Nobody was on my side’, that maybe you should have a look at.

A 2007 study in the Archives of General Psychiatry found that the number of office visits resulting in a diagnosis of bipolar disorder for those under 19 was 1,003 per 100,000 people in 2002-03 in the United States. This was a dramatic uptick from 25 per 100,000 people in 1994-95.

Now tell me, what changed so much in less than 10 years that bipolar disorder must skyrocket among the juvenile set. From 25 in 100,000 to 1,003 in 100,000 is quite some leap. I feel that the public should be reacting with outrage to this sort of thing.

What is the solution to this dilemma?

That partly [is] why some psychiatrists have proposed a new diagnosis for such kids for the forthcoming edition of the Diagnostic and Statistical Manual of Mental Disorders, the bible of psychiatry. It’s called Temper Dysregulation Disorder with Dysphoria, and it would include young children who have recurrent temper outbursts to common stressors.

I have some problems, to say the least, with this approach. First, you begin by labeling kids that would have been labeled with attention deficit hyperactivity disorder bipolar disorder sufferers. Oops. Childhood bipolar disorder booms. Second, you come up with a third disorder, TDD. This is not going to bring the childhood mental illness rate down one iota. If anything it is going to further exasperate any present mental health crisis we happen to be in. What next? Developing a psychiatric drug and treatment for TDD, of course. Now you have 3 disorders where before you had 2. Quite some improvement, wouldn’t you say.

The news story itself shares the experience of a couple of parents, a psychiatrist who is pills, pills, pills, and a psychiatrist who believes dispensing drugs should be combined with talk therapy.

[Dr. Rakeesh] Jain agreed that some patients who do well can go for stretches without medication, but he has never been able to completely remove a bipolar patient from drugs and say, “you’re cured.” Bipolar disorder should be viewed as a chronic illness like hypertension or diabetes, which require lifelong management, he said.

Dr. Jain is the psychiatrist relying most heavily on psychiatric drugs.

I have met a number of ex-patients who have gotten over the bipolar disorder label, who are off psychiatric drugs completely, and who are doing quite well. Perhaps Dr. Jain would benefit from interacting with such people.

What about 25 in 100,000 versus 1,003 in 100,000 do you think he doesn’t understand!?

Faking Out The Fakers: A Litmus Test For ADHD

Let’s not pull any punches here; attention deficit hyperactivity disorder has meaning only so far as people give it meaning. It’s not a real “disease”. It’s a bogus “disease”. Belief in “mental illness” gives the “disorder” life and keeps it “breathing”. ADHD as a sect of the “mental illness” religion would collapse under any serious sustained assault from skepticism and responsible parenting.

Well, now a study has been conducted on people who fake having this fake “disease”. Bloomsburg Businessweek covers the subject with an article in their executive health section, Some Fake ADHD to Get Meds, Special Treatment.

“People who want to fake ADHD could be able to do a good job of faking on a number of standard clinical instruments that are used to diagnose ADHD,” said David Berry, senior author of the report appearing in the current issue of Psychological Assessment. Obviously, health-care professionals need to be concerned, he said, adding that “our evidence suggests [fakers] are pretty good at it if they want to be.”

Why fake this fake disease? Why, of course, drug dealers need drugs while bad students need performance enhancers and other shortcuts to success.

Seventy-three University of Kentucky students were split into two groups, one of which was instructed to respond honestly to questions on standard assessments of ADHD. The others were given five minutes to review easily accessible information from the Internet on the condition and told to do their best to fake it. Their incentive: $45 if they succeeded (in reality, all participants were given $45 at the end of the study).

A third control group consisted of people labeled ADHD sufferers.

“Almost nobody [in the fakers’ group] failed the test,” said Berry.

“Drugs is the obvious [motivation], but there are others,” he continued. “Most universities provide people who have a diagnosis of ADHD with a variety of things that vary from one institution to another — extra time on tests, copies of teachers’ notes that they’re lecturing from. They may get special accommodations in terms of where they’re staying at the university, a single room versus a double room.”

