Medicating grief isn’t the answer April 28, 2009

We need more doctors like this. From an op-ed at the Boston Globe:

ON A RECENT episode of the HBO series “In Treatment,” a CEO of a major company describes with complete absence of emotion the death of his 16-year-old brother when he was 6. When Paul, his therapist, suggests that his panic attacks may be related, he leaves the office, saying he will ask his doctor to prescribe medication now that he has a diagnosis. Paul gently suggests that they continue the important work they have begun. I am eager to see how this plays out. I am quite certain, however, that in the real world, the CEO would find many doctors to prescribe medication, enabling him to eliminate the symptom without the hard work of grieving.

This episode reminded me of a case in my pediatric practice (with the details changed to protect privacy). A 5-year-old girl was referred by her kindergarten teacher for evaluation of attention deficit hyperactivity disorder, with a strong recommendation that medication be considered. Her behavior had been disruptive since preschool, but was now affecting her ability to learn. There was concern that she might not be able to move on to first grade. Before I even saw the patient, armed with standardized forms and psychological testing, I was quite sure that she would meet diagnostic criteria for ADHD and that medication would be a reasonable consideration.

I met with her parents, who described classic symptoms of ADHD, including prolonged battles at home around such simple tasks as getting dressed for school. About halfway through the visit, I began to ask, as I always do, about past history. “How was your pregnancy with her?” There was a pause, during which the parents exchanged looks. “Actually, I’m not her biological mother.”

Now it was my turn to pause, as I was quite shocked to receive this important piece of information so late in the evaluation process. With some reluctance, they went on to tell me that the girl’s mother was seriously mentally ill, had been intermittently involved in her life, and had disappeared completely two years earlier. But, they assured me, she never talked about her mother and it wasn’t an important issue.

This story has a happy ending. I agreed that medication could be helpful, but, building on the trust they had developed with me as their pediatrician, I suggested that the loss of her mother was actually very important and needed to be addressed. They accepted my referral to a therapist. I am fortunate to have an excellent colleague across the street who accepts their insurance. He wisely explained to them that children do grieve, and now the whole family is engaged in working with him around this painful and difficult task. This child is now thriving in first grade.

For this one positive outcome, there are hundreds that do not end this way. Children who have experienced terrible loss do not have the opportunity this girl had. They are aggressive and disruptive, and their symptoms are medicated away. They continue to struggle, often failing in school. Some of the reasons this path is chosen are lack of time, limited access to mental health services, and resistance to doing this hard work.

I recently received a letter from the state with the alarming statistic that 37 percent (nearly $190 million) of the MassHealth pharmacy budget is spent on behavioral health medication. The letter asks for input regarding possible ways to improve patient care while reducing costs.

I proposed that we as a society recognize that grief and loss cannot be medicated away. As one friend who recently lost her husband so eloquently put it, “Grief is a powerful release that validates your loss, relieves stress, and helps you heal.” Certainly medication may be an adjunct, particularly when people are so incapacitated by their symptoms that they are unable to function. But if we as a culture validate the experience of grief, if we offer the time and space and resources to support people through the difficult process, I am quite certain that in the long run we will not only spend less on medication, but will help people to heal and return to being productive members of society. It is with children that this investment will have the greatest return.

Dr. Claudia Meininger Gold, a pediatrician, practices in Great Barrington.

Joe Pantoliano on mental illness stigma April 27, 2009

thanks to Van for posting on this-I’ve been out of the loop and missed it although I am familiar with what Joe has been doing lately.

Joe Pantoliano (The Sopranos, Memento, The Matrix, The Goonies) started an organization called No Kidding, Me Too! He has a documentary coming out with the same title. I want to start off my saying, I commend him for this. Stigma is a real problem in America and throughout the world. We must bring an end to it!

This is Joe’s message at his website:
We are ready for the fight and we ask you to please join us in the revolution and help us educate souls all over the world to “Remove the Stigma!”

Mission
No Kidding, Me Too! is an organization whose purpose is to remove the stigma attached to brain dis-ease through education and the breaking down of societal barriers. Our goal is to empower those with brain dis-ease to admit their illness, seek treatment, and become even greater members of society.

