Sometimes I see a study that makes me groan. OK, it's once a day. But here's news of an Australian study in which depression among gays and lesbians is linked to a sometimes-hostile society making them feel poorly. Sorry, but I am not buying that. When it comes to discrimination and human nastiness, you are responsible for how that makes you feel, as opressive as human nastiness can feel. Blow it off. Be who you are. Accept yourself. Have a nice day. Sounds a whole lot like this Utah study in which Latinos blamed their depression on racial discrimination.
And, no, I am not feeding you unfeeling macho bullshit here. Hell, when i was a teen I was openly discriminated against when my family lived in Utah. Reason: we were non-Mormon. I've felt the kind of discrimination folks with mental illness encounter every day. Still, it was my job to not let it get me down. And, guess what? I did, which is a form of revenge that'll make you feel just fine about yourself.
So Kyle Huff shot up my neighborhood last weekend. I wrote an article in which I called him a sociopath. A reader wrote me to acuse me of copping out, that I should've declared the guy mentally ill or straight-up evil. He was right--I was straddling the fence since there was no solid evidence, not even flimsy evidence really, that the guy was schizophrenic or something. And evil is just one of those words I rarely use, since it too easily used and what do we really know about the psychological nature of evil? The beast's actions were evil, true, but are the acts the person? Sometimes, I wonder. And last weekend gave me plenty to wonder about. Ah, fuck it. The freak was evil, but it was an evil that was deeply hidden from all of thsoe around him. Somehow that is far creepier than your garden variety evil.
This also begs the question of whether someone who is evil is also mentally ill. For that, I have no answer.
Should be back to regular posting over the weekend.
Those of you who read my drivel here know that I've been away working on reporting on the mass murder in Seattle--OK, my neighborhood--last Saturday. Last evening, my story went up establishing that Kyle Huff spent at least two weeks showing up at raves and parties sizing up the rave scene and, possibly, some of his victims before killing 6 of them plus himself at an after-party. No one knows precisely why he honed in on the rave scene or what drove him to murder, much less mass murder, although it is clear from his actions in the moments leading up to the killings that he was a stone-cold sociopath. That's scary. What's scarier is that, to date, no clues have emerged from his past that would even be suggestive of his actions. The guy may have kept his plans and twisted psychology secret from his twin brother with whom he shared an apartment. The whole thing is beyond weird and beyond sad.
Hi. The last two days have been sad and ugly ones in Seattle, as I noted on Saturday, due to some irrational human shooting up a party in my neighborhood. I am writing and reporting on this saddness. Ergo, I am not going to be posting much of anything until mid-week. My resulting article will be avilable on Tuesday evening at Seattle Weekly. Be well.
You may have heard that six partygoers were murdered at a party in Seattle early this morning and that the gunman then shot himself in the head as a cop approached. All of this saddness happened mere blocks from my apartment. I've been over there most of the day playing reporter. It was the largest mass killing in this city in 23 years. There really isn't anything else worth posting today. Stay well.
The first of this week's STAR-D papers is the one the media bit on the hardest. The dominant message is that the paper by John Rush et al. shows that patients just need to keep switching meds until they find the anti-depressant for them. That assessment is not supported by the study itself (to its credit, the WaPo got this bit right).
The paper looked at 727 patients for whom Celexa didn't work. They were, then, given either Wellbutrin-SR, Zoloft or Effexor-XR for a period of 14 weeks. The paper explains that all the patients had extreme, long-term depression--some had been battling the illness for well over a decade. Almost half are unemployed as a result and almost half had no insurance coverage of any kind, not even Medicaid which you get if you are on disability. That's nasty. So were the results with the meds.
Twenty-one percent of Wellbutrin patients had symptoms remit, as did 18 percent of the Zoloft patients and 25 percent of Effexor patients. Keep in mind that this was over a 14-week trial, a short period of time for depression that will likely be with a patient for much of their lives. A one-fifth to one-fourth shot at remission (and about the same proportions for what docs call "response") is pretty slim, especially when it's your butt on the line.
