I Hate HP

See HP customer service nightmare comments here, here, and here. So if you’re having crappy service, call (877) 917-4380 ext. 79 to speak to an English-speaking case manager. Not that it’ll help matters much, but hopefully you won’t be restricted from accessing your personal e-mail on a daily basis.

And I don’t mean to be racist, but I really CANNOT speak to (East) Indians about technical issues. I have enough trouble trying to get Americans to understand me.

I have comments on Furious Seasons’ post here, but maybe once I can get my life back, I can throw my thoughts out. Eventually.

About that job search…

… there’s a position available for editing and layout design at a pharmaceutical company in the editorial/marketing department. I amuse myself by thinking I should apply for it, but feel like I’d be violating some kind of personal ethics. I probably won’t apply for it, but I am certainly amused by the idea since I’m qualified for it.

Constructive criticism complaining and oh yeah, I'm technologically S.O.L.

I’m feeling particularly crappy today. I fell asleep around 1 a.m. and woke up at 6:10 a.m. on the dot. I know, I know, sleep is important. If only I could adhere to a schedule…

I’ve been avoiding my blog because I basically have nothing to say except to complain, complain, complain. I really shouldn’t, but that’s what I want to do.

As I said before, it’s peer-review time at my company and the main feedback I’ve gotten is "Marissa needs to handle change better and become more adaptable to fluctuating, hectic circumstances." I could take one of two positions here: I could basically say that all of my co-workers view my ability to handle change incorrectly OR I could accept their constructive criticism and admit it’s a weak area.

I feel a little bit of both. But then again, I am incredibly subjective. I’m trying to assess how it’s a weak area of mine. My defensive mechanism jumps up at that and I think to myself, "They don’t know me! I deal with the way I need to! I’m high-strung anyway when it comes to stress. That doesn’t mean I don’t handle it well! I get my tasks done and I do them effectively. What’s the big deal?"

Then I try to step outside of myself and view myself objectively (as much as I can) and think, "Well, if I saw someone stomping all around the place during a hectic time, looking grumpy, constantly complaining, and looking freaked out and stressed, I’d tell her she needs to improve as well." I battle back and forth with this.

"This is just the way I am. I can’t change."

"Yes, you can. It’s a behavioral pattern that you can take control of."

"I used to work at a daily newspaper, an extremely stressful environment. I handled shifting priorities well there!"

"Apparently, you’re doing something wrong if your co-workers feel this way about you."

So I’m left hanging. I’m pretty open to constructive criticism so I do realize my co-workers have a good point. From my POV, of course, I don’t see things the way they do and feel like it’s just a part of my personality and they need to get used to me. But at the same time, if my co-workers need to work with me, they need to feel I’m reliable enough to stay level-headed and get the job done. I really don’t want to work on the latter. It’s out of my comfort zone. Regardless, I’ll have to anyway.

I also think, "I’m looking for another job. I can ignore what they say here and go there and work much better." True. But if the criticisms of my co-workers are valid (they do have merit), it’s a characteristic I need to work on, regardless of where I work.

I’m disappointed. I’m new to this whole peer-review thing so my "constructive" criticisms for others weren’t very helpful. Out of the four people who requested my feedback, I don’t remember really handing out ANY constructive criticism to ANYONE. I’m pretty unobservant and try to see the best in everyone. I feel like the retarded member of my team. I probably criticize myself (not constructively) more than anyone on my team. The closest I came to constructive criticism for one member was, "So-and-so can continue to develop her technical skills and attend training programs to become a more effective member of the team." My competitive nature always gets me paranoid. I’m pretty certain that everyone on the team likes her more than me and thinks she works better than I do despite the fact that I’ve been here for one year and she’s been here for just over three months. So-and-so is sweet, funny, has a good spirit, is always upbeat, and within the span of three months, has made enough work friends to attend attend happy hour with them regularly. I’ve been here a year and am lucky to eek out more than, "Hi." I shouldn’t care what other people think of me, but I can’t help but realize that I’m an incredibly lame person when it comes to social skills. I often wonder if my impaired social skills have to do with being an only child. (We’re pretty rare.)

I was right. All I’ve done this entire post is complain. I no longer like my job. (I’ve learned to love the paycheck I get every other Thursday, though!) I don’t handle constructive criticism as well as I thought I did (or used to). I feel socially impaired. (It doesn’t help that I met many of my friends and my husband via the Internet.) My competitive nature drives me nuts. (I’m constantly worried about how I stack up to others. Especially those with less experience than I have.)

