invincible summers

in the middle of winter I at last discovered that there was in me an invincible summer. (albert camus)

Medicating grief isn’t the answer April 28, 2009

Filed under: change,hope,news — clementine @ 12:46 pm
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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.


Hello AstraZeneca, here’s a little Bob Dylan for you. March 17, 2009

Hello there. You guys are always here and I think you know my story. What is your name? What is your story? Until you’d like to share, please stop visiting. Or did my last message to you piss you off so much that it left you speechless and you simply couldn’t comment? Or maybe you were sitting at your desk snickering and thinking: another crazy girl who’s gone off her meds! No, I bet I know what it is, you’re taking Seroquel! Your speech is slurred and you can hardly type or put a sentence together! I’m surprised you’re even awake this early, it’s not easy, I know from previous experience! A few more questions for you, my dear reader:

Do you have a child or a friend or a loved one? Is he or she depressed? If so, have you suggested Seroquel for their depression? And lastly, if you are taking Seroquel, have you been to your doctor lately to check for diabetes?

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I’ll end this entry with the great Bob Dylan. Maybe you’ll hear his words over and over in your head today, tomorrow and the next….


this is goop December 28, 2008

Filed under: change,life,peace — clementine @ 11:38 am
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a few months ago actress, Gwyneth Paltrow started a website called GOOP. Some might be thinking who cares about an actress and her stupid website. But I hope you will see Gwyneth as a human being just like us and check out her website. Especially the BE section. There you will find Q & A’s from people like Deepak Chopra, Michael Berg of the Kabbalah Centre, Episcopal priest Cynthia Bourgeault, Sufi Shaikh Kabir Helminski, and New York psychologist Karen Binder-Brynes.

I signed up for the GOOP newsletter and have found some things to be very helpful and inspirational.


wise up December 27, 2008

Filed under: change,hope,life,love,pain,peace — clementine @ 11:33 pm
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a clip from one of my favorite films, Magnolia


Beyond Meds at NING

From Gianna at Beyond Meds.

I just started a NING social network called Beyond Meds for like minded souls to converse and socialize. If you are interested in joining (and right now I’m the only member—I have no idea if this will fly) please click here and sign up!!

Thanks to a long-time reader and friend who suggested it.

I’ve been thinking of starting some sort of yahoo group for a while, but this is better. Now we just have to see if people are interested. Pass it on to anyone who might be interested in the support group aspect of it but might not want to visit this blog regularly.

Anyone who wants to help me or give me feedback it’s welcome. It took all of three minutes to start this and really I don’t know what I’m doing. I also only feel half way decent a couple of hours a day and sometimes not even that. If you have experience with NING and can help please let me know!!

What is a NING social network? It’s a place for us all to gather and give each other support about alternatives to psychiatry, drug withdrawal, the politics of mental health etc etc. You can largely define what happens there. Please give it a whirl.

And spread the word!!

click here to join!


get kids off medicine December 19, 2008

Quickly, I would like to direct everyone to my new page (35 things: a continuous entry) at the top of my website, to the left of ‘about me’. I frequently update there with personal stories. It’s been very therapeutic.

my sincere thanks to Beyond Meds for this linking to this story. I think it’s a wonderful idea and hope to see more to follow.

Martin Irwin, MD, Professor of Psychiatry at LSU Health Sciences Center New Orleans School of Medicine, is launching what he believes is a first- of-its kind-program nationally to “Get Kids Off Medicine.”

The LSUHSC Get Kids Off Medicine Program, dedicated to tapering and discontinuing psychiatric medication for children being treated with three or more psychiatric medications, is being implemented three half days a week at the LSU Behavioral Science Center at 3450 Chestnut Street. The program accepts Medicaid and most insurance. Discounted and possible free care will be provided to those who qualify based on income.

“Along with the increase in prevalence of mental illness in children and youth, is a skyrocketing rate of use of psychiatric medication often as the sole treatment and most commonly to treat disruptive behaviors and aggression,” says Dr. Irwin, who specializes in Child and Adolescent Psychiatry. “It is not uncommon for children even as young as five to six years of age to be on multiple medications, as many as four to five at the same time.”

Dr. Irwin says the over-medicating of the problems of children in the mental health system is likely to result in misdiagnosis-labeling of behavioral problems that result from interpersonal difficulties, realistic feelings that are not excessive or out of proportion to the child’s real life experiences, or reactions to current life stresses as major psychiatric disorders leading to unnecessary medical treatment. Many of the medications used to treat children are either not approved by the FDA for use in this age group, or are not approved for the indication they are being prescribed.


for the robert downey jr fans December 17, 2008

Filed under: change,hope,love — clementine @ 2:37 pm
Tags: , ,

a man who has been through it all and survived. i deeply admire him and still love this Elton John video he made in 2001.

“I Want Love”

(after you click play, you will have to click on the youtube logo as this video does not allow embedding)

Music by Elton John
Lyrics by Bernie Taupin

I want love, but it’s impossible
A man like me, so irresponsible
A man like me is dead in places
Other men feel liberated

I can’t love, shot full of holes
Don’t feel nothing, I just feel cold
Don’t feel nothing, just old scars
Toughening up around my heart

But I want love, just a different kind
I want love, won’t break me down
Won’t brick me up, won’t fence me in
I want a love, that don’t mean a thing
That’s the love I want, I want love

I want love on my own terms
After everything I’ve ever learned
Me, I carry too much baggage
Oh man I’ve seen so much traffic

So bring it on, I’ve been bruised
Don’t give me love that’s clean and smooth
I’m ready for the rougher stuff
No sweet romance, I’ve had enough