Having a diagnosis of ADHD has its perks then. Should we call these kids disabled or previleged?

A review of the data from other studies had suggested to researchers that 8% – 35% of the current ADHD cases were phony.

Some of the “side effects” of the stimulants used in the treatment of childhood are touched upon briefly in the article. These “side effects” include high blood pressure, irregular heart beat, heightened anxiety, and chemical dependence.

Berry advocates using additional anti-fraud screening — also called “malingering” tests — to sort out the ADHD frauds from the legitimate cases. (In medical terms, “malingering” means fabricating or exaggerating symptoms of physical or mental disorders for a variety of “secondary gains” motives, such as drugs, money, or even sympathy and attention.)

I would suggest instead that we remove ADHD from the “mental disorder” category altogether, and consider it a misnomer for misbegotten traits of childhood and adolescense. Childhood and adolescense are not disorders. You’re malingerers test, in this instance, would only be good for separating the con artists from the con artist victims while the main con artist grouping, those people who have convinced people of the reality of ADHD, gets off scot free.

What they don’t tell you is that attaching this label to kids can lead to other and more serious “mental illness” labels being attached to them. It’s not because we’ve got an infectious “disease” label here. It’s because the drugs used to treat the disorder trigger effects that resemble other “mental illness” labels.

Nope, there are better ways to treat children and adolescents. Perhaps the time has come when we should return to some of those better ways.

Rosalynn Carter’s Rose Colored Mental Health Care Glasses

ABC has a very brief interview with ex-president Jimmy Carter’s wife, Rosalynn Carter, Books: Rosalynn Carter discusses her new book, ‘Within Our Reach’. I understand that Rosalynn has arrived a certain point in her life, and I don’t want to endanger her health, but all the same, I think she misses a big part of what the issue is here. The problem is that given the large influx of people receiving mental health care treatment, ending any mental health crisis is getting further and further away from our grasp than it ever has been before.

Q: The scope of the problem you describe is eye-opening: Each year, almost 60 million adults in the United States suffer from a diagnosable mental disorder. How much has changed in the years you’ve been involved in the field?

A: What’s exciting is the science and what we know about the brain and new medications and treatment. When I started in the field, people were institutionalized, and there was a belief that their productive days were gone. That’s totally false. Just in the last few years, we’ve learned a lot about how people can recover from mental illness and lead productive lives.

Nonsense. There is a growing epidemic in psychiatric disability, yes, but what we are learning is merely how little we knew in the first place. Are we recovering people from “mental illness” so that they can lead productive lives? Define recovery. Redefine it to make it mean anything you want it to, and maybe so. Use Webster or Oxford or Random House dictionaries, and maybe not.

Q: You point out in your book that many mental illnesses have early onset and are developmental, and that 50 percent of all major mental illnesses start in children before the age of 14, and 75 percent by the age of 24.

A: For years and years, the mental-health profession did not think that mental illness could start in children. Now the whole mental-health community is moving toward treatment for recovery and away from just controlling mental illness. Early diagnosis is so important because the earlier a mental illness can be detected, diagnosed and treatment can begin, the better off that person can be for the rest of his or her life.

Hello!? Labeling children “seriously mental ill” was virtually nonexistence until just a few years ago. This labeling can start with something as small as conduct disorder, obedient defiant disorder, or bugaboo of bugaboos attention deficit hyperactivity disorder. ADHD just didn’t exist 60 years ago, and now it’s cropping up everywhere. Sometimes these relatively minor labels then lead to much more serious “mental illness” labels being applied. Many of these children so labeled end up being under employed and receiving disability payments for the rest of their lives.

Q: How do you feel about psychiatric drugs for children and youth?