I’ll stop here. I’m feeling incredibly low and I need to focus on my work. The boring, boring task that I’ve been assigned to makes me want to put a .38 caliber to my head. (Um, I guess I was kidding.)

Oh and yeah, my laptop’s crapped out on me for the THIRD time. I’m S.O.L. when it comes to checking my personal e-mail now. Sigh.

Contentment vs. Discontentment: Round 1

I began working at my current position exactly one year ago. I’m not fond of it. Despite the many critical posts about the pharmaceutical industry (and hence, pharmaceuticals), I’m not a fan of medical writing. (I can make an exception for psychology/psychiatry or following pharmaceutical trends.)

It’s peer review time. My coworkers rate me and comment on how well I’m doing at my job. Here’s one person’s input on improving my performance:

"Marissa is eager to learn new tasks related to editing; however, sometimes this enthusiasm replaces a focus to fulfill her assigned role. The most important thing I can suggest to improve her performance would be to focus on efficiency and accuracy for the assignments she has been given and not allow a desire to edit or make decisions override the more important task of performing her assigned duties accurately." [emphasis mine] (My name’s been changed and I’ve revised some of the text so it doesn’t give away exactly what I do.)

I’m not saying that I’m perfect and don’t have room for improvement at my job. (I probably do focus on editing more than my actual job – mainly data entry.) But that comment alerts me that this isn’t the right job for me. I don’t write original copy; I don’t edit; my job allows little room for creativity. As for the "make decisions" part – you got me.

I think back to my first job out of college and (I don’t mean to brag, but) I did one heckuva job. I worked at a daily paper and dove into my position as a copy editor/page designer/proofreader. Within seven months, I was designing and editing front page articles. I also organized and maintained a supplement publication after the chief page designed left. (The supplement was – as my husband likes to put it – an absolute "clusterfuck.") By the time I quit, I’d left it in an organized and manageable state for others to work with. I worked my ass off until 2 a.m. sometimes. I know my boss saw this and appreciated the work I did.

Now, I’m in Philadelphia working as an entry-level medical EA and basically performing data entry. (I admit, I get paid a really good salary to do this.) I’m dealing with it, but starting to look for something else. There’s an editorial assistant position with another company closer to home that actually involves interviewing, reporting, and editing. I interviewed for a similar position at the company last year while living in the South, but had to decline the second round of interviews because I couldn’t afford the airline expense (or the time off). I know I’m much more suited to it than what I’m doing now. It won’t be copy editing – which may slow me down in writing my articles – but it’ll be more than converting Celsius to Fahrenheit and kilograms to pounds. If it’s still available by the time I get my resume together (maybe this weekend), I’ll apply for it.

Read the rest of this entry »

Get prescription medication without a prescription

I went to retrieve a printed document at the main office copier/printer/fax yesterday and noticed two unsolicited faxes sitting on the upper tray. The first one was the generic tropical vacation deal; the second was from myfirstpharma.com encouraging whomever to order “prescription medication without a prescription.”

You can go on the site and order the prescription medication they offer:

“Just fill out our online questioner [sic] and one of our doctors will write your prescription. Our pharmacy will then fill your order and ship it overnight to your Door.”

First, let’s address the online “questioner.” It doesn’t ask for your symptoms or why you want the drug. The only exception is purchasing a weight-loss drug. You fill in your height, weight, and BMI to verify obesity. So of course, you can’t lie and say you’re 5′ 4″ and 210 lbs when you’re really 5′ 4″ and 110 lbs. [sarcasm] Click the “Buy now” button and all of the shipping and billing information pops up with the “questionnaire” at the end. You must agree or disagree with the questionnaire that consists of the following:

  1. I agree not to take any over-the-counter medicines without approval from my pharmacist. If you disagree, please explain why.
  2. I agree not to take medication if I am pregnant, breast-feeding, or trying to get pregnant. If you disagree, please explain why.
  3. Please list all current medical conditions.
  4. Is there anything in your medical history that you consider to be relevant?
  5. Please list all over-the-counter and prescription medications that you are currently taking and the length of time for each.
  6. Please list all medication that you plan to take while on this program.
  7. Please list all past or present allergies including allergies to any medications.
  8. Please list all past surgeries and provide details including the condition that was treated with each surgery.
  9. Please explain the specific medical reason for ordering this medication. The physician must know the exact nature of your medical problem in order to prescribe this medication. This cannot be left blank.
  10. Are you currently taking this medication? If yes. How frequent do you take the medication in one day?

