Greetings. As most of you know, I have been slacking off this summer, mostly to recharge my mind after writing entirely too much here since last September. I had planned to be a little bit more back at it by now, but life has interceded in the form of lots of work at my regular reporting gig. And as some of you know, there have been major personnel changes at my paper, detailed and discussed by the Seattle Post-Intelligencer (with quotes from yours truly) and theSeattle Times.
As a result of all that, I am still holding off regular posting here. And believe me, I am itching to get back at this. After all, we still have psych meds that don't work too well, a culture of medicine that ignores that, new labels required on ADHD meds, people like Fuller Torrey trying to restrict civil liberties, and a media that is, for the most part, blind to all of this. But I only have so much brain power for one day. Be well.
Yesterday, I wrote a post nit-picking an article in the American Spectator by conservative blogger Michael Fumento. He responded in comments, thus:
"Please note: ". . . or some combination thereof." Assuming the accuracy of your 30% figure, that would require only 21% from EC and talk therapy to reach "most." And I have tried it. Clinical depression runs in my family including me. I have successfully been treated pharmaceutically for 10 years."
I'll let his response speak for itself, and will play media critic with it later.
John McManamy attended a scientific conference on bipolar disorder in Scotland last week. In one of his posts, he notes that many researchers were pointing to the fact that about 50 percent of patients who take meds don't take them as prescribed (I don't dispute that percentage), blaming the phenomenon on patients in "denial" and side effects of meds. The solution is for patients to be educated by their docs, therapists and so on, say the docs.
I wonder how these education sessions might go. "Hi, you're bipolar and your meds are going to make you feel like shit, but you have to take them so that you don't feel like shit." I am only be half-sarcastic here.
But, yeah, we'd all better go take our meds before Fuller Torrey sends the outpatient commitment boogeyman after us. To be fair, the researchers at the conference weren't blaming patients for this situation, but god knows Torrey would.
OK, to be a bit more serious, wouldn't that dynamic work a bit better if meds worked better than 30 to 50 percent of the time and if the side effects weren't so nasty, working or not? I'm thinking there would be a lot less denial then. And, the education would be easier too!
That study showing rapid-onset anti-depressant effects from ketamine has been getting a lot of play, including from conservative blogger Michael Fumento. I hope NIMH plans on funding further studies of the anesthetic, at least on whatever its underlying mechanism is in the brain since it seems to skip the many steps it takes for a regular anti-depressant to have an effect. Or maybe ketamine could be studied where docs might ordinarily slap a massively depressed patient with an antipsychotic—at the right dose, I bet ketamine is no more risky than Zyprexa. So study the hell out of Special K.
While running through that argument, however, Fumento says something bizarre: "The good news is that most depressives can be treated with drugs, talk therapy, electroconvulsive treatment, or a combination thereof. " Drugs? Thirty percent success rate. ECT? You go try it, Mike.
No doubt, most of you have already run into news of the study that establishes that the anesthetic ketamine—aka, Special K, aka the club drug that makes you want to dance all night—has rapid, positive and long-acting effects on treatment refractory depression. This comes to us courtesy of an NIMH-sponsored study which involved 17 patients (so the evidence is preliminary at best), but it comes as no surprise to me that a pain killer used in low doses would have a positive effect on depression. It won't become widely (or even narrowly) used, because it is only injectable and it's not practical to restrict people from using it in higher doses—and getting high.
What amuses the hell out of me is that the government funded a study involving a drug which, on the other hand, the government (ie, the DEA) says is bad for people—cuz it gets you high. Typical governmental paradox there.
What makes this even funnier to me is that the feds will allow ketamine to be studied for use in depression but will not allow studies of marijuana for depression. Apparently, ketamine's manufacturer has a better lobbyist that the tens of millions of Americans who smoke weed.
And you know the rest. On the Treatment Advocacy Center's website there is now a new special section slugged "Welcome NAMI Members." Gee, I wonder why TAC is getting so much interest from the NAMI crowd. Could it be anything to do with Fuller Torrey's speech to the NAMI convention last month? Could it have anything to do with Torrey's claim, in his speech, that forced medication is never a civil liberties issue? Could it have anything to do with the fact that NAMI National has completely lost its mind and is now swining back around to openly-advocating for forced medication?
Yes.
I was able to confirm yesterday that Naveed Afzal Haq, a bipolar man who shot up the Jewish Federation's offices in Seattle last week was in treatment for bipolar disorder. It's not clear to me what he was taking—he's known to have taken Lithium and Depakote, in the past. To me that's more disturbing than if he were not on meds, because we act in this culture as if meds are the great buffer between bad behavior and insanity. Sometimes, they are. Too often they are not.
This idiot had a beef with Jews, shot six women, killing one. I think his actions have very little to do with the disorder.
I am still waiting for the fine folks at the Treatment Advocacy Center to add this case to their database, obsessively-maintained, about violent acts perpetrated by the mentally ill. I am waiting for them to use this as yet another example of a mental health system gone amok. Too bad it doesn't fit their usual line of advocacy that people who do bad things aren't taking meds and that, therefore, anyone with a serious mental illness must be forced to take meds by a court should they disagree with treatment "plans" pushed on them by doctors and their own families. Their very disagreement signals that they are delusional. So the TAC storyline goes.
As I have pointed out on this blog and communicated to TAC directly, there are violent acts perpetrated by people who are on meds. They are compliant with treatment. In its vast database, TAC enumerates hundreds of cases of mentally ill people who have committed acts of violence, but the group fails to distinguish whether the acts were committed by those on or off-meds. Neither does TAC make anything other than cursory inquiries to determine that. Why? Because knowing the difference might give them answers they don't like—such as that their simple minded arguments and disregard for individual liberties are intellectually corrupt and inhumane.
What's more, the group never reports on whether these violent acts were connected in any way to drug or alcohol abuse. Both drugs and alcohol are often connected with acts of violence, exclusive of mental illness issues. There is lots of research on that point and if you don't believe the researchers, then ask any cop.
That TAC has become so powerful in the conversation around mental illness in our culture (especially in the media) is unbelievable. I blame newspapers like the Washington Post for making this happen, I blame the media in general for being intellectually lazy when it comes to reporting issues that affect how 50 million Americans are regarded by their fellow citizens (excuses of deadline pressure are unacceptable) and I also blame NAMI National for being co-opted by TAC and its head, Fuller Torrey. To date, the Seattle media has not poked into the whole question of mental illness and violence. We'll see if that holds.
That's a lot of blame. I mean every word of it.