Furious Seasons

February 15, 2008

REPORT: Northern Illinois Shooter Had Long Mental Health History

This news comes from the ABC affiliate in Chicago:

Steven Kazmierczak, the shooter who killed five people plus himself at Northern Illinois University yesterday, had a mental health treatment history that went back to his teens.

"Kazmierczak, 27, was treated for mental illness nine years ago. He was considered volatile, according to a staff member who worked at the facility at the time, and violent if he stopped taking the antidepressant and anti-anxiety pills prescribed for him. It was medication he was supposed to still be taking and apparently stopped a couple of weeks ago.
"Shortly after Kazmierczak graduated from Elk Grove Village High School in 1998, his parents became unable to handle him, according to a woman who worked as a residential manager at a psychiatric treatment center for mentally and behaviorally troubled teenagers. Kazmierczak lived at the Mary Hill Home on Chicago's Northwest Side and received psychiatric treatment for more than a year after he was diagnosed as mentally ill in the late 1990s. His parents sent him for treatment."

Obviously, that news flash ignores the possibility that it may have been withdrawal from medications that could have caused some of his troubles. Then again, maybe not. And, let's be clear: We have no idea what meds he was on until recently. He could've been taking anything.

"He was already on medication, but he was not taking it at home and would not follow instructions," said Louise Gbadamashi, former manager of Thresholds, the company that ran the home. She said the first thing she thought when she learned the shooter was Kazmierczak was, "he didn't take his meds. He was kind of quiet, kept to himself. He picked his friends, he was kind of passive aggressive.
"He was a cutter," said Gbadamashi. "He would cut himself. Then he would let you discover it. He wouldn't tell you, he would roll up his sleeve and ask you a question, and you'd turn around and see it."

She said Kazmierczak's expression rarely changed, so it was hard to tell if he was depressed.

"He strikes out, and you have to really know him," said Gbadamashi. "In his eye, you can see it. You can't look at him like, 'I'm angry, you're going to know it.' It's just stoic, just stoic."

In the shooter's defense:

"Alexandra Chapman was a friend of Kazmierczak.
"He was one of the most genuine people I have ever met. I want people to know that he was a really great person, that he was just a really great guy, he was so kind and would always do anything for you. So it doesn't make sense. I just don't want people to think of him as a monster," said Chapman."

So what would turn a "really great guy" who had an undetermined mental health diagnosis into a "stoic" killer?

Let me know what you think.

Here's what beats the hell out of me: About 30 million people took an anti-depressant in the US in 2006. Let's assume the number is about the same now and let's assume the shooter was one of them. So how is it that if anti-depressants cause some problems and so many people take them that we only wind up with people committing violence towards others where anti-depressant use may be connected perhaps three to six times a year? Or does it happen more? And why does it always seem to be the men who do this? Or are there stories of women doing this kind of thing that I am unaware of?

I'm not enough of an expert to say.

UPDATE: (7:25 p.m. PST) Looks like the shooter had been taking classes on mental health issues at the University of Illinois last fall. So why would someone who was smart and likely very aware of problems with coming off or going on psych meds not be hugely aware of his own situation and take appropriate steps to ensure that he and others were safe?

There's something in all of this that doesn't quite add up for me yet.

Posted by Philip Dawdy at February 15, 2008 07:01 PM

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Comments

First, How do people like these get their hands on guns?
Ban all shotguns.
Second, there ought be a study of effects of anti-depressant pills. There are too many instances of violence attributed to Prozac et al that it has become serious issue that needs to be addressed by autorities.

Posted by: Hasib at February 15, 2008 08:12 PM

"when a dog behaves badly - for example, mauling a baby - we blame it for its behavior and its owner for not having domesticated it.

when a teenager behaves badly - for example, killing and injuring students and teachers in a school shooting - medical experts blame it on everything EXCEPT him and his parents for not having domesticated him."

p.10 - words to the wise - (c)-2oo4-t.szasz

Posted by: z0tl at February 15, 2008 09:02 PM

z0tl: i'm not quite sure how szasz has squat to offer us here sicne the guy seemed to be pretty well liked overall one assumes his domestication was all there and alright mostly.

