Crazy Psychiatric Treatments

As if some psychotropic meds out on the market aren’t bad enough, out from the archives of Neatorama is a post on 10 Mind-Boggling Psychiatric Treatments. Somehow Insulin-Coma Therapy made it to #1 and lobotomy was listed as #10. I don’t know if they were placed in order of craziness. I didn’t even read the text of most of the treatments. The graphics and headlines were enough to make me cringe.

(Hat Tip: Bob Thompson)

Analysis of "Depression: Out of the Shadows"


The show is essentially Depression 101 – for those new to learning
about the illness.
As someone who struggles with depression (within
bipolar disorder), I found a lot of the two hours pretty boring (90
minutes on personal stories and about 22 minutes for "candid
conversation"). The "a lot" comes from the stuff that I've either heard before or flies over my head, eg, how depression affects the brain, prefrontal cortex, neurotransmitters, synapses, etc. The personal stories were powerful: depressingly heartwarming. (Yes, I mean that.)

My heart sank as I heard the stories of Emma and Hart, teenagers who were diagnosed with depression and bipolar disorder, respectively. Both were such extreme cases that they needed to be sent away for special psychiatric care. They are on medications for their disorders; the specific drugs are never mentioned.

While watching Deana's story of treatment-resistant depression, I instantly thought of Herb of VNSDepression.com whose wife suffers from the same malady.

I tried to listen attentively for the antidepressant that Ellie, who suffered from PPD after the birth of her first child, would be taking during her next pregnancy. It was never mentioned.

My jaw nearly dropped to the carpet as Andrew Solomon, carefully plucked brightly colored pills from his pillbox that he takes every morning for his unipolar depression: Remeron, Zoloft, Zyprexa, Wellbutrin, Namenda, Ranitidine, and two kinds of fish oil. He might have even mentioned Prozac. He takes Namenda, an Alzheimer's drug to combat the effects of an adverse interaction between Wellbutrin and one of the other drugs that I can't remember. Solomon says he's happy. I'm happy for him and I'm happy that his drug cocktail works for him but I couldn't help but sit there and wonder, "Isn't there a better way?"

While I thought the stories covered the gamut, in retrospect, I'm surprised they didn't interview a veteran or U.S. soldier to discuss PTSD. If the producers were able to fit in dysthymia, I'm sure they might have been able to throw in a story about a soldier who struggles with depression and suicidal thoughts stemming out of PTSD. Considering all the stories coming out of the VA, it's rather relevant. It would have been more interesting than the Jane Pauley segment. But I'll get to that in a minute.

As I listened to the narrator, I couldn't help but wonder what alternate perspectives could have popped up. For what it was, I fear none. This was a Depression 101 show — a program designed to either get people to fight against fear and stigma and get help or to open the eyes of loved ones to this debilitating disorder. I'm not sure how to slip in an opposing view on medication from a doctor without confusing or scaring people away. What would Healy or Breggin say that would encourage people to seek appropriate care?

Holistic or natural treatment was not mentioned. It's not mainstream and it's not recommended by most doctors as first-line therapy. I would have been surprised had something been said about it.

The depression portion of bipolar disorder was briefly discussed in Hart's story then Pauley added commentary about her personal experience in the remaining 22 minutes of the program.

Pauley appears at the end of the show promising a "candid conversation" on the topic. The three experts: Drs. Charney, Duckworth, and Primm sit and smile politely as Pauley rattles on occasionally about herself. Some people might find her exchange endearing and personal. After the first 3 minutes, I found it annoying. As a journalist, I wish she would have taken the impartial observer approach rather than the "intimate discussion" approach. In my opinion, she seemed to have dominated the "discussion."

It ended up being a Q&A with each doctor. Her questions were focused and direct. I expected a little bit of an exchange between doctors, talking not only about the pros of medication and treatment like ECT and VNS but also the cons. (Should I apologize for being optimistic?) Charney interjected into the conversation maybe once or twice but was only to offer an assenting opinion. Primm spoke least of everyone on the panel. I think she was placed on the show solely to represent diversity.