The second paper examined another group of 565 patients. These are patients who took Celexa but had poor results. They continued taking Celexa and either added Wellbutrin or Buspar to their regime. Docs wanted to see what kind of results they got with adding a non-SSRI to an SSRI where an SSRI alone did not work. Both groups had 30 percent symptom remission over the course of the trial, or about as rotten an outcome as did the patients in the first paper.
None of this is what I would call hope, although NAMI painted it that way, and it isn't what I would call success. It's nice if it happens for you, but chances are that it won't. And, in the meantime, some of these same meds have awful side-effects. Effexor is the worst of this group in that regard.
The results are what I would call disappointing and further confirmation that no matter how much researchers like to waive their arms about how much we now know about the human brain and the biochemical roots of depression and that there's a special pill that'll set all that straight, we simply do not have an answer here. We have a treatment that barely works and for short periods of time. What we have is the failure of the psychopharmacological revolution--or at least of its rhetoric. We also have a failure of the media. But that's another story.
Full disclosure: I took Zoloft for a short period in the mid-1990s. It didn't do jack shit for me. It was as lame as the other SSRs I had taken. By the time Effexor later hit the market, I wanted nothing to do with a med that targeted the serotonin receptor. I took Wellbutrin for perhaps three years all told. It was largely side effect free, so I labored on with it, even though it wasn't a very strong anti-depressant. And then I just decided I was tired of spending money on something that only sorta-kinda worked, especially without any solid knowledge of what its long term effects might be on my body, and walked away from the purple pill.
As I mentioned previously, important results from the STAR-D study of depression and treatments with anti-depressants came out this week in the New England Journal of Medicine. Most of the press bought the spin that all these studies meant was that patients just need to keep switching meds until they find the magic anti-depressant. That assessment is bullshit and I am not sure who was spinning it for reporters out there in cubicle land.
Based upon actually reading the studies (this is something more reporters need to do and thanks to NEJM for giving me the .pdfs), it's clear that the two studies paint a very gloomy picture of the state of the art in treating depression. What's more, if you understand the real world patients live in, then the studies are even more damning. Accompanying two studies in NEJM was an editorial by David Rubinow, a psych researcher at UNC-Chapel Hill. Rubinow partially agrees with my assessment of just how crappy things are.
He notes that the first end of the multi-part STAR-D study showed that patients taking Celexa, the main med used in the study as a proxy for the major SSRIs, only experienced remission of symptoms 30 percent of the time. Then he moves to the current results: "The results suggest that at least half of the patients with depression do not have a remission."
Where have we heard that before? The bad news is compeltely lost on the folks at NAMI National who declared that the results are "hope." Kind of an odd statement to make in response to a study that both confirms that psych meds work about half the time and the full remission happens even less. An odd statemnt, too, in light of the fact that these meds aren't just taken by people with depression but by millions of bipolars. But, whatever. I guess that's why I am not in the advocacy business, where you apparently have to take money from pharma companies like NAMI does.
I'll take up the two sets of results in a following post.
Although my inital post today may have made it sound like the study results in the New England Journal of Medicinewere pretty benign, here's a glass half empty take on things from the WaPo. The nice folks at NEJM are sending me the full journal articles, so I can look at the data for myself. But bottom line: this ain't good for anyone and confirms the point I have been making on this blog for six months like a ranting two-year old--psych meds work about half the time and that's just unacceptable. More to come.
I just want to restate what I got at inarticulately in a post yesterday: I am tired of this blaming bipolar disorder for every flawed behavior, as did Debra LaFave, the Florida teacher who was humping some of her students. That's bullshit. There's right and wrong in the world, you know what they are and bipolar disorder does not change your ability to act upon that knowledge unless you are truly psychotic. Hypomania doesn't count.
So LaFave now joins Jayson Blair in my bipolar rogues gallery. Maybe they can have children.
