Breaking the Silence on Mental Health

Today is World Mental Health Day. I took my dog and pony show to a lunch time presentation on mental health and stigma, given by the former Prime Minister of Norway, Mr. Kjell Magne Bondevik.

Prime Minister Bondevik briefly considered resigning as Prime Minister in 1998 due to depression. He was urged not to resign, but to seek treatment and make this known to the Norwegian public. Three and a half weeks later, he resumed his duties, having succesfully engaged in walking and talking therapy with his psychiatrist, who took him on long walks up the mountains. Medications were also part of this therapy. He received top drawer treatment being the Prime Minister, and a Norwegian one at that, but he was also suffering from a top drawer diagnosis, depression, a time-limited condition. More importantly, the public thinks it understands, and is therefore sympathetic to depression, because it is so easily relatable to sad events in one’s own life. Schizophrenia is not at all easily understood by the public. There are some people whose schizophrenia, like their depression, may be biochemical in nature and therefore can be “corrected” employing short term orthomolecular or drug therapy, but for a lot of people, the cause of the condition is higher up the food chain, so to speak, and related to the same things that make a depressed person, depressed.

I was madly scribbing some ideas to challenge his contention that people should be open and honest about their mental health problems. I think three and half weeks of major depression makes him a credible spokesperson, but I doubt he’s got the full picture of what a major mental health label will do for someone over the long term.

So, I raised my hand and said that anti-stigma campaigns were all well and good, but the cause of stigma is more complex. Why do people discriminate in the first place? I said that as a mother of a son with a diagnosed major mental illness, I would not be so open about opening up and I cited the Sheila Mehta (Auburn University) study*, which found that stigma is increased if people think you have a mental illness caused by a biochemical imbalance as opposed to a mental illness resulting from understandable events in a person’s life. Today, of course, everybody thinks mental illness is caused by a biochemical imbalance. I can run the numbers. This means that a large number of people are willing to discriminate against you.

I made my point. I sat down. Mr. Bondevik’s answer didn’t address my point about belief in the biochemical basis of the condition increasing stigma. He said it was everyone’s personal decision about how much they wanted to open up about their mental illness. Fine, sure, but the Mehta study has raised some provocative issues about stigma that need further thoughtful discourse.

People who know that Chris was diagnosed with a major mental illness (in this case, the S-word), from what they have said to me, think Chris is somehow fundamentally flawed, will always be a “burden” to some extent in Ian’s and my life, and they feel that as long as he stays on his medications he will be able to “cope.” Gee, Chris is doing well,” they may say, “the medications must be working.” Had I not blabbed away the diagnosis in the first place, and did not let people know Chris has been on medications, the Mehta study suggests that people would not single him out as different, and therefore not apply the same pessimistic outlook.

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Mehta, S. , & Farina, A. (1997). Is being sick really better? Effect of the disease view of mental disorder on stigma. Journal of Social and Clinical Psychology, 16(4), 405-419.

The diagnosis creates chronic stress and prevents healing

Today’s big idea was prompted by a reader in a discussion group to which I belong. Commenting on an article in the New York Times, Talk Therapy Lifts Severe Schizophrenics, she wrote, “It’s interesting that these are patients doctors had given up on as hopeless, who would “never get better” …might not the docs’ own expectations play a role in their previous stagnation?”

Replying to her questions was easy. I simply went to my book manuscript and lifted a section from Chapter 15, The Levels of Healing, which is printed in italics below. I bolded what he has to say about the diagnosis.

Dr. Ryke Geert Hamer is a German physician and researcher known for his “10 Iron Rules of Cancer.” He considers schizophrenia, a cancer-equivalent. (Bear in mind when reading the passage, it’s not just the doctors’ expectations that prevent healing – also contributing to whether the person “heals” are the expectations of the family, which have been heavily influenced by the diagnosis.)

