Don't give up. Don't ever give up.

Stephany’s post over at soulful sepulcher reminded me of this 1993 ESPY Speech by Jim Valvano in which he reminds his audience: “Don’t give up, don’t ever give up.” My husband made me watch it a few weeks ago and it’s pretty inspiring. Skip to 1 minute in to get past the clapping. The rest of it is close to 10 minutes but it’s worth every minute.

depressive introspective

I’m not sure I’ll be posting many newsworthy items as much as I used to. I suppose I’m getting lazy in some respects. Maybe my brain is tired or not fully energized. I’m also going through a period in my life where I’d rather discuss my personal experiences and explore broader issues affecting my mental health (like emotional eating) rather than daily current events.

Grow with me. I may shift back to regular news and celeb updates but I don’t feel obligated to post on them right now. And I don’t feel any pressure to do so. I’m feeling particularly… introspective. 😉

Great blogs that analyze and post on current events can be found below (in no particular order):

Another one biting the dust…

Bipolar Wellness Writer has mentioned that she will discontinue writing her blog in a few weeks. (UPDATED—See bottom of this post.) Furious Seasons and Soulful Sepulcher have mentioned various mental health blogs that have authors who either are considering the possibility of discontinuing their blog (The Trouble with Spikol), have gone on hiatus (Psychiatric Drug Withdrawal and Recovery), have discontinued blogging (Been Broken (gone for now)) , or have deleted their blog altogether (Psych Survivor).

I answered Philip Dawdy’s questions about the recent spate of mental health blogs that are ceasing regular updates
. But I’m beginning to form my own questions as well. The common theme that I’ve read among many of these blogs is that the authors feel "held back" or that they need to move on with their lives or pursue other interests. Is writing about mental health issues—not just about personal experiences but in general—a burden that many people feel they no longer enjoy? Sort of like a job in which the work seemed enjoyable at first but has become too much to bear and it’s time to "quit" and move on?

I appreciate all of the bloggers who have contributed to the mental health blogosphere. I guess my main question is why the bloggers of political, technology, and celebrity blogs don’t feel that their blogs are holding them back. Is it perhaps the fact that these sites are more likely to make money? Or maybe Big Pharma owns so much of the corner market on generating ad revenue that mainstream outlets are hesitant to publicize anything that would criticize them. Or maybe mental health blogs are so personal that people feel as though they can’t continue to dwell on the past. I don’t have any answers this time. However, those who search Google for blogs regarding various topics on mental health can find these (unfortunately, they’re not all blogs):

UPDATE: Susan Bernard at Bipolar Wellness Writer responded to my comment on her blog:

Dear Marissa,
All may not be lost. Ever since I’ve written this post, friends have been suggesting ways to continue blogging–but not feel "stuck." So, I may change my mind. I’m noodling a bunch of ideas!

Thanks for your comment! I’ll let you know.

Susan

She’s also made a recent post in which she’s weighing her options and may consider changing her mind. (Thanks to BPD in OKC for tipping me off to this.)

Neurontin 0, Placebo 1. Pfizer loses, Placebo wins.

Stephany at soulful sepulcher has a post up on how Neurontin has not shown itself to be more effective for bipolar disorder than placebo in clinical trials.

It's actually kind of funny that this discovery has been made in April 2008 because I'd reported on this back in January of 2007:

So let's recap: gabapentin is FDA-approved for epilepsy ONLY. But gabapentin has a slew of off-label uses.

Don't know what off-label means? It means "not FDA-approved to be prescribed for this use."

Now that we've got that out of the way, gabapentin is prescribed off-label for migraines, bipolar disorder, social anxiety disorder, OCD, treatment-resistant depression, insomnia, multiple sclerosis, neuropathic pain, and in some instances, post-operative chronic pain.

Where did this off-label usage come from? Basically, one journal article published data on beneficial effects for patients on Neurontin for bipolar disorder and then other articles would cite that article as supporting evidence then more articles cited all the other articles that published the positive efficacy data on the drug, creating what UNC researcher Tim Carey calls the "echo chamber effect."  From Fierce Pharma:

Hearing it over and over, doctors were led to believe that Neurontin worked for bipolar patients, and prescribed it to lots and lots of them.