The Goal
Make Brain Dis-ease cool and sexy. We want a normal conversation in America to be:

“I have bipolar disorder/schizophrenia/insert dis-ease”

“No Kidding, Me Too!”

Who Has The Stigma:
Those suffering from brain dis-eases including anxiety disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), panic disorder, social anxiety disorder, specific phobias, depression, bipolar disorder, schizophrenia, anorexia nervosa, bulimia nervosa, binge eating, pyromania, kleptomania, compulsive gambling, addictions, paranoia, multiple personality disorder, gender identity disorder, Down’s syndrome, psychosomatic disorder, tic disorders, and others.

How Will NKMT Accomplish This?
h Create strategic partnerships with members of industry, academia, organizations and government to ensure a broad-based spectrum of support and input.
h Organize the creative talents of our industry professionals to generate messages for various media and use our celebrity status to ensure these messages are heard. The messages will be of empowerment and acceptance and can include topics as basic as giving job opportunities to those with a brain dis-ease.
h Coordinate, participate in and generate interest for national and regional educational events consistent with our goal.

He has an impressive list of Advisory Board members, some of whom I greatly admire in the industry Joey and I share: Robert Downey, Jr, Ed Begley, Jr, Jeff Bridges, Edie Falco, Marcia Gay Harden, Ang Lee, Robin Williams and many more.

At his website there are photos of Joey from the screening of the teaser at the Democratic National Convention with people like Tony Goldwyn, Dana Delaney, Bobby Kennedy, Melissa Etheridge and Tom Fontana.

Here’s the teaser to his documentary:

Under the resources section at his website-the very first resource listed is NAMI. ahem. I wonder if Joe has researched Big Pharma’s influence at NAMI? Is he aware that Sen. Grassley is investigating NAMI’s funding? I am a registered Democrat and I’m becoming increasingly frustrated with this party, a party who is ignoring the corruption of Big Pharma and anyone linked to Big Pharma mainly because of their involvement with them. They are looking out for themselves and those that financially support them instead of the PEOPLE. Senator Grassley is all alone and that is sad.

At Joe’s website he links to several articles, letters, humorous videos and some of this favorite quotes, here’s a sampling:

To Fight Stigmas, Start With Treatment

Call for New Home to Address Health Disparities for Mentally Ill

FDA Approves Depressant Drug For The Annoyingly Cheerful

some of Joey’s favorite quotes

The teaser for his documentary opens with the statement:
1 in 4 Americans suffer from mental illness
4 in 5 Americans are affected by it

And then throughout you see more statistics on the screen:
87 million Americans have been diagnosed with some form of mental illness
There are over 350,000 diagnosed cases of PTSD resulting from the Iraq war
18 of our American heroes are committing suicide every day

And statements like these:
There is a fine line between madness & creativity
Mental illness is the only DIS-EASE which you can be diagnosed with, and get yelled at for having

Joe went public with his illness after he was hired to do a film. (FYI: one of the first things required for actors and directors before they start filming is to see a doctor and production schedules a physical for insurance purposes) He had done this over 70 times but in this case he told the doctor the two medications he was currently taking, one for depression and one for heart disease. His lawyers were then informed that the production company/studio could not insure Joe because he was taking an antidepressant. They were told Joe could sign a waiver basically saying if he had a ‘breakdown’ he would be financially responsible for the loss of work or a shutdown. Joe’s real problem and awakening was simple: they were willing to cover his heart but not his brain. That is stigma. We all know it and it’s something I’ve been fighting and living with for countless years. It’s heartbreaking.

However, in a separate (lengthy) taped discussion with Joe he discusses a number of topics, mostly stigma, his films, politics & mental illness. He also talks about the fact the he quit drinking and has started practicing yoga, he exercises, etc. He believes in the theory that mental illness is genetic. I believe he mentioned his mother was diagnosed bipolar. Now, I haven’t seen his documentary but when his teaser states 87 million Americans suffer from a mental illness-I doubt (and I hope I’m incorrect) that he mentions why we have this false statistic. This number has increased drastically simply due to Big Pharma’s influence and a bunch of doctors started diagnosing people for a variety of reasons: more money in their pockets, get the patient in and out as quickly as possible, falsified data and studies…the list goes on and on. Instead of dealing with the true issue at hand, whether it be trauma or dysfunction, it seems Joe has partially bought into the quick fix system. And he’s using his celebrity status with people in the government in hopes that his message will be heard. That would be all fine and good except there are many flaws in his message. I agree with ending stigma but ‘his message’ goes much, much deeper than that.