Posted by: Philip Dawdy at February 15, 2008 09:13 PM

Interesting. The Thresholds case manager does offer a very different picture from those who knew Steve Kazmierczak in recent years at NIU.

From today's Chicago Tribune:

Friends, family of accused gunman stunned

On the Northern Illinois University campus, Steven P. Kazmierczak was considered a gentle, hard-working student, who was honored two years ago with a dean's award for his sociology work.

Professors who taught him said it was hard to imagine he was the same person authorities identified as the gunman in Thursday's classroom shootings.

"I knew Steve both as an undergraduate and as a graduate student. I have had him in my home. I knew him as a warm, sensitive, very bright student," said Professor Kristen Myers in an e-mail. "I never would believe that he could do this. I know that when these horrible things happen, everyone searches for roots to explain it. Here, I'm afraid I don't have any."

***

[Prof. Jim] Thomas first became acquainted with Kazmierczak when the student took an introductory sociology course, taught in Cole Hall—where Thursday's shooting took place.

"In this large class he stood out. So I tried to use him as an unpaid assistant," Thomas said. "He stood out because he was hard-working, he was bright, he would come up and talk about ideas behind what I'd taught."

Thomas said he was left dumbfounded when the news of the gunman's identity trickled out around campus Thursday.

"When I heard yesterday that it was a student in corrections and social justice, former grad student, I thought, 'Oh, my God, that's Steve. That has to be Steve," he said. "It's nuts, nuts, totally nuts. He was the most gentle, even guy."

http://www.chicagotribune.com/news/local/chi-steve-kazmierczak-gunman_webfeb16,0,319031,print.story

Posted by: Johanna at February 15, 2008 09:36 PM

z0tl: your two recent comments, which i did not approve, were abusive to me personally. therefore, you are banned from this site. i also know your ip address and your isp, so stay away from this site or i'll report you for abuse.

good luck to you

Posted by: Philip Dawdy at February 15, 2008 09:38 PM

Everybody seems to be buying BS these days, by the looks of things (behavioral description) Steven Kazmierczak was a paranoid schizophrenic on Zyprexa and not some dude with unidefined mental problems that were controlled by antidepressants and anti-anxiety pills for nine years, just give your head a shake people.

Unfortunatelly none of the so called miraculous psychotropic drugs address real issues underlying mental illnesses like schizophrenia; all that they ever do is address symptoms.

Just think of someone suffering from tuberculosis that is given an inhaler that stops his coughing. Does this inhaler cure tuberculosis?? No. Does it stop spread of disease?? No. What does it do then??? It prevents coughing nothing more.

“Miracle” psychotropic drug like Zyprexa (Olanzapine) or Resperidal (Resperidone) block serotonin receptors and dopamine receptors in brains of people suffering from schizophrenia and are slowing down and terminating neural signals transmissions in affected individuals. The regions of the brain (containing traumatic memories) that generate visual and auditory hallucinations and emotional responses are basically prevented from communicating with regions of brain responsible for basic functioning of affected individual (exspressionless face is just one of the clues).

In essence Zyprexa and Resperidal act as chemical lobotomising agent flooding whole brain of affected individual. Once psychiatrists get rid of the most obvious symptoms they go on and pretend that they have cured their patient and that he or she is ready to join society and function normally (providing he or she takes his or her meds).

I just wonder how would it work out if doctors were doing same thing with people suffering from tuberculosis and we were sending them out of the hospital with inhalers?

We know so much about real causes of schizophrenia (traumatic experiences of childhood that were never emotionally processed by affected individual) but current options of quick fix of alleviating symptoms by use the of Zyprexa prevents us from developing effective methods of therapy of psychiatric patients.

Instead of hospitalization and intensive psychotherapy (object relation therapy) that can be greatly enhanced and sped up by use of antidepressants and resulting intensification of symptoms due to increased neural transmission we create holding tanks for psychiatric patients where we use psychotropic drugs to suppress symptoms of their mental illness and send them back into the environment that made them mentally ill in a first place.

