Mean behavior isn't always mental illness

OK – I continue my streak of NYTimesing (lookee! A verb!) and post a link to an essay by Dr. Richard Friedman about how chronically "mean" people may not have a mental illness. They are just… well, mean.

Friedman raises an interesting point about how psychiatry and psychology try to explain away so much of people’s behaviors via diagnosis that people aren’t left any room to be "normal." Mean people don’t need to be lumped into a category of "anger disorder" or some crazy nonsense like that. Perhaps there are people who have extreme issues with anger and need to learn behavioral techniques to get it under control. But other people at their very core like to hurt, manipulate, and demean others. This is not a mental illness. This is a human, sinful nature.

Babies and toddlers are mentally ill

The new fad? Diagnosing young children with mental illness.

Oh and I mean young.

Originally, I’d written about how psychiatrists are diagnosing mental illness in infants. Mental health blogs now are all over the Rebecca Riley case and rightly so.  She was a 2½-­year-old toddler diagnosed with ADHD and bipolar disorder. How a psychiatrist can diagnose a child that young is beyond me.

intueri has written a brilliant post about the case and diagnosing children that young:

“We need to stop labeling behavior as pathological just because it causes us inconvenience. We also need to stop using diagnoses as means of absolving us of our responsibilities (”it was the bipolar that made me say those mean things to you; it wasn’t me”). We, as providers, need to stop colluding in these goals: We need to stop the belief that a pill will always cure everything.”

(linkage attribution: Furious Seasons)

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: Part II

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

On the heels of discussing my cynicism about pharmaceutics and pharmaceutical companies (namely, psychiatric-related), I have a few questions regarding the approach of psychiatric evalutations:

1. Why aren’t people tested for biochemical imbalances?
2. Is there a way to determine from blood work or an MRI what kind of mental illness a person is suffering from (in conjunction with the patient’s psychiatric assessment)?
3. How do doctors know the appropriate dosage for a patient? Does s/he start a patient off on what is considered “normal” for an average person and then increase or reduce the dosage based on reactions and side effects?
4. How does a doctor know when to increase a dosage? (Figuring out when to reduce a dosage SHOULD be much easier.)


Psychiatry is an inexact science. For the most part, I think much of it — regarding medication, Freud, and now, the pharmaceutical industry — is a crock.

Continue reading “Just another day: Part II”

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?

Continue reading “Just another day”

Pharmaceutical cynicism

seroquelA mental health blog I’ve recently started reading, Furious Seasons written by P. Dawdy, has been blogging about Seroquel, a medication that has normally been used for acute mania in bipolar disorder. Now, Seroquel is being pushed for depression in bipolar disorder. In one of his older posts, he wrote: “So my hunch is that there must be money for researchers in going after BP, and Pharma companies must be willing to foot the bill. Yes, I am cynical.”

This has been my thinking for sometime now and I’m glad that someone had the gumption to say so. I’m highly cynical of pharmaceutical companies. Pharmaceutical companies don’t care about whether medications help people as long as they don’t kill anybody, which detracts from their profits in the form of class-action lawsuits. (See the Vioxx case with Merck.)

Dawdy also writes: “We are the only group in the psych business that matters. But our interests are not well served in the current power arrangment, in which we don’t even have much of a share or a voice. That is also bullshit and must change.”

I often feel disconnected from the pharmaceutical industry and the world of psychiatry. I am being told things and diagnosed left and right and I don’t understand much of what I’m being told by anybody. My concern is that clinical trial data is being fudged by doctors who receive funding from pharmaceutical companies but fail to disclose their ties. This area needs government regulation and a higher standard of ethical practice. Perhaps the APA should form a bureaucratic board of ethics specifically to overseen the relation between doctors working with (and often for) pharmaceutical companies.

Mood: 4