The Bipolar Child, Part I: Reactions

Newsweek If you haven’t been reading the news recently, Newsweek magazine published a feature article on Max, a 10-year-old who struggles mainly with bipolar and attention-deficit/hyperactivity disorders among other mental illnesses. I read the article and was astounded at what Amy and Richie Blake, Max’s parents, have to contend with. I’m astounded at what Max suffers with.

The article was educational but for all the 8 computer pages that I printed, I didn’t read about Max; I read about his diagnoses:

Max Blake was 7 the first time he tried to kill himself. He wrote a four-page will bequeathing his toys to his friends and jumped out his ground-floor bedroom window, falling six feet into his backyard, bruised but in one piece.

He cried for hours at a time. He banged his head against his crib and screamed until his face burned red. Nursing, cuddling, pacifiers—none of them helped.

Richie carried his son to the backyard and tried to put him down, but Max shrank back in his father’s arms; he hated the feel of the grass beneath his small bare feet. Amy gave Max a bath and turned on the exhaust fan; he put his hands over his ears and screamed. At 13 months, he lined up dozens of Hot Wheels in the same direction, and when Amy nudged one out of order, he shrieked “like you’d just cut his arm off.” At day care, he terrorized his teachers and playmates. He wasn’t the biggest kid in the class, but he attacked without provocation or warning, biting hard enough to leave teeth marks. Every day, he hit and kicked and spat.

By 7½, Max was on so many different drugs that Frazier and his parents could no longer tell if they were helping or hurting him. He was suffering from tics, blinking his eyes, clearing his throat and “pulling his clothes like he wanted to get out of his skin,” says Richie. In February 2005, under Frazier’s supervision, the Blakes took Max off all his meds. With the chemicals out of his system, Max was not the same child he had been at 2. He was worse. … Off his meds, Max became delusional and paranoid. He imagined Amy was poisoning him and refused to eat anything she cooked. He talked about death constantly and slept little more than two hours a night.

During a recent appointment at Frazier’s office, he went into full-fledged mania. Laughing wildly, he rolled on the floor, then crawled over to his parents and grabbed an empty medication bottle, yelling, “Drugs! I’ve got drugs! It’s child safety!” Richie grabbed it back, Max screamed, Richie threw the bottle across the room, as if playing fetch. Max squealed and dove for it, then began to sing into the neck of the bottle: “Booorn to be wiiiiild …” Amy rolled her eyes: “Two kids.” And then: “It’s hard not to laugh.” (I’m not the only one who doesn’t think this is mania.)

All throughout the article, I couldn’t help but think to myself: Who is Max? Max without meds — does he have a personality? What does like to do for fun, even for short periods of time? Karate is mentioned — does he read? He has trouble writing for long stretches. He’s got a friend. What makes Max so charming other than the fact that he’s 10 years old?

(Image from Newsweek)

Continue reading “The Bipolar Child, Part I: Reactions”

Furious Seasons's Spring Fundraiser

Since its September 2005 inception, Furious Seasons (www.furiousseasons.com) has been a resource for many people who may struggle with mental illness or know someone who deals with mental illness. Author Philip Dawdy has shed light on the dealings of pharmaceutical companies and provided keen insight on today’s psychiatric practices. His investigative journalism skills have helped educate thousands of people. As a result of his blog, I am aware of the negative effects that antipsychotics – namely Zyprexa and Seroquel — can have on people. Upon learning of his experience of Lamictal withdrawal and from the comments of others, I am much more aware of the potential side effects I may endure should I choose to taper off of the drug.

In keeping with the title of his blog, Dawdy has begun to host seasonal fundraisers to help maintain his site and support the extensive research he performs for the blog. His site is read by thousands on a regular basis and he needs all the support he can to keep his work going and the site functioning.

If you don’t read his site (and you should), please go to his blog (link above) and read some of his posts. After you’re done, I’m pretty sure you’ll realize what an asset he is for the mental health community.

Then, donate. It doesn’t matter how much — $5, $10, $25, $50, $100 — whatever you can give! He’s got a PayPal button on his site (just like I do, ahem) that you can click on to support his work. If you’re not comfortable with putting your credit card info on a Web site, he also accepts checks, money orders… whatever will clear in the bank.

By the way, Dawdy has helped me out in the past (yep, he too clicked on my PayPal button and helped me out when I needed it) and I intend to return the favor. A donation to his site helps this mental health patient — and many others — in return.

Breggin takes on Newsweek's "Growing Up Bipolar" article

Breggin’s post on Newsweek‘s "Growing Up Bipolar" article makes good points but steers clear into wackiness throughout. My only wish is that instead of pointing out the problems of the psychiatric industry, he would have offered some suggested solutions.

Oh, and he flat-out gets some things wrong:

Newsweek makes clear that Max’s parents have serious conflicts over how to raise their son, but they have not pursued therapy, marriage counseling or, apparently, not even parenting classes.

The article DID mention that they tried to pursue marriage counseling but dropped out.

