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Do Big Pharma Kickbacks Influence The Practice of Medicine? Do Hogs Grunt?

An article has appeared in PR Newswire about a Carnegie Mellon University research study dealing with drug company kickbacks to doctors. The heading speaks to the rationale behind the corruption of many dirty doctors, ‘Because I’m Worth It’ – CMU Research Sheds Light On How Doctors Rationalize Accepting Industry Gifts.

Despite heightened awareness about the undue influence that gifts from pharmaceutical companies can have on doctors’ prescribing practices, and despite expanding institutional conflict-of-interest policies and state laws targeted at preventing such practices, companies continue to reward doctors for prescribing their drugs with gifts ranging from pens and paper, to free dinners and trips. A new study by two researchers at Carnegie Mellon University, published in the Journal of the American Medical Association, helps to explain how doctors rationalize acceptance of such gifts, which author George Loewenstein, the Herbert A. Simon Professor of Economics and Psychology, describes as “barely described bribes.” The study found that physicians rationalize acceptance of these gifts as a form of reward for the sacrifices they made obtaining their education.

If you’re thinking about the relationship between Mexican cops, government bureaucrats and drug cartel racketeers, you’ve got a pretty clear picture of what’s going on here.

Somewhere along the line the idea of caring foremost about patient health has taken a nosedive where physician vanity, prestige and profits are concerned.

Reminding physicians first of their medical training burdens more than doubled their willingness to accept gifts — from 21.7 percent to 47.5 percent — and suggesting the potential rationalization further increased their willingness to accept the gifts — to 60.3 percent. The impact of the suggested rationalization was surprising because, when asked whether their hardships justified taking gifts, most respondents said it did not. Sunita Sah, the study’s lead author and a physician herself who is completing her Ph.D. at Carnegie Mellon’s Tepper School of Business, commented that “this finding suggests that even justifications that people don’t accept at a conscious level can nonetheless help them to rationalize behavior that they otherwise might find unacceptable.”

The authors of this study conclude that pharmaceutical company physician bribes should be outlawed.

Both authors agree that the implications of the study are straightforward. “Given how easy it is for doctors to rationalize accepting gifts, which, from other research, we know influences their prescribing behavior, the inescapable conclusion is that gifts should simply be prohibited,” said Loewenstein, who has done extensive research and writing on the role of human psychology in exacerbating conflicts of interest.

On a related note, South Carolina researchers have conducted a study that shows doctors who respond to such bribes are less likely to identify some of the harmful effects of the drugs they are using. As reported in Business Week, an article entitled Possible Conflict of Interest in Industry Funded Basic Research states the case very succinctly.

Researchers without pharmaceutical industry support are more likely than those with support to identify detrimental in vitro effects of erythropoietin-stimulating agents (ESAs), including potentially harmful effects on cancer patients, according to a study in the Sept. 13 issue of the Archives of Internal Medicine.

The ongoing, more or less, intimate relationship of the American Psychiatric Association to the pharmaceutical industry, and the continuing conflicts of interest involved, not to mention the damaging effects and the therapeutic ineffectiveness of some of the most commonly used prescription drugs they dispense, indicate why this area of research can be so very important outside of the narrow confines of the strictly physiological branches of medical science.

This sort of ‘conflict of interest’ research has a potential for being very beneficial. Just think, should any effective legislation come of it, given a pie chart or a graph, the results of that legislation could be tallied up in terms of saved lives.

In Scorn Of Chemical “Enhancements”

Drugs have never had a better rap in this country than they have today. If some drugs are illegal, what bother, there are prescription drugs, too, and you can always get some of those if you think yourself “needy”. A very Brave New World type of idea is that of using drugs as “performance enhancers”. On the big think website, it is the month of going mental (I have known of people who would object to that description), and for this “going mental” month, we get a blog post bearing the heading ADHD and Stimulants: Brain Boost or Drug Abuse?

I think, uh, right. You go up into the stratosphere, and you come down with a kaboom. Ever wonder why they call it crashing? Some people, let it be pointed out, aren’t even able to limp away.

