Another space race in mental health

Official Washington rallies ’round a cause

Patrick Kennedy announced earlier this year that he would not seek relection to Congress in order to devote the next phase of his life to fighting the stigma of mental illness. I did an earlier post in which I expressed the hope that he would investigate the world of holistic mental health if he really wanted to make a difference in the lives of the so-called mentally ill. Most of us know that this a naive hope, given that Kennedy’s world is Washington politics. Power brokers in Washington like to associate with power brokers like themselves, even long after they’ve left Washington.

It comes as no surprise that Kennedy has announced the formation of www.moonshot.org
to bring the best minds in neuroscience together to work on the to fight the “stigma” of mental illness by taking the same old tired scientific backscratching approach.

The website has posted a letter to Mr. Kennedy from The Society for Neuroscience (SfN) that makes my holistic heart sink. It’s the usual scientific neurobabble about mental illness as a diseased brain, and how SCIENCE is going to tackle a subject where it has continously failed to get even a passing grade.

The SfN has been tasked by Kennedy to identify gaps in the knowledge base and research infrastructure 

  • Identify critical research areas and gaps in scientific knowledge
  • Support the most creative science, both emerging topics and innovative approaches 
  • Ensure outstanding young scientists are inspired and motivated to continue in research and are free to take risks and innovate 
  • Establish new partnerships across disciplines that are currently far apart and disconnected 
  • Enrich the scientific infrastructure by developing new cutting-edge technologies to explore how genes, cells, neural networks and systems operate in the healthy brain and how normal processes are altered in the diseased or injured brain 
  • Develop and support coordinating mechanisms, helping researchers collaborate, share resources, and exchange ideas and information among different institutions both nationally and internationally 
  • Remove barriers to new treatments through radically rethinking partnerships between academic laboratories, the pharmaceutical industry, and health care providers 
  • Ensure a sustained and aggressive national research funding commitment that enables progress on all of the above.  

I’m sure you’ve all noticed the glaring gap in this initiative. The gap is that there are plenty of people who know how to overcome so-called mental illness, have been doing so successfully for years, and apparently this organization is not at all aware that this is happening all over the world.  Those who have succeeded in overcoming the stigma of mental illness almost unanimously discredit brain chemistry as a source of their problems but also cite the brain chemistry model as the reason why their recovery is prolongued.  That’s why there is no representation from working well in the SfN.
 
The outcomes of this discredited approach will be: drum roll, please: 

  • More conferences
  • More chance for neuroscientists to network at conferences
  • More money thrown at universities to attract young, rigid scientifc minds
  • More drugs
  • More academic articles
  • More funded people to shout down dissent
  • Washington galas “to fight the stigma”
  • Presidential iniatives “to fight the stigma”
  • Little or no progress in overcoming mental illness, because, as you can see, the biochemical model of mental illness is a front for industry.

Mr. Kennedy, there would be no stigma if the labelled mentally ill were actually getting well in sufficiently large numbers to make public health and social policies over the last few decades look well-directed.  As a population, the so-called mentally ill are in dire straights. As individuals, many are doing really well because they have taken it upon themselves to do so, against the best scientific advice.
 
Washington loves a good stigma buster chance to party and party it will.

Vitamins work, but sometimes not enough

I got to thinking about the role of vitamins in recovery early this morning (4 a.m.) when I suddenly woke up from a deep sleep. That’s funny, I thought. I haven’t even had a drop of alcohol, I went to yoga; so why am I waking up? Then blinding insight struck. Waking up must have been to bring my perspective to Marian’s and Duane’s recent exchange of comments on the chicken and egg subject “is it mental or is it physical?” Yes, that was it!

I probably have got some of their points wrong, so please read the comment string at the bottom of the post. Marian, Duane and I agree more than disagree about the importance of vitamins for good mental health. For Duane, recovery seems more about the vitamins correcting underlying health conditions that can lead to psychosis. For Marian, it’s more about healing the trauma that produced the symptoms. Marian feels more strongly than Duane that original trauma lies at the heart of an eventual schizophrenia diagnosis. Duane has experienced success when supplements were administered to his teenage son, so naturally, he sees the value of this strategy. Duane’s not alone, because there are thousands of people who have credited their recovery to orthomolecular therapy. I have seen instant turn-around in myself when I use vitamins for specific health problems.

Actress Margo Kidder, recovered from bipolar disorder, always says that the first thing you need to do is get a hair test. I took her advice for my youngest son, Taylor, who was beginning to worry me back in high school. This was after Chris got his “diagnosis.” Taylor’s rebound was phenomenal and you can read about it here.  I only wish I had known about hair tests and orthomolecular therapy before Chris fell into the mental health maze. Based on what I observed with Taylor, it is very possible that Chris would have recovered quickly if I had got to him around the age of sixteen when he first began showing symptoms. (Severe acne may be one of the symptoms, according to Dr. Hoffer, as sufferers from pellagra, a vitamin B deficiency, have the same skin problems.)