Most cancers or cancer-equivalent ailments, according to Dr. Hamer, begin with “Dirk Hamer syndrome”——a severe, highly acute, dramatic, and isolating conflict-occurrence shock that registers simultaneously on three levels: in the psyche, in the brain, and in an organ. The shock registered to the brain can be identified as concentric circles (or Hamer Herds) using computed tomography (CT). Where in the brain the Hamer Herd is located determines the theme of the conflict. By finding the location of the Hamer Herd in the brain, it can be predicted in which organ the cancer will arise and vice versa. Dr. Hamer maintains that the actual cause of the cancer is an unexpected shock but that the hopelessness, despair and meaninglessness felt by the patient after the diagnosis of the cancer and other diseases creates chronic stress, which prevents these diseases from healing.

In the case of the “schizophrenic” brain, according to Dr. Hamer, there are two (and sometimes three) such concentric circles, which register as a result of two (or three) shocks. Dr. Hamer does not indicate where the conflict/shock originates.

Plastic versus concrete

I have swiped another excellent post from today’s Beyond Meds in order to make a schizophrenia related point. That point is about how psychiatry tries to scare us (patients/families) into medication compliance by telling us that “untreated” schizophrenia, meaning in pharma-speak, pharma treated mental illness, leads to brain damage. Never mind the fact that there is no sign of brain damage in the untreated schizophrenic brain on the autopsy table, as psychiatrist Thomas Szasz insists there should be in order to show damage.

Beyond Meds guest blogger Alto Strata, in her blog post entitled Neuropsychiatry: Same baloney, different sandwich, writes

And there has to be some stick to use to drive them to drugs, so psychiatry has enthusiastically taken up the cudgel of depression as progressive brain damage.

The progressive brain damage trope doesn’t fly — clearly many people recover from “depression” and other mood disorders without drugs and seem to be as good as anyone else.

It is an absurdity and an offense to humanity to argue, for example, that 2 weeks of grieving, which can be diagnosed as major depression, becomes brain damage if allowed to continue longer. In general, the brains of “depressed” people, even ridden with all those diseased circuits, work fine. Many are even intellectual leaders and creative geniuses.

Imagine, you are like me, a vulnerable parent, arriving at the emergency entrance of the hospital with your “loved one” in tow. You are panic stricken. Your “loved one” sure is acting weird, no doubt about it, and this is the perfect opportunity for the doctors to spring upon you the news that, without medications, your relative’s brain is going to look like Swiss cheese. You don’t need much convincing that there is something definitely wrong with his or her brain, because he/she sure is acting strangely, and you cling to the drugs like a shipwrecked sailor to a life raft. You think you’re being responsible, and you are, based on the information that you’ve just been given. Unfortunately, it’s false information. Remember, schizophrenia is not seen on the autopsy table, nobody has discovered a gene for it, and it is repeatedly alleged that neuro-imaging anomalies are often due to the effects of medication.

Back in Dec. 2003, the intake psychiatrists at the Centre for Addictions and Mental Health (CAMH) in Toronto had either never heard of neuroplasticity, or else they were trying not to let the latest research escape into the hands of the general population until they got the new story line straight. The doctors told my husband and me in all earnestness that my son’s brain was going to slowly solidify like drying concrete (new word “neuroconcretivity” LOL)  if he didn’t get on those drugs toute de suite. That was only in 2003. Then, suddenly, around 2005, I would say, we start hearing that the brain has endless capacity to reinvent itself, busily erecting new turnpikes in the neuronal information highway. The brain was now plastic.

Is being plastic good or bad? I dunno, it initially sounded to me like good news, but the pharmaceutical companies are dealing with the new findings like it’s business as usual: “The brain needs to be protected from progressive brain damage.”

Damage caused by what, exactly? The fact that neurons may have taken a detour around the diagnosis? The damage in lost revenue, perhaps?

B vitamins for brains

Here is yet another B vitamin study raising tantalizing links between ingestion of high doses of B vitamins and staving off dementia. Dr. Celeste de Jager of Oxford University, who led the trial, said, “A lot of the time brain changes start in your forties and fifties before you get clinical symptoms. I would think that in middle age people should start thinking about their vitamin levels.”