There were no "a recent study said…" or "critics say such-and-such, how do you address that?" It was a straightforward emphasis on encouraging people to get help or for those suffering to get treatment. Pauley's segment didn't discuss any negatives (not with the medical director of NAMI there!). The closest the entire 2 hours gets to any cons is with ECT shock treatment and giving medication to growing children. The childhood medication thing isn't dwelt on. The basic gist is: Doctors don't understand how medication works in children but are working on trying to understand it and improve its efficacy.

Forgive me for being negative. The point of the program was designed to give hope to those suffering. Instead, it just made me feel even worse. Thoughts raced through my head: "Well, if this doesn't work, then it's on to that. And if that medication doesn't work then I'll probably be prescribed this therapy, and if that doesn't work, then I'm treatment-resistant at which point, I'll have to do…"

I hope the program does what it's designed to do and that's to get those suffering with depression to seek appropriate care. The one upside is that talk therapy was stressed. I'm a huge proponent of talk therapy myself. Let me know what you thought of the show if you were able to catch it.

In the meantime, this depressed girl is going to cure herself for the night by going to bed.

P.S. Is it really fact that depression is a disease?

My official position on pharmaceutical companies and psychotropic meds

In previous posts, perhaps I’ve come off a little bit as “I hate Big Pharma.” I did. For a while.

I’m not in love with pharmaceutical companies either. I’ve quoted it before but “to whom much is given, much is required.” As a result of accumulating knowledge through reading and research, I know a whole lot more about pharmaceutical companies, the treatment options they put out there, and what lengths they go to get those treatments out there. Most of the things I read are negative. Much of what I’ve said is negative. Perhaps “ignorance is bliss.” My husband said this recently:

“The Internet is the great bitching ground. No one’s going to talk about how great medication is. Everyone’s going to go on and just bitch about side effects and bad experiences.”

I agree. “Effexor really helped me feel better today” doesn’t make for an interesting blog post. No one pays attention to medication when it’s working, however, everyone will complain if something is going wrong. The most “positive” drug comments I’ve seen are on my seemingly “negative” posts from people who are being helped by a drug.

Take, for instance, the following comment from Suffering:

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Thoughts on Bipolar Overawareness Week: Part I

I finally sat down and read all those posts that I linked to about Bipolar Overawareness Week. I mentioned in my previous post that I feel like I had a contrarian view. Well, I do. Somewhat. Although it’s probably not as contrarian as I’d think.

Let’s take my experience, for example.

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NYTimes

“The drugs save lives, and we often have no choice but to use them — even if we have questions about their long-term use. But the questions are big ones, and we owe it to our patients to try to answer them.”

Richard FriedmanDr. Richard Friedman, a frequent mental health columnist for the New York Times, has written a piece that questions the use of antidepressants and how dependent patients have become on them. I’ve read Friedman’s previous columns and appreciate his realistic take on the psychiatric and psychological field. His most recent piece is worth reading.

Loose Screws Mental Health News

An article in the NYTimes addresses the issue of diagnosing mental health in developing countries. A startling fact:

Depression and anxiety have long been seen as Western afflictions, diseases of the affluent. But new studies find that they are just as common in poor countries, with rates up to 20 percent in a given year.

emoIn India, as in much of the developing world, depression and anxiety are rarely diagnosed or treated. With a population of more than one billion, India has fewer than 4,000 psychiatrists, one-tenth the United States total. Because most psychiatrists are clustered in a few urban areas, the problem is much worse elsewhere.

Looks like depression is really more than just a whiny rich American kid who chooses to be upset because he’s got nothing better to do. That’s “emo” for those who aren’t hip-to-the-jive. 😉


On The Elite Agenda, Dr. Fred Baughman mentions Swedish writer Janne Larson who asserts that “over 80 percent of persons killing themselves were treated with psychiatric drugs.” Thank God for FOIA that provides the docs to back this up:

According to data received via a Freedom of Information Act request, more than 80 percent of the 367 suicides had been receiving psychiatric medications. More than half of these were receiving antidepressants, while more than 60 percent were receiving either antidepressants or antipsychotics. There is no mention of this either in the NBHW paper or in major Swedish media reports about the health care suicides.

