Bipolar 2 From Inside and Out

Posts tagged ‘media and mental illness’

New Hope for Mental Illness

Did you hear the news?

Bullying, inflammation, anger, low self-esteem, abuse, biochemicals, unsettled gender identity, cat parasites, and anything bad causes depression/bipolar disorder/PTSD. (Double-jointedness, too, except I don’t know if that’s bad or not.)

But don’t worry. Reading, happy memories, cat videos, a new vaccine, or Tylenol can help!

Science reporting these days is confusing, deceptive, and sometimes just plain wrong. Perhaps science reporters don’t mean to mislead, but that’s exactly what they do. Among the problems are publishing demands, lack of knowledge, logical fallacies, and the difference between correlation and causation.

Let me explain.

Publishers demand big, catchy headlines, and they prefer “New Hope for Bipolar on Your Grocer’s Shelf” to “Experiments on Genes and Diseases Continue.” Add to that the fact that editorial budgets have been slashed and personnel shuffled around so much that todays’s “science reporter” may have been last month’s “political correspondent” – and trained only in basic journalism, if that.

Science is complicated and difficult to understand, unless you’ve got special training. Even then, your expertise is likely to be only in one area – the microbiology of prostate cancer in mice, for example. And most people’s understanding of how scientific research works is, well, not understanding so much as knowing that DNA is somehow like a fingerprint.

Here’s a website with videos that tackle the subject quite nicely. My personal favorite is the one about animal trials in research, which explains (among other things) why my father, who had bone cancer, always said he was tired of being compared to a white rat.

http://www.vocativ.com/culture/junk-science/

Another problem is argument by analogy, which appears more in opinion pieces than in stories labeled as science. But here’s a sample, damning research on psychotropic drugs, written by Kelly Brogan, MD, ABIHM (American Board of Integrative Holistic Medicine).

The most applicable analogy is that of the woman with social phobia who finds that drinking two cocktails eases her symptoms. One could imagine how, in a 6 week randomized trial, this “treatment” could be found efficacious and recommended for daily use and even prevention of symptoms. How her withdrawal symptoms after 10 years of daily compliance could lead those around her to believe that she “needed” the alcohol to correct an imbalance. This analogy is all too close to the truth.

Well, no it’s not, for a number of reasons. Analogies always break down after a while, some sooner than others. For example, that hypothetical six-week trial would be longer than six weeks, come only after years of animal studies (including ones that focused on unwanted side effects like, I don’t know, hangovers or liver damage). The trial would have included control groups, placebos, and other research protocols. The ten-year “withdrawal” effect wouldn’t show up in six weeks; people who drink only two drinks per day are not generally considered alcoholics or go into withdrawal (indeed they may be drinking wine for heart health).

(See http://www.madinamerica.com/2014/12/depression-serotonin/)

And so forth. Having two drinks per day is not analogous to taking a medication for social anxiety disorder. It’s associating the disliked thing (psychotropic meds) with a thing known to be bad (alcoholism) and damning by association.

Here’s another flaw: the principle that “correlation does not equal causation.” The classic example comes from the 1950s, when it was claimed that rock and roll music would lead to teenage pregnancies. It’s true that some teenagers who listened to rock and roll became pregnant (correlation). But some didn’t. And some teenagers who listened to country or jazz became pregnant. And I think by now we know what really causes pregnancy (causation).

This problem is illustrated by an article, “Scientists: The ‘Tortured Artist’ Is a Real Thing.”
The first thing to notice is that the headline is misleading, or possibly completely untrue. The article explains a study that supposedly shows that “creative genius and mental disorders are connected at a genetic level,” then goes on to debunk it:

“Any particular set of genes is only going to explain a very small part of variation in any psychological trait,” says Scott Barry Kaufman, a psychologist at the University of Pennsylvania. Indeed, the variants in the new study have a tiny, miniscule impact on creativity – less than 1 percent.

The rest of the article waffles back and forth and concludes inconclusively. Are creativity and “madness” linked somehow? Possibly. Does one cause the other? We don’t know, but there are a lot of theories. There are lots of other possible factors. Without the headline, would anyone read that? How do you define “creativity,” anyway?

(See http://mentalfloss.com/article/64852/scientists-tortured-artist-real-thing).

Here’s a selection of recent articles that purport to have some relevance to mental illness or mental health.

Can Reading Make You Happier?
Answer: Bibliotherapy helps some people, possibly because of changes in the brain.
(http://www.newyorker.com/culture/cultural-comment/can-reading-make-you-happier?)