If you disagree with any of the above, you need to specify why. (Not sure if you get denied, but it’s what the site requires.) Need an anxiety medication? You can buy Buspar. Want to try different antidepressants without having to go through the hassle of seeing your doctor and dealing with insurance? You can choose from Bupropion, Fluoxetine, Wellbutrin, Paxil, Effexor, and Lexapro.

I highly getting recommend Effexor on your own. [sarcasm]

Pharma AdNeedless to say – but I’ll say it anyway – this is ridiculously dangerous. It’s cheaper to go through your doctor ($15 copay, most likely) and insurance (probably a $20 copay), but if you can’t afford that and can somehow afford prescription medication on your own, you’d better cough up some serious dough. Here’s the going rate for effexor on the site:

30 pills at 37.5 mg – $191.00
30 pills at 75 mg – $209.00
30 pills at 150 mg – $217.00
90 pills at 37.5 mg – $361.00
90 pills at 75 mg – $447.00
90 pills at 150 mg – $427.00

In KBTX.com’s article about the subject, Dr. Garth Morgan of University Family Medicine makes a few good points:

“It’s actually very scary for this type of website to actually exist. You have no way of knowing the physician that is prescribing this to you, or if they’re actually a physician,” [Morgan] said. “Looking at the website there is nothing on there that tells you who the doctors are that are prescribing it.”

“Medicines on the site are addictive, medicines on there have a black market value, and people could sell them on the black market,” said Morgan. “If people get on these sites and start ordering these medications and taking them incorrectly they’re going to be coming to the emergency rooms or my office and I won’t have an idea what they’re taking.”

“The medicines that are meant for prescriptions mean you have to have someone follow over you, look over your shoulder, work with you,” said Morgan. “It doesn’t mean it’s just an inconvenience that you have to have a piece of paper to get the medication.”

I found some more information on panicdisorder.about.com (of all places) about the risks involving the purchase of non-prescribed medications:

What is dangerous about buying medications online?
You may find yourself facing the following dangers if you purchase drugs online without a prescription:

  • Web sites offering medications without prescriptions are illegal and are not regulated in any way. The medication you purchase may be contaminated. It may not be the correct product or it may not even be a medication. You may be given the wrong dose.
  • Wrong medications and dosages put you at risk for drug interactions and other health consequences.
  • Both the FDA and the American Medical Association agree that it is unsafe to take prescription medication without seeing a doctor for a prescription. These illegal Web sites often will provide you with medication after you have filled out a questionnaire. A questionnaire cannot determine if a treatment is appropriate for you nor can it figure out if you have any underlying medical conditions that may be complicated by the medication.
  • If you purchase medications without a prescription from a foreign Web site, you are at risk for being ripped off financially and there will be little you can do about it. It is generally illegal to import most drugs purchased from these kinds of sites.

I’d like some illegal Percocet, but I’d be too much of a scaredy-cat to give any of my credit card info online.

Here’s the lesson, kiddies: Don’t purchase meds online, even if your PCP is clueless to the risks of psych drugs. It’s worth adding that you shouldn’t even purchase psych meds if your PCP is prescribing them.

(photo from The Red State)

Nothing to say

So I finally have a bit of time to post, but my mind is blank. I really have nothing to say.

I have a swirl of ideas in my mind and half-finished posts on various topics, but I don’t have the energy or the focus to write out anything coherent. See Bipolar Blast. (Watch this change later on. I’m great at contradicting myself.)

We’ll see what I can come up with, but in the meantime, I’m a total blank. Check out …salted lithium.’s post on debunking the "manic depression made me do this" excuse.

Saturday Stats

"A recent study in the Journal of the American Medical Association (JAMA) concluded that the frequency of severe and fatal reactions to prescribed drugs in the United States is ‘extremely high.’ More than 100,000 people per year are estimated to die in hospitals from drug reactions, implicating medications as one of the nation’s top killers. Depending on the specific estimate, drug reactions in hospitals may constitute either the fourth or the sixth leading cause of death behind heart disease, cancer, and stroke." — Breggin & Cohen, "Your Drug May Be Your Problem"

A few things

I’m having the crappiest time with technology (and interpersonal relationships at work). My laptop has crapped out for the second time in the past two months so it’s off to HP for another  fix. (I’m not happy about this.) This means little to no personal e-mail access for at least a week – maybe two – and a possible lack of updates. I do most of my blogging at work, but work has been coming in waves so I’ll have a straight week of posts and catching up on blogs and then I have no time to myself. To top it off, my laptop has put my Shuffle on the fritz so I can’t even listen to music while exercising or commuting.