These articles that touted the benefits of Neurontin were cited 400 times. Carey:

It “becomes a rumor mill in which physicians may be exposed to these types of articles, and citations of articles, which then gives credibility to off-label use.”

The conclusion?

“No scientifically acceptable clinical trial evidence supports use” of the drug in bipolar disorder.

Ouch. Hitting Pfizer where it hurts.

Response to "Mental Health Blogs Going Bye-Bye?"

From one of Furious Seasons’s latest posts:

Mental Health Blogs Going Bye-Bye?

As I noted earlier, there’s a spate of mental health blogs that are going on hiatus of some kind. Now, it’s my sad duty to report that Gianna Kali’s Bipolar Blast blog is going on an indefinite hiatus as well. You can read her post "Quitting?" for the details. Bottom line: all those years of very high doses of psych meds seem to have injured her body. I cannot even begin to send her enough good wishes. I cannot even begin to express my disgust with some of the bad doctors she ran into over the years.

Also, the Psych Survivor blog, written by a man I only know as Mark, was taken down a few weeks ago, and from what I gather he is in the hospital with heart problems. His was/is a good and strident voice on these issues we all care about and his work is missed.

All of this kind of makes me feel glum, since the two people above had been at the blogging game for well over a year and I sensed that they’d both be around long-term. These are people I care about and it sucks that they won’t be the presence they once were.

Why is it that mental health blogs are so difficult to do and keep going? Why is it so hard for them to find the substantial audiences they deserve? The Internet is crowded with blogs about politics, technology, gadgets, gossip and parenting and many of these seem to do quite well and have huge audiences and long lives, despite the fact that many of them are merely echoes of one another. Are readers of blogs that simple-minded that all they need is the latest news and opinion on Apple’s or Microsoft’s latest bit of software or Obama’s or Hillary’s latest gaffe?

You’d think in a country where 10 percent of the population is on anti-depressants and another 5 percent to 10 percent is likely on some other psych med that there would be a substantial audience for these issues (regardless of what one makes of the dominant mental health paradigm), especially given how wildly popular neuroscience is on the Net. It makes me wonder if we all–and here I include myself–have done something wrong in how we analyze these issues (are we too contrarian?) or if we all simply haven’t been crowded out of the big search engines (that’s how most people find mental health information online) because the Net is so over-populated with pharma sites and allied pro-pharma health websites. I can certainly say that the mainstream media–which usually loves writing about characters on the Net who push against life’s many intellectual tides–has given very little attention to sites like this one, despite the fact that sites like mine have been a very real service to many in the media.

Or maybe the mainstream approach to mental health care is right and the public is just trying to tell us something.

What do you think?

I’ll tell you what I think.

Read the rest of this entry »

Blogs around the way

I’m catching up on reading my fellow bloggers’ posts (see Blogroll to the right), so if you’re not reading their site already, I’d encourage you to do so. Below  are some posts that caught my attention. Some might be a little dated.

Gianna at Bipolar Blast: Has a video up of Gwen Olsen, an ex-pharma rep who says that pharmaceutical companies aren’t in the  business of curing but in the business of "disease maintenance and symptom management." It’s nothing new but here are two quotes that caught my attention:

"And what I’m saying is provable is that the pharmaceutical industry doesn’t want to cure people. You need to understand specifically when we’re talking about psychiatric drugs in particular that these are drugs that encourage people to remain customers of the pharmaceutical industry. In fact, you will be told if you’re given a drug such as an anxiolytic, or an antidepressant, or an antipsychotic drug, that you may be on the drug for the rest of your life. And very frequently, people find that they are on the drug for a very long period of time, if not permanently, because they’re almost impossible to get off of. Some of them can have very serious withdrawal symptoms – most of them can have extremely serious withdrawal symptoms if they’re stopped cold turkey – but some people experience even withdrawal symptoms when they try to titrate or they try to eliminate the drug little by little, day after day."

"We have got to start making the pharmaceutical industry accountable for their actions and for the defective products they’re putting on the market. It won’t be long before every American is affected by this disaster and we need to be aware of what the differences are between diseases between disorders and between syndromes. Because if it doesn’t have to be scientifically proven, if there are no tests, if there are no blood tests, CAT scans, urine tests, MRIs – if there is nothing to document that you have disease, then you in fact, do not have a disease, you have a disorder and it has been given and has been diagnosed pretentiously and you need to get yourself educated and understand that there are options and those options are much more effective than drugs."