He says he has never been to therapy. But late last year, Amy demanded that the two of them see a marriage counselor. Richie agreed. They went a few times, but there were "scheduling issues," says Richie, and they haven’t gone back. For the moment, they are getting help from the same people who help Max. Anything that makes his life easier makes theirs easier, too.

Then he applies a broad brush from the cases of "out-of-control" children that he’s seen:

In every case of an out-of-control child I have seen in my psychiatric practice, either the parents were unable to reach agreement on a consistent approach to disciplining their child, or a single working mom was trying to raise a young boy without the aid of a male adult in the child’s life.

I like Peter Breggin’s approach to psychotropic drugs for the most part, but sometimes he just gets a little off-base for me.

Pharma's "me-too" drugs face skeptical docs and health insurers

As patents expire on a variety of drugmakers’ moneymakers, pharma companies have gone to great lengths to structurally reinvent the successful drugs then tout the benefits that differ from their predecessors.

InvegaCase in point — Johnson & Johnson’s Invega. Invega is the successor to the popular antipsychotic drug, Risperdal, and competitor to AstraZeneca’s widely used antipsychotic Seroquel. Scott Hensley at The Wall Street Journal’s Health Blog (WSJ) reports that Risperdal is going generic in June. Gianna at Beyond Meds recently said it will not. According to the Dow Jones Newswires (DJN), these “junior” drugs face skepticism from health insurers and doctors. California-based Kaiser Permanente and Minneapolis-based UnitedHealth Group Inc. (UNH) are example of companies that have somewhat discouraged use of the drug. Kaiser doesn’t cover Invega at all, and members of UNH are required to pay higher copays for the brand name. The wire reports New York-based psychiatrist Jeffrey Lieberman wasn’t “buying it” the difference between Invega and Risperdal.

Invega is “basically a me-too drug, and the company hasn’t done the studies that would be required to really distinguish it,” Lieberman, chairman of the psychiatry department at Columbia University’s medical school told Peter Loftus of Dow Jones Newswires.

Ouch.

The blog also quotes Daniel Carlat from the The Carlat Psychiatry Report.

Dan Carlat, a psychiatrist and a tough critic of Invega, wrote that J&J’s “marketing team apparently missed the fact that the word in the English language that sounds most like “Invega” is “inveigle,” meaning “to entice, lure, or ensnare by flattery or artful talk or inducements.’ ” He asked doctors: “Will you be doing your patients a favor by taking the plunge? Or will you simply be giving them the same wine in a fancier bottle?”

Even J&J’s Group Chairman of Pharmaceuticals, David Norton, admitted that Invega is a tough sell.

“We need to do a better job at drawing a differentiation in a difficult-to-treat population.

So far, Invega sales have been incredibly disappointing compared to the Risperdal blockbuster.

Wyeth (antidepressant Effexor XR cum Pristiq) and Shire (ADHD drug Adderall XR cum Vyvanse) face the same uphill battle. Wyeth’s Effexor faces generic competition from Teva Pharmaceuticals despite efforts to halt generic sales of the drug and the patent on Shire’s Adderall is set to expire next year.

Hensley, in his analysis, raises a question in which the answer remains to be seen:

Cheap generics abound to treat a broad assortment of illnesses these days. What’s the point, the critics ask, of paying more for drugs that are at best only slight improvements over tried and true medicines available at bargain prices?

It’s something that I’ve questioned myself.

In an attempt to have the “me-too” drugs compete with its derivative, both Wyeth and Shire are slashing their prices, or as the DJN reported, “emphasizing improved dosing for the newer drugs.” Although Pristiq’s efficacy comes at higher doses, it’s being priced 20 percent lower than Effexor.

[Deutsche Bank pharmaceutical analyst Barbara Ryan] thinks the odds of
Pristiq’s success are slim because it appears to offer few benefits
beyond those of Effexor.

That remains to be seen. So far, a few patients have commented on my blog that Pristiq has already begun to help them. I haven’t seen any DTC ads for Pristiq so I can only assume that drug reps are doing a fine marketing job at selling the different benefits of the drug to doctors.

Vyvanse, on the other hand, is looking promising for Shire, already having 7 percent of U.S. ADHD drug prescriptions. Chief Executive Matthew Emmens says the drug is chemically different from Adderall (aren’t they all?) and has better pricing. Shire expects to beat Adderall’s 26 percent peak market share. Seems like a lofty goal to me.

As for Invega, J&J is currently seeking FDA approval to use the drug for bipolar disorder and not just treatment for schizophrenia. It is also l0oking to get approval for an injectable Invega XR.

(Invega logo from Janssen.com)

Celebrity Sensitivity: Kirsten Dunst

Kirsten Dunst I’m not a fan of Kirsten Dunst or her acting (but Interview with the Vampire was pretty good) but I have to give her sympathy if she was depressed enough to check into a hospital. Her admission comes toward the end of Depression Overawareness and Overmedication Week and May’s Mental Health Awareness Month.