In chapter 15 of the discussion linked above someone asked him if he’s tried alternative treatments like acupuncture and he states that he does practice yoga and meditation, he partakes in talk therapy, 12 step groups, etc. He seems to be all over the map and that is fine. It is his path. But it will truly disturb me if he does not mention Big Pharma’s influence within our modern psychiatric world (doctors, NAMI, etc) in his documentary, No Kidding, Me Too!

happy post April 27, 2009

Maru-the box kitty. ah, I love cats!

compassion April 26, 2009

I’ve been wanting to write about my beloved dog, Foxy, for quite sometime. She passed away a few years ago although she’s still here with me in my heart. She had been in my life for 12 years, since she was a sweet puppy. She was a Shetland Sheepdog and one of the kindest pets I have ever had. When I lived with my parents, she usually slept with me or nearby. Her coat and features were not as “attractive” as her husband, our other Shetland Sheepdog, but her beauty inside is what made her so special. I told Foxy things I felt I could tell nobody else in fear of receiving the standard response, “Cheer up, move on and forget about your past!” It wasn’t until I started this blog and then got married that I was able to ‘open up’ and express my feelings fully to human beings. But, for the longest time, Foxy was pretty much my only true friend and confidant.

She had a real gift with people. At one point, we were living in a small town and I remember bringing her to a local nursing home over the holidays. The sight there was horrific. I overheard nurses mocking their patients and complaining about cleaning up “their messes” and well, you get the picture. I wish I had reported them because I saw some very ugly things. However, at that moment in my life I was very lost and depressed and I simply wanted to share my dog’s love and gift with others. I would dress her in a santa hat and scarf and we would visit very lonely patients. I was shocked how many of them never received visitors from their own families. They had been sent off, forgotten and left to die alone. It was tragic and an eye-opening experience for me at that point in my life. When I would enter a room with Foxy, I would watch the patient’s eyes light up. She would kiss them and love them-it was such a beautiful thing. They always looked forward to her visits. It is my hope that she brought beauty and love into their lives or reminded them of the beauty and love in life before they passed on. And, oh how I miss her so.

I was recently reminded of Foxy while watching the tail end of an Ellen Degeneres episode. I do not watch much network television but when I can, I do watch Ellen. I adore her. She had Sirdeaner Walker on her show whose 11-year-old son, Carl Joseph Walker-Hoover, committed suicide on April 6th after being bullied by fellow students at his school. This story is heartbreaking and his mother is an amazing woman.

Here’s the interview:

Anyway, Ellen said something that has stayed with me:

“I feel like there needs to be a class taught every single day in school that’s compassion. You have History, you have Math, you have English, you have Compassion. Every single day kids should be taught kindness to other kids.”

Ellen’s words are so very important. Compassion does need to be taught in schools, especially when so many children are not taught this at home. Compassion is a very powerful thing and without it, we are nothing.

So, I’m dedicating this post to my sweet Foxy who was very compassionate, to Ellen Degeneres, to Carl and his mother and to all of the compassionate human beings in this world.

Memorial contributions for Carl Walker-Hoover may be sent to:

Carl J. Walker Trust Fund
c/o Hampden Bank
19 Harrison Avenue
Springfield, MA 01103

quotes April 26, 2009

peace quotes by kids:

Let the sun shine in the night time and please no more dying.
Please let us have peace and no more fighting. People are dying.

Southwest Elementary
San Antonio, TX, US
++++++++++++++++++++++++++++++++
Peace remained by my side until I understood
what she wanted from me—that I be free

Parque Ecologico
Porangaba, Brazil
++++++++++++++++++++++++++++++++
Why destroy when we could create,
Keep the peace, erase the hate.