A: We haven’t been giving these drugs for enough years to really see what happens. But I have seen so many children who have been stabilized and function so much better and lead good lives once they are on the drugs. What must be done, what we do know, is that the children have to be watched very carefully. We also know that one in five children develops mental illness that can damage their functioning, but only about 20 percent of them get professional help.

The drugs have been around for 50 plus years. We have seen what they do to adults. They do the same things to children only worse. Stimulants, such as those prescribed for ADHD, and antidepressants can trigger manic reactions, and increase the number of people, children, too, labeled schizophrenia or bipolar disorder sufferers. Neuroleptic drugs given to people labeled schizophrenic and bipolar cause a movement disorder, a neurological condition, Tardive Dyskinesia. This neurological condition points to structural brain changes and damage as the result of this drug treatment. The newer neuroleptic drugs, developed to have fewer side effects than the older ones, not only produce TD, but also cause a metabolic syndrome known to appreciably shorten the lifespan of people taking these drugs.

Part of the problem arises when you try to catch people before they develop a “serious mental illness”. Proposals have arisen for a Psychosis Risk Syndrome to be listed in the upcoming DSM V. Diagnosed pre-schizophrenia, I would imagine, is much more likely to lead to schizophrenia than is undiagnosed pre-schizophrenia. We’ve all heard about negative self-fulfilling prophesies, and we’ve got more than our share of those in the field of pediatric psychiatry.

If 50% of the labeled “mentally ill” are so labeled in childhood, and 75% of the labeled “mentally ill” are so labeled before the age of 24, how many of these people fully recover their wits and go onto lead rich and productive lives? This is the unanswered question here, and I would imagine that that % is not a large one at all. First, you have to unlabel or undiagnose people, and I don’t think there is a whole lot of that going on at the present point in time.

One of the major factors in whether a patient will fully recover from a serious mental condition or not has to do with whether that patient has been prescribed psychiatric drugs. Patients maintained on psychiatric drugs are much less likely to fully recover than those who are not maintained on such drugs. Masking a problem with the effects of a drug is not the same thing, after all, as dealing with the problem and resolving it. There are other factors involved, surely, systematic factors, but none of them is so glaringly obvious as the chemical disability created by our public mental health system’s over reliance on chemical substances to suppress and subdue personal life crises.

Great Potential Seen In Scanning Brains For “Mental Illness”

Some scientists are exploring the uses of brain scans in the detection and treatment of people labeled “mentally ill”. Media-Newswire has an article on the subject, Brain imaging gives new insight into mental disorders.

A new kind of psychiatry built on objective measures derived from functional magnetic resonance imaging ( or fMRI ) of the brain performed while patients play economic games could provide new insight into the diagnosis and, eventually, treatment of mental disorders, said researchers from Baylor College of Medicine in a review in the current issue of the journal Neuron.

Brain scans are used to explore the level of blood flow in different areas of the brain; increased blood flow indicates increased cognitive activity.

Not only will these brain scans be used in the labeling of “mental disorders”, researchers are also looking into the possibility of diagnosing and studying “normality” disorder through the use of these same machines.

These new tools will not only help produce new brain “signatures” associated with disorders such as autism, schizophrenia and borderline personality, they will also help identify the nature of normal variation in human decision making and the brain, said Dr. P. Read Montague, professor of neuroscience and director of the Computational Psychiatry Unit at BCM, and Dr. Kenneth T. Kishida, a postdoctoral fellow in the area.

They’ve found borderline personality disorder, they think.

In a crucial prior study, King-Casas and others at BCM identified a characteristic fMRI “signal” that distinguished borderline personality disorder – a disorder that is extremely hard to diagnose – from psychologically healthy controls.

The objective of these brain imaging studies seems to be directed at trying to determine the genes behind the “illness”, based on a more surefire method of determining the “illness”. One of the problems with this objective is that we haven’t yet determined that genes lie behind the “illness”.