I know I’m complaining, but I figured I’d put this post up to let people know that I haven’t disappeared or committed suicide or anything. I’m just having a crappy few weeks. I hope everyone else’s week turns out better.

Saturday Stats

"Rates of mania caused by antidepressants frequently reach or surpass 1 percent of patients." — Breggin & Cohen, "Your Drug May Be Your Problem"

Crappy Post of the Week

Comment on this post if you’ve had a crappy day/week like me.

Things will get better soon. There’s a light at the end of the tunnel – even if you’ve been in the darkest part of the tunnel for 25 years (me).

A pic to cheer some animal lovers up:

Invisible Onion and Knife


Should those with mental illness possess firearms?

Liz Spikol (The Trouble With Spikol) wrote about whether those struggling with mental illness should have the ability to buy and possess guns in her weekly column for the Philadelphia Weekly. I can certainly identify with some of her feelings:

I don’t always want to die. Just … usually. It’s hard to wake up every morning and consider the facts—I’m going to have to hang in there for another day, get through the working and the sleeping until the next day comes with the same question: Can I make it through today?

I did it yesterday, but what about tomorrow?

I drive past a bridge, and think about jumping. I see a sale on razor blades, and I think of slitting my wrists. I wait for the trolley, and think of throwing myself in front of it. It’s a macabre parlor game I play without being entirely aware of it. Like absently counting yellow cars as you go down the highway.

My obsession with suicide—and my daily struggle not to give in—isn’t, I’d venture, so unusual for people with serious mental illness. So much of the time we’re locked in battle.

Tell me about it, sistah. She goes on:

Now, a question: Do you want a person like me to own a gun? I could walk into a gun store today, put on a smile, chat with the clerk and go over with him which firearm would be best for a single woman who wants home protection.

I could get a gun more easily than I could adopt a dog from most animal shelters.

So could a lot of people like me—sad, angry, desperate, but smiling and going out to dinner and seeing a movie and talking to friends. Hiding is the most natural thing in the world to us. We’re all covert operators of a kind.

When Seung-Hui Cho killed 32 people at Virginia Tech, it got several debates going at once, many of them to do with gun ownership and mental illness. What are the privacy rights of students with mental troubles? Does the right to bear arms apply equally to those who are delusional and suicidal?

Despite my normal facade, which I master, there is no way in hell I should own a gun. A couple days after the massacre, I wrote as much on my blog, expecting to be pilloried.

Whether we’re talking about depression that leads to suicide or the kind of mental troubles that engender mass slaughter, the fundamental problem is the same: We don’t effectively keep guns out of the hands of people who—through no fault of their own and for organic reasons they have no control over—should not be allowed to own them.

Liz, I agree with you wholeheartedly. I know there’s debate among the mentally ill about whether they should be able to purchase firearms because they have the "right" to.

The right to bear arms should have a restiction akin to that on free speech:

"The government can regulate speech that is intended and likely to incite "imminent lawless action," or where the speech presents a "clear and present danger" to the security of the nation."

Those who are severely mentally ill should NOT be allowed to possess firearms. I’m on the border of sounding TAC-ish here, but those with severe mental illness represent a sort of "clear and present danger" to others and themselves.

Determining who is or isn’t severely mentally ill is a tough call. I’ll even play Devil’s Advocate on myself and refer to my last post on "supposedly shooting the messenger" in which I said that 50 percent of participants in a study admitted to having a lifetime psychiatric disorder. I’m basically saying that’s 150 million people who can’t own firearms. Even I think that’s a bit too much.

So how is it possible to regulate this problem? In all honesty, I do not have the answers. Background checks are supposed to be performed before a purchase goes through. (I think the waiting time varies from state to state. If I gauge myself correctly, New York state has a 7-day waiting period.) Background checks do not include a mental history. Congressmen around the country have begun introducing bills that require states to identify people who were ordered by a court to be committed to a hospital for inpatient care. This means if a person voluntarily checks himself into a hospital or receives outpatient care (including psychiatrist/therapist sessions), this information would not be required. Virginia Governor Tim Kaine went a step further in his bill, however, saying that he wanted to include people who receive outpatient care. That’s a little – no pun intended – insane to me. Either way, Cho wouldn’t have – another pun here – completely fit the bill. Although a judge ordered that he receive outpatient treatment, he was never committed. As a result, "his name was never entered into the FBI’s National Instant Criminal Background Check System and he was later allowed to by a gun." I’m curious about the number of guns Cho purchased. It sounded like a possessed a few handguns at the time of the shooting.