The narrative of personal improvement is as American as baseball—almost as American as a fondness for illegal and prescription drugs. From steroids and human growth hormones on the baseball diamond to amphetamines in college libraries and quadrangles, performance enhancing drugs combine a desire for productivity and success with drug abuse in a way that is uniquely American. And the statistics confirm their growing demand: the journal Addiction reports that on certain college campuses, especially competitive Northeastern colleges, up to 25 percent of students admitted to having misused ADHD medication in the past year. Yet despite their prevalence, these drugs, and the disorder they treat, are highly misunderstood.

Due to the fact that the percentage of people taking antidepressants is approaching 10% in the USA, and that the USA is a world leader in the taking of such substances, with the entire world following suit, at its varying paces, as new markets open up for drug companies to exploit, I think it may help to look into this Brave New World scenario a little further.

In Aldous Huxley’s dystopian novel Brave New World, Soma is a popular dream-inducing, hallucinogenic drug. It provides an easy escape from the hassles of daily life and is employed by the government as a method of control through pleasure. It is ubiquitous and ordinary among the culture of the novel and everyone is shown to use it at some point, in various situations: sex, relaxation, concentration, confidence. It is seemingly a single-chemical combination of many of today’s drugs’ effects, giving its users the full hedonistic spectrum depending on dosage.

~from Soma – Wikipedia

As I said, very Brave New World. Consider the following, and if that doesn’t sound like an antidepressant (or maybe cannabis) to you, maybe you have found some other kind of fascinating diversion to keep yourself permanently preoccupied.

“I don’t understand anything,” she said with decision, determined to preserve her incomprehension intact. “Nothing. Least of all,” she continued in another tone “why you don’t take soma when you have these dreadful ideas of yours. You’d forget all about them. And instead of feeling miserable, you’d be jolly. So jolly.”

~from Soma In Aldous Huxley’s Brave New World

This big mind post even drags in a psychiatrist to make the highly dubious argument (just think about it) that the stimulants kids take for ADHD affect those kids differently than they would affect any kid who hadn’t been slapped with an ADHD tag. How so? Why, of course, through the magic of shrink-speak. Dr. Simon, in other words, says ‘take your meds’, and therefore it must be true, otherwise, of course, Dr. Simon wouldn’t have demanded you do so. You only get a turn to play drug company exe Simon for the doctor when it’s a game, and it isn’t a game. No, it’s the very serious business of receiving psychiatric “help”. The scary aspect of all this is that some people believe that hokum.

At the heart of this debate lies a much larger question, one that will become even more relevant in the future: Is all human enhancement ethically wrong? Transhumanists like Ray Kurzweil and Julian Savulescu are squarely in favor of enhancement but there is still a sense among many that there is something morally dubious about improving something with chemicals that isn’t broken.

I think you are much more likely to enhance performance through selective breeding than you are ever likely to do through the ingesting of chemical compounds. When, and if, performance is enhanced through the use of a pill, it would usually be of a short duration, and we don’t know what the long term consequence of the persistant taking of any performance changing drugs would be. It might ultimately result in a deterioration of that performance quality it had initially enhanced.

There are of course ethical concerns that must be addressed, including the the fairness of access to these drugs and the long-term safety of their non-pharmaceutical use, something about which many remain skeptical. In fact, recent studies claim that these drugs stunt growth and causes hallucinations; others link them to suicide and sudden death. Greely urges more long-term, evidence-based studies on the effects of ADHD drugs, but pharmaceutical industries have proven resistant to this idea. A report from pharmaceutical giant Novartis, on behalf of a consortium of drugmakers, nixed the idea of further long-term studies in 2009. The reason, they cited: comorbidity. “It is well established that ADHD co-occurs with other psychiatric disorders, including disruptive behavioral disorders such as oppositional defiant disorder, conduct disorder; and mood disorders such as depression, bipolar disorder, and anxiety disorders,” the report states. In other words, negative effects measured in the study might result from co-existing mental disorders which would require other forms of treatment.