There must be a better way and modern antidepressants combined with proper psychotherapy in proper hospital setting hold a great promise in that respect. Recent discoveries of strengthening of proper (adaptive) neural connections thru antidepressants enhanced psychotherapy and neurogenesis phenomena resulting from prolonged use of antidepressants indicate that this promise is very real and that it is within our grasp.

Anecdotal evidence of effectiveness of psychotherapy from a movie "Patch Adams", where Robin Williams signs himself into psychiatric ward and tunes in and starts a dialogue with highly psychotic patient sharing with him hospital room holds much more truth to it that anybody would have ever imagined.

Posted by: Karol Karolak P. Eng. at February 15, 2008 10:28 PM

so what was the meds? Prozac? what.

Posted by: dab at February 15, 2008 11:22 PM

dab: no idea at this point.

as for karol's comment: i can find no information that the shooter was dx'd with schizophrenia much less taking zyprexa. this strikes me as a comment by a troll until i now differently.

Posted by: Philip Dawdy at February 15, 2008 11:25 PM

I think it was Dr David Healey who estimated withdrawal symptoms (speak to somebody who's tried to come off Seroxat/Paxil, in order to understand just what these two words can amount to), to affect as many as 80% of those attempting to come off the Seroxat/Paxil. The official (ie, acknowledged by GSK, the manufacturer), is 30%.

We can only speculate as to how honest GSK is being, but it doesn't have a good track record, in this department. If, and I stress IF, the vast majority of patients are impacted by withdrawal symptoms as Healey suggests (don't forget, it's standard for patients to be told that their symptoms are a recurrence of their depression/anxiety/whatever, before being put back on the drug), then the only question concerns the severity to which they experience them.

Some more severely than others, I imagine. Fidders has got a post, listing the great thoughts of PinBenbow, just now (http://fiddaman.blogspot.com/2008/02/gsk-ali-benbow-unaware-or-just-liar.html). Ali B says that withdrawal symptoms are mild and shortlived, and he lists a series of innocuous-sounding stuff that might be experienced. He forgot to mention the akathasia and the electric zaps, though.

Matt

Posted by: Matthew Holford at February 16, 2008 03:20 AM

Hi Phil,

You said:

I have not found the link to confirm this so I understand this is hearsay but on another board, one poster said she had read that when he started taking the meds again, they made him feel strange and that is why he wanted to get off of them. I know from personal experience that because of my concern about the damage these meds are doing to me (hearing loss and tinnitus plus affordability), I would like to be off them yesterday. In fact, I did make a cut after two weeks, which was a big mistake. Since that time, I have not made cuts sooner than every 4 weeks and have kept them as small as possible.

I think what I am trying to say that in spite all my knowledge of what these drugs can do if you taper too quickly, I still made the mistake of making a quick cut. Also, I still have to constantly remind myself not to go too fast in spite of all my knowledge.

If most medical professionals are clueless about withdrawal (If you think I am making an unfair assumption, ask them about tapering 10% of the current dose every 3 to 6 weeks and see what they say), it stands to reason that this guy would sadly be also.

Finally, when Douglas Kennedy, recently did a report feature Laurie Yorke, the owner of Paxil Progress Boards, who almost lost her son to a Paxil induced suicide, he featured a teenage female who had shot people while on an SSRI. Sorry, I forgot her name but I wanted to let you know we are trying to make this an equal opportunity affair. Sorry, lame attempt at dark humor.

Posted by: AA at February 16, 2008 03:37 AM

Phil,

Sorry, I didn't catch this in my initial comment.

The article said it was the Paxil that he suddenly quit taking. Because that drug has one of the shortest half lives, that is the worst drug to be stopping suddenly.

Joseph Glenmullen, in his book, the Antidepressant Solution, quotes a student being arrested for stealing a backback, who suddenly stopped the drug. This guy had no criminal background at all and was horrified at what he had done.

Laurie York, the administrator of the Paxil Progress Boards, says if she hadn't learned about what this drug was doing to her son, Ryan, she feels she easily could have been in the position of the shooter's father. She took him out of school because she realized during withdrawal, he was a danger to himself and others. He had knives in his bedroom after the psychiatrist tapered him from 50mg to 37mg.