Interestingly enough, National Rifle Association (NRA) Executive Vice President Wayne LaPierre  supports preventing access to guns for those who have been committed to a hospital via court order. The vice president of the American Psychiatric Association and the president of Mental Health America (MHA) have spoken out against releasing medical records.

"David Shern, president of the [MHA], denounced the measure as ‘an extremely ill-informed regressive social policy that further stigmatizes people and will do nothing to reduce gun violence.’

The critics say the ban discriminates against people with mental illness, based on the erroneous assumption that they are more violent than other people."

[Aside: Enter TAC]

Should we [as mentally ill patients] give up our HIPAA rights and allow stores that sell weapons to peek into our medical history to detemine whether we’re fit to own a gun? I don’t think our entire medical history should be divulged. (Not unless you want to, which for some reason, you actually can.) National mental health organizations are against any policies that would require state or federal access to confidential medical information.  The argument is it would deter people from seeking treatment. (I’m not normally thinking that I shouldn’t get treatment for my depression because the government won’t allow me to buy a gun, but that’s just me.) Perhaps at least three witnesses should be involved (like applying for a financial loan) in the purchase who can verify that the buyer is mentally fit to purchase a weapon. This isn’t foolproof solution, but it might help.

If I had access to a gun, I’d have been dead a long time ago. Actually, my father-in-law, who used to to be an avid hunter, possesses guns in his home. I don’t know where they are, but even if I did, the key to the cabinet is located somewhere else. I get pretty suicidal, but I probably would get tired and give up after hours of searching for the key and the cabinet. I could go to a Super Wal-Mart and maybe get my hands on one, but, uh, I won’t go that route.

I’ve been hospitalized twice for suicide attempts. The first for overdosing on over-the-counter medications and the second for several attempts (attempting to hang myself, drink household cleaners, etc.). The outcome to resolve both incidents were not very fun. (Try drinking even a Dixie cup full of charcoal and see how you can swallow it.)

I can go to a store to purchase firearms and likely pass a background check with flying colors. Since I’ve voluntarily committed myself to a hospital. I’ve never been "court-ordered" to do so. Given my mental history, this is a problem. I’m sure there are many other people out there who are worse off than I am and can still obtain guns.

The law has to include information to alert a firearms seller as to who can and can’t use a gun responsibly. The inability to do so could affect (and will) affect the lives of countless others. The route to doing that, however, is not easy or as simple as we’d like to think.

And remember, even if the bills mentioned above had already been law, they would have never stopped the VTech shootings. Cho would have passed with flying colors.

Quote of the Week

"Spiritual orphans see themselves as humble sufferers in their emotional pain. But in fact, they are simply closed off people who are too proud and fearful (the two are closely related) to admit failure, imperfections, and sins, and acknowledge their complete dependence on God." — Rose Marie Miller, from fear to freedom

Saturday Stats

"Studies show that at least 75 percent of the antidepressant effect is a placebo effect — the positive response that people have to any treatment that they hope or think will work. But the remaining 25 percent of the positive result may be caused by the ‘active placebo’ effect — which is related to the fact that the antidepressants, unlike placebos, have noticeable side effects that convince the subjects that they are getting ‘strong’ or ‘real’ medicine." — Breggin & Cohen, "Your Drug May Be Your Problem"

Loose Screws Mental Health News

Advance apologies for sounding like I’m in a cynical mood. I’m working on something today that I’m not fond of.

An article in Newsday (by the Associated Press) says that researchers are becoming hopeful that hormonal therapy can ward off mental health decline in menopausal women, such as dementia. It seems that previous research found that hormonal therapy produced negative results, but the new research suggests that timing may be the defining factor. Older women in the later stages of menopause seem to be at more risk for heart attacks, strokes, and breast cancer. Doctors are saying hormone therapy may work in women in the earliest stages of menopause.

The Long and Short of It

  1. Researchers have discovered that the malfunction of a gene thought to be associated with  schizophrenia or depression seems to have symptoms associated with those illnesses. They figured it out thanks to our trusty mice. The mutated gene is called DISC1 (Disrupted in schizophrenia 1).
  2. Breast-feeding helps new moms battle depression. Consuming foods with omega-3 fatty acids also provides benefits. According to an author named Kathleen Kendall-Tackett, breast-feeding lowers stress levels. However, if the mother is having issues feeding her child, it can have the opposite effect and bring on depression.
  3. Kathy CronkiteWalter Cronkite’s daughter Kathy has a book, The Edge of Darkness, which details her battle with depression. Oh, and by the way, Joan Rivers and Mike Wallace deal with depression too. (That’s in the book.) EDIT: Polly of polarcoaster.net let me know that Cronkite’s book isn’t new.  She was just discussing her experience with depression in Cincinnati’s The Enquirer.
  4. A new study shows that chronic depression may lead to diabetes in older people.