I guess Sweden isn’t the only country in the world that wants to sweep unfavorable mental health coverage under the rug. By the way, Sweden also is considered to be the seventh happiest country in the world.

While the FDA has recognized that antidepressants can cause an increase in suicidal behavior (as indicated by the “black box warning”), antipsychotics seem to have fallen under the radar. In fact in 2002, Clozaril was approved to combat suicidal behavior in schizophrenic patients. Since then, research has shown that antipsychotics can increase suicidal behavior in schizophrenic patients twenty-fold.

Akathisia – a serious side effect that has occurred for nearly all psych drugs in clinical trials – has been found to be linked to suicidal behavior with not only antidepressants but also in conjunction with antipsychotics.

Finally, Baughman closes with this:

It is important to note that nearly every school shooting that has happened in the United States over the last decade has been conducted by young males who were taking antidepressant drugs. The drugs not only cause suicidal behavior, they also seem to promote extreme violence towards other individuals. In most school shooting cases, the young men committing the violence also committed suicide after killing classmates and teachers. These are classic signs of antidepressant use.

I don’t know if that’s wholly true but it’s a trend I’ve seen with Cho, Kazmierczak, and Eric Harris of Columbine. Since 1996, there have been 55 major school shootings all around the world; 43 of them occurred in the U.S. Makes you wonder how many of these gunmen were on a psychotropic drug – prescribed or not – of some kind.

(Image from Style Hair Magazine)

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.

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Loose Screws Mental Health News

According to a press release (I’m well aware what I’m saying), a recent study possibly shows that schizophrenia’s physical effects are more widespread in the body; researchers previously theorized that schizophrenia was limited to the central nervous system.

“The findings could lead to better diagnostic testing for the disease and could help explain why those afflicted with it are more prone to type II diabetes, cardiovascular diseases, and other chronic health problems.”

Apparently, those who suffer from schizophrenia have abnormal proteins in the liver and red blood cells. While schizophrenia’s most visible effects are psychological, researchers have noted that schizophrenics are at a higher risk for “chronic diseases.” The genetic and physical implications of such a study could prove interesting, especially for those suffering from and at risk for schizophrenia. Also in schizophrenia news, researchers have noticed an “excessive startle response.” The startle response, known as prepulse inhibition (PPI), is being considered as a biomarker for the illness.

Something Furious Seasons might like to argue if he hasn’t taken the following on:

“Lastly, but quite importantly, atypical antipsychotic were found to be more effective than typical antipsychotics in improving PPI, thus ‘normalizing’ the startle response. This led the authors to note:

‘Because an overwhelming number of patients with schizophrenia are currently treated with atypical APs, it is possible that PPI deficits in this population are a vanishing biomarker.”

What’s the advantage with atypicals vs. typicals? How do they work differently? *sigh* I need a pharmaceutical-specific wikipedia.

Schizophrenia News previously wrote about how proof is lacking in schizophrenia developing in those who have suffered from child abuse. (Excuse me for the awful construction of that sentence.) However, a new study shows that those at a high risk for schizophrenia benefit from having a good relationship with their parents during childhood. Read more.

Editor and Publisher has noted that suicides among Army soldiers doubled in 2005 compared to 2004.

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Loose Screws Mental Health News

Yeah – the copy editor in me wants to try “Loose Screws News.” For now.

Clinical Psychology and Psychiatry is among many of my favorite blogs to read. In this particular post, he rips on Eli Lilly’s zyprexafacts.com, which was set up in response to NYT articles that alleged Lilly drug reps pushed Zyprexa to physicians for off-label uses. I hope to just have a stupid ol’ time and rip on each Eli Lilly press release in response to each NYT article, but we’ll see what happens. I’ve already got one lined up with notes scribbled on the printout; I just need to transfer it into electronic form. (Oh, the joys of being a transit commuter.)