Posted by: AA at February 16, 2008 03:52 AM

We can only speculate since we know so little about what medication Steven was or was not taking.

My own bias leans towards interpreting this as a med withdrawl issue or even a med switch. It seems he did try to discontinue (unsuccessfully) at least one time previously and did not fare so well.

I don't know of any sociology/psychology progam (university level) that even acknowledges any viryue of med discontinuaion. I myself didn't come to grips with it until I discovered the initial information on the internet.

[Painting with Broad Brush (PBB)]
Doctors aren't generally aware of it. Psychiatrists are in denial about it. Pharma covers it up unless you were on placebo... FDA??? I see them with their finger in the dike covering their eyes with the other hand.

The loss is terrible. Those who have lost their lives. Those who lost loved ones. Let's not forget the futur victims of involuntary OC legislation that's surely to follow.

Posted by: Paul at February 16, 2008 05:55 AM

RE:dx'd with schizophrenia
Give me a break. I have a dx of schizophrenia, and a few others. It is not a science. Just because someone in authority, officially gives the dx doesn't make it true or untrue.

Posted by: mark p.s. at February 16, 2008 05:56 AM

There have been female shooters, at least one I know of. Not as many as male, though.

Posted by: meme at February 16, 2008 06:02 AM

If it was something for schizophrenia, it would have been all over the news because we all know how dangerous they are, thank you Hollywood.

I think that they are withholding the name of his medication because it is probably a common antidepressant. So many of the school shootings were on SSRI's that a class-action suit might be in the offing or at the least, stock prices would fall.

One newspaper account said he was interested in prison life and wrote a paper on self injury in prison, so perhaps the part of self harming is true.

Posted by: Mad Crone at February 16, 2008 06:10 AM

interesting that the staff person broke confidentiality -- I did a google to see if she has a lisc (if she did, I'd report her).

As for this being a rebound effect (from d/c'ing the meds) -- I don't think we know enough.

Posted by: jan at February 16, 2008 08:09 AM

I don't think questioning why an educated smart student would just stop taking his medications is a very fair question. Many doctors do not know how to take people off these medications. I would guess probably 90% or greater of the people taking these medications are unware of the serious side effects of stopping these medications abruptly. This information is not readily available. Most people think the behavior from stopping the mediations is just a progression of the illness (which it is not).

Posted by: Jane at February 16, 2008 09:00 AM

Who wants to bet that there probably will be a lot of pressure on the authorities to not release the name of the med he was on, at least not for a while, till some other story has taken the center stage.

Posted by: Masale.Wallah at February 16, 2008 09:38 AM

jane: i think it's a legit issue to bring up because ultimately each patient is responsible for their own well being and safety, and in the age of the net information about withdrawal probs is easily available (hell i knw about it in the days before the net and was damn careful about dosage changes) and he should've known from his past experience that going off meds could make him weird. we don't need docs to tell us that. he flunked the personal responsibility test big time.

aa: were you saying you had specific info that this guy was on paxil or were you referring to one of the other examples?

for the person who brought up the issue of confidentiality being breached: the woman was a former employee of the place, the guy is dead and several murders were committed. i'd say she's not bound by whatever confidentiality agreement she was previously under.

Posted by: Philip Dawdy at February 16, 2008 09:49 AM

Phil,

It was mentioned on the link you provided for the article. Here is the exert that everyone missed:

"ncluding Paxil, it was medication he was supposed to still be taking and apparently stopped a couple of weeks ago."

Jan, no matter how we all feel about these meds, the evidence is clear that it is very dangerous to stop these meds cold turkey. Even people like Dr. Joseph Glenmullen, who is not anti meds agrees with that.

Not everyone will obviously turn into shooter but you are taking a great risk cold turkeying an SSRI like Paxil with its short half live.

Posted by: AA at February 16, 2008 10:02 AM

aa: looks like they updated that article after i posted. fro mthe language they use, it's hard to tell if they are referring to him taking paxil back when he was at that facility or in 2008. so for now, who knows. there is now one report that he was being treated for anxiety. obviously paxil is a very common drug for that dx. i'll try and stay on top of this but could really use a day off.