Normal Community West High School
Normal, IL, US
++++++++++++++++++++++++++++++++
Let it blow in your direction
Let it touch you, melt you and mould you

SOS-Hermann Gmeiner International College, secondary school
Tema, Ghana

7-year-old commits suicide while taking psychiatric meds April 25, 2009

This story at the Miami Herald saddens me. It also infuriates me. When are doctors and the FDA going to wake up? What will it take? How many more lives will be lost before this madness stops?

From the article:

Weeks before his death, Gabriel Myers, the 7-year-old Broward boy who hanged himself in the shower of his foster home, had been prescribed a powerful mind-altering drug linked by federal regulators to an increased risk of suicide in children.

In all, Gabriel had been prescribed four psychiatric drugs, two or three of which he was taking at the time of his death, said Jack Moss, Broward chief of the state Department of Children & Families. Moss said he is not sure which medications the boy was taking because Margate police took the foster home’s medication log as part of an investigation into Gabriel’s death last week.

Three of the psychotropic drugs carry U.S. Food and Drug Administration ”black box” label warnings for children’s safety, the strongest advisory the federal agency issues. Three of the medications are not approved for use with young children, though they are widely prescribed to youngsters ”off label” — meaning doctors can prescribe the drug even if not formally approved for that use.

Gabriel had been prescribed Symbyax, Lexapro, Vyvanase and Zyprexa. Again, three of these meds are not approved by the FDA for use with young children. And of course, prescribing them nonetheless is not uncommon, doctors must be held accountable.

Four feet tall and 67 pounds, with short-cropped brown hair, Gabriel was a bright, charming and often sweet little boy, those who knew him say.

But he already had a sad past hinting at a troubling future. Records obtained by The Miami Herald show Gabriel may have been molested by an older boy while he was living with grandparents in Ohio, while his mother was in jail.

On Thursday, Gabriel locked himself in a bathroom and hanged himself with a detachable shower head after arguing with the 19-year-old son of his foster dad about his lunch, Moss said.

this screams trauma. and yet again, another precious child did not get the help he so desperately needed. Instead he got the “quick fix”-medicate. medicate. medicate. so very tragic.

Myers said the boy’s pediatrician had discontinued all psychotropic drugs while Gabriel lived with him, and the boy did well, earning A’s and B’s at the Hollywood Christian Academy.

”We did not have any issues with him having tantrums,” Myers said. “He would get upset, like little boys do.”

A week or two before Gabriel died, his grandfather in Ohio expressed concerns that the boy sounded overmedicated. ”My father said that the last conversation he had a couple of weeks ago Gabriel sounded like he was too drugged,” Myers said. “He sounded like he was doped up.”

Gabriel’s doctor, Dr. Sohail Punjwani, said he did not recall Gabriel. This statement sums up part of my problem with modern psychiatry today. Dr. Punjwani, since you seem to have forgotten your patient-here is a picture:

What a sweet face. Rest in peace, Gabriel. Let this picture be a reminder to any parents thinking about medicating their children with dangerous meds like Zyprexa. Do the research on these medications before you think about filling that prescription. Unfortunately in today’s modern psychiatric world, your child’s life and well-being is rarely your doctor’s concern.

pregnancy and antidepressants April 25, 2009

Thanks to Gianna at Beyond Meds for this. And I agree with Gianna, Vogue is definitely a mainstream magazine so maybe a few lives will be saved. That’s all I’ve ever wanted.

Back in 2005 GlaxoSmithKline sent a warning letter to doctors, advising that the antidepressant Paxil may be linked to a slightly higher risk of birth defects in babies exposed to the drug during the first trimester of pregnancy.