OK, well not really on trial. But yesterday an FDA advisory panel recommended that ADHD drugs--our pals Ritalin, Concerta and Adderall--get slapped with warnings due to their causing psychosis in some children. It's about damn time. Coupled with calls for warnings related to heart problems caused by these same meds in adults and some instances of suicidality, you've got to wonder why these meds are being handed out so casually, and why parents are letting their kids take them so aggressively.
I think we need a Golden Mean for psych meds in this culture.
A couple of NIMIH-funded studies have come out in the last couple of days asserting that if the first anti-depressant you try doesn't work, try something else. You'll get results. I haven't been able to read the papers yet, but the many press accounts sure make it sound like researchers are getting funded to state the obvious. Only now it's more scientific 'cuz it's got numbers and such.
The sad thing is that there are many people for whom no anti-depressant works for very long. You get the 3-to-6 month boost and it's back to the doc for a dosage increase or med switch. And so on, ad infinitum.
For fun, here's the list of anti-depressants I have been on in my life: Prozac, Paxil, Zoloft, Lexapro, Wellbutrin, Luvox. I think that's all. And I assure you it was quite enough. None of these every really wiped out depression for very long, but they sure had lovely side effects. And Prozac had me so scrambled at one point that I damn near killed myself. Good times.
So Florida school teacher Debra LaFave had sexual misconduct charges dropped against her yesterday. She was charged with having sex with a minor-aged male student of hers. I am not completely clear why the charges were dropped by the judge (press accounts vary on this), but what is clear is that she was going to mount an insanity defense based on being bipolar. Her lawyer came out and said as much on "Good Morning America" today.
So now we are going to have half of America rolling around thinking that bipolar disorder turns people into sexual deviants, for lack of a better term. Great, fucking great. When do we actually get some decent publicity for bipolars? Why is it always about someone committing a crime? Why is it never about someone living a fairly normal life?
Hell, I am as bipolar as the day is long and I am going to go into the office, work my ass off until 6 p.m., and then go home. But it's never about that reality, now is it?
Today's New York Times has an article on a few renegades in the psych profession who are challenging conventional wisdom about how to treat schizophrenia. It is an important article and you should all read it. As you know, the conventional wisdom holds that the illness must be treated with antipsychotics at the first onset of psychosis--and that it must be treated very aggressively almost without any regard to the age of the patient. There are no options to this approach, schizophrenics are told. I am not an expert on schizophrenia, but I have always felt that this advice is far too broad.
In my professional and personal life, I have encountered a fair number of schizophrenics who don't respond well to antipsychotics. They continue to experiences hallucinations, delusions and crippling paranoia. This is true even if they are on extremely high doses of antipsychotics. What's more, the meds beat the hell out of their bodies, their cognition and, in my opinion, their souls. Their lives and their suffering are staggering. Ever time, I walk into a state hospital, for example, it is difficult to look into the faces of patients who have taken large doses of antipsychotics for many years. There is very little there there. I once drove away from Western State Hospital in tears after touring its wards. I wouldn't want to guess at what percentage of schizophrenics don't respond to treatment--and whether the driver is that, for them, the meds don't work or that they are that profoundly ill. But I'd say the percentage is fairly high.
Think I am joking? Take a look at how many people are housed in state hospitals, residential treatment programs and transitional housing (the latter two have essentially become quasi-state hospitals), as well as the homeless (about 50 percent of them are estimated to suffer from some form of mental illness). These are all people for whom their illness has proven so disabling that even with treatment, they are unable to live typical workaday lives. Or for whom the standard treatments just don't work fully enough. Most of these people would either be schizophrenic, bipolar or have extreme depression.
We are talking several million people here. In the State of Washington, there are about 100,000 people who are in the various levels of the public mental health system or are homeless. I have done a lot of reporting on these people the last few years and have interviewed many dozens of them and observed even more at close range. I'd have to say that well over half of them have an unsatisfactory response to standard treatments. I don't think it's wild to expect that we are talking about several million Americans for whom there is no thorough effective treatment within the current mental health paradigm.