A full scale national (U.K.) trial to establish whether the breakthrough can actually delay the slide into Alzheimer’s and other forms of dementia is expected to begin within the next year.

Let’s not forget that Dr. Abram Hoffer also endorsed high doses of B vitamins, especially Vitamin B3 (niacin) for not only schizophrenia but also for preventing dementia, although, in the latter case, he did not conduct clinical trials. Anecdotally, he noticed that after he started recommending niacin to his older relatives, over a twenty-five year period, none developed dementia. He recommended a daily 3 grams of niacin or niacinimide for people in their fifties and older, along with an equal amount of vitamin C and a B complex.

The endorsement surrounding B vitamins, and vitamins in general, is rather timid, and vitamins may never become officially sanctioned by the medical profession because, after all, vitamins in their pure form can’t be patented. They are low cost. If you want to get serious about getting the best benefits from them, you often have to take megadoses, and that’s when it gets tricky. Very few doctors will go on record to endorse high doses of vitamins. Their patients, on the other hand, often take their health concerns into their own hands. Nobel prize winning chemist Dr. Linus Pauling collaborated with Abram Hoffer in research into high dose vitamin C as an adjunct cancer therapy.

Here’s what Dr. de Jager has to say. It’s hardly bold. To my way of thinking, if you want results, you probably need consistent and high daily doses of certain vitamins targetted to the specific condition.

“People should not begin taking supplements without consulting their doctor because they can have a harmful impact on other conditions such as cancer,” she added.

Asked if she would take the vitamins as a precaution, Dr de Jager said: “I would ask the doctor to check my B12 and my folic acid levels for starters.”

“I take supplements when I’m feeling a bit low, I don’t take one every day but I would certainly have multi-vitamins and B vitamins in my cupboard.”

An excellent web site with factual information on vitamins and supplements is www.doctoryourself.com

Do psychiatric institutions want to make people well?

from FLASHBACKS, an Autobiography by Timothy Leary (Published by Jeremy P. Tarcher ©1983, 1990 Timothy Leary.

excerpt 
MARCH 1961
HARVARD UNIVERSITY I walked through the first tall cellblock, across the prison yard to the hospital. Bell, peephole, metal hinges creaking. Entered the hospital. Knocked on the door of the prison psychiatrist. It opened and facing me was good news. The prison psychiatrist was black and definitely avant-garde. Hurray! Philosopher Thomas Kuhn said that when you wish to introduce change-technology to a culture, you’ll find your best allies among the outsiders, those whose alienation from the establishment makes them more open to change.

Aside from being a black psychiatrist Dr. Jefferson Monroe [Madison Presnell] stood out in the primitive period of 1961 as another kind of rarity—a sophisticated psychiatrist. Impeccable, graceful, hip. He had a twinkle in his eye and a wise, cool way of looking at you. He was definitely ready for something neew.

A few days later Dr. Monroe paid a return call at the Faculty Club and then came to a staff meeting at the Center. We put him on the Harvard payroll as a consultant. The following Sunday he brought his wife over for cocktails.

“Your plan to teach prisoners to brainwash themselves is simply delicious. There’s even a slight chance you can pull it off. Do you know what that might mean?”

“A great boon to society,” I suggested.

Dr. Monroe crossed his legs gracefully and laughed. “My dear, you don’t really understand what you’re getting into, do you? Sooner or later you’re going to discover that law enforcement people and prison administrators have no desire to cut crime. They want more crime and more money to fight it. I’ll cover you from the medical and psychiatric end, but sooner or later, if your methods work they’ll start coming down on you. Reporters, bureaucrats, officials. ‘Harvard Gives Drugs to Prisoners!’ And you’re going to have to do the impossible. Cure prisoners with your left hand while you try to hold off the entire bureaucracy with your right. ”

“So what? If it works.”

“Being human, sooner or later you’ll make a teeny little mistake. One of your subjects will revert. ‘Harvard Drug Parolee Robs Bank.’ ”

 “As long as we do everything out front, no secrets,” I said, “we can make a few honest mistakes.”