Posted by: Philip Dawdy at February 16, 2008 10:12 AM

Phil,

"we don't need docs to tell us that. he flunked the personal responsibility test big time."

Yes, we have personal responsibility but why is everything put on the patient? If these drugs can cause dangerous side effects when cold turkeying off of them, the doctors are just as responsible for informing the patient.

Initially, I thought that perhaps this guy's doctor might have and then I realized that since I started taking meds in 1995, I was never warned not to do this. And many people on the Paxil Progress Boards report their doctors said it was safe to cold turkey.

If you don't know any better, of course, you are going to trust yoru doctor. They have the MD, right?

By the way, there are still doctors saying it is ok to cold turkey off of Prozac safely. Doing so caused me to have suicidal ideation. This was before I had access to the internet and I didn't know any better.

Fortunately, when I became severely agiatated on 5mg Celexa, I knew intuively this drug was bad news and got off of it. But believe it or not, my doctor encouraged me to stay on it. If I had god forbid, killed someone, yes, I would have been responsible but my doctor certainly would have deserved some blame also for his bad advice.

In summary, this is the issue - doctors have a responsibility to warn patients not to cold turkey off these meds. People's lives depend on it.

Posted by: AA at February 16, 2008 10:18 AM

Phil,

You may have a point but I would be willing to bet I am right.

Day off? Surely you jest .

In all seriousness, you know one of us will post the link if we find it.

Posted by: AA at February 16, 2008 10:20 AM

"i think it's a legit issue to bring up because ultimately each patient is responsible for their own well being and safety, and in the age of the net information about withdrawal probs is easily available (hell i knw about it in the days before the net and was damn careful about dosage changes) and he should've known from his past experience that going off meds could make him weird. we don't need docs to tell us that. he flunked the personal responsibility test big time."
Yes, the patient is ultimately is responsible for his/her well being and safety and yes, today there is some information regarding withdrawing from these medications. However, if one is not aware they need to look up this kind of information they won't know where to start looking.

The fact is, and I'm sure you are aware of this, doctors say nothing to their patients about the dangers of going off these medications. If anything is said at all, it is about how their illness will get worse, nothing is said about the withdrawl effects of these medications. I have an AA degree, 2 bachlors degrees (sociology and psychology), a paralegal certificate, I also had a computer at the time I went off the medications cold turkey. I was on the medications for many years and never once did a doctor tell me it was dangerous to just stop these medications and I had know reason whatsoever to look up the effects of abruptly stopping the medications. Why would I, the doctors stop and started different medications (abruptly) throughout the years I took them. Never was I told of the withdrawl effects. When I became suicidal I was told it was a progression of my illness, not a symptom of the withdrawl effects.

Without someone having knowledge about these withdrawl effects, how do they know where to look? If you do an internet search for a particular medication more than likely the first hits are going to be the pharma company site that sale the drug. Then you get other sites funded by the pharma companies. Maybe you could post some links from the medical community and pharma companies that make this information readily available and very clear. I sure can't find them. Even your site is questioning the validity of the dangers, so where is this information?

You were very forunate Philip to have been aware of the adverse effects of stopping these medications. To assume because you knew everyone should know is highly irresponsible. And to assume the shooter should have known because he previously went of his medications is also irresponsible as it is highly likely the only thing he was ever told about any adverse effects of stopping his medications was a progression of his illness, not that he could potentially go and shoot up a class room of students. BTW, we do need the doc's to be telling us he flunked the personal responibility test as this would tell us they are telling their patients about the danagers"i think it's a legit issue to bring up because ultimately each patient is responsible for their own well being and safety, and in the age of the net information about withdrawal probs is easily available (hell i knw about it in the days before the net and was damn careful about dosage changes) and he should've known from his past experience that going off meds could make him weird. we don't need docs to tell us that. he flunked the personal responsibility test big time."
Yes, the patient is ultimately is responsible for his/her well being and safety and yes, today there is some information regarding withdrawing from these medications. However, if one is not aware they need to look up this kind of information they won't know where to start looking.