From the FDA Public Health Advisory:

* In a study using Swedish national registry data, women who received paroxetine in early pregnancy had an approximately 2-fold increased risk for having an infant with a cardiac defect compared to the entire national registry population (the risk of a cardiac defect was about 2% in paroxetine-exposed infants vs. 1% among all registry infants).
* In a separate study using a United States insurance claims database, infants of women who received paroxetine in the first trimester had a 1.5-fold increased risk for cardiac malformations and a 1.8-fold increased risk for congenital malformations overall compared to infants of women who received other antidepressants in the first trimester. The risk of a cardiac defect was about 1.5% in paroxetine-exposed infants vs. 1% among infants exposed to other antidepressants.
* Most of the cardiac defects observed in these studies were atrial or ventricular septal defects, conditions in which the wall between the right and left sides of the heart is not completely developed. In general, septal defects are one of the most common type of congenital malformations. They range from those that are symptomatic and may require surgery to those that are asymptomatic and may resolve on their own. It is of note that the data in these studies was limited to first trimester exposures only, and there are not currently data to address whether this or any other risk extends to later periods of pregnancy.

The Vogue interview can be viewed here.

Harvard medical students rebel April 22, 2009

Thanks to a friend for passing this along.

Click here to read the entire article.

Two hundred Harvard Medical School students are confronting the school’s administration, demanding an end to pharmaceutical industry influence in the classroom.

The students worry that pharmaceutical industry scandals in recent years, including criminal convictions, billions of dollars in fines, proof of bias in research and publishing and false marketing claims, have cast a bad light on the medical profession. The students have criticized Harvard as being less vigilant than other leading medical schools in monitoring potential financial conflicts by faculty members.

Harvard received the lowest possible grade, an “F,” from the American Medical Student Association, a national group that rates how well medical schools monitor and control drug industry money.

The FDA on drug ads April 20, 2009

This story at the NY Times just infuriates me. The FDA should not be warning Big Pharma that their online ads must start including risk information about each drug. This is ridiculous. The solution is much simpler: BAN THE ADS COMPLETELY.

A quick note to the FDA: Wake up! Whose side are you on? The patients or Big Pharma? I think we know the answer.

WHEN the Food and Drug Administration sent letters to 14 major pharmaceutical companies late last month, the warning was strong. The companies’ search advertisements — the short text ads that run beside Google results — had to start including risk information about each drug or else be rewritten or removed.

Just how the companies were supposed to comply was not so clear. In the 95 characters that Google allowed for search ads, there was no way to include all the required information, the companies argued.

Now, as the companies change their search ads to comply with the letters, industry executives say the solution is worse than the problem: their ads are even more confusing and misleading now, they say. And they worry that regulators will enforce standards that were created for magazines and television, rather than making new rules that acknowledge how Internet ads have evolved.

The letters were sent to almost all of the major pharmaceutical companies, including GlaxoSmithKline, Pfizer, Merck and Eli Lilly. The letters said ads for widely prescribed drugs, including Celebrex, Propecia and Yaz, did not include the paragraphs of precautions the agency required.

Though the texts of the ads varied, the agency’s objections to each ad were similar. One such ad was for Merck’s allergy drug Singulair. The ad read, “Allergy Medication Relief of Allergy Symptoms: Learn About a Treatment Option. www.SINGULAIR.com.”

The ad omitted “the most serious and frequently occurring risks associated with the drugs promoted in the links above,” the agency wrote in its letter to Merck, and the links “misleadingly suggest” that the drug was “safer than has been demonstrated.”

Until these letters were sent, pharmaceutical and media companies had assumed that there was a one-click rule, said Arnie Friede, counsel at the corporate law firm McDermott, Will & Emery: as long as pharmaceutical companies provided risk information within one click of their search ads — on the page that the ad linked to — they assumed they were in compliance. These letters made clear that was not the case.

click here to continue reading….

the road to recovery April 18, 2009

This past week (via email) I was accused of being “ALWAYS UNHAPPY” with my life. Yes, the always unhappy was in caps and it came from a someone that has said things like this before who no longer wants to be mentioned in my blog. She feels I’m living in a “cyber world” and not the “real world”. I beg to differ on all accounts and I told her so. She also seemed to fear for her life by saying, “It’s scary to me, how do you know someone won’t come after us?” I did not respond to that-she said this after reading an article in Readers Digest on Myspace. This is a) not Myspace and b) the people who read my blog are not the types to “go after” this person or anyone for that matter. It’s completely beyond belief and yet I will say she did admit to being “computer illiterate” and so I must believe that she is simply misinformed and that is fine.