Artificial Recreation Of Happy Memories May Become The Next Big Weapon Against Depression
Thesis: “Urging a depressed person to stay positive by remembering the good things in life is unlikely to be helpful advice. That is because depression blocks access to happy memories. But what if we could somehow artificially recreate such memories to allow for some more positive thinking? A study suggests that this is indeed possible – at least in rats….However, more research will be necessary to obtain a clearer picture of how this might work in humans.”
(Again with the rats.)
(http://www.iflscience.com/health-and-medicine/artificial-recreation-happy-memories-may-become-next-big-weapon-against)

Science Shows that Watching Cat Videos is Good for You
The article, which says “research suggests that the pleasure you derive from watching cat videos can often outweigh the guilt of procrastination,” is largely tongue-in-cheek, but that headline is a grabber. Headlines that use “waffle words” like may, can, might, possibly, someday, appears to usually indicate a story that says nothing significant. They build up hope, but if a study comes along that disproves the theory, it will never be reported.
(http://www.iflscience.com/environment/science-shows-watching-cat-videos-good-you)

Researchers Are Developing A Vaccine For Post-Traumatic Stress Disorder
It begins: “New studies are suggesting a link between the immune system and the way the body reacts to stress. Research with rodents are raising hopes that one day, tweaking a person’s immune system could be a way to treat or even prevent conditions like PTSD, Nature reports.” How many warning signs can you spot there?
(http://www.iflscience.com/health-and-medicine/vaccine-help-ptsd)

Double-Jointedness Is Linked to Anxiety
One of my favorites. Correlation/causation much?
(http://mentalfloss.com/article/65333/double-jointedness-linked-anxiety)

Your pain reliever may also be diminishing your joy
Actually it says that acetaminophen blunts both positive and negative emotions. And, it adds, “this study offers support to a relatively new theory that says that common factors may influence how sensitive we are to both the bad as well as the good things in life.” Gee, who would have guessed?
(https://news.osu.edu/news/2015/04/13/emotion-reliever/)

Is Depression a Mental or Physical Illness? Unravelling the Inflammation Hypothesis
This is actually a good article. The headline question is a valid and interesting one, and the author states, “But while there may be a connection between inflammation and depression, one doesn’t necessarily lead to the other. So it’s too simplistic to say depression is a physical, rather than a psychiatric, illness.” Hooray for correlation/causation!
(http://www.iflscience.com/health-and-medicine/depression-mental-or-physical-illness-unravelling-inflammation-hypothesis)

What does all this reporting prove? Almost nothing. Except “let the reader beware.”

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Mental Health

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We’ve Got Demons in Our Heads

I posted this just after the Charleston shootings, but it needs saying again.

The media don’t say it in so many words, but that’s what they mean when they talk about “mental illness” after a tragedy, especially one that involves gun violence and mass murder.

Demons are responsible. And those demons are the mentally ill (and/or) their medications (or lack of medications). Any way you look at it, we are the demons.

Here’s one of my favorite examples lately:

“It seems to me, again without having all the details about this, that these individuals have been medicated and there may be a real issue in this country from the standpoint of these drugs and how they’re used.”

This was from Rick Perry, Daily Kos reminds us, “the fellow who destroyed his last presidential bid after a bizarre debate performance that he later blamed on prescription painkillers he had taken beforehand.”

(Don’t you love that part about speaking without having the details?)

And this, from Mike Adams, who calls himself “The Health Ranger” and Editor of NaturalNews.com:

The headline is “Every mass shooting over last 20 years has one thing in common… and it’s not guns.” The article is actually a reprint of “an important article written by Dan Roberts from AmmoLand.com.”

(NaturalNews sounds maybe okay, but when the source is AmmoLand, you’ve got to wonder about bias.)

Here goes:

“The overwhelming evidence points to the signal [sic] largest common factor in all of these incidents is the fact that all of the perpetrators were either actively taking powerful psychotropic drugs or had been at some point in the immediate past before they committed their crimes.”

Then follows a list of people, crimes, and drug names. The list was compiled and published to Facebook by “John Noveske, founder and owner of Noveske Rifleworks just days before he was mysteriously killed in a single car accident.”

(Again note the source and possible bias, plus the hint of conspiracy theory. Gotta love it.)

Want something more mainstream? How about Newsweek?

“Charleston Massacre: Mental Illness Common Thread for Mass Shootings,” by Matthew Lysiak:

“…. If history is any indication, the shooter most likely has a history of severe mental health issues that have either gone untreated or undiagnosed.”