“The culprit appears to cortisol, a hormone produced in response to stress. When someone is depressed, cortisol levels rise. If depression is chronic, cortisol levels may stay consistently high.” – Debra Manzella, R.N.

Also, make sure you’re working on your 300+ crunches daily:

“Excess belly fat is a known risk factor for diabetes.”

One of the saddest mental illness stories I've ever read

Jan B., a mother of six children, has one autistic son and another severely schizophrenic son.

This post is about her schizophrenic son. The post was prompted by the VTech shooting and the number of murders committed by men. Not to belittle her experience here, but this is an real example of what the TAC would point to. I feel bad for Jan becayse she’s deathly afraid of her son, who has attempted suicide several times and threatened to kill family members at various points (hallucinations). He didn’t get better until he was placed in a state mental hospital and put on Haldol. The story is a very good example of a mental health (and insurance) system gone awry. It’s a long post, but such a heart-wrenching read that it almost makes you feel lucky to deal with your daily challenges.

A statistic that jumped out at me:

"45% of people with schizophrenia refuse treatment or quit taking medicines"

My father was a classic case of this. (He did both.) To allude to my last post, he died of heart disease.

Mentally ill? Expect to die sooner

In the midst of the Virginia Tech shootings and the Rebecca Riley case, the media have finally shone a spotlight on mental illness. Some good, some bad (see TAC’s lock ’em and throw away the key).

Marilyn Elias’ article in USAToday, "Mental illness linked to short life," points to obesity and antipsychotics as two of the main factors. (They’re inextricably linked.)

"Obesity is a serious problem. These patients often get little exercise, and many take a newer type of anti-psychotic, on the market for 18 years, that can cause drastic weight gains, promoting diabetes and heart disease, Parks says. He thinks these drugs are contributing to deaths from cardiovascular disease.

Recent studies question the advantage of the newer drugs. "Many could be switched to safer medicines," Parks says. Schizophrenics are thought to have a higher risk for diabetes already, he says."

The article specifically mentions that people with mental illness tend to die at the age of 51 as opposed to the national average of 76. The odds of dying are as follows:

  • 3.4 for heart disease and diabetes, respectively
  • 3.8 for accidents
  • 5.0 for respiratory disease
  • 6.6 for pneumonia and the flu

The staggering fact here is "three out of five" people die from diseases that can either be prevented or easily treated. This combats the widespread myth that the mentally ill die mostly by accidents and suicide.

My hope here is that as the NY Times and USAT pick up on the issues of mental illness, the public can become less callous to those who are – ahem – "crazy" and try to reach out to them. Despite the TAC’s point of view, most of us are NOT violence and benefit from the help of a caring few.

What a shame that 32 lives had to be taken to spark this discussion.

USAToday has a great list of related articles. I recommend "New antipsychotic drugs carry risks for children."

PERSPECTIVES: One family’s success story
PERSPECTIVES: Mom feels betrayed by doctors, FDA
Adult antipsychotics can worsen troubles
For foster kids, oversight of prescriptions is scarce
A rush to overprescribe?
Opinion: An outraged journalist and father discovers the mental health system is in ‘shambles’
Welcome to the club.

TAC's Irrelevant Statistics

A couple of things:

  • I’m going to go the way of Gianna at Bipolar Blast and admit that my stats weren’t as accurate as I would have liked them to be. (Hey, I did say, "I could be wrong.") My math is about average and stats were never my thing so please, feel free to take a page out of John Grohol’s book at PsychCentral.com and do a kick-ass analysis of studies or stats that interest you. I must say, however, I am quite flattered at helping raise awareness about the TAC’s stupidity. All credit goes to Furious Seasons for picking at them piece by piece first. Cairn, a commenter over at CLPsych, did a better job of analyzing the stats I used. It seems pretty spot on to me.
  • My husband – the better mathematician and also my better half – pointed out something I’m not sure anyone picked up on. (My apologies to anyone who did.) Let’s recap:

USPRA: “Violence is no more prevalent among individuals with mental illness than the general public”
Fact: The CATIE violence study found that patients with schizophrenia were 10 times more likely to engage in violent behavior than the general public (19.1% vs. 2% in the general population).