Liz Spikol linked to an article originally published in bp magazine about how difficult marriages are when one spouse suffers from bipolar disorder. The saddest statistic I’ve ever read:

“In the United States and Canada, at least 40 percent of all marriages fail. But the statistics for marriages involving a person who has bipolar disorder are especially sobering—an estimated 90 percent of these end in divorce, according to a November 2003 article, ‘Managing Bipolar Disorder,’ in Psychology Today.”

Um, joy considering that I’m I suffer from bipolar and have been married for just over a year now. This strikes incredible fear in my heart. It’s not that we don’t love and care for each other, but I can only imagine how much a spouse who doesn’t suffer from bipd can take. I hate to say it, but I keep waiting for my husband to walk out on me. Not because I’m pessimistic (OK, I am, but that’s beside the point), but because I fear that he’ll reach a point where he’ll say, “I can’t take anymore of this! I’ve dealt with this for 10 years and nothing’s changed, nothing’s getting better. I’m sorry, but I can’t be married to you and deal with this anymore.” Just waiting.

Kelly Osborne Retarded celebrity story of the day: Kelly Osborne suffers from depression because she’s so privileged. But hey! — she’ll pose for Playboy and get photoshopped so she can feel better. *gags*

If you’re mentally ill and fired for it, don’t bother suing. It looks like the mentally ill don’t have a case unless there’s a physical illness to somehow “prove” it:

“Sixteen years after Congress enacted the Americans with Disabilities Act (ADA), people with psychiatric disabilities are faring worse in court cases against employers for discrimination than are people with physical disabilities, researchers have found in a national study.

‘People with psychiatric disabilities were less likely to receive a monetary award or job-related benefit, more likely to feel as though they were not treated fairly during the legal proceedings and more likely to believe they received less respect in court,’ said Jeffrey Swanson, Ph.D., a study investigator and an associate professor of psychiatry at Duke University Medical Center.”

I’m not sure how to solve this problem. Psychiatric disabilities are less tangible and harder to prove than a physical disability. It’s easier to wage war against a company if you suffer from a bad back vs. if you suffer from depression. (Whether or not the bad back is a fictional illness is up to you.)

Another oy moment. (The Long Islander in me is coming back full force.) Got a pet that’s misbehaving? Put him or her on an antidepressant. Double oy.

New Zealand is being introduced to lamotrigine (trade name Lamictal in the U.S.). Good luck, bipolar New Zealanders. Best wishes.

And finally, a study has discovered that about half of patients who suffer from some kind of severe burn suffer from clinical depression. (Shouldn’t someone diagnose this as PTSD? That’s pretty traumatic, if you ask me.) While the finding isn’t surprising, the study highlights the need not only to treat the physical ailment, but also to address the mental healing necessary to overcome stress from the injury.

Just another day

Originally written October 16, 2006 (Updated edits in bold red)

“So sad / so sad / sometimes she feels so sad” ~ Paul McCartney, “Another Day”

I’m finishing up my third full day in the psych hospital and I’m accomplishing things totally unrelated to my “treatment.”

I’ve gotten through 100 pages of Mark Twain’s The Adventures of Tom Sawyer. It’s an interesting book — never read it before – and reading about Tom’s mischevous ways takes me away from the dreariness of a psych hospital. I have a mind to read Huck Finn afterward.

Your Drug May Be Your ProblemI’m reading several books at once, however. (I’ve got ADD when it comes to books; sometimes I finish them, sometimes I don’t.) I’m finally reading my Bible again and trying to plow through Your Drug May Be Your Problem. It’s an interesting book but most of it is alarming. The authors, Breggin and Cohen, argue against psychiatric drugs completely. The books raises some awareness about the use of psychiatric drugs but I think the authors are mostly crying “Fire!” about an unattended candle. The only time I somewhat took them seriously was their discussion about lithium. I’ve already heard — and now seen — its effects. I think lithium is a drug that really shouldn’t be used any more. Are the therapeutic effects of lithium really worth risking a patient to possible toxic levels?

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