Somebody has to do a little reading between the lines here. Notice where it says recent studies claim these drugs stunt grown and cause hallucinations, not to mention, suicide and early death. Drug companies are pleading “comorbidity” as a reason as to why long-term studies shouldn’t be conducted. Hallucinations are symptoms of a disorder beyond ADHD for which another drug would be given. A botched suicide attempt means a certain “mental illness” diagnosis, and that certain diagnosis would probably be something besides ADHD. If we pretend these conditions were always there, no hassle, right. If we think that maybe the ADHD caused a problem, then we have to think detox, and the drug companies lose dough. “Comorbidity” is the best possible answer for these drug companies as it means nothing to them but increased profit. Let me tell you, the same companies that make drugs to treat ADHD make drugs to treat psychosis, mania, and depression, too.

There is a solution, yes, and it’s a solution that was pointed to in the novel Brave New World, but it’s a solution that I expect will remain more personal than popular.

“Don’t you want to be free and men? Don’t you even understand what manhood and freedom are?” Rage was making him fluent; the words came easily, in a rush. “Don’t you?” he repeated, but got no answer to his question. “Very well then,” he went on grimly. “I’ll teach you; I’ll make you be free whether you want to or not.” And pushing open a window that looked on to the inner court of the Hospital, he began to throw the little pill-boxes of soma tablets in handfuls out into the area.”

For a moment the khaki mob was silent, petrified, at the spectacle of this wanton sacrilege, with amazement and horror.”

~from Soma In Aldous Huxley’s Brave New World

“Good” doesn’t always mean good. Freedom is under threat, and people are not cognizant of that threat. There is always the “drug” defense, and it works much like the “mental illness” defense (we’ve got courts for both), “drugs made me do it”. Another person may say, “my ‘mental illness’ made me do it.” What there isn’t here is any acceptance of the responsibility for one’s own actions that freedom entails and requires. Instead we have an excuse. I don’t need to practice self-control if I’ve got the control that comes from a pill bottle. I don’t have to be good if a mind-altering substance can do my performing for me. I tend to think of adulthood as a matter of getting over such excuses.

Prejudice Associated With “Mental Illness” Tag Increases

The perception that the “mental illness” label is attributed to neurobiological causes has actually increased the prejudice associated with that label. ScienceDaily is one of a number online sources reporting on research showing that what is commonly referred to as stigma directed at people labeled “mentally ill” has done anything but decline in recent years. The article in question is titled Mental Illness Stigma Entrenched in American Culture; New Strategies Needed, Study Finds.

A joint study by Indiana University and Columbia University researchers found no change in prejudice and discrimination toward people with serious mental illness or substance abuse problems despite a greater embrace by the public of neurobiological explanations for these illnesses.

In other words, this study showed that “the disease like any other” approach to “stigma”, that it was hoped would decrease “stigma”, did not serve to decrease “stigma”, but may have actually served to increase “stigma”.

In brief, a random population of almost 2000 (1,956) people were surveyed in 1996 and then again in 2006.

Holding a belief in neurobiological causes for these disorders increased the likelihood of support for treatment but was generally unrelated to stigma. Where associated, the effect was to increase, not decrease, community rejection of the person described in the vignettes.

The ScienceDaily story concludes in a fashion that is both enlightening and helpful.

The research article suggests that stigma reduction efforts focus on the person rather than on the disease, and emphasize the abilities and competencies of people with mental health problems. [Bernice] Pescosolido says well-established civic groups — groups normally not involved with mental health issues — could be very effective in making people aware of the need for inclusion and the importance of increasing the dignity and rights of citizenship for persons with mental illnesses.

Saying that a person has a “mental health problem” is not the same thing as saying that a person has a “mental illness”.

Community segregation and discrimination then play a big part in a problem that could be more easily alleviated through a little community involvement and integration.

Yeah, that’s the way I tend to see it, too.

“Mental Illness” Debate Planned In The Bahamas

A very curious announcement has appeared in Bahamas Island Info. The announcement bears the heading First Psychiatric Debate On Mental Illness Planned. The theme of this debate has got me to wondering.

The debate will be held under the theme: “All Persons in society have the potential to develop a mental health disorder.” It is scheduled for Monday, November 15 at the Church of God on Bernard Road.

Researchers are currently searching for “mental illness” genes. If all persons in society have the potential to develop such a “disorder”, then it stands to reason that “mental illness” genes must exist in 100% of the population.

NIMBYism (Not In My BackYard-ism) would perhaps be less acceptable if all the potential neighbors of all people in mental health treatment were also potential mental patients.