He then provides a list of crimes and psychiatric diagnoses with a number of the same instances as the AmmoLand account, though not a listing of medications.

The author goes on to say that the “rise [in mass shootings] correlates directly with the closure of the mental health institutions in 1969, according to mental health experts.”

(Correlates with – not caused – please note. That’s important. I’ll have more to say about that, probably next week.)

Lysiak goes on to say that the requirements for civil commitment (read: involuntary) are too loose. He quotes Liza Gold, a forensic psychiatrist in Arlington, Virginia: “The commitment requirement needs to be less strict. Today it currently requires both mental illness and dangerousness to have someone committed. I think we need to focus more on the dangerousness and keep these people from getting guns.”

If that’s so, we should be worried more about “sane” people such as abusive partners with histories of violence and restraining orders than about the mentally disordered, shouldn’t we? Comments revealing that “most people who commit acts of violence don’t exhibit signs of mental illness, and most people who are mentally ill are not violent” are buried near the end of the article.

Fortunately, not all the media are demonizing the mentally ill, though the dissent doesn’t seem to be coming from the major media. Slate and Salon have published articles that question the automatic connection.

The article on Slate, by Anne Skomorowsky, is long, and refers to the Germanwings airplane deaths, but it’s thoughtful reading and well worth the time.

“Because Germanwings pilot Andreas Lubitz killed himself when he purposefully drove a plane carrying 149 other people into a mountain in the Alps, there has been an assumption that he suffered from “depression” — an assumption strengthened by the discovery of antidepressants in his home and reports that he had been treated in psychiatry and neurology clinics.” She adds, “Lubitz did not die quietly at home. He maliciously engineered a spectacular plane crash and killed 150 people. Suicidal thoughts can be a hallmark of depression, but mass murder is another beast entirely.”

And the take-away: “Many patients and other interested parties are rightly concerned that Lubitz’s murderous behavior will further stigmatize the mentally ill.”

Salon’s Arthur Chu talked about the more recent Charleston, SC, shootings and other incidents in “It’s not about mental illness: The big lie that always follows mass shootings by white males.”

“I get really really tired of hearing the phrase ‘mental illness’ thrown around as a way to avoid saying other terms like ‘toxic masculinity,’ ‘white supremacy,’ ‘misogyny’ or ‘racism.’

“’The real issue is mental illness’ is a goddamn cop-out. I almost never hear it from actual mental health professionals, or advocates working in the mental health sphere….Seeking medical help for depression or anxiety is apparently stronger evidence of violent tendencies than going out and purchasing a weapon….Doing the former is something we’re OK with stigmatizing but not the latter.”

I’ll let that be the last word, fellow demons. Until the next time, that is. Until the next time.

Correction: The Skomorowsky article appeared on Slate, not Business Insider, as originally stated. I have fixed the text and regret the error.

Here are the references for the articles cited, in order:

http://www.dailykos.com/story/2015/06/19/1394713/-Rick-Perry-says-guns-aren-t-to-blame-for-Charleston-accident-it-was-prescription-drugs

http://www.naturalnews.com/039752_mass_shootings_psychiatric_drugs_antidepressants.html

http://www.newsweek.com/charleston-massacre-mental-illness-common-thread-mass-shootings-344789

http://www.slate.com/articles/health_and_science/medical_examiner/2015/03/germanwings_co_pilot_mental_illness_suicide_is_linked_to_depression_but.html

http://www.salon.com/2015/06/18/its_not_about_mental_illness_the_big_lie_that_always_follows_mass_shootings_by_white_males/

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Mental Health

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The Answer to Bullying

“Being bullied is not a harmless rite of passage or an inevitable part of growing up; it has serious long-term consequences,” says Stephen Luntz in an article, “Study Finds Bullying Affects Mental Health More Than Child Abuse” [http://www.iflscience.com/brain/price-bullying-measured].

Well, duh.

But wait. Look at that title again. “Bullying Affects Mental Health More Than Child Abuse“?

Yes. That’s an accurate headline, not just clickbait.

“Our results showed those who were bullied were more likely to suffer from mental health problems than those who were maltreated,” says Professor Dieter Wolke of the University of Warwick in the article. “Being both bullied and maltreated also increased the risk of overall mental health problems, anxiety and depression.”

He adds, “It is important for schools, health services and other agencies to work together to reduce bullying and the adverse effects related to it.”

