Great editorial in NYTimes

The New York Times published a great editorial supporting a ban on much of the lavish treatment that doctors get from drug reps. If adopted by medical schools, restrictions would include:

  • Ban on personal gifts, industry-supplied foods and meals, free travel (not reimbursed for services), and payment for attending industry-sponsored meetings
  • Ban on ghostwriting, the practice of drug companies drafting an article and then getting a doc to slap his or her name on it making it look at though the doc actually wrote it
  • Drug samples would have to be submitted to a central pharmacy not individual doctors

The restrictions, however, end there. The editorial says the proposal goes far but not far enough.

Patients need to be assured that their doctors are prescribing what’s best for them, not what’s best for companies.

Can someone get a doctor to read this?

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Bipolar & the Workplace

I was surprised to see an ABC News article on bipolar disorder. Bipolar disorder is the “hip” mental illness these days — especially when used to characterize someone with extreme mood swings. One section addressed admitting to bipolar disorder in a work environment:

One day, he let it slip.

“I just blurted it out. ‘I’m sorry I’m getting shock treatments. I can’t remember anything,'” Steve said. His colleagues’ reactions were less than encouraging, he recalled.

“I would say that they were afraid of me,” Steve said. “They stopped referring their clients to me.”

Steve said that eventually his colleagues’ attitudes forced him to leave his job.

I admitted my problem to three people at my job: my managing editor at my last job and three of my coworkers (one with whom I am still friendly).

  • The managing editor, who had picked on me mercilessly, finally backed off. As far as I know, she didn’t tell anyone which I appreciated.
  • One of my coworkers admitted she had depression to me first before I told her I had bipolar disorder. It’s understood between us that we won’t go around and talk about these things.
  • The other coworker also told me about her journey through depression and her treatment afterward. I then revealed my struggle with bipolar disorder. We are friends outside of work now.
  • I’d told the last coworker about this shortly after I received my diagnosis after being released from the psych hospital. As far as I know, she didn’t tell anyone. But in the end, she’s the one who said the hurtful things about me in the e-mail I inadvertently received. It’s anyone’s guess if she told other coworkers or if she completely forgot.

From Bipolar Journey:

My experience is: work is work.  Outside of work is where one gains support for any illness they struggle with.  Acknowledging my response is skewed on the basis of recent events, I can’t recommend telling anyone you work with about one’s illness.  I should have kept to my Psychology professor’s advice:  “Never tell anyone you work with about your illness, trust me when I tell you:  they will treat you differently.”

I attended an outpatient group in late October 2006 after my hospitalization. One lady said that one of her coworkers admitted she was bipolar; since then, the coworker was teased and verbally abused by her supervisor and other coworkers. I’m not positive but I think the person might have even gotten fired lest her disorder interfere with her ability to do her job. (She cleaned pools.)

People with the disorder often have trouble keeping a job and are 40 percent less likely to be employed than the average person, said Ronald Kessler, a public health researcher at Harvard University.

On the other hand, Kessler said, if treated properly, they can be creative and invaluable individuals. Many highly successful authors, artists and professionals have the disorder.

I’ve seen statistics like this before and they worry me. I constantly wonder whether I’ll ever be able to hold down a full-time job for a long period of time. I’m currently unemployed and – to my disbelief – enjoying it. I’m afraid I’ll get lazy and never go back to work. I’m afraid that I’ll start to go in and out of jobs like a revolving door. One of my psychotherapists in college flat out told me that I’d never be able to hold down a job.

As I try to venture into editorial freelancing, I’m afraid of a host of things: outdated skills, inexperience, lack of confidence, failure, libel, confrontation, socializing, networking, creating expectations (of myself) that I never live up to. My counselor told me to just jump in and do it first then worry about the details later. [deep breath]

failureI fear failure the most. Failure that I’ve forgotten my editorial skills because they haven’t been used daily since 2005. Failure that editors will write me off because I’m a 26-year-old with unimpressive clips like “Bees Infest Dorm Hall” (yawn), “Student Organization Rallies Youth to Vote” (so cliche), and “Penn State Strikes Deal with Napster on File-Sharing” (Nov. 2003 = old). Failure that I’ll write an article, misinterpret the facts, and then get the publication slapped with a lawsuit. Failure that I’ll have to be “pleasantly persistent” in calling up editors, asking for prompt payment of my freelance services. Failure that I will intentionally avoid things that would otherwise propel my career: attending social mixers, networking, doing all the social things that makes my blood run cold because I hate meeting new people (in person). Failure that I’ll look at past awards I’ve received and then never live up to the reason why I received them in the first place. I don’t want to blame bipolar disorder from holding me back but sometimes, I can’t help but think where I’d be in my professional career without it.