The simply truth is, yes, I get the majority of my support from the cyber world. And here’s the simple reason: the real world has failed me for more than twenty years. Psychiatrists, therapists, people who stigmatize, etc. When you spend tens of thousands of dollars on medical bills in the real world-the outcome for me was, well, I am pretty much back to square one except for severe memory loss, other problems from the many medications I have taken over the past 15 plus years and lastly, massive debt thanks to the lack of mental health parity. I’m trying to recall a specific doctor that has really helped me-there have been two or three out of more than thirty. The ones that did help-well, at the time, when I still chose the path of medication (the quick fix), I told them what I wanted to be on. I told them I was there for med management only. I cannot think of one therapist that helped me or gave me tools that actually worked in the real world. Scratch that-I had a sexual abuse therapist many years ago tell me, “my mind may never fully remember my entire rape-my mind will only allow me to remember what it can handle” or something to that effect. And she was right. I do believe that. I have not had one doctor suggest dealing with trauma from my past (my rape, etc) instead they’ve always labeled me, threw pills at me which made me sicker and certainly did not deal with the true issue at hand.

So, a few years ago I started this blog because I was feeling very alone and misunderstood in the “real” world and over the past three years I have met so many wonderful, amazing human beings in the cyber world-you all know who you are. But, hey, lets make you REAL just for fun: Gianna, Stephany,Duane, Van, Ana, Stan, Susan, Alex, Susan, Jon, Denise and so many others. Kidding aside-you are all real. You are all amazing, compassionate, strong and wise people that have helped me along my journey and I will never be able to properly thank you-because there are no words as to how much your support and your personal stories have meant to me. Now that I have opted to travel a different road to recovery, one without meds, I will need support more than ever. There are reasons some of us have at one point traveled the different road: the medication quick fix road. I won’t get into those reasons here because they are varied and some are very sad (ie. forced treatment, forced drugging, etc.) Some of us, well, me…I chose that road simply because it was the ONLY road I knew until I began my venture into the cyber alternative healing world. It reminds me of something recently posted at the great website/resource: Beyond Meds-Alternatives to psychiatry.

“Recovery is a deeply personal, unique process of changing one’s attitude, values, feelings, goals, skills, and/or roles. It is a way of living a satisfying, hopeful and contributing life. Recovery involves the development of new meaning and purpose in one’s life as one grows beyond the catastrophic effects of psychiatric disability.” ~ Dr. William Anthony, Director, Center for Psych Rehab

and:

Dr. Lori Ashcroft suggests that we can experience “moments of recovery” by choosing new ways to respond and breaking old patterns.

- Developing a series of wellness tools
- Recognizing our triggers and learning how to best deal with trauma
- Learning our personal bill of rights
- Setting short and long-term goals and determining actions for change
- Finding our sense of purpose and ridding ourselves of negative self-talk

The above is exactly what I plan to do-it will be part of my new road to recovery. It is part of the reason behind this post. Another being the email I received and I felt I needed to write about it here. And lastly, I just read my sister-in-law’s blog and it reminded me of so many things. She has three children (my nieces) two of whom are in their teens and have cystic fibrosis. It would take forever to properly describe my sister-in-law: strong, loving, intelligent, spiritual, patient and giving. Those are just a few adjectives but there are many more. I will strive to be more like her-I want to attempt yoga, meditation and well, just live in the moment. That is not at all easy for someone like me and I commend those that are able to do so. But anything is possible and I hope to someday live in the moment and find true peace and a calmness in my heart. It will be a long, difficult road as so many of you know-but it will be worth it in the end.

Oh, I just realized the time-I have to end this. I must venture out into the real world, which is not easy for so many of us and only WE seem to know the reasons why, unfortunately due to stigma. I am going to pick up a 40s vintage jacket that a friend of mine altered for me yesterday after trying it on. (It was a twisted scene from Pretty Woman-imagine me trying on numerous outfits-many of which didn’t fit thanks to weight gain from psych meds and I didn’t have the unlimited credit card!) This jacket is part of what I’m wearing to tonight’s screening of a film I worked on and I will be, yes, amongst thousands of people in the real world. Not here on my laptop. I spent 6 weeks in the real world working on this film, giving my all for a story/film that I truly loved. The creative outlet is an important one for me. I personally believe it has saved my life. peace to you all.