Again, duh. Easier said than done.

And how big is the problem? A CBS News poll reports that most Americans reported being bullied at some point while growing up http://www.cbsnews.com/news/cbs-news-poll-majority-of-americans-were-bullied-as-kids/. Only 41 percent report never being bullied.

“Just” 10 percent said they were bullied “a lot.” That’s still a lot of children who are bullied a lot.

I know I was. And I’m willing to bet that many of you were too.

So what’s to be done?

Well, we know what doesn’t work.

Telling those who are bullied:
“They’re just joking.”
“Learn to take a little teasing.”
“You’re too sensitive.” (my personal favorite)
“Learn to fight back.”
“Get used to it.”
“Just ignore it.”
“What they say doesn’t matter.”
“Don’t let them see that they hurt you.”
“Laugh it off.”
“Handle it yourself.”
“Try to make friends with them.”
“Give them what they want and they’ll leave you alone.”
“Don’t give them what they want and they’ll stop.”
“Stay away from them.”
“Stand up to them.”
“Get your friends together when they’re around.”
“Tell your parents/teacher/principal.”
“Take karate lessons.”
“Avoid the second floor bathroom (or wherever).”
“Grow up.”

(If you have any other favorites, let us all know in the comments!)

Look again at that list. They are pieces of advice to the VICTIMS of bullying on HOW NOT TO BE BULLIED. What’s wrong with this picture?

Feminists and their allies have begun questioning the advice given to women on HOW NOT TO BE RAPED. Instead, they say, the focus should be on teaching men HOW NOT TO BE RAPISTS.

http://www.ifyouonlynews.com/feminist-issues/10-rape-prevention-tips-that-are-guaranteed-to-work-image/

And apparently, this approach is having some success.

http://freethoughtblogs.com/greta/2013/01/08/rape-prevention-aimed-at-rapists-does-work/

Of course, bullying is not rape; the analogy breaks down quickly. But both are about power and “the other” – asserting dominance over someone who is different.

In bullying, that difference can be real or merely perceived, and can be literally anything – weight, height, intelligence, socioeconomic level, race, ethnicity, popularity, clothing, sex, gender, hair color, disability, athletic prowess, speech, preference of superhero. The criteria for who is a victim seem completely arbitrary, because they are. The victim is the other, someone who is by definition different.

Is it fair, or even reasonable, to tell victims to alter whatever it is about themselves that makes them different? It can be soul-killing to have to pretend you are not smart, not poor, not gay, not Muslim. It can be impossible to pretend you’re not short, don’t have a disability, are good at sports. And why should victims have to, any more than women should never go out alone at night or never flirt?

We need to start teaching kids HOW NOT TO BE BULLIES, not how not to be bullied.

Some specifics, like this:
“If you think another kid is gay, ignore it.”
“If someone is not as popular as you, so what?”
“if a kid in your class dresses funny, don’t say anything.”
“If it’s not fun for everyone, stop.”

Or this:
“Don’t hit people because you don’t like the way they look.”
“Don’t joke about people who don’t enjoy it.”
“Don’t call people anything but what they want to be called.”
“If someone is unhappy, don’t make it worse.”

Or this:
“If someone is smarter or less smart than you, form a study group.”
“If someone has less money than you, do things that don’t cost money.”
“If someone is always dropping her books, help pick them up.”

I’m not an educator or a child psychologist – just a former smart, scrawny girl with weird hair and poor eyesight. In other words, bully-bait.

Maybe my ideas won’t work. But what we’re doing now sure doesn’t. That poll I mentioned earlier suggests that bullying is actually increasing, despite all the attention the topic is getting. Generalities like “All people deserve your respect” and “Celebrate differences” and “Be-kind-keep-your-hands-to-yourself-no-hazing-no-fighting-no-name-calling” aren’t getting the job done.

Bully culture is well and truly entrenched in our society. To change that, we need to change the culture – if for no other reason, to head off all those mental health problems waiting up ahead for bullied children.

Who’s with me?

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Mental Health

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Why Do They Do This? (And Why Do We Allow It?)

The big story last week for those of us with mental disorders was this one:

http://www.rawstory.com/rs/2015/02/truly-barbaric-florida-deputy-drags-mentally-ill-woman-through-courthouse-by-shackled-feet/#.VOyTNKh2Gbc.facebook

For those of you who haven’t read it or seen the video, here’s the gist. A woman, Ms. Rios, was declared mentally incompetent at a hearing for a minor offense and not allowed to say goodbye to her mother. She wanted to sit on a bench and cry for a bit. When she did not go promptly with the officer, he dragged her through the courthouse by her shackled feet. A video was taken on a cellphone camera by a lawyer who happened to be present, but had nothing to do with Ms. Rios’s case. If you watch the video clip you can see and hear her distress.