You don’t have to be as young as sixteen to experience turn-around on vitamins alone, but then there are the people, like Chris, and like many others, who have become psychotic, and that’s where I think it gets tricky. It is possible that once someone experiences psychosis, recovery on vitamins alone is more problematic, not because it can’t happen, but because it takes longer, or perhaps because the person begins to “enjoy” certain aspects of the psychosis and/or starts to question every aspect of existence. If you experience a spiritual awakening, also known as a kundalini crisis, once the djinii is out of the bottle, it gets harder to put it back in. The crisis begins to take on a life of its own. Kundalini crises don’t resolve overnight.

The problem is, and always will be, the meds. It becomes very hard to untangle what is actually going on once meds enter the picture. I have no doubt that many more people would recover quicker than they do if megavitamins and dietary changes were introduced at the outset instead of the meds. Many more people would also recover quicker if they encountered the right kind of therapy or found the right person who said the right thing at the right time.

That’s why I don’t play up the role of vitamins as much in my blog as much as some readers would wish. Much of the impetus for my blog comes from wanting to show people that the “harder” cases, the so-called chronic or “treatment resistant” cases are often the people where it just means you have to work harder to get at the roots of the problem. I have seen my son improve when vitamins were introduced on top of the meds, I’ve seen him do very well when he was off the meds and on vitamins alone, and I’ve seen him relapse after doing very well on vitamins alone. Some people have recovered never having been introduced to vitamins at all.

The drugs don’t work, and yet they do

I’ve been busy lately and not able to focus much on the blog. My OLF (old lady friend) who I wrote about two posts ago got out of the hospital after three days and is bouncing around like a someone half her age. She was telling everyone she knew that she didn’t need to go to the hospital and I did her no favor by taking her there. So, I read her the Riot Act, telling her that her symptoms were such that I would have been negligent if I didn’t take her to the hospital. What I was trying to impress on her was that at her age, not having regular, reliable medical care isn’t going to work for her much longer. She was having none of it.

This and pre-Christmas preparations have distracted me from being able to focus on cranking out a decent post. Here’s what I was working on before I got side-tracked.

The Drugs Don’t Work is the title of a 2009 article in Prospect magazine (“Good writing about things that matter”). I won’t bore you with summary of the article, except to say that it’s an in-depth review of “The Emperor’s New Drugs,” by Irving Kirsch, yet another book that claims that antidepressant SSRI’s are worse than useless. While many of us are heartened that we finally are getting to hear the bad news about antidepressants and neuroleptics, when it comes to antidepressants, we also know that these kinds of meds work for most people. David Nutt, of Imperial College, who heads one of the largest departments of psychopharmacology in Britain says “Antidepressants work in clinical practice, and everybody knows they work.”

We all know they work, due to something called the placebo effect, and we also know that while they in most cases are quick depression busters, they come with the price tag of side effects. (Peter Jones, psychiatry prof at Cambridge University, makes the astonishing claim in the article that no teenager ever committed suicide while in a clinical trial.) Kirsch’s contribution is to point out that there cannot possibly be blinded studies on this particular class of medications because the clinical trial participants will quickly figure out if they are on an SSRI because they will be experiencing side effects.

The key to the placebo effect in clinical trials is expectation. People who believe they are taking the real drug are more confident that they are improving, and improve they will, even if they are on the placebo. The article explains that research shows the worse your depression, the more you will improve on an SSRI. According to Kirsch, as dosages increase in response to increasing depression, the side effects increase, too, making it more obvious to the patient that they are taking the real drug. So much for double blind trials.

Today’s obituary

John E. du Pont

I’d like to see the autopsy report.

John E. du Pont, an heir to the du Pont chemical fortune whose benevolent support of Olympic athletes deteriorated into delusion and ended in the shooting death of a champion wrestler, died Thursday in a western Pennsylvania prison. He was 72.

Mr. du Pont was found unresponsive in his cell at Laurel Highlands State Prison near Somerset, Pa., a prison spokeswoman told The Associated Press.

“He had had some illnesses, so we are considering it natural,” Susan McNaughton, the spokeswoman, told The A.P., adding that the Somerset County coroner would make the final determination of the cause of death.

‘Tis the season to be jolly

I make a point on my blog not to enter the territory of Gloom because enough people get their fill of gloom from the professionals dealing with “serious mental illness.”