Have you figured out what it is yet? Well, the TAC took the USPRA’s broad statement about violence among people with mental illness and applied data about violence among schizophrenics only. The data the TAC used is irrelevant because it doesn’t even apply. The percentages that the TAC used to combat the USPRA’s statement isn’t even an accurate because, well, the USPRA wasn’t talking about schizophrenics; they were talking about the mentally ill in general. So all my stats in my last post are pretty much moot at this revelation because of TAC’s skewed application of the CATIE violence study statistics.

"There are three kinds of lies: lies, damned lies,
and statistics."
~ Mark Twain

Copies of published studies

All right, I think I asked this before and I know one of my readers sent me a few links to the STAR*D study (which I haven’t had the chance to read). Does anyone know where I can get my hands on CATIE and BOLDER (I and II)? Will this PDF from The New England Journal of Medicine suffice? (I believe it’s phase 1.)

Otherwise, I’ll cross my fingers and hope – oh crap, wait! Maybe I can use the library at my job! Geez, why didn’t I think of this before?

Well, if anyone’s got an electronic copy, that’s preferable. Many thanks in advance.

UPDATE: I just checked the medical library in my building and apparently, I do have access to medical publications that require subscription online. It’s probably unethical to disseminate business material for personal purposes (especially since my other duties require me to work with confidential material), but I can always read the articles and try to pass along bits and pieces that jump out at me here and there.

More during the summer…

Dr. Dinosaur Analysis: How Doctors Think

Dr. Dinosaur’s post showed up in my Google alerts and it turns out that he evaluates Jerome Gloopman’s book, How Doctors Think. Dr. Dinosaur’s expectations for the book are met with disappointment:

"As I read through the book, though, I realized that the omission of psychiatry and the discussion of the proper role of psychiatric diagnosis in medicine (as opposed to the misdiagnosis with which he opens the book) renders many of his comments irrelevant to the day-to-day practice of medicine in the community. By "community" I specifically refer to the non-Harvard, non-Massachusetts General, non-assorted-other-institutional-names dropped in the name of prestige. Out here in the real world, psychiatrists think just like the rest of us. They care for diseases that are primarily mental in origin. These diseases have criteria for diagnosis, treatment protocols, risk factors and prognoses. Making these diagnoses is often straightforward — and sometimes less so. Treatment succeeds or fails, or stops working, at which point it often helps to change the treatment or re-visit the diagnosis. Sounds a lot like medicine, because it IS medicine."

My favorite anecdote from Dinosaur’s post:

"I have experienced this phenomenon. A patient of mine almost from the day I hung out my shingle kept having great difficulty with depressive symptoms and anger issues. Antidepressants didn’t really help, nor did counseling. About two years ago I attended a seminar on Bipolar Disorder, including the fact that it’s far more prevalent than previously recognized, and that it’s much more than just classic manic-depressive symptoms. One of the talking points was that on average, patients waited seventeen years before being correctly diagnosed. After that, I brought tools from the seminar into my practice. I didn’t go around diagnosing everyone with bipolar, but I did begin recognizing it more than I had. The first time after the seminar I saw the lady I mentioned, I listened to her telling me once more about her symptoms; her anger, her explosiveness. Whoa, I thought. I whipped out the Mood Disorders Questionnaire from the seminar to confirm my impression. Sure enough, now that I had become familiar with a diagnosis with criteria different from what I had learned, I was able to see her in a new light. I treated her with mood stabilizers, and she responded beautifully; very grateful that "something finally worked!" I looked back over her chart. Ironically, it had taken seventeen years to make the diagnosis."

Perhaps the rising percentage of people suffering from bipolar disorder can be attributed to misdiagnoses as opposed to bipolar being the "hip and trendy" mental illness to have. (Although, the latter is true among teenagers.)

A classic case of twisting the words of someone who supposedly shot the messenger

The subject title is long, but – I think – apropos.

The Treatment Advocacy Center’s post, “A classic case of shooting the messenger,” has been bothering me all day. I’ve been wanting to do further research on their claim that “patients with schizophrenia were 10 times more likely to engage in violent behavior than the general public.” Funny thing is, I didn’t have to look far.

The TAC links to a summary of the CATIE violence study and surprisingly, it contradicts the TAC’s post. I couldn’t help but chuckle once I realized I could easily debunk their claims from what they considered supporting evidence.

USPRA: “Violence is no more prevalent among individuals with mental illness than the general public”
Fact: The CATIE violence study found that patients with schizophrenia were 10 times more likely to engage in violent behavior than the general public (19.1% vs. 2% in the general population).