The reason for all my gibbering and half-assertions is that the Times article floats the question of whether meds are always necessary when treating schizophrenia. The article was inspired by a forthcoming paper in Schizophrenia Bulletin. I want to congratulate the Times for poking into the matter, especially since I have long been a critic of the paper's coverage of mental health. I want to be very careful with asserting just how many schizophrenics could do just fine without meds, but the article puts the number at between 10 percent to 40 percent. At 40 percent that would work out to 1.2 million American schizophrenics who might do well without medication. I'm sure that there are some in the psych and pharma and policymaking worlds who would prefer that such news didn't get out.
To be clear, I am not saying that all the folks with mental illnesses, especially schizophrenia, whom I've encountered would do well without meds. I am simply saying it's hard to make the case that meds work well for them--and that's always made me wonder what their deal would be like without meds. It's made me wonder about my own situation as well.
So how would these people get their illness treated? Beats the hell out of me. But it's obvious that something about the current paradigm isn't working well. And that does make people like me begin to wonder about what the hell else can be done to address mental illnesses. You just want to rethink the whole psychopharmacological revolution when you see millions of Americans not getting relief even if they are playing by the rules.
There is, of course, some division within the psych business on whether every schizophrenic must take antipsychotics at all times and forever. Most docs would say all-meds-all-the-time. But there are enough who'd say No that there has long been a quiet debate within the psych world about the meds question. Of course, it's been a quiet debate because the media has done a poor job of paying attention to sources in the psych world beyond the prototypical researcher saying Med X works darn well for treating schizophrenia or bipolar disorder and, as a result, the dissenters within the psych field have largely gone ignored. To be fair, even the dissenters will generally say that meds are highly useful in crises. The sticky problem is the long-term. Regular readers know my thoughts on the sticky part.
Certainly, the sheer numbers of patients in the real world who keep having problems lends credibility to last year's landmark CATIE study. It showed that atypicals perform like shit in patients. The STEP-BD study is also showing plenty of problems on the bipolar disorder front, although that study's data on atypicals will be thinner than CATIE's, owing to differences in study design.
For the three-four-five-six-whatever million Americans with bipolar disorder this question is as important as it is for schizophrenics. That's because we are now being encouraged/asked/forced to take the same meds as schizophrenics. These are atypical antipsychotics. In some cases, bipolars take them at the same dosages as schizophrenics do. They have the same effects on our bodies and minds and souls. So it is important the same questions that the Times article floats about schizophrenia get asked about treating bipolar disorder. These questions need to be asked about the anti-depressants many of us take as well, since their side effects are problematic, albeit milder. Legitimately, you can ask these same kinds of questions about ADHD drugs and mood stabilizers as well.
I've been asking these questions in print, in small and in large, for about two years. At times, I have been attacked for writing articles like this. I've been asking them on this blog since last September. I've been asking them in my own life on-and-off for almost 17 years, although most acutely over the last three years. Here's where I am at: Next month, I will discuss with my doctor, whom I trust and who actually gets me, the possibility of my going off meds altogether. Right now, I am only taking Lamictal. Since, phasing atypicals out of my life last summer, I have done much better than I thought I would, excepting a tough patch here and there (but I was having those tough patches with meds!). Logic demands that I consider how far to push this. But I will be careful and judicious in my decision--but it is my decision after all. Experience reminds me, though, that the one time I went off-meds in all those years I didn't have a great experience. So we shall see.
But I am rethinking all of this. I hope to god I come up with an answer someday.
Much credit to the usually awful San Diego Tribune for this excellent article. In it, the military admits that they are rotating soldiers and marines back to Iraq who suffer from mental illness. What's more, the military conceded that these troops were going back to the war theatre while taking psychotropic medication. This is a very odd, troubling and fascinating social experiment. I wouldn't even have a guess as to how it will work out, aside from it being war and war being hell.