“Maybe,” said Monroe. “Look, here’s the deal. I’ll back you all-out, until you goof. When they start coming down on you, exactly at that point I’ll have to protect my own pretty black ass. ‘Cause, I’m not you. I’m not the new Freud. So I’ll win with you, but I can’t afford to lose with you.”

On that basis we agreed on a plan: Monroe would line up volunteers in the prison population for the drug project and I’d line up Harvard graduate students willing to put their nervous systems on the line taking drugs with maximum security prisoners.

Bruce E. Levine’s review of Revolutionary Road

I missed this wonderful review of Revolutionary Road by Bruce E. Levine* when it appeared in the Huffington Post in 2009. In it, he focuses on a minor but key character by the name of John Givings. Please read this review in its entirety. I’ve posted a few excerpts below.

The current PC explanation of serious mental illness brought to us by Big Pharma — follow the money trail — is that it is caused by this or that neurotransmitter or brain structure and has nothing to do with oppressive families and dehumanizing environments. It is also now PC to mock the notion that mentally-ill diagnosed people may sometimes be like canaries in the mine, more sensitive and reactive to insidious toxins.

John Givings — though psychiatrically hospitalized and a recipient of multiple electroshock treatments which have damaged his mathematical abilities — is clearly not delusional about oppressive family relationships, not wrong about meaningless jobs, not incorrect about gutless frauds, and not mistaken about a dehumanizing society. He, like many people I have known diagnosed with mental illness, feels alienated and powerless. And he is no diplomat. Truth serves as his only source of potency, and he uses it as both a constructive tool to celebrate and validate courage and as a hurtful weapon to castigate and punish gutlessness.

It is convenient for many people — and lucrative for drug companies and the institutions that they support – if all disruptive, crazy-sounding, tension-producing people can simply be handed off to doctors to be labeled and drugged. If we can neatly compartmentalize and medicalize the John Givings of the world, then families and society don’t have to halt the assembly line and ask questions such as: “What is exactly happening in this person’s life that has made him or her so angry or frightened? Why does he or she feel so alienated? Is society oppressive for many people, and is this person simply more unbridled in their reaction to that fact? Is there something suffocating about nuclear families in which temperamentally mismatched people are forced to have relationships? Should we be satisfied with a paycheck and a full belly — or is that not enough?

I have met many angry, rude, tension-producing people labeled with severe mental illness. Some of them are completely dominated by their own victimization and seek only to inflict payback pain on those around them. Others though, when feeling safe, state truths which, if taken seriously, would create a more loving family, a more caring community, and a more stimulating world.

When April and Frank take John seriously, he relaxes, stops being hurtful, and shares with them, among other insights, that “maybe it does take a certain amount of guts to see the emptiness, but it takes a whole hell of a lot more to see the hopelessness. And I guess when you do see the hopelessness, that’s where there’s nothing to do but take off. If you can.”

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Bruce E. Levine, Ph.D., is a clinical psychologist, and his latest book is Get Up, Stand Up: Uniting Populists, Energizing the Defeated, and Battling the Corporate Elite (Chelsea Green Publishing, April 2011). Dr. Levine, also the author of Surviving America’s Depression Epidemic: How to Find Morale, Energy, and Community in a World Gone Crazy (Chelsea Green Publishing, 2007), has been in private practice since 1985 and has presented talks and workshops to diverse organizations throughout North America. He is also the author of Commonsense Rebellion: Taking Back Your Life from Drugs, Shrinks, Corporations, and a World Gone Crazy (Continuum, 2003), and he has authored the chapter “Troubled Children and Teens: Commonsense Solutions without Psychiatric Drugs or Manipulations” for Alternatives Beyond Psychiatry (Peter Lehmann Publishing, 2007). Dr. Levine has been a regular contributor to and AlterNet, CounterPunch, and Z Magazine, and his articles and interviews have been published in numerous other magazines. He is an editorial advisor for the Icarus Project/Freedom Center Harm Reduction Guide to Coming Off Psychiatric Drugs and on the editorial advisory board of the journal Ethical Human Psychology and Psychiatry.