MY TAKE:Overall, the amount of violence committed by people with schizophrenia is small, and only 1 percent of the U.S. population has schizophrenia. Of the 1,140 participants in this analysis, 80.9 percent reported no violence, while 3.6 percent reported engaging in serious violence in the past six months. Serious violence was defined as assault resulting in injury, use of a lethal weapon, or sexual assault. During the same period, 15.5 percent of participants reported engaging in minor violence, such as simple assault without injury or weapon. By comparison, about 2 percent of the general population without psychiatric disorder engages in any violent behavior in a one-year period, according to the NIMH-funded Epidemiologic Catchment Area Study.”

This data is a little skewed here. (CLPsych or Philip Dawdy could do a better job at clarifying this for me.) First of all, “about 2 percent of the general population without psychiatric disorder engages in any violent behavior in a one-year period.” How many people does this constitute? The sentence doesn’t specify ‘without schizophrenia’; it says “without psychiatric disorder.” That means Americans who do not suffer at any given time from depression, bipolar disorder, psychosis, anxiety, schizophrenia, obsessive-compulsive disorder, postpartum depression, and the list goes on and on. Can anyone compile complete data of Americans who suffer from a psychiatric disorder? (Why do I have the funny feeling that Americans without psychiatric disorders are becoming the minority?)

In the January 1994 issue of the Archives of General Psychiatry, results of the National Comorbidity Study were released. Diagnoses from the DSM-III were applied to the participants ranging from ages 15-54. The study found that 50 percent of participants reported “one lifetime disorder” and 30 percent said they had “at least one 12-month disorder.”

That was January 1994. The American population has grown significantly since then, so I have a hunch that there's an increase in diagnosing people with psychiatric illnesses. But like I said, that’s, uh, just a hunch. (Keep in mind that the study does not include children ranging from ages 4-14 who are likely to receive ADHD and/or bipolar diagnoses.)

Humor me: Let’s take the NC study’s findings and apply it to the current estimated U.S. population (assuming that the percentage of those with a lifetime disorder has remained the same). Out of nearly 300 million Americans (July ’06 estimate), that means about 150 million Americans have at least some form of a psychiatric disorder. If 1 percent of the general population suffers from schizophrenia, that comes out to 3 million people. If we apply CATIE’s violence percentages, TAC’s right; 19.1 percent of schizophrenic patients engage in violent behavior of any kind. However, the CATIE study also says that two percent of the general population without psychiatric disorder engages in violent behavior. That means out of the remaining 150 million, 2 percent of that would be —*drumroll please* — 3 million Americans! Maybe it’s just me, but doesn’t seem 10 times likely. I could always be wrong.

Read the rest of this entry »

Loose Screws Mental Health News

I haven’t done this for a while so hopefully I can pick this up again a little more regularly. (crosses fingers)

Read a heart-wrenching story in the UK Daily Mail about a mother whose postpartum depression led her to begin slitting her wrists.

Tom ChaplinTom Chaplin, singer for the band Keane, has admitted to contemplating suicide.

Tom – who was taking up to two grams of cocaine a day – revealed to Britain’s Q Magazine: “I was at the end of my tether in Japan. I was tired of my life and feeling pretty suicidal. I got off the plane and called my dad. I’d told him that I’d left the band and that I was falling apart. I checked myself into The Priory.”

Chaplin’s interesting view:

Despite his own drugs hell, Tom says it’s a personal decision to experiment with substances. He claims troubled rock star Pete Doherty should be left to take all the drugs he wants.

Tom said: “No-one’s got any right to stop him killing himself.”

An article in the Chicago Tribune on how VNS is beginning to show benefits for some patients. Which reminds me, browse on over to VNSdepression.com to learn more.

Nicholas Vakkur must have read the Treatment Advocacy Center’s post on how the CATIE study shows an increase in violent offenses by mentally ill patients (namely those with psychosis and schizophrenia). He refutes this idea on dissidentvoice.org:

Individuals with a mental illness are far more likely to be the victims, rather than the perpetrators of violence, while the vast majority of people who commit acts of violence against others are not in fact mentally ill.

This rush to stereotype individuals suffering from psychiatric illness as likely murderers is reckless and lacks credulity. Mental illness has no role in the majority of violent crimes committed in our society. Alcohol and substance abuse far outweigh mental illness as factors contributing to violence, while the strongest predictor of violent and/or criminal behavior is a past history of violence and criminality, not a major mental illness.

Treatment Advocacy Center?

Please correct me if I’m wrong, but the Treatment Advocacy Center sounds prejudiced against those with mental illness. I’ve come to this conclusion after skimming a few posts. Can anyone refute this for me?