I have no idea of course. But here's a heartbreaking account of an 11-year-old Japanese boy killing himself soon after being disciplined by a teacher. Suicide amongst pre-teens has always existed in Japan, and there are reports of some of these internet suicide groups among such kids. America is not immune from this either. Two years ago, in Seattle, a 12-year-old girl jumepd to her death from a bridge a few days after Christmas. I knew one of her teachers and she told me that everyone at her school was at a loss. So was the girl's mother apparently. I'm not even sure how to address this issue, but it is a serious one nonetheless.
Looks like the Catholic Church is going to go after the British Government's plan to legalize assisted suicide for terminally-ill patients. I think the church is out of its mind, but at least they are consistent with their sanctity of human life talk. I've long-supported right-to-die laws and was thrilled to see the US Supreme Court wind up on the right side of this issue recently. The Court shot down the Bush Administration's attempt to squelch Oregon's "death with dignity" law. It'll be interesting to watch the fight go down in England. Stay tuned.
You may have heard the simmering controversies around South Park and the Scientology spoof episode--that the Church may have used its influence to keep the episode from airing on Comedy Central. Then again, perhaps you have been asleep in a cave. I agree with Andrew Sullivan's take on this. Please go to this post and, if you agree with him, then let the fools at the cable network and Viacom know by email. Isaac Hayes quit the show over this matter, feeling that CoS had been, um, shafted. Good riddance.
According to a new poll, 46 percent of Americans believe states should be allowed to legalize, tax and regulate marijuana within their borders. That's a huge shift over the last generation. Fascinating, and ironically the news comes on the greenest day of the year in America. I can't wait to see the drug czar's reaction to this bit of news.
Japan has long had a suicide rate much higher than this country's--perhaps 3 times the rate. Maybe more. suicide is wrapped up in Japanese culture in a way I hope it never will be in this country. Typically, it's a measure used by older Japanese faced with old age and financial problems. But, over the last week, I've seen numerous press accounts of increased suicide among 20somethings in Japan, some of whom are forming death pacts over the Internet. I pass it along for what it's worth to you, because I sure don't know what to make out of it.
He's just an average citizen in Arizona who wrote to the Arizona Republic after its editors recently dinged up the Scientologists for trying to push a nutso bill through the Arizona State Legislature. Hays made several intelligent points, among them that the Scientologists are wrong; there is over-prescribing of psych meds; and, policy debate in America is so under the thumb of non-profit advocacy groups (aka special interest groups) that even a bloody UFO cult can get a bill through one house of a state's legislature and that shit like that is a threat to democracy. As long as citizens like Hays are around, I'd say democracy has a fighting chance and so does mental health treatment.
I ask myself that question all the time. Why am I doing this? Why am I on this earth? Why am I a writer and not a stockbroker? Why am I never going to get ahead? And so on. I had planned to ask those sorts of broad, public questions earlier today when I posted my 200th entry on this blog. But I spaced it. And now I am on post #204 or something like that. In terms of words, that works out to over 40,000 words--the length of a short book--in less than six months. That's on top of my day job, where I have churned out 30,000 words in the same period. 70,000 words. Why do I do it? What does it get me? How does it improve my life to work that hard?
It doesn't sadly. This was driven home to me in a few ways today. One, my bosses declined to pay for treatment to a muscle injured suffered on the job due to an improper workstation and my insurance won't cover it and worker's comp will take forever and they'll likely fight it, even though the fix is $300 to $400. Basically I was told to stuff it. I pointed out to my bosses in my emailed reply that my salary hasn't kept pace with inflation. I got 3 percent last year and that's what I have been told to expect this year, despite all the attention and new readers I have gotten the paper in the last two years. What's more, my rent has gone up 10 percent this year, my student loan payment has gone up by 20 percent and now much of my raise will go to dealing with something my bosses should be footing the bill for. Even worse, real estate in Seattle has just exploded. A pre-sold studio in my neighborhood cost about $180,000 a year ago. Now, that the project is finished and units are being occupied, people are turning around and selling those teensy 425 square foot studios for $279,000. Fucking amazing. I am being priced out of Seattle, just like I was priced out of the Bay Area.