As the headline says, this was barbaric.

But there’s lots neither the headline nor the story says. I have questions.

What is the woman’s mental illness? Or why is she mentally incompetent? The stories vary, usually calling her “mentally ill,” which is shorter for the headline writers, but so far I have seen nothing more specific. One could get the impression that in the mind of the media – and therefore their readers – that the two terms mean the same thing. Was she medicated or unmedicated or off her prescribed meds? Does she have a developmental disability? An autism spectrum disorder? An emotional or behavioral disorder? We don’t know. But does the label make her automatically suspected of potential violence? The woman did not behave like an animal even when she was treated like one.

I think we all know people who have mental disorders but are still mentally competent to conduct their own affairs, up to and including court proceedings. In fact, I know you know one – me. But who among us, or among the sanest and most stable of the general public, wouldn’t have needed to sit on a bench and cry before going to wherever the officer thought we should go? Who wouldn’t yell and protest and try to hold on to a table if we were dragged anywhere by our shackled feet?

Why is the officer’s action called “barbaric”? I’m not saying it wasn’t barbaric. But how was it more barbaric than other things routinely done to the incarcerated mentally ill (or incompetent)? Could it be because the officer’s actions were caught on tape? How many everyday barbaric actions aren’t? And putting aside simple human compassion (which he did), didn’t the officer’s actions create a larger, potentially more dangerous disturbance?

Why did the other officers present do nothing? You can see them on the video. They are spectators. No one says, “Hey, do you have to do that?” or “Give her a minute to calm down” or “Here, let me take care of this” or “You know, there are other ways to handle this” or even “Are you sure you want to do that with the camera rolling?” Nothing. Nada. Zippety. Doo-dah.

Why weren’t the officers and other courthouse personnel trained to handle situations like that? They obviously happen occasionally. Officers are (supposedly) trained to handle situations involving violent felons (which Ms. Rios wasn’t), domestic violence, and how to restrain suspects properly. Some even get sensitivity training on race, sexual orientation, and ethnicity. Where’s the training for interacting with the mentally ill (or mentally incompetent)? For de-escalating a situation instead of throwing gas on the fire? How about anger management before incidents like this one instead of after? Shouldn’t every law enforcement official be able to control or channel his or her anger and not take it out on the public?

Why the hell aren’t police officers required to wear body cameras – and have someone whose job it is to, oh, I don’t know, review them occasionally? Certainly when there’s been a complaint, but spot checks might also do some good. Why are civilians subject to increasing surveillance, while law enforcement personnel – who are also civilians, by the way – perform their jobs with minimal oversight.

And why is the Golden Rule suspended when the “others” have a mental disturbance? I’d really like to know.

___________________________________

I am cross-posting a slightly altered version of this essay to Et Cetera, etc., my general purpose blog (janetcobur.wordpress.com).

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Mental Health

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Yes, I Am Crazy. Thanks for Asking.

I’ve been called a lot of things in my time, from schoolyard taunts (loony tunes, weirdo) to psychiatric labels (clinically depressed, bipolar 2). This used to bother me, but anymore, I don’t mind.

It’s not because of the old saying, “Sticks and sones can break my bones, but words will never hurt me. We all know that’s a damn filthy lie. I think it’s because I’ve developed a sense of humor about the “crazy” thing. If Al Yankovic can embrace “Weird,” I can embrace “squirrel-bait” or “wacko.” Even “bat-shit” or “bug-fuck” crazy don’t get me riled, though many find them offensive – and I can’t fault them for that. Everyone has a different level of tolerance and sense of what’s funny.

Take, for example, the time when my sister Kathy gave me a t-shirt that said, “Leave Me Alone. I’m Having a Crisis.” Her husband was dubious about the gift, thinking that I would be offended. I wasn’t. Kathy thought it was a hoot and so did I. (I just bought a t-short that says, “You Won’t Believe the Crazy Shit That Happens Next…” I’m going to wear it to my next psychotherapist appointment.)