I’ve always wondered why doctors don’t run tests to diagnose any psychiatric disorders. From NIMH:

Research indicates that depressive illnesses are disorders of the brain. Brain-imaging technologies, such as magnetic resonance imaging (MRI), have shown that the brains of people who have depression look different than those of people without depression. The parts of the brain responsible for regulating mood, thinking, sleep, appetite and behavior appear to function abnormally. In addition, important neurotransmitters–chemicals that brain cells use to communicate–appear to be out of balance. But these images do not reveal why the depression has occurred.

If MRIs have shown that the people with depression have a part of the brain that functions abnormally then why isn’t it standard for all people diagnosed with depression to have an MRI done to confirm this? I have one of two hypotheses:  it’s too expensive to get an MRI done for each person and that insurance won’t pay for it or the abnormal functioning cannot be detected in the brain of every depressed person.  Therefore, is major depressive disorder really a made-up diagnosis?

Read the rest of this entry »

Recently viewed sites

I think something went screwy with my company's blog block so I was temporarily able to access two blogspot sites. I enjoyed reading Susan Bernard's piece on Bipolar Etiquette at Bipolar Wellness Writer. A helpful excerpt for me:

In order to maintain these relationships over the years, I always made sure of doing two things. First, when I could feel a depressive episode coming on–and I always had at least three days to try and stave it off–I emailed my friends to let them know that I wasn't feeling well and might not be available for a few months. Usually, I just sent a fairly short note, something like this:

Dear Friends,
I'm feeling a depressive episode on the horizon. Hopefully, it won't be a bad one, but if it is, I want to apologize in advance in case I miss your birthday, anniversary, or other milestones. I'll be thinking of you and I'll let you know when I'm well again.

Love,
Susan
P.S. Although I'm not feeling like talking on the telephone, for the time being I will respond to email–although it might take a few days. If I feel worse and can't answer your emails, I'll try and let you know.


I was also able to briefly access soulful sepulcher's site and read about the latest developments regarding her 19-year-old daughter experiencing a hell – and there's really no other way to describe it – of a time with the mental health system in Seattle. As I read the post, my jaw continued to drop, my eyes widened, and my heart broke so much that I was near tears. I can't imagine that people can be as callous as they are. It makes me realize that I've been very fortunate in my experience with the health system. When a sexual predator entered my room when I was in the hospital, my family and I lobbied for me to leave ASAP; either that day or the next day, I was gone. The only resistance I encountered was with the police when I tried to file a report. It wasn't outright said, but the general feeling was, "Okay, you're in a mental hospital and want to file a report. What's the point?" It was the only time I'd ever personally felt let down by the justice system. I can't imagine the feeling of being let down by a justice system, a mental health system, a health care system… My heart bleeds for Stephany's daughter and the pain they are both experiencing. Go read their story – it's absolutely heart-wrenching.

Lamictal is hot shit

“In its own way, the best patient group for Lamictal therapy is the bipolar II patient, a person with mild manias and severe depressions.” The side effects are also more tolerable than those of any bipolar drugs: little weight gain, lethargy, or nausea. “It’s the most interesting drug to come along since lithium,” says Ivan Goldberg. “Lamictal is hot shit.”

I found this on soulful sepulcher and have to admit – Lamictal has killed my manias. Since going up to 200 mg in January, I haven’t had a real manic episode – well, it’s really a mixed episode, but whatever. This makes me wonder if the Lamictal IS working; if I’ve tricked myself with a placebo; or if God is just being merciful to me. I try to convince myself with the last two. (Well, I find the latter to be absolutely true.)

Despite my pharma rantings, I have to agree: "Lamictal is hot shit."

Drug Interactions

soulful sepulcher has a post up on drug interactions. You can find nearly all meds and find out the interactions as drugdigest.org. I did a search for lamotrigine (Lamictal) and venlafaxine (Effexor), which included interactions with food and alcohol and there were none. (That was a relief.) I’d encourage anyone on medication to do this search to make sure that multiple psych drugs are not interfering with each other.