Without someone having knowledge about these withdrawl effects, how do they know where to look? If you do an internet search for a particular medication more than likely the first hits are going to be the pharma company site that sales the drug. Then you get other sites funded by the pharma companies. Maybe you could post some links for the medical community and pharma companies that make this information readily available. I sure can't find them.

Posted by: Jane at February 16, 2008 11:37 AM

It seems like many people are making an error in assuming that correlation implies causation. Why can't it be possible that the sort of person who'd have the propensity to commit mass murder would be someone to pursue psychiatric help? We don't know so it seems like a major leap in judgment to assume so.

Millions of people take anti-depressants (and go off anti-depressants) without shooting up a lecture hall. It seems unreasonable to say that either a medication or medication withdrawal is alone capable or responsible for his actions.

From the excerpts, it appears apparent that this man had psychological trouble far deeper than depression. None of us is familiar with his situation and it seems perfectly plausible that an SSRI was given to him instead of addressing these issues.

I definitely agree that there are huge flaws in much of psychiatry and the behavior of the pharmaceutical businesses is absolutely inexcusable, but it seems like many readers are searching for absolutely any reason to condemn all of psychiatry and validate their bad experiences. I appreciate that this blog covers issues that will go overlooked by most others, but it seems remarkably unscientific or unprofessional to use any situation like this as an opportunity for a tirade.

It seems like there are very, very few people in between fervent support of Eli Lily and absolute hatred of psychiatry. Let's aim for some more objectivity.

Posted by: Anne at February 16, 2008 11:43 AM

Thirty million people [or more] have taken these new antidepressants and about one out of five of these people had some kind of bizarre, weird reaction to them - usually in the nature of objectionable behavior. So here we have a nation where 6 million people in the last 20 years, have acted weird. Have we, as a nation, noticed. No, we have not.

The only thing we have noticed is the increase in school shootings and maybe a bit of the road rage and air rage. A few have noticed the increase in murder-suicides in general.

SSRI Stories [www.SSRIstories.com] has documented over 2,100 of these tragedies. These stories appeared in the newspapers, on TV etc., and were captured by SSRI Stories.

How do we know that one in five people acted 'nutty' on these antidepressants? Because the Journal Articles have said that one out of five adults with depression really have 'bipolar' disorder and that one out of three children and adolescents with depression actually have 'bipolar' disorder. Translated from the psychobabble, this means that researchers and doctors found one out of five [and one out of three] having a bizarre reaction to the drugs.

So then they call these people "Bipolar" which is an insult to anyone with the real, natural disorder known as bipolar disorder.

The school shooter was most likely one of these 'one out of three' adolescents - especially with the clue we have of the 'cutting' he did but, as God as my witness, I truly do not believe he had the natural disease of bipolar disorder because a person with the real bipolar disorder would not kill 5 of his classmates, injure 15 and then kill himself. A person with the real bipolar disorder is not that insensitive.

Posted by: Rosie at February 16, 2008 11:55 AM

"Three to six times a year?" You must be kidding. Why do you think Rosie and I started www.ssristories.com? To provide evidence that this type of behavior is occurring way more than is immediately obvious to the general public. We have literally hundreds of murder-suicide stories on the site, most of which have occurred in the last few years. Just go to the site and sort by date -- instructions on how to do so are readily available. Remember these stories are only the tip of the iceberg, because not all murder-suicides that are reported in the media provide evidence of whether the perpetrator was on psych meds or not and not all murder-suicides are reported in the media in the first place. Rosie doesn't catch every story either. We have 29 school shootings, all of which have occurred since 1998. Literally ALL the "famous" ones have some connection with psych drugs. Even in the case of the worst school shooting, although we do NOT know for sure Cho's recent history, there was confirmation that he took Paxil for at least a year at some point in his history. And yes, there are definitely some in which women are perpetrators.