I admit to being disconcerted when publicly confronted by a person who asks “Are you the one there’s something wrong with?” or “Do you have mental problems?” (In the first case, the elderly gentleman was thinking of my sister-in-law, who had MS, and in the second, the person recognized me from the psychiatrist’s waiting room.) But I’m not offended. Mostly I regret that I didn’t have snappy come-backs. (I thought of some great ones later.)

There are still some assumptions that do offend or at least irritate me. Here’s a link to an article that enumerates a few of the touchy subjects and unwelcome phrases.

10 Harmful Myths About People with Bipolar Disorder

That sums it up pretty well. I’m not going to walk into a fast food outlet and start shooting up the place. Mania is not fun. I’ve decided not to reproduce, but nobody can tell me that I shouldn’t.

Oh, and there’s one other thing. In the past, when I’ve mentioned my mood disorder to acquaintances or co-workers, they feel obliged to take my emotional temperature five times a day. “Are you okay? How are you feeling?” So I would add to the list: Not all people with bipolar disorder are rapid cycling.

So, am I crazy? Yes. But I don’t think that’s necessarily a bad thing. Most people use the word “crazy” to describe how they feel when they’re in love. And I’m good with that.

https://www.youtube.com/watch?v=EE34cSvZCd8

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Mental Health, Uncategorized

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Family Matters

No one in my family understands me.

Actually, no one in my family understands my illness.

My mother-in-law doesn’t believe that mental illness exists. And in a way she has a point. If she hasn’t experienced something, for her it doesn’t exist. Most people are a bit like that sometimes, especially regarding mental disorders. There are only a few varieties of broken arms, and when you’ve got one, you know it. When you’re talking synapses and neurotransmitters, thoughts and feelings, it’s obvious why “invisible illnesses” aren’t obvious or well understood.

I didn’t understand my disorder at first, either. I remember driving past a building with a sign: South Community Mental Health. I didn’t know what I was feeling, but I was pretty sure it wasn’t mentally healthy. I went in and began the journey.

My family had the following reactions when I told them I was going into therapy and when I first started taking medication:

Dad: Just as long as I don’t have to go.

Mom: I’ve heard Prozac is a ticking time bomb.

Mom (later): I thought you would feel better after you found a good job.

Sister: Why should you spend $100 a month just to talk to someone? (The clinic was on a sliding scale, so I actually paid only $5 per visit.)

I understand some of those reactions. Dad had heard about how psychologists blame parents for messed-up kids and he wasn’t going to someone to be told he was crazy, and a bad parent besides. And his fear was not that unreasonable. Dysfunctional kids often do come from dysfunctional families. But underlying my disorder was brain chemistry. I never asked him to join the couch gang.

Mom watched Phil Donahue (for you youngsters, think Dr. Phil). And there was at first over-prescribing of Prozac and suicides once the patients gained enough energy. Plus she thought my depression and anxiety were reactive and would clear up when my living situation was more stable.

My sister, I don’t know. I don’t understand her either. I’m sure she has psychological problems too, of one sort or another. But I’ve been diagnosed, so I’m the crazy one.

My husband, who has a background in psychology, “got it” a little better once he stopped trying to “fix” me. But he never understood in a visceral way until he had his own first meltdown.

“You know how you’re feeling now?” I said. “Try feeling that way for a couple of years instead of a month.” Later he did. So at least he knew what half of bipolar was all about. He still hasn’t felt the rapid cycling or the constant roller coaster or the extreme physical and mental battering of going on and off medication after medication, hoping the next one will do more than make his hands shake worse or his memory turn into Swiss cheese.

Still, it’s better to be partly understood than completely dismissed, and to have a family that tries. And to have a family of choice that does understand, because a lot of them are in the same leaky, patched boat.

I could have done a lot worse.

 

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Mental Health, Uncategorized

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All in Our Heads

Well, mental disorders probably are mostly in our heads, or at least our brains (and genes), but I keep seeing news features that “offer hope” for new diagnostic tools and treatments that “may someday” alleviate the suffering.

Here’s an example from the University of Pennsylvania:

Many factors, both genetic and environmental, have been blamed for increasing the risk of a diagnosis of schizophrenia. Some, such as a family history of schizophrenia, are widely accepted. Others, such as infection with Toxoplasma gondii, a parasite transmitted by soil, undercooked meat and cat feces, are still viewed with skepticism. A new study used epidemiological modeling methods to determine the proportion of schizophrenia cases that may be attributable to T. gondii infection. The work suggests that about one-fifth of cases may involve the parasite.

Great. I am sure that schizophrenics will be comforted by the thought that their problems are caused by brain parasites and cat poop.