a doctor voluntarily took an antipsychotic drug April 16, 2009

Thanks to Beyond Meds for posting this very interesting story. And I say interesting for a number of reasons. One, whenever a doctor would deny the side effects I was experiencing from Seroquel or Abilify, I wanted to say, “Have you tried it?” Two, after my swain learned of my horrible experiences with Seroquel he took 1/4 of the dose I used to take (100mg) to see what would happen. He took 25 mg one time and was knocked out for nearly 24 hours. After he woke he could barely form a sentence, he was extremely sluggish and it took him a few days for him to recover from that one small dosage. He simply could not imagine what it must have been like for me, taking a stronger dosage for a much longer time. And thirdly, anytime I’ve ever seen a pharma rep selling (marketing, pimping or whatever you choose to call it) these horrific drugs, I have always wanted to ask, “Would you take this? Would you have your child take this?” I did ask a former friend and Wyeth rep the last question and his answer was no. Of course it was. So, here we have the story of a doctor who voluntarily took an antipsychotic drug:

In 1993 Richard Bentall went a bit mad.

He voluntarily took an antipsychotic drug and at first thought he’d get through unscathed.

“For the first hour I didn’t feel too bad. I thought maybe this is okay. I can get away with this. I felt a bit light-headed.”

Then somebody asked him to fill in a form. “I looked at this test and I couldn’t have filled it in to save my life. It would have been easier to climb Mt Everest.”

That was the least of his troubles. Bentall, an expert on psychosis from the University of Bangor in Wales who is in New Zealand under the University of Auckland Hood Fellowship programme, developed akathisia – unpleasant sensations of inner restlessness and an inability to sit still.

“It was accompanied by a feeling that I couldn’t do anything, which is really distressing. I felt profoundly depressed. They tried to persuade me to do these cognitive tests on the computer and I just started crying.”

Bentall had volunteered to be in a study run by Irish psychiatrist Dr David Healy. Volunteers were given either 5mg of the antipsychotic droperidol, 1mg of lorazepam, a type of tranquillizer, or a placebo.

“The experiment completely failed,” says Bentall. “Because first, it’s absolutely mind-bogglingly obvious to anybody after an hour whether or not they are taking an antipsychotic or a placebo – the side effects are so marked. There is no such thing as a placebo antipsychotic in that sense.”

But it was the fact that most of the healthy volunteers who took the antipsychotic became so unwell, let alone do the cognitive tests, that meant the study couldn’t continue. One psychiatrist became suicidal and had to be put under observation.

In his controversial book Let Them Eat Prozac Healy wrote about what the volunteers experienced. “It was not like anything that had happened to them before… Highly personal memories of previous unhappy times – broken relationships or loneliness – seemed to be flooding back. And if they previously held themselves responsible for these unhappy times, they seemed to hold themselves responsible for feeling the way they did now as well.”

The antipsychotic experiment, which gave him a hangover for a week, typifies Bentall’s approach to mental illness – rigorous scientific research coupled with a clinical psychologist’s perspective.

He has a doctorate in experimental psychology. “Most of my arguments are research-based,” says Bentall. “I’m just interested in what the evidence says about the nature of mental illness and how best to treat it. I’m a scientist at heart.”

What worries Bentall is how many mental health services seem to ignore what the research says and when an antipsychotic medicine doesn’t work, simply up the dose.

Once again Bentall refers to the science – that about a third of recipients don’t get any benefit whatsoever from the drugs. And research that shows if patients don’t respond at a relatively low dose, they’re not going to respond to a high dose. And are very likely not going to respond to any other anti-psychotic.

The optimum dose of antipsychotics is about 350mg per day (measured as chlorpromazine equivalents). Yet a recent study in the north of England found the median dose of antipsychotic drugs was about 600mg and about a quarter of those reviewed were on a gram or more a day.

“The average dose was about twice the optimum. How does that happen? It doesn’t make any sense.” Bentall suggests the reason such “unethical doses” occur is because mental health services have come to rely on these drugs as if they are the only treatment available. “When a patient doesn’t respond, they just up the dose in some magical belief that hopefully something will happen.”