This kind of reasoning goes to the heart of the matter. Are we dealing with more or less intact human beings, or are we dealing with an inferior subset who are less entitled to the same rights and consideration as everybody else, their kindred?

I’d like to see such debates conducted all over the world. There are a number of theoretical assumptions, given standard bio-medical model psychiatric practice, that debates of this nature might call into question.

Psychiatric Oppression 101

Defining our terms

Psychiatric Oppression

The first word, psychiatric, being defined in relation to another word, psychiatry, we will have to go to that initial word to get to the bottom of this matter.

Psychiatric

Medical Dictionary: psy•chi•at•ric

(sī’kē-ăt’rĭk)
adj.

Of or relating to psychiatry.

~from http://www.answers.com/topic/psychiatric

Psychiatry

Psychiatry is the medical specialty devoted to the study and treatment of mental disorders—which include various affective, behavioural, cognitive and perceptual disorders. The term was first coined by the German physician Johann Christian Reil in 1808. It literally means the ‘medical treatment of the mind’ (psych-: mind; -iatry: medical treatment; from Greek iātrikos: medical, iāsthai: to heal). A medical doctor specializing in psychiatry is a psychiatrist.

~from http://en.wikipedia.org/wiki/Psychiatry

Oppression

Oppression is the exercise of authority or power in a burdensome, cruel, or unjust manner. It can also be defined as an act or instance of oppressing, the state of being oppressed, and the feeling of being heavily burdened, mentally or physically, by troubles, adverse conditions, and anxiety.

Psychiatric oppression then refers to the “exercise of authority or power in a burdensome, cruel, or unjust manner” by people associated with “the medical specialty devoted to the study and treatment of mental disorders” over people targeted by that “medical specialty”, it’s lackeys, and accomplices.

Elaboration

In psychology, racism, sexism and other prejudices are often studied as individual beliefs which, although not necessarily oppressive in themselves, can lead to oppression if they are codified in law or become parts of a culture. By comparison, in sociology, these prejudices are often studied as being institutionalized systems of oppression in some societies. In sociology, the tools of oppression include a progression of denigration, dehumanization, and demonization; which often generate scapegoating, which is used to justify aggression against targeted groups and individuals.

Among those “other prejudices” one might add agism, mentalism, conformism, disablism and other such targets for societal oppression.

Internalized oppression

In sociology and psychology, internalized oppression is the manner in which an oppressed group comes to use against itself the methods of the oppressor. For example, sometimes members of marginalized groups hold an oppressive view toward their own group, or start to believe in negative stereotypes of themselves.

~from http://en.wikipedia.org/wiki/Oppression

There is every indication that the more recent concept of learned helplessness is actually a new twist given to internalized oppression to make it seem like it is something other than what it is.

Learned Helplessness

Learned helplessness, as a technical term in animal psychology and related human psychology, means a condition of a human being or an animal in which it has learned to behave helplessly, even when the opportunity is restored for it to help itself by avoiding an unpleasant or harmful circumstance to which it has been subjected. Learned helplessness theory is the view that clinical depression and related mental illnesses result from a perceived absence of control over the outcome of a situation.

~from http://en.wikipedia.org/wiki/Learned_helplessness

Related terms.

Marginalization

In sociology, marginalization also marginalisation (British) is the social process of becoming or being made marginal (to relegate or confine to a lower social standing or outer limit or edge, as of social standing); “the marginalization of the underclass”; “marginalisation of literature” and many other are some examples. In its most extreme form, marginalization can exterminate groups. (Mullaly, 2007).

Being marginalized refers to being separated from the rest of the society, forced to occupy the fringes and edges and not to be at the centre of things. Marginalized people are not considered to be a part of the society.(Arko Koley, 2010)

~from http://en.wikipedia.org/wiki/Marginalization

Second-class citizen

Second-class citizen is an informal term used to describe a person who is systematically discriminated against within a state or other political jurisdiction, despite their nominal status as a citizen or legal resident there. While not necessarily slaves, outlaws or criminals, second-class citizens have limited legal rights, civil rights and economic opportunities, and are often subject to mistreatment or neglect at the hands of their putative superiors. Instead of being protected by the law, the law disregards a second-class citizen, or it may actually be used to harass them. (see police misconduct and racial profiling) Second-class citizenry is generally regarded as a violation of human rights. Typical impediments facing second-class citizens include, but are not limited to, disenfranchisement (a lack or loss of voting rights), limitations on civil or military service (not including conscription in every case), as well as restrictions on language, religion, freedom of movement and association, weapons ownership, marriage, housing and property ownership.education, freedom of movement and association, weapons ownership, marriage, housing and property ownership.