(Image from gobears.wordpress.com)

Today's lesson: Paxil and Lexapro are not great antidepressants

Dawdy at Furious Seasons wrote a post on an editorial in the LA Times by Summer Beretsky’s experience with Paxil. After reading her editorial, I’m reminded that my own experience with one antidepressant wasn’t all that unique. Her drug was Paxil for panic attacks; mine was Lexapro for depression following a 3-month (on-and-off) stint with Paxil. I’m struck by the similarity of our experiences; not only did the same thing happened to me but I was also a communications major in college as well.

Paxil had one pretty undesirable effect on me: I started to lose interest in just about everything. I stopped initiating social activities (who needs that sort of thing?) and was no longer motivated to perform well academically.

My emotions had flat-lined: I hadn’t cried in months, nor had I proverbially jumped for joy. I felt — nothing.

I can still remember sleeping in bed at home on a weekday when I should have been at class. It was 2 in the afternoon, around the time my copy editing class was to begin. My boyfriend at the time (now my husband) lived in Kentucky while I attended college in New York. He planned to visit me that weekend but was getting fed up with my depression and listlessness. He called from work to tell me to get up and go to class. I mumbled on the phone, half-confused, and said no. He demanded, “Why not?” I said quite plainly, “Because I don’t care.” He said, “If you don’t get up and go to class, I won’t visit you this weekend.”

I replied, “I don’t care.”

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Catching up…

After a hectic week between work and excessive blogging, I've finally caught up to the latest NYTimes articles on Eli Lilly's troubles with Zyprexa.  I also read the NYT's editorial on the issue. The last paragraph caught my eye:

"Lilly contends that it has never promoted Zyprexa for unapproved uses and has always shown its marketing materials to the Food and Drug Administration, as required by law. Both claims ought to be tested in Congressional hearings that should focus on how well the industry complies with existing laws and how effectively the F.D.A. regulates the industry’s marketing materials."

Furious Seasons and CL Psych beat me to the punch on the skepticism. Congressional hearings would do nothing and I am even more skeptical of the FDA. Pharma companies like Lilly probably slip Dr. Andrew C. von Eschenbach some money to get their stuff approved. But I'm merely speculating because I'm tired and haven't done more research on this at the moment.

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Teens should not have access to parents' guns

“Montgomery County District Attorney Bruce Castor said he thought the teen had gone to school ‘to make a big show without shooting anyone.'” – Philly Inquirer article

AK-47The more I read about Shane Halligan, the more I realize that this 16-year-old had more access to guns and agility with them than most his age. He was an Eagle Scout and had an intense fascination with guns. He also knew where the key to his father’s gun cabinet was located.

It seems a bit of a stretch to hold his parents accountable in the face of such a tragedy but why did Halligan know where the key was located? Why? Was it that they trusted him? Was it because he had taken so many shooting classes and was so well-versed in gun technology that his parents had no reason to fear? It is a tragedy, but one at the very least, parents with guns should learn from:


Never let your child know where the key to your gun cabinet is.


The Inquirer editorial addresses this:

“That fatal mistake was put in motion by Shane Halligan himself. Eagle Scout, fire company volunteer, ‘all-American boy,’ in the words of one parent, Halligan apparently despaired over falling grades. His parents talked of limiting free-time activities until he raised his grades.

Such caring parenting should not have become a life-and-death matter. But Shane Halligan was able to secretly grab his father’s AK-47, smuggle it into school, and shoot himself – with no chance for anyone to talk him safely through his pain.

Why does anyone need such a powerful weapon at home, and how could a teen get his hands on it so easily? Those questions no doubt haunt the Halligan family today.”

Kids might seem well, but teenagers are a volatile bunch. One never knows when a teen might “snap.” With the recent surge of school shootings, I’m not going overboard when I say parents should not allow their children – no matter how old – to have access to their gun cabinet. If your son or daughter does not have a permit to use a gun, s/he should not have easy access to a gun. It’s that simple.

Much of the latest articles surrounding the Montgomery County shooting have focused on better protection for schools and how to prevent children from bringing weapons to school. These focuses are valid. However, focusing on what drives teenagers to performing such actions is also just as valid. The Inquirer has an article on how to spot the signs of depression in teens. It doesn’t cover everything but it gives a bit of help. One thing I do appreciate the article pointing out is that males tend to seem more angry than sad when struggling with depression.

“Young boys and some men tend to manifest this profound depression more in irritability and angry outbursts,” said Nadine Bean, an associate professor in West Chester University’s master of social work program. “Sometimes, a boy is labeled as incorrigible when, in fact, he may be struggling with major depression.”

And why do some students choose school – a public place – to take their lives?

“Typically, those committing suicide at school are looking for a place where they can enjoy greater attention and recognition,” [Ronald Stephens, director of the National School Safety Center, a nonprofit that studies school violence and provides violence-prevention training, in Westlake Village, Calif.] said.