But while promoting alternatives like cognitive behavioral therapy – the Government-sanctioned treatment of choice for depression and anxiety disorders in England – Bentall also points to research that shows all psychotherapies work, and that no type is more effective than any other. It’s a finding that surprised many, including Bentall.

Closer analysis highlights a common theme. “The quality of the relationship between therapist and patient explained most of the result.”

It seems blindingly obvious that having a good quality, empathetic therapist is likely to get good results, so why doesn’t it happen? “Establishing good relationships with patients shouldn’t be that difficult, but most psychiatric services seem to find it very difficult indeed,” says Bentall.

He says many services operate from a coercive model: “We know best. We’ve got the treatment. Better take these no matter what the side effects. Do what we say and if you don’t, we’ll put you on a community treatment order and you’ll be legally obliged to do what we say.”

click here for the rest of this incredible story.

David Helfgott-a beautiful man April 16, 2009

Years ago I watched the film Shine several times. Tonight my swain and I watched it together and I felt like posting a couple of clips-one of the real David Helfgott and the other is the trailer from 1996.

from wikipedia:

When he was nineteen, he won a scholarship to study at the Royal College of Music in London, England for three years, where he studied under Cyril Smith. During his time in London he began showing more definite manifestations of mental illness. His doctor in Australia, Chris Reynolds, whom he met some twenty years later, said that he suffers from an acute anxiety neurosis. He returned to Perth in 1970, and married his first wife, Clara, in 1971. He also took part in several Australian Broadcasting Corporation concerts. After his marriage broke down he was institutionalised in Graylands, a Perth mental hospital. Over the next ten years, he underwent psychiatric treatment which included psychotropic medication and electroconvulsive therapy.

Today, David Helfgott now lives in “The Promised Land”, a valley near Bellingen in New South Wales with his second wife, Gillian. He continues to perform concerts at his home. His other interests include cats, chess, philosophy, tennis, swimming and keeping fit in general.

Quotes April 15, 2009

My posting will be sporadic for awhile. Most of you know where to find me. Peace to you all….

“People who cease to grow can’t inspire others. Leadership begins with challenging oneself.” ~Daisaku Ikeda

“Smile, breathe, and go slowly.” ~Thich Nhat Hanh

“Friendship is the only cure for hatred, the only guarantee of peace.” ~Buddha

“When you love the unlovable and forgive the unforgivable, you’re free.” ~Bernie Siegel

“It’s not what you look at that matters, it’s what you see.” ~Henry David Thoreau

“Physical gifts will break or fade, but your gift of love will last forever.”

“If we could see the miracle of a single flower clearly, our whole life would change.” ~Buddha

“How sad it is that we give up on people who are just like us.” ~Mr. Rogers

“Love all, trust a few. Do wrong to none.” ~William Shakespeare

and something from one of my favorite films, Ordinary People:

“A little advice about feelings kiddo; don’t expect it always to tickle.” ~Dr. Berger to Conrad

anonymity April 12, 2009

To my regular readers and new readers: I will be using a different name on my posts. I picked Clementine because it’s a character from one of my favorite films, Eternal Sunshine of the Spotless Mind. I would greatly appreciate it if you address me in the comments section as Clementine or anything other than my real name which most of you know. Some of you know my nickname in the business I work in, please do not address me with that nickname. This is one of the reasons I’m switching to a pseudonym. Although my business is generally open and accepting, there have been a few occasions where this has been proven not be the case. And so, to protect my career that I’ve worked long and hard to achieve and remain in, I can no longer use my real name.

Unfortunately, I will have to go back and delete certain comments and posts. I am terribly sorry for this but I must protect myself and my career. Stigma is still widespread. I have also changed my email address in the contact section. If you are a regular reader or know me personally, by all means, please email me directly at my normal email address. If not, contact me via the new address.

I don’t know if this will solve anything or prevent anything. I am simply taking a precaution, especially after my latest trauma post.

happy post April 12, 2009

a clip from one of my all time favorite films, Le fabuleux destin d’Amélie Poulain:

KINDNESS AND LOVE.