Oh, well. Details…

One could easily imagine drug companies pouring money into such research. Alright, researchers are selling brain scan devices, yes, but once the brain is scanned, and the genes are identified, drug companies have got the drugs to maintain “the disorder”. If “the disorder” is genetic in origin, there is little a patient can do, of course, except pay drug companies for the chemical compounds to subdue it. So the theory runs anyway.

I would reckon “normality” must be equated with conformity, and so we could also be well on the way to “curing” an intransigent Western world of it’s treatment resistant democratic tendencies through the use of this and other such deviant detection devices.

Trashing The Panacea of Contemporary Psychiatry

I’ve noticed a number of articles of late delving into the possibility of utilizing different drugs than those that are currently approved by the FDA for dealing with “psychiatric disorders”. One article proposes an anti-abortion drug for depression, another proposes psychedelic drugs for “psychiatric disorders” in general, and yet another suggests the rave drug, ketamine, be used in treating bipolar disorder.

I have always had a problem with the wonder drug search formula for solving social ills. All the talk in the world about “mental illness” being like a physical illness is not going to make “mental illness” a physical illness. We have a problem with our semantic construction, for starters, in that the brain, a physical organ, is not the mind, the actions performed by that organ. The “sick” thinking of the organ of thought then doesn’t necessarily indicate a sick organ of thought; if it did, we would have a physical disorder.

Drugs taken for “psychiatric disorders” make people physically sick. The older psychiatric drugs used in the treatment of “mental illness” cause a neurological disorder. The newer psychiatric drugs, not only cause this neurological disorder, but these drugs also produce a metabolic syndrome associated with a large number of potentially deadly life threatening ill health conditions. These health conditions are thought to be largely responsible for the lifespan of people in mental health treatment being 10-25 years shorter than that of the rest of the population.

If, as statistics show, the search for a drug patients will take, has resulted in drugs the patient will take that kill the patient, maybe its time to take a different approach to the matter. I really don’t think that any of these other drugs being proposed are likely to improve the physical health of the patient, and I think that is one thing we need to be looking at seriously.

When exercise has been shown to have tremendous merits as a treatment for depression, in one study I have heard about beating out both drugs with exercise and drugs alone, I think it would be a good idea to put more emphasis on physical health, and then we could see whether or not a better mental health might develop there from.

Repairs Needed For A Broken Mental Health System

Psychiatric hospitalization disrupts lives. After hospitalization occurs, we are not only talking about the need for recovery of rationality and emotional stability, we are also talking about the need for recovery of economic status, and the recovery of, and possibly even reinvention of, family, friends and lifestyle.

The creation of an unbridgeable gulf between before hospitalization and after hospitalization is a professional cop out.

I think an over reliance on psychiatric drugs has a great deal to do with why this is so, but I don’t think that this over reliance on psychiatric drugs is the only culprit when it comes to low recovery rates. I think a lot of it is built into the mental health system, a system that encourages people not to work and, in fact, rewards them for not doing so.

Among these other culprits are:

1. Cynicism, cowardice, and pessimism among mental health professionals.

2. Paternalism and the devaluation of people into “adult children” (i.e. people with “chronic” uncontainable “mental illnesses”) deemed unworthy or incapable of making their own decisions and managing their own affairs.

3. The results of this paternalism: a poverty that forces people to live on federal benefits within the mental health ghetto. The lack of any upward mobility, for people who have had “issues”, outside of the mental health field.

4. The business advancement end of mental health treatment: facilities would prefer expansion over closure. More patients foster greater job security and more status for employees, a more pressing need that also encourages more bucks to be spent in the field. Fewer patients are bad for business. (Doctors and mental health facility staff, in other words, get rewarded for their failures rather than for their successes.)

5. Mental health consumerism: there is no mechanism for cessation of consumerism except personal decision, a decision that need not ever be arrived at. Mental health recovery (i.e. the cessation of consumerism) is a tag word. Recovery is not a consumed “service”, or a consumer “product”. Treatment junkies just aren’t recognized for being what they are–addicts. The dependency habit can be a very difficult habit for some people to overcome and break.