I know that there is a reluctance to believe that the cause of these horrific events could be as simple as a medication reaction and I wish to reiterate that one must make a distinction between a necessary condition and a sufficient condition. These incidents must be viewed as a "perfect storm" between a certain set of emotional disturbances and an adverse reaction to medication or its withdrawal. Both must be present for the violence to occur. To those of us who have been following it closely we believe that the medication plays a far larger role in the final "denouement" than the disorder but yes, the stage has to be set in some way. Furthermore just how big a role the medication plays compared to the emotional disorder depends in part on just how badly treatment has been managed, how much chopping and changing of meds there has been, how inappropriate the dosing is, what kind of metabolizer the perp is and exactly what kind of personality the perp indeed has etc. etc. All I can say is that the exponential increase in incidents over the past few years suggests to me that there is incredible urgency around the issue of withdrawal. There is a need across the nation for scores of withdrawal clinics where professionals and patients alike can learn how to do this safely and with supervision. The ignorance surrounding current protocols of treatment where people are switched around on meds willy nilly is creating enormous problems in mental health. There is also the issue that once someone stops taking a med like Paxil, even if they get off it reasonably smoothly, if they start it up again after a hiatus there is often a much worse adverse reaction -- no one ever talks about this but I have seen it personally. Someone who thought Paxil saved her life the first time she took it became violently suicidal the second time she tried to go back on it after a 6-9 month hiatus. There is a tremendous amount we don't know and big pharma is not going to help us figure it out that's for sure.

Posted by: Sara at February 16, 2008 12:21 PM

I'm not the first to point out this recurring thought pattern among anti-med advocates, but it is interesting to see it out in full force today:

1- If a person is on psych meds and does something horrible, it was the meds that caused it.

2- If a person goes off psych meds and then does something horrible, it was the meds that caused it.

No evidence required. Confirmation bias, anyone?

Posted by: Garth at February 16, 2008 12:24 PM

1 in 5 people on anti-depressants commit objectionable behavior? Anti-depressants are definitely over-prescribed and as a result I know a great number of people either currently on or were taking them, as far as I know without this objectionable behavior. Also, I'm not even sure what qualifies as objectionable behavior. Again, it also has to be taken into account that you're not working with a well-controlled sample.

I will look up these journal articles seeing as I haven't heard of these results and see what I think. Just because big pharma would like to promote a large prevalence of bipolar disorder through some journal articles doesn't mean it's a widely accepted or factual position in psychiatry.

Although I am very genuinely bipolar, I don't think I would be able to generalize that every person with bipolar disorder is peaceful, non-violent and sensitive. Psychosis often times accompanies bipolar disorder (or let's not forget the prevalent substance abuse), which (although not as a rule) could make someone more capable of homicidal or suicidal acts.

Also, you can't assume that someone with bipolar disorder isn't capable of having co-morbid psychiatric disorders. The shooter's flat affect is an interesting thing to note, something not characteristic of bipolar disorder. Cutting definitely doesn't necessarily indicate an adverse side effect of an SSRI or bipolar disorder as well. Self-injury absolutely happens without being under the influence of any psychoactives.

Was the shooter even bipolar though? We're not even sure what medication he was on, right? I'd taken from this conversation he was but going back to the information it wasn't disclosed.

Posted by: Anne at February 16, 2008 12:52 PM

Garth,

If homicidal ideation is listed as a medication withdrawal side effect and it is well known that it is dangerous to cold turkey a psych meds (even GSK doesn't advocate that), it is a reasonable opinion that this guy cold turkeying his med led to homicidal behavior. The common theme in this story and the ones that people list on SSRI stories is that people are absolutely stunned that this behavior occurred.

I realize that there are cases where people are stunned and when you go back, you find out there were clues that people missed. But with a few exceptions, this doesn't seem to be the case with these SSRI stories.

How do you explain the fact that Jeff Riordon, a former major league baseball player who was financially set for life, held up a jewrly store for $100 while on 5 antidepressants?

Please look at the facts instead of at ideology.

By the way, it isn't AA's opinion, Rosie's opinion, the anti psychiatry crowd, or the scientologists that these drugs can cause homicidal behavior. This is the opinion of psychiatrists like Jay Cohen, David Healy, and Joseph Glenmullen who are