~from http://en.wikipedia.org/wiki/Second_class_citizen

& on a more positive note

Empowerment

Empowerment refers to increasing the spiritual, political, social, or economic strength of individuals and communities. It often involves the empowered developing confidence in their own capacities.

~from http://en.wikipedia.org/wiki/Empowerment

Should you find yourself a little confused at our not attributing all psychiatric labeling to the alleged existence of certain bio-medical conditions, or conditions that resemble certain bio-medical conditions, perhaps I can clear those issues up in a later post: Human Rights 101.

Human Rights, those rights pertaining specifically to the species Homo Sapiens, are to be distinquished from Mental Patient Rights, or Mental Health Consumer Rights, or Psychiatric Disability Rights. As the latter described rights grew out of one enormous infringement of Human Rights, known as Mental Health Law, we do not see fit to acknowledge the existence of any of those other such illusory organisms.

Anxiety treatment drugs and sleeping pills increase death risk

I’m a firm believer in self-reliance. The drug crutch for facing life’s little bumps and dips is seldom, if ever, a fully adequate measure. One of the inconveniences associated with using this crutch for any significant length of time is the escalated possibility of an early death. An article submitted by a registered nurse in EmaxHealth details a study in which people on such drugs were found to have died more often within the 12 year period the study encompassed than other people in the study. This article bears the heading Insomnia and Anxiety Medications Linked to Increased Mortality.

The findings come from a study that followed 14,000 Canadians in the Statistics Canada’s National Population Health Survey from 1994 and 2007. During the survey, participants who used drugs for insomnia or anxiety were noted to have a thirty-six percent higher chance of dying after adjusting for other personal factors, including depression, tobacco and alcohol use, other health issues and activity levels.

I imagine if you have a 36% increased chance of dying within a 12 year period, that percentage is not going down over time, if anything, it’s likely to go up. This is to say that if the study had gone on longer, say for 24 years, this increased mortality in all likelihood would have been much higher.

The author gives some reasons for this increased mortality.

Medicines used for insomnia decrease reaction time and alertness and lead to lack of coordination, potentially leading to falls and other mishaps. Impaired judgment could also increase the chances of suicide among depressed patients.

Then there is the possibility of respiratory failure.

Geneviève Belleville, a professor at Université Laval’s School of Psychology where the study was conducted says, “These medications aren’t candy, and taking them is far from harmless.” Another theory is that insomnia drugs and anxiolytics lead to respiratory depression, aggravating existing breathing problems that can lead to death.

Professor Belleville suggests combining short term drug therapy with psychological treatment as a promising strategy for dealing with this dilemma. My worry is that doctors, with real patients of flesh and blood, reading these studies, will tend to ignore such suggestions. Conflicts of interest and negative prognoses tend to go hand in hand with the medical model of psychiatry that relies so heavily on such drugs.

People on the receiving end of psychiatric services need to educate themselves on these matters when, as you can see, doing so is so often a matter of life and death.

Despite Mental Illness Anti-Stigma Campaigns, Stigma Remains A Constant

The American Journal of Psychiatry has its biases, no doubt, but sometimes it just can’t ignore the results of its own studies. One of those studies that has appeared in the AJP was featured recently on an National Public Radio (NPR) blog post, Despite Deeper Understanding Of Mental Illness, Stigma Lingers.

We can now contrast theory…

Knowledge is power. And some research has suggested that emphasizing the science behind mental illness — that it’s a brain disorder and not a defect in character — could be powerful enough to help shake the stigma of the condition.

As if “brain disorder” was an improvement over “defect in character”. You can self correct “defects of character”, no hassle, but can you readily restore order to “disordered brains”? That, as mad Prince Hamlet might have phrased it, is the question.