6. People are prejudiced. Employers won’t hire people labeled “mentally ill” on account of their sketchy work histories. NIMBYism [Not-In-My-Back-Yard-ism] prevents them from getting decent housing, and from building workable alternatives to what the public mental health system provides. Legislation enacted to deal with these matters is often, if not inadequate, unevenly enforced or unenforced.

7. The mental health system has not yet seen its role in promoting community integration, recovering people from mental health consumerism, and remedying a situation it has created (i.e. the disruption of lives caused by hospitalization.) Until it does so, it is only managing the convalescence of the artificial invalids it has created. It is also avoiding responsibility for its own part in these matters.

We’ve got a system that is going from bad to worse. Warehousing people labeled “mentally ill” in a community setting is little better than warehousing people in state mental hospitals. Until the overall treatment paradigm changes dramatically as practiced by community mental health facilities across the country, this situation is bound to grow even worse.

Let’s return to the 7 criticisms offered above, and let’s take a look at the improvements that are implicit within them.

1. Experimentation and guarded optimism from professionals. Exceptions should be permitted to the professional standard of care. Different results are bound to result from doing things differently, and these are matters that take a long time to register in meta-analysis.

2. Empowerment of mental patients and mental health consumers is bound to result in improved performance. Responsibility breeds responsibility. Give them something to do with their hands, and pay them for it! Having them pay you to pretend to work…Hey, it’s not really rehabilitation either, is it?

3. I never had much faith in the “self-esteem” theory of mental health. It is, in fact, one of those myths exposed in research that we haven’t yet disposed of entirely. I think other esteem has a lot more to do with it. Finding ways to advance human interests outside of those in the mental health system I feel can help improve our other esteem. Relationships matter much more in these matters than do smoke and mirrors.

4. Facilities and professionals need to be judged more on their outcomes and recovery rates than on their acceptance of the problem as a permanent fixture. It’s a growing problem, too, and what it grows upon is this “acceptance”. Why pay people to acknowledge a failure when maybe it’s a failure they can do something about? Unworking and unworkable treatment programs don’t need to be paid for with taxpayer monies.

5. Incorporate cessation of mental health services into mental health services. Cease to use the terms “chronic” and “long term”. Don’t adopt treatment plans without beginnings, middles and, most importantly, ends. Treatment plans should have timelines and deadlines, extensions are permitted, but they should never be permanent or indefinite.

6. Enforce and extend legislation directed against discrimination in education, employment and housing practices. Enact more legislation where appropriate and possible. Direct public relations campaigns at showing that people can leave mental health treatment, perform responsibly, and advance in the community.

7. Mental health professionals and paraprofessionals need to work with employers and community members to get people engaged in their communities. Insulating people from community ultimately does more harm than it does good. The community needs to be encouraged to include people who have experienced the mental health system, too.

I’ve heard it said that nobody ever succeeded alone; the same can be said for failure, nobody ever failed alone. Failures receive a great deal of help at becoming failures. We can change the system, and by doing so, we can raise the success rates and lower the failure rates. I have always thought so called “mental illness” ultimately was about failure. Get rid of the failure, and you’ve also gotten rid of the “illness”. The human condition should be different from the wild boar condition. The ethics of the roulette wheel doesn’t need to rule our species. When more people succeed in the world, it is my belief that there will be fewer people labeled “mentally ill” among them.