I am so fucked. I wonder where I am going to go or do next cuz' I can't make this game work for me.
But who the fuck cares, right? Reporters and writers are just supposed to keep putting information out there that the public desperately wants but isn't willing to pay for. Nice arrangement.
Am I alone in this or is anyone getting a bit freaked out by how America is working out for them? Anyone questioning why they went to college? Anyone happy with their slice of the American Dream?
I know I should be blogging about how the US Senate just passed a bill undoing all the mental health parity in the 35 states that have it, but I need a drink.
Stocks for pharm company Cephalon dropped yesterday on news that the FDA may require suicide risk warning on the company's experimental ADHD drug Sparlon. Boo-hoo. An FDA panel is to consider warnings on a suite of ADHD drugs on March 22, although it is unclear whether those warnings will be fore heart problems or suicide or what.
I mentioned yesterday that the Scientologists, through the ever-lovable CCHR, were pushing to get greater patient consent and other restrictions on psych meds used in testing tightened in the State of Arizona (where my great-great grandfather died in the state hospital). Now, the state's main paper is banging on the Legislature. Yee-haw.
Regular readers know that I've been pounding on the theme of psych meds work about half the time and that just isn't good enough. Here's a researcher--a prominent one, even--getting my back in a recent letter to the American Journal of Psychiatry. Key quote: "The results are so similar to those observed in lithium treatment studies reported 20 to 35 years ago that the question of whether today’s best treatments available for bipolar disorder are better than older treatment begs for an answer." He's referring to some of the results of the STEP-BD study which I've already posted about. Read the whole letter here. I think some of us know what that answer is.
So I shot off my mouth yesterday about my doc saying I am in recovery or recovered or whatever the hell it's called. Before I shoot off my mouth anymore, I wonder what the terms mean to you all. Do they mean anything? Let me know.
Here's one of the most spectacular screw-ups I've seen by a media outlet in a while, when it comes to citing statistics on a mental illness. In this piece, one of the authors claims that bipolar disorder affects 22 percent of the American populace and even cites a source for the number, the Mental Illness Research Association. That struck me as very odd. NIMH has long asserted that bipolar affects about 1 percent of the American populace, a number that I believe is understated since it is an old estimate (1992) and more recent estimates place it at around 2 percent to 3 percent of the populace. Pharma companies often claim that bipolar affects as much as 5 percent of America. Nice for marketing purposes I suppose. Thankfully, the MIRA website only claims that 22 percent of Americans have a diagnosable mental illness, not 22 percent have bipolar disorder. Big difference.
So the Citizens Commission on Human Rights, sworn enemies of the psych profession and a Scientology front group, appears to have been very influential in getting a bill before the Arizona State Legislature. The bill would, and it appears headed to passage, require greater informed consent in the testing of psych meds in state-funded institutions. Reportedly, several legislators were wined and dined by the UFO cult...and I won't even get into the propriety of that. Generally, I am all in favor of greater rights for patients, especially ones in state hospitals, but I don't trust the Scientologists, so I'll have to actually read the bill. But it's late.
Regular readers know that despite occasional setbacks, I have come a long way back from the hell bipolar had me in for much of my adult life. I am not comfortable with terms like "recovery" and "recovered" since they just beg for manipulation by pharma companies, and are little more than a shorthand for "doing pretty damn well, thanks," but my doctor last week told me that I meet the criteria. Another day, I will go into what I think is going on with me because it's been fairly unexpected, even though I worked my ass off to achieve it. So many years with no progress went by, etc. If only the rest of my life worked as well!
On another front, I wish my fellow bipolar blogger Liz Spikol from The Trouble With Spikol as well as I can wish another human. Lately, she's been having a rough go with depression and has had to turn to the ever-tricky Effexor, and she's been chroniciling her progress/non-progress with the med. I know how she feels. Someday soon, I hope she knows how I feel.