…with fact…

Researchers found that while more people understand mental illness is caused by brain biology, that hasn’t translated into a decrease in stigmatization.

The lead researcher on this project says stubbornly that she doesn’t think “the disease is like any other line” is going to fail, no, instead she thinks it has taken us as far as it can take us. I’m left dangling in suspence from the ledge of what’s next.

I, for one, find this conclusion a total cop out. Psychiatric workers are some of the most prejudiced people in the world when it comes to the people they are “treating”, and this is just another example of the detrimental “help” some people find themselves stuck in.

[Bernice] Pescosolido and colleagues analyzed how people responded to questions about vignettes describing people with schizophrenia, major depression and alcohol dependence. The data, from 1996 and 2006, came from General Social Survey.

Researchers found that 67 percent of the nearly 2,000 adults surveyed attributed major depression to neurobiological causes — up from 54 percent 10 years before.

Looking at schizophrenia, 86 percent of those surveyed connected the disease with brain biology, which is 10 points higher than a decade earlier. And the same figure for alcohol dependence rose to 47 percent from 38 percent.

Also, there was an across-the-board increase in those who recommended medical treatment for people with mental illness.

However, there was no significant change in stigma indicators. For example, 62 percent indicated an unwillingness to work closely with someone with schizophrenia. And 74 percent said the same for people with alcohol dependence.

Here’s the problem, if you want to do something about the stigma associated with the “mental illness” tag, you should be treating people for stigma. Obviously, the wrong people have found themselves in mental health treatment.

This insight leads to a further insight, perhaps the people who stigmatize the labeled “mentally ill” are biologically programmed to do so, and thus they wouldn’t be able to stop such behaviors without outside intervention.

Uh huh. This is another one of those ahha moments brought to you by Lunatic Fringe.

Treating Pre-psychosis

The Boston Globe has an article on the detection and treatment of pre-psychosis bearing the heading Getting ahead of trouble.

Only 0.5 percent to 1.5 percent of the general population has schizophrenia, but studies conducted in the late 1990s and early 2000s found that some 40 percent of patients diagnosed with psychosis risk syndrome went on to develop a full-fledged psychotic disorder, such as schizophrenia, within 6 to 12 months.

40% of pre-psychotic cases then develop into full-blown psychosis within a half a year to a full years time. Good thing we caught them then, huh? No telling how many pre-psychotics are wandering around loose out there now. The statistics we don’t have here? What percentage of undiagnosed pre-psychotics develop into full-blown psychotics.

But the suggestion has proven to be controversial, partly because most patients with the syndrome will never develop an official psychotic disorder. Over the last 10 years, the percentage of people who have transitioned from the risk syndrome to full-blown psychosis — the so-called conversion rate — has dropped from 40 percent to 27 percent or even lower, by some accounts.

Uh, but we still have to protect vulnerable members of the general public from pre-psychotic people, don’t we?

The issue of false positives is immense, says [Dr. Oliver] Freudenreich. “There’s an enormous concern in the US that we are already using a lot of antipsychotics in children,’’ he says.

Use of these drugs is growing. In 1995, 8.6 out of every 1,000 children ages 2 to 18 were on some type of antipsychotic medication. By 2002, that number had risen to 39.4 children out of every 1,000, according to a 2006 study by researchers at Vanderbilt University.

One little draw back to consider here is that the pre-psychosis diagnosis is not going to diminish the number of children on neuroleptic drugs, if anything it is likely to increase that number. I imagine the notion of having schizophrenia is a lot easier for a person to digest once that person has already digested the notion of having pre-schizophrenia.

Naturally enough this leads to my next question. Could it be that some of our prevention efforts serve not so much as prevention efforts as they do catalysts for the spread of “disease”?

Three Nuts On Film, Not Necessarily Three Film Nuts

Three young men are becoming known for their “mental illnesses”. I have a problem with that script from the get go. Hey, were they known for their “mental” acumen and cognitive gymnastics, the situation would be different. You seldom hear about people becoming known for their zits, but I imagine it happens.

Rewriting the script on mental illness is a news story that recently appeared in the Record, a Canadian news source, about this film the three of them, all Simon Frazer University students, are making.