The Hollywood Lowdown: Of Pictures and Prima Donnas

I recently watched the movie Shrink starring Kevin Spacey, and I determined the movie was all Hollywood, and probably very little Hollywood shrink. Where, after all, can you find a shrink who blows weed all the time, but doesn’t fill out prescriptions for psychiatric drugs? The news reports all say psychoanalyst is dying, and drug treatment booming. Are things a little slow to catch up on these matters over there in the Hollywood Hills? You’d think all sorts of actor types, and would be actor types, would be showing up at his doorsteps looking for a mental anguish pain killer to be put on. He wrote a book on achieving happiness, but he doesn’t seem to be very happy himself. Whatever happened to Paxil, Celestra, etc? Don’t those shrink guys dish those drugs out right, left, and center? This shrink writing about the key to happiness he hasn’t found himself, doesn’t deal in antidepressants? I find that highly unlikely. On the other hand, he might realize sugar pills do as well, of course, and that long term antidepressant use has negative consequences. If he had made such a leap, well, he’d have been an exception among shrinks. The thing is the guy felt like a failure because he was unhappy, and he was counseling people on their lack of happiness.

This brings me to the real subject of this post, Lindsey Lohan. Lindsey Lohan left jail early for psychiatric rehab. Whoopee! My counterbalancing thought is that that might have been a big mistake because it could have meant more time than jail time. That thought was quickly vanquished by the fact that the present buzz has the rehab center she’s being held in claiming Lindsey was misdiagnosed. As ALLVOICES Entertainment news puts it, questioningly, Lindsay Lohan’s Problems Caused By Medical Misdiagnosis?

Sources say the doctors at the UCLA rehab facility who evaluated actress Lindsay Lohan have concluded she does not suffer from the drug or psychiatric problems that were previously diagnosed.

I’m still waiting for the diagnosis she has if all her other diagnoses are incorrect. She must have something. You never hear of shrinks being locked up for wrongful “diagnosis”.

They believe that Lindsay was misdiagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and prescribed Adderall, an amphetamine, to treat it.

A prominent addiction specialist, Dr. Joe Haraszti told TMZ that people who take the drug when they don’t need it can experience similar effects as those who use cocaine or methamphetamine (a.k.a. crystal meth).

The doctors at the UCLA rehab facility don’t think that the “Mean Girls” star is an addict. They also disagree with Morningside Recovery, the rehab facility that determined Lindsay was bipolar. They say she’s not.

Alright. ADHD and Bipolar disorder down, what else you got?

In a latest update, Lindsay’s attorney Shawn Chapman Holley says, “I have never seen any psych report concerning Ms. Lohan which references a ‘bi-polar’ diagnosis or an addiction to ‘methamphetamine.’ I think this is a total fabrication.”

I wish I had her lawyer.

The article concludes, mock ironically, by asking if Lindsey is not just a victim. Let me tell you, she’s not a victim. Is she a victim of misdiagnosis and misprescription? Maybe. Just like thousands of other people, only they don’t have the money and influence to buy their way out of these things. It looks like Lindsey’s going to get a relatively clean bill of mental health unlike so many other people these days. If it’s not this, it’s that, unless we’ve seen you on the silver screen apparently.

The good news? If Lindsey’s adderall was making her act strange, maybe there are a lot of other people out there who aren’t ADHD or bipolar either, maybe there are other people who are acting strange because of the drugs they’ve been placed on. All we have to do now is to convince the doctors.

Look out! Once released, who knows what Lindsey Lohan will have to do next to maintain her notoriety?

Once Again, The Wild Mad Gene Evades Capture

A fascinating article just appeared in The New Statesman about what’s wrong in the search for the mad gene, now mad genes. This piece written by Brit Oliver James starts out by exploring biological psychiatry’s relationship to Social Darwinism. It bears the heading, The Genes Don’t Fit.

There has long been an assumption on the right that genes explain why the rich are rich and sane, and the poor more likely to be bad, mad and impoverished. Yet the key question for molecular geneticists today is: why are siblings so different from each other, despite having had the same biological parents? Many incline to the cosy answer that “it’s a bit of both” – by which they mean a bit of nature and a bit of nurture. Yet the evidence I presented eight years ago in my book They F*** You Up already showed that, even if you accepted the validity of studies of identical twins (which I did not), on which nearly all claims about the role of genes were based, they still did not support this idea of a bit of both. In fact, for most common traits, such as sociability, memory or creativity, genetic inheritance accounted for only close to a quarter.