This week-end has been gloomy. The winter weather where I live would make even a cock-eyed optimist slit his wrists, but it’s actually loneliness I’m speaking of. I spent part of Saturday night in an ambulance accompanying an elderly friend to the hospital. On reflection and without knowing further medical details, I believe that her extreme loneliness caused neurological symptoms.  I found her sitting in a darkened apartment, her skin was flaming hot to the touch, and she had a look of shock on her face. She kept repeating that she didn’t feel well and that she was so sad. Well, she has every reason to be sad. Her beloved husband passed away three years ago last month, the Christmas season is fast approaching, and she lives completely alone.

This brings me to the next story. Chris visited a friend on Saturday night who he met at the day program he attended a few years ago. The friend is living with two cats in subsidized housing. I sent Chris off with a couple of good steaks to accompany their jamming session because his friend’s refrigerator is usually empty. Chris told me that his friend doesn’t understand why his family keeps him at a distance and that most people find him strange. He’s been living on an electrical apprentice stipend of $20 a day for the past five years. Since he lives far from the training site, occasionally he is forced to take a cab. The people who run this sheltered workshop type of arrangement criticize him for taking a cab when he’s paid so little. He’s thinking of quitting.

I suspect that this sheltered workshop arrangement is the final step of the program that they both attended. Chris was encouraged to try out furniture repair after the program ended. Chris never learned furniture repair. The whole experiment fizzled out through lack of interest on his part. Since he emerged from the “recovery” program in pretty marginal shape he didn’t enthusiastically embrace the work. He sat on a chair, sipping a coffee, watching the work, not doing it. The day program had the best of intentions, of course, but, as the saying goes, the road to Hell is paved with good intentions.

This sheltered workshop is a “good idea” that doesn’t work for a lot of people, maybe because it’s stigmatizing. It says to the individual that something isn’t right with him while perhaps punishing the individual for living marginally, as was the case with Chris’s friend. Recovery does take a while and one wonders where would the person be if these programs weren’t available. In the absence of an encouraging family that person may well be on the streets.

Being separated from the family can be an outgrowth of the “good intention” approach. I maintain that more families would nurture their relatives if they weren’t put off by the gloomy diagnosis in the first place. Families need to be told that complete recovery is indeed expected and here’s what they can do to help. Instead, the doctors tell us that our children have brain diseases and will have to take medications their entire lives. Maybe they can live productively, but don’t count on it. The medical model encourages sheltered workshops and subsidized housing. The individual becomes a problem from the families’ perspective. People like Chris’s friend are the biggest victims in this way of thinking.

Extending the hand of friendship is a powerful influence on outcomes in people’s lives. Words and gestures can turn lives around.

NAMI 2011 Convention

Blockbuster Line Up Of Convention Symposia

NAMI is pleased to announce an exciting line up of symposia for our 2011 Convention.

Health Care Reform.

Part I will offer a Washington,D.C., focus on how the health care reform bill is likely to be handled by the new Congress.

Part II will offer “take aways,” or what to do with this information when you return home.

Veterans. How NAMI is working to help veterans, the National Guard and reservists in need of mental health and readjustment services post-deployment.

Employment. Why, after all the work to develop supported employment, are 80 percent of adults living with mental illness unemployed? What can local NAMI State Organizations and Affiliates do?

Disciplinary Confinement. Isolation and confinement exacerbate psychiatric symptoms. Efforts underway to respond–including legislation, litigation and voluntary initiatives–will be examined.

Disparities and Cultural Competence. These issues will be addressed in the context of health care reform, supports and treatment availability and strategies for input and action.

Faith, Spirituality and Mental Illness. Dr. Nancy Kehoe returns to further explore the impact of religious and spiritual beliefs on recovery.

Emerging Creativity in Diagnosis and Treatment. Cutting-edge ideas to push the boundaries of our understanding of mental illness and further the effectiveness of diagnosis and treatment.

Federal Special Education Laws. Understanding IDEA, knowing your child’s rights and getting effective services.

Change of environment needed

In the car on the week-end, listening to the same radio show. This time the interview was with a management somebody, who was making the same point as the sports psychologist. He said that people are sent on management courses all the time, yet they usually come back to the same dysfunctional office environment that they left. Very quickly they slide back into the same way of thinking and acting.

Here we go again. The same is true with mental health. The patient is released from the hospital (not necessarily improved, just patched over, I may point out) back into the same environment. It could be the family, it could be social housing, it could be living alone. Often, the person regresses because the environment has not changed. It needs to in order to begin or sustain recovery.

I have yet to have a psychiatrist tell me this simple truth or suggest books to me that would help me see how this works because it goes against the disease model of mental illness. Honesty is needed here, even if it means suggesting things people have trouble accepting.