In February of this year, Dunst checked into Cirque Lodge Treatment Center, a “posh facility” in Utah that has treated the likes of Eva Mendes (wouldn’t say) and Lindsay Lohan (substance abuse).

In any event, Dunst stayed low-key about her treatment for depression.

As for why she decided to talk about her struggles now, Dunst tells E!, “Now that I’m feeling stronger, I was prepared to say something … Depression is pretty serious and should not be gossiped about.”

(Does this count as gossiping?)

Dunst dealt with her depression allegedly by partying and engaging in “wild nights.” However, a supportive friend says that she had been struggling for quite a while.

“She’s been crying a lot lately, ” said the friend. “Everybody hits that bottom where you feel [so] scared that that one heavy night of partying can really wake you up. It’s good she’s getting herself help.”

I’m glad that she was able to get treatment. Although I still envy the “posh facility” part of it. Checking in to a hospital is never fun but I can only imagine that celebrities are treated comfortably. See it here.

(Hat tip: Gianna at Beyond Meds)

Light posting & Quote of the Week returns

Posting might be light this week. The full-time editor/proofreader at the agency I’m currently working for got into a bad car accident early Tuesday morning and is suffering from a concussion and may have a broken wrist. She was hoping to be back at work by Thursday but her concussion’s still pretty bad and she can’t really see. I’m filling in for her full-time this week. Depending on how she progresses, I may be working for the company full-time next week as well. The company begins summer hours on Friday, which means that I’ll get out at 2 pm if all work goes smoothly. Maybe some posting then.

In the meantime, Quotes of the Week will be posted regularly every Sunday. Enjoy.

Loose Screws Mental Health News

ABC News covers the potential legal wrangling that might occur for Internet users as a result of the MySpace suicide case. I mentioned this in a recent post.

In some sad news after this Memorial Day weekend, Greg Mitchell at the Daily Kos reports that Chad Oligschlaeger, a 21-year-old Marine suffering from PTSD, committed suicide. According to family members, he was taking 8 different kinds of medication to control the disorder. Mitchell has an update on the story.

In some (somewhat) good news, mental health specialists from across the board are offering free services to current troops in an effort to help out with the shortage of mental health assistance in the military.

My Chemical RomanceAlso in a recent post, I also mentioned how people (namely in the UK) have been in an uproar over the fact that some people are equating “emo” music with the glorification of suicide, cutting, and death. My Chemical Romance (MCR), the band seen at the forefront of the emo music scene, has released a statement concerning the uproar and 13-year-old Hannah Bond’s death:

We have recently learned of the suicide and tragic loss of Hannah Bond. We’d like to send our condolences to her family during this time of mourning. Our hearts and thoughts are with them.

My Chemical Romance are and always have been vocally anti-violence and anti-suicide. As a band, we have always made it one of our missions through our actions to provide comfort, support, and solace to our fans. The message and theme of our album “The Black Parade” is hope and courage. Our lyrics are about finding the strength to keep living through pain and hard times. The last song on our album states: “I am not afraid to keep on living” – a sentiment that embodies the band’s position on hardships we all face as human beings. If you or anyone that you know have feelings of depression or suicide, we urge you to find your way and your voice to deal with these feelings positively.

I blame MCR for Hannah’s death about as much as I blame Nirvana and “grunge” music for making me suicidal. (I don’t blame Mr. Cobain at all.) Granted, Nirvana’s music put me in a mental state where I was much more open to depression but I can’t blame a band for my actions. Besides, every generation has the band that every parent feels the need to hate. Nirvana and “grunge” music were “it” for the 90s. MCR and “emo” will soon be out for the 00s. We’ll see what the next band and music genre will influence teenagers in the next decade.

Celebrity Sensitivity: Maurice Benard

This one’s for the women.

If you’re anything like me, sometime during the 90’s you watched the long-running soap opera General Hospital at one point or another. Well, remember bad boy Sonny Corinthos?

Maurice BenardMaurice Benard, the actor behind the character, has openly admitted to struggling with severe bipolar disorder and is a spokesperson for Mental Health America. While I’m not sure which came first (the chicken or the egg), Benard’s charcter, Sonny, also struggles with bipolar disorder on the show. In the past, I’ve read that he flew into rages so bad that he needed to be hospitalized and had to take time away from the set to recover. It’s only fitting that Sonny’s character — as ruthless as he is — shows a true side of Benard who seeks to educate viewers about the disorder.

Combined with his stressful career in organized crime, Sonny’s bipolar disease has caused him to routinely break out in acts of senseless violence.  The most infamous example of Sonny’s violent side was when Sonny, during one of his “manic” moods, shot his wife Carly in the skull while she was in the process of giving birth to his son.

That episode sounds like it might have pissed me off instead. But Benard seemed okay with it.

“Two years ago the head writer came up to me about doing a breakdown story. I said as long as it’s done to educate people and to make it right.  And we did it.  It was fantastic,” the General Hospital actor added.

I wonder what people learned from the overall storyline.