I’ve read biological psychiatry texts claiming that the development of a serious mental illness was approaching 75% determined by genetic makeup. When you consider that this determination has to be almost entirely a matter of complete speculation and bias, coupled with the above information, you just have to wince, “That can’t be right.”

Other convenient theories would be likely to hit the dust, too, if researchers were really interested in scientific validity rather than in advancing more selfish professional and corporate interests.

Another fallback is to claim that our genes create vulnerabilities that environments may or may not cause to be expressed. But this position was undermined in June 2009. Studies by Avshalom Caspi in New Zealand had shown that people with a particular gene variant were more likely to become depressed if they were maltreated as children; the variant created a vulnerability. This has been all but disproved. Published in the Journal of the American Medical Association, a meta-analysis by a team of ten scientists led by Neil Risch, of 14,250 people in total whose DNA had been mapped across 14 separate studies, showed that those with the variant were not at greater risk of depression than those without it. Nor were they more likely to be depressed in cases where childhood maltreatment combined with the variant.

The case for the depressed gene can get even weaker when you widen the scope of your studies to explore the relationship of disparities in income and power to the development of depression.

There are convincing reasons, as I wrote in my book The Selfish Capitalist, for supposing that free-market (what I call selfish capitalist) economics are a leading cause of high levels of mental illness. Using data from a very reliable 2004 World Health Organisation study (the World Mental Health Consortium), I found that the prevalence of mental illness is twice as great in New Zealand and the US as in six relatively unselfish, capitalist, mainland western European nations (Belgium, France, Germany, Italy, the Netherlands and Spain). If you include other studies for Australia, Canada and the UK, the average level of mental illness for all the English-speaking, selfish capitalist nations is 23 per cent of the general population, against 11.5 per cent for continental European countries. This cannot have anything to do with genes.

It is interesting to note, when considering the above statistics, that New Zealand and the USA are the only countries in the world in which Direct to Consumer Advertizing for pharmaceutical products is legal. You can’t, after all, sell psychiatric drugs to a consumer without having first sold “mental illness” to the same consumer.

At the close of his article Oliver James discloses 3 very good “fundamental considerations”, 2 of them supported by science, he would have the Labour Party of Great Britian incorporate into its policies. These “fundamental considerations” could also apply to the USA or any other country wishing to improve, rather than profit from, the mental health of its populace. At the present time he doesn’t think our politicians are capable of understanding the science behind these studies, but 20 to 50 years from now, he seems to feel such considerations are going to prove unavoidable.

Bipolar Disorder Risk Syndrome

Perhaps you took notice of the projection of psychosis risk syndrome for the upcoming DSM-V. Well, bipolar disorder, of course, has its own and comparitive risk syndrome. An article just made its way into Bloomsburg Businessweek on the subject, Many Depressed People Have Mild, Brief Episodes of Mania.

Nearly 40 percent of Americans with major depression also have brief but recurring episodes of manic behavior, a new study suggests.

This matter of looking for pre-bipolar disorder is a little tricky, and perhaps perverted, wouldn’t you say?

Researchers at the U.S. National Institute of Mental Health (NIMH) reported that these patients have what’s called “subthreshold hypomania” — meaning a milder form of mania that lasts fewer than four days, and is therefore below the threshold for bipolar disorder.

Translation: energizing happiness is a “mental disorder”.

Merikangas and her colleagues analyzed data from a survey of more than 5,000 U.S. households. They found that people with subthreshold hypomania have higher rates of anxiety and substance abuse and more depressive episodes than depressed people who don’t exhibit manic behavior. What’s more, they were just as likely to have a family history of mania as people with bipolar disorder, which suggests that they may be at a higher risk of developing full-blown bipolar disorder down the road.