Athletes and mental health sufferers unite!

I was listening in the car this morning to a radio interview with a sports psychologist. He was discussing the case of an internationally competitive skier who had suffered extensive head trauma. The psychologist mentioned that after major accidents like these there is often Post Traumatic Stress Disorder (PTSD) as well as the actual physical trauma.

The sports psychologist treats his athletes using visualizations and other psychological techniques. It occurred to me while he was talking that with professional athletes, the focus is always on getting them back to their former level of fitness and ability to compete. It seems to be universally expected. Athletes are considered society’s “winners.” All kinds of “right thinking” behavior is credited to them, from being exceptionally focused and mature, to being “intrinsically better” than the next guy, who is roundly criticized for quitting athletics early despite obvious talent.

You probably can tell that I have limited tolerance for putting jocks on Mount Olympus. What irks me is that positive expectations are lavished on jocks and the same cannot be said for those suffering from mental illness. Where are the sports psychologists for our relatives? Our relatives, too, have to get back in the game.

The radio interview discussed the long term prognosis for returning to the sport for the worst kinds of injuries, and the psychologist said that it can be done. He made it sound like it wasn’t even such a big deal. In several cases he cited, athletes even managed to surpass their previous records. The psychologist mentioned that PTSD and subsequent recovery can be delayed by people around the athlete, who, in their worried state, actually make the athlete doubt his ability to get back in the game. (That would be the high expressed emotion that I have referred to elsewhere on this blog.)

The sports psychologist discussed the importance of allowing time to heal, and not rushing back too soon because, thinking you are well before you actually are is not a good strategy. I have heard that, too, from psychiatrists, but the difference is that they were coming from a place of pessimism, not positivism. They believe schizophrenia is chronic and, of course, the medications treat everybody as if they were chronic.

So, the psychiatric patient is not getting the kind of treatment that star athletes get. The typical psychiatric patient gets lowered expectations, no hope of full recovery and ability to surpass the previous self. Nobody clues in the family that being worried hinders the individual’s recovery.

What’s so special about athletes that we can’t apply the same treatment to those suffering from mental health problems?

NAMI loves consumers

A festive newsletter from NAMI, exhorting the consumer mentality. You don’t even have to get dressed up and go out.

This year, as you recover from your “turkey hangover,” start your holiday shopping from the comfort of your own computer by shopping at Amazon.com.

The best part? By shopping Amazon.com NAMI will receive a portion of the proceeds generated by the sale.

Those dollars will go directly to improving the lives of individuals and families affected by mental illness.

Time to practice what I preach

The teenage son of a colleague of mine has just been committed to a psychiatric hospital. He’s fourteen years old. He’s been receiving psychiatric help for years, but the situation was taking a new turn and becoming dangerous. His father feels all the psychiatry his son has had to date hasn’t prevented what is happening now.

Here’s an excellent opportunity for me to rush in and give my friend the benefit of all my experience, and yet, I don’t. At least, I don’t very much.

My advice wouldn’t be understood because it’s too soon for most people in crisis mode to absorb its simple and, at the same time, complicated message. Mental illness is so personal that it seems that nobody else can possibly have the answers for your own relative. And, of course that’s true to some extent. It seems all of us are fated to learn about how to get over mental illness the hard way.

It shouldn’t have to be this hard, but it is, because, unfortunately, most psychiatrists aren’t willing to embrace alternatives. Right now my friend’s son is in isolation, so early empathetic intervention à la Soteria or Open Dialogue isn’t being considered. Even if it’s not Soteria, doctors should get in there early and tell the parents it’s their job to be non-judgmental, low expressed emotion and unafraid. They should but they don’t. As long as the parents are scared stiff and worried, doctors can count on being in control.

In our own case, Chris’s psychiatrists have, at various times, rejected vitamins, second opinions, sound therapy, and ideas coming from us. Had Chris’s psychiatrist known about the Assemblage Point shift, well, I never even proposed it because I knew it would be rejected.  Most psychiatrists, even the ones I think have been helpful for Chris, don’t appreciate hearing about add-on therapies. I can understand that to a point. But it often looks more like they want to control the entire process, even if it means that recovery will never happen or be delayed.

So, what did I say to my colleague? Not much, but I tried to interject optimism and a positive attitude about his son’s future. I suggested that psychiatrists don’t have most of the answers and a healthy amount of skepticism is needed. I mentioned that the Internet is full of different views about mental health. It’s far too early to confide in him that one of the best therapies for Chris was for his parents to decide to change the family dynamics by changing ourselves, rather than our thinking that Chris was the problem in need of changing.

It’s too bad that psychiatry doesn’t share these insights with the family. If it did, recovery would be quicker than it actually is.