Unbelievable. A student at George Washington University checks himself into the hospital for help with his suicidality. Then he is banned from returning to campus for being dangerous and violating the student code of conduct. I have never heard such horseshit before. I wish him luck winning his lawsuit because schools like this must be stopped before students get banned for...oh God knows what's next.
I'm curious what books and other websites readers have found useful in learning about or coping with mental illnesses. Let us all know in comments, please.
Also, this is an easy way for me to get out of doing a regular post this morning. I am under the gun to get a story into my editor by 9 a.m. Arg.
It's been interesting watching the wave of depression awareness hitting US colleges the past few months. It's good that the matter is being discussed. But, as I suspected, it's leading to some wild claims such as this one from the UW-Madison college paper, in which a college counselor asserts that 80 percent of college students experience depression. Maybe during finals week, but seriously that claim isn't even supported by any research I have seen, so maybe the young reporter at the campus paper should've checked into the claim. I'll buy 10 percent, I'll buy 20 percent. Hell, maybe even 30 percent. But 80 percent? I'm giving that counselor an F and mandatory drug testing.
In the world of perpetually befuddling research, the pointy-heads are claiming a link between allergies and depression in women. They can't say if one drives the other, but are calling for long-term studies. Somewhere in academia, I hear a cash register ringing.
Only with California government would it take a $2 million study to determine whether or not it's a good idea to build a suicide barrier on the Golden Gate Bridge. Dude.
I am taking 24 hours off. A new, long article of mine was just published and my small cinder of a brain needs a rest. I shall return.
Hamlet's "madness" has long been debated by pointy-headed professors and lit majors and theatre geeks. And, now, here's an interesting little essay asserting that Wm. Shakespeare himself may have been bipolar. There isn't enough known about his life to say much of anything about his love life much less whether he had the fine madness, but I wouldn't be surprised at all. Similar assertions have been made about other historical figures, most prominently Mozart. I'm not sure what any of that proves. But it is fun to speculate about such things.
As for the Prince of Denmark, he was certainly one fucked-up frat boy.
Yesterday's Seattle Post-Intelligencer has an article about the city's moronic decision to cut down some trees in a park because some asshole homeowners--read: elitist fuck nuts--didn't like that the homeless were sacking out under the trees. Here's a stunning quote from the story:
"Other neighbors, such as Pat Burke, felt strongly that the trees had to come down. As branches fell, Burke said, 'Almost anything (the city) could do would be an improvement. (The park) has been such a disgrace. On the north side is where the mentally ill people congregate, and the south side is where the drug dealers hang out. This is going to let some sun in.'"
Hey, Pat Burke, you live mere blocks from where I work. One day, I hope to tell you to go fuck yourself right to your face, you discriminating sack of shit. I'll just be helping you let some sun into your black heart!
It's not often that I praise another journalist for writing a short, smart article on depression and implications of genetic research, but this is one of those times. The shocker is that the article is in Time magazine, an outfit notorious for insipid writing and sweeping conclusions based on little evidence.
That's the view of a Rutgers University sociologist, who says that some survey findings that 50 percent of the American populace suffers from depression are hogwash, little more than the result of survey artifact. I agree. The good news is that those claims are rare and most studies suggest that depression runs between 10 and 13 percent of the population. Fifty percent is little more than public health nut jobs run amok and looking to proclaim an epidemic so they can get more funding. Let's stick with what we can prove or no one will ever take mental health treatment seriously.
Oh nice. A school board member in Rhode Island claims that bipolar disorder made him concoct a fundraising scam. Lame excuse. Right up there with Jayson Blair blaming some of his transgressions at the New York Times on bipolar disorder. Hm. I wonder how Jayson's book on bipolar is coming along.
In the meantime, bipolar is not an excuse for doing stupid shit, unless you are well and truly in a psychotic state in which case you should probably not be prancing around in public. There is right and wrong in the world and bipolar disorder doesn't remove your obligation to know the difference and do the right thing.
Kirby Puckett died yesterday, following a stroke. That sucks. Great player, whose health went south years ago and forced him to retire young. He deserved better.