If you don’t like the stereotypical role you’ve been given, why not rewrite the script? That’s what three SFU students did by creating and broadcasting videos on YouTube, detailing their personal experiences with serious mental illnesses.

Whoa. Hold on right there. I think we have a language problem here already. We could be detailing people’s personal experiences with dragons or unicorns, too. Nobody has ever found one of those either.

Three lads, one with a pal known as schizophrenia, the other with these two pets referred to as depression and anxiety, and a third with this fellow called bipolar disorder Type 1 with severe mania. No, no stereotypes there whatsoever.

Here, for example, is bipolar dude.

Joe Roback, 24, is a psychology student with Type 1 bipolar disorder, with severe mania. He is president of SFU’s chess club, and he writes music as a creative outlet. For him, the hardest part of having a mental illness is the attached stigma and misunderstanding.

Alright. I’ve read studies showing that the brightest students in class (as well as the dumbest) are the ones most often labeled bipolar disorder sufferers. This guy is president of the chess club and a composer of music. No stereotypes there, surely.

“They really are just our personal stories and how we view stigma and how we view possible changes as far as stereotypes and negative attitudes around mental illness,” [Taylor] Kagel adds.

The trio describes some of the typical stereotypes of people with mental illnesses: lazy, homeless, unable to take care of themselves, untrustworthy, unreliable.

Really? I thought those were shiftless bums and tramps. Now you tell me they might be “people with mental illnesses”. Are you sure? If you are not sure, perhaps you have a “serious mental illness”, and you should be seeking “professional help”.

At one point one of the students starts talking about internalized stigma. He talks about having had to build a self-identity that incorporates his “illness”. I’m not sure playing up the “illness” card is such a great strategy for success, but who knows? Maybe it will work for him eventually.

Good luck with the chicks, guys. Also, good luck nurturing each of your respective “mental illnesses”. I hear they tend to be more faithful.

Think Before You Drug A Toddler

You get an object lesson on how not to raise children with a recent article in the New York Times, Child’s Ordeal Shows Dangers of Psychosis Drugs.

Kyle Warren was 18 months old when he was put on a neuroleptic drug for his temper tantrums.

You, me, and everybody else is going, “Whoa! Kid’s parents can’t even wait until he gets past his terrible twos before resorting to desperate measures.”

I suggest his parents look up a couple of words in any handy dictionary. The first word I’d have them look up is child, and the second word I’d have them look up is abuse. Throw the two together, and what have we got: child abuse.

Thus began a troubled toddler’s journey from one doctor to another, from one diagnosis to another, involving even more drugs. Autism, bipolar disorder, hyperactivity, insomnia, oppositional defiant disorder. The boy’s daily pill regimen multiplied: the antipsychotic Risperdal, the antidepressant Prozac, two sleeping medicines and one for attention-deficit disorder. All by the time he was 3.

Life is full of surprises, isn’t it?

His mother goes onto say he was doped up, obese, and drooling.

Now 6, and getting high marks in the 1st grade, he’s more outgoing, and he’s lost weight.

Ms. Warren and Kyle’s new doctors point to his remarkable progress — and a more common diagnosis for children of attention-deficit hyperactivity disorder — as proof that he should have never been prescribed such powerful drugs in the first place.

If I remember correctly a certain bipolar disorder boom started when kids who would have been labeled ADHD were labeled bipolar instead. Wow. You could clear up a lot of bipolar disorder by relabeling people with bipolar disorder ADHD.

What’s more, I imagine you could clear up a lot of ADHD by not labeling children at all.

Now rather than having him on 5 drugs, he’s on 1 drug. That’s got to be an improvement, but giving even 1 potent drug to a child of 6 is still child abuse in my book.

I think the best response to this situation came from a comment to answers the child’s psychiatrist was giving readers in a fielding session, A Child Psychiatrist Responds… Brooklyn Reader writes:

Simple test for psychiatrists that prescribe medications to young children.

“Can you honestly say you would prescribe the same medication(s) to your own children if they had the same problems? If not, don’t prescribe them to someone else’s children.”

Post this on your desk; tape it to your bathroom mirror; print it out and put it in your wallet. Stop playing pharmaceutical roulette with other people’s kids!

There, that wasn’t difficult, was it?