One point I wanted to make that you may not have caught is, uh, we’re making a big to-do out of may.

What you may not have heard is that SSRI antidepressants, the drugs predominately used in the treatment of major depression, trigger mania in a certain percentage of the cases given these drugs. Usually when this happens the person who was labeled depressive receives a bipolar label. This means, of course, more severe diagnosis, less optimistic prognosis, and multiple psychiatric drugs.

A better course of action, rather than crying misdiagnosis, and proceeding with your rediagnosis, might be detoxification. Remove the anti-depressant, and see if the mania resolved itself. Exercise, counseling, and other non-drug measures might do much to dispell the dark mood of the original depression. It must be remembered that once, before the introduction of anti-depressant drugs, clinical depression was not the lifelong illness that it is often seen as being today. I think it much more probable that this situation was due to a change in the nature of the treatment rather than in a change in the nature of the “disease”.

Of course, it must be remembered that we’re dealing with a prediagnosis here. There, I said it, and now let me add, treating is not preventing. In fact, sometimes treatment can exasperate the problem.

Although the article recommends seeking professional psychiatric help for this type of “latent mental illness”, I would seriously advise against it unless, of course, you want your Monday morning blahs to blossom into full-blown bipolar disorder.

The Selling Of “Mental Illness”

The stigma theory of mental health treatment has me a little worried. How does this theory work? The stigma theory holds that there are more people in need of mental health treatment than there are people who are receiving mental health treatment. All we have to do is change the way people look at people who have crack ups, and more of these untreated unidentified crazies will come forward to receive their mental health treatment, too.

The problem with this outlook is that there are more people in mental health treatment than ever before. This is particularly true in the United States. When people leave mental health treatment, they could be said to have recovered from a mental illness. When people don’t leave treatment, they are said to be chronic or long term cases. Chronic or long term nut jobs survive by taking disability checks and medical care from the federal government. Joe Taxpayer pays for the disability benefits and the public insurance policies these chronic or long term cases receive just as surely as he pays the salaries of his state and national representatives.

When people in mental health treatment are not recovering their mental health, the mental health system is not working as it should work. The mental health system could therefore be said to be broken. Well, according to a report of a meta-analysis I read about recently, the prospects for anybodies recovery, as regards serious mental illness, in the mental health system are not good. Okay, given this fact, why should we get more people into this system, and expand this systemic failure even farther? When recovery is a matter of removing bodies from this mental health system, working to add more bodies to this system is not making doing so any easier.

Psychiatrists and mental health workers absolutely don’t want to concede that their actions have anything to do with this state of affairs. It’s not a broken system, its broken people with broken brains, irreparably broken. This conveniently lets the repairman off the hook. The repairman is no longer a repairman, no; he’s the keeper of a junkyard, or a landfill. We’ve got this big trash space, if you have any human garbage you want to get rid of, just send it to us. What is a broken man or woman but human refuse? Taking care of human garbage, that’s our business.

The anti-stigma campaign is about making this situation acceptable. It’s about selling and popularizing the notion of people being labeled mentally ill, chronically mentally ill. It’s about hiring bums as psychiatrists and mental health workers, and praising them for putting up with the pathetic situation. When people don’t get out of treatment, when Samhsa has redefined recovery as non-recovery, when more and more people are seeking treatment, etc., business is booming and, therefore, all’s right with the world.

Excuse me, let’s slow down a little bit. The mental health of the nation is improving when the business of treating the mentally ill is not booming so much. When the problem is less big rather than even bigger the situation could be said to have gotten better. What do you think? If it were profitable to get people out of mental health treatment, do you think we’d see more people had recovered from a serious mental illness in a relatively short period of time? I think so. It’s a business, and what we are paying for is more so called “mental illness”, and not more mental health. There are solutions, but not when people are encouraged to tow the line, not when it’s a bad line in the first place.