I noticed that the study showed that only 20 percent of schizophrenia “may” involve the parasite. What about the other 80 percent? Are those cases caused by some other parasite? And how will the parasites be detected? Blood test? Brain biopsy? Could be a world of horrors there for the already mentally unstable. And, perhaps most important, will real-world results back up the computer simulations?

Schizophrenia is far from the only illness being studied. Bipolar disorder and our old pal depression come in for their share of lab work too. USA Today recently reported on a procedure that might help with depression:

The treatment — transcranial magnetic stimulation — was approved by the Food and Drug Administration in 2008 for the treatment of patients with medication-resistant depression.

Magnets generate a directed, pulsed magnetic field — similar to an MRI in strength — to the prefrontal cortex, the front part of the brain behind the forehead. The magnetic fields induce small electrical currents, which encourage a mood-lifting chemical reaction in the brain.

The treatment is daily, for four to six weeks. If the patient improves enough, the treatment is then provided as a periodic booster.

Never mind that it’s entirely subjective when a patient has improved “enough” or even shows anything other than a placebo effect. And never mind the effects of having 42 MRI-strength treatments in a row.

Apparently scientists and insurance companies are battling it out on the money front (there’s a surprise).

Plus, as always, there are nay-sayers:

The National Institute of Mental Health describes the treatment as effective for some patients, but notes that studies of its efficacy have been “mixed.” The American Psychiatric Association’s guidelines for depression treatment states the procedure conveys “relatively small to moderate benefits.”

To the desperate, any potential “cure” or even palliative treatment eventually seems worth a try. I should know. I came that close (imagine several millimeters here) to having a go at electro-convulsive therapy (ECT). Formerly know as shock treatment.

The thing is, you only hear about theories that “might” be correct and treatments that “may” help. Studies are hardly ever published that say, “You know that treatment we said was going to relieve the suffering of millions? Turns out, not so much.” If the general public even gets to see the negative results, they may still cling to the hope offered by the earlier reports.

Just look at the anti-vaxxers. It has been repeatedly proved that childhood vaccines do not cause autism. The experiment that reported that finding was a fraud and the author (Andrew Wakefield) has been discredited – investigated and found guilty of “four counts of dishonesty and 12 involving the abuse of developmentally challenged children.” Basically, he’s been kicked out of medicine altogether and given the Lifetime Achievement in Quackery award by the Good Thinking Society. (I’m not making that up.)

And yet epidemics of measles and other deadly diseases continue to rise as parents yield to fear and refuse to have their children vaccinated.

I’m not trying to say that a parasite doesn’t cause some cases of schizophrenia or that magnetic therapy will never relieve anyone’s depression.

I’m just saying that if those theories are proved false, we’ll likely never hear about it from the popular press.

 

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Mental Health, Uncategorized

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Cutters

If that title wasn’t enough of a trigger warning, well, here goes:

TRIGGER WARNING: Self-Harm

Recently a small discount store a couple of miles from my house was caught up in a furor because a “Princess Wand” toy they were selling (ominously named an “EvilStick”) would reveal a hidden image of a teenage girl cutting her arm with a knife. Here’s a link to a local news story about it, and the snopes.com report verifying it. If you want to, you can easily search out a copy of the image, but I don’t recommend it.

Self-Injury

http://www.snopes.com/photos/odd/evilstick.asp

The “toy” is in horrifically bad taste (so, for that matter, is the snopes article’s headline, “Wristcutters – A Toy Story”). But items that adults consider dreadful can attract kids (remember the Garbage Pail Kids trading cards?). The image of the teenage cutter looks like a macabre Halloween costume rather than anything realistic (I’ve seen it), but we don’t really know whether a mistake, an error in judgment, a misunderstanding, or a prank at the factory that went way over the line resulted in the image on the toy. I kind of hope so, because if it was intentional, that’s way worse.

But bad taste is the least of the problem. The toy and the reaction to it have introduced the subject of cutting to a wider audience, if they choose to look beyond the squick factor and think about what the image really means. Cutting is a reality that’s mostly hidden from view.

Of course, it’s not always cutting. Burning is popular too. But cutting is perhaps the most common name. There are websites devoted to it, some offering help, facts, and information on quitting (see below) – but others glorifying it as, I don’t know, a creative expression of teen angst or something.