At a conference over the weekend, researchers announced that a study at Duke University of patients with coronary artery disease had a 55 percent higher risk of death than patients who took no anti-depressants. Researchers are at a loss to explain the finding--and hell I don't even have a guess--especially since it flies in the face of earlier studies showing that anti-depressants helped the same type of patients. In light of this finding, I wonder how many cardiologists are itching to make sure their patients take Prozac and how many law firms are lining up lawsuits.
If there's one thing I admire about pharma companies, it's that they are always looking to build a better drug. OK, it's the only thing I admire about them. That said, here's a report on what we'll hear a lot more about in the next few years--the triple-uptake inhibitors. Unlike SSRIs, they will target the dopamine, serotonin and norepinephrine receptors. We'll see how these work, but I don't expect much improvement since anti-depressants that target two receptors haven't exactly set the world on fire.
I am really at the point where I begin to question if we haven't made all the advances we can on the meds side of the equation.
I've been banging the drum for CIT--crisis intervention training--for a long time. It basically clues street cops into the fact that mentally ill folks they encounter on patrol are not the threats they appear to be, and that there are ways to get them off the cliff, so to speak, without having to shot anyone. This training has saved countless lives of cops and citizens already, but sadly it's typically only the larger progressive police forces that have the training and not every cop gets it. That's sad and needs to change, but here are some cops in San Mateo County, Calif. getting the training.
Andrea Yates, who drowned her children in a bath tub in Texas a few years ago, will go back on trial on March 20. Her previous murder conviction was thrown out last year based upon bogus testimony by an expert witness. It's never been clear how sane she was or wasn't at the time, but the suspicion was that she was schizophrenic. Last year, however, her mother and brother were on CNN and said Yates has bipolar disorder. It will inevitably come up at her trial. The Bill O'Reillys and Nancy Graces of the world will act shocked that she could claim insanity. Some boob will say bipolar disorder is just an excuse for going on criminal rampages. CNN will probably spend two minutes discussing the disorder in the simplest way possible. That will leave all the rest of us to be suspects just a little bit more each day. Or maybe not.
A few years ago, I tried to get my editor in Portland to let me write publicly about the disorder and my experience with it, since it kept popping up in the news. He refused, principally because I was the paper's city hall reporter and he feared that important sources like the Mayor and Chief of Police either wouldn't talk to me anymore or would make sure they had armed guards when they did. I understood his reluctance. It is a leap into the unknown discussing living with that which scares the hell out of most reasonable people.
Two years ago, in Seattle and at another paper, I began writing publicly about having bipolar disorder. It was very scary to do that. I figured my career was over and that people would avoid me on the street. The response was the exact opposite. Two weeks ago, I was at a press conference and the Chief of Police came over to talk to me. Last week, I interviewed Seattle's Deputy Mayor and he and I got tense with one another in the manner in which that sort of relationship should be. People talk to me on the streets all the time these days.
I don't know what demons drove Yates to kill her children or what punishment she merits--I cannot imagine a sane person doing such a thing--but I do know about demons. They can be beaten. Life goes on. You interview the Deputy Mayor and hang up the phone and file your damn story and pay your taxes and go home. I hope that kind of thing doesn't get lost in the next few weeks when the media starts stirring the pot over the Yates tragedy. There are many examples out there of how life plays out with bipolar disorder and they merit as much attention as the bad ones.
I took several days away from posting due to a bad back, and a separate project I am finishing, which is eating my damn brain. Ought to be back to the regular flow by Friday. Be well.
The National Alliance on Mental Illness, aka NAMI, has released its grades of state public mental health systems, which serve low-income people, and the results aren't good. No surprise there. America gets a D. Washington State, where I live, gets a D. A few states got Bs, some got Fs. Colorado refused to cooperate with NAMI and got a U. Nice open-government you've got there, Colorado.
Last year, I posted about some surprising data showing that about 25 percent of returning Iraq War troops reported some kind of mental health issue. Now, the fed reports that it looks more like 33 percent. Great, just great. And those WMDs are where?