The name does keep changing. The last I heard, the “approved” psychiatric term was “Non-Suicidal Self-Injury” (NSSI). Self-mutilation, deliberate self-harm, non-fatal self-harm, self-destructive acts, self-inflicted violence, parasuicide, and self-wounding are all names for the dangerous practice performed by desperate people. The subject still isn’t talked about much and carries a huge stigma. As if the mental and physical scars were not enough.

Some facts: Self-harm is not attempted suicide, though with some miscalculation it can lead to serious permanent injury or death. Most people associate it with teenage girls, but I’ve know at least one man in his 50s who cut himself fairly regularly. It is not a matter of attention-seeking, since most cutters hide their physical wounds.

As I understand it, the practice results from one of two phenomena: the build-up of painful pressure such as perfectionism, or a feeling of severe alienation to the point of numbness. Cutting is a coping mechanism, though a dangerous, dysfunctional, and unsuccessful one, to deal with pain.

In my case, it was probably the numbness. I was feeling a lot of psychological pain at the time (college age) and irrationally wondered if physical pain would lessen that, or increase it, or feel any different. Like I said, irrational. All this was before I was diagnosed bipolar, had a therapist, or was medicated.

I made a few small cuts on my wrist to watch the blood well up. (Ironically, they became mildly infected; I neglected to sterilize the knife.)

I wasn’t suicidal. They weren’t that kind of cuts. I do know the difference. (I didn’t realize that I could have damaged tendons or nerves in my hand or arm, perhaps permanently.) It was more like when you stand on a bridge or balcony and look over the edge. You walk away. But you know the bridge is always there.

All told, I cut myself maybe three or four times. The scars are very faint now, white against my pale inner wrist, almost invisible. The memories are vivid. A friend who’s a psychologist once asked me why I stopped. “Because I didn’t need to any more,” was the only answer I could give. I’ve only felt the urge once since, and it was easy enough to push aside. But I recognized it.

I hesitated to write and post this, though I knew I would have to sooner or later, if I meant this blog to share my experiences truthfully. One of my dearest friends once said that if he ever found out I was a cutter, I would never hear from him again. Except for his publicly mocking me for being so stupid.

Naturally, this sort of reaction, though common, is not helpful. I didn’t tell him (or practically anyone else). And I didn’t tell him that at least two other people he knew – one fairly intimately – were also cutters.

Anyway, Tom, if you’re reading this and still feel the same, I guess this is goodbye – just not the long goodbye. I would rather skip the public mocking, though. I’ll just assume you’ve done it while I wasn’t there, mm-kay?

Cutting isn’t going away if we ignore it. It won’t go away even if we do talk about it. (Or mock it, or gasp in horror.) But understanding self-injury is a big step.

If you’re a cutter, or know someone who is, here are some places you can go for information, hope, and help:

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Mental Health, Uncategorized

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Going Public

I just posted this on my Facebook page. Now we wait and see what happens.

Along with the news of Robin Williams’s death have come discussions of mental illness and suicide. I’ve decided to go public with my own experience. I have bipolar disorder – type 2 (which means that I have lots of depression and anxiety, but very few manic phases). I’ve had this all my life, most likely, so whenever you met me, I had it.

Some of my friends already know and I’m sure others have guessed or suspected it. It is the result of a biochemical imbalance in my brain and is now treated with medication and therapy. I’m working on it.

Anyway, I ask for your understanding when I sometimes go hide under a rock for a while or say or do something odd or rude or unkind. My social skills have never been great, and having a disorder like this doesn’t improve them. I’m working on that too.

But you don’t have to do anything special or tiptoe around me. I’m still who I always was. I don’t freak out when people call me crazy or nuts or weird.

If you are interested, I blog about it: bipolarjan.wordpress.com (I also have a general purpose blog: janetcobur.wordpress.com.) Anyone is welcome to visit. I can also recommend other resources.

Here is the article about Robin Williams that noodged me into taking this step: http://www.slate.com/blogs/xx_factor/2014/08/12/robin_williams_and_mental_illness_when_depression_is_breaking_news.html

I Bet Robin Williams Knew He Was Loved. Unfortunately, Love Doesn’t Cure Mental Illness.
http://www.slate.com
It is jarring when a beloved celebrity dies of something you could possibly die of yourself—when all of a sudden everyone is talking about the illness you have, the one that they usually…

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Mental Health

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Mental Illness and Gun Violence

If you haven’t seen this article, I recommend you do so.

What Do We Actually Know About the Relationship Between Mental Illness and Mass Shootings?

There’s a lot more to be said on the subject, but this is a good jumping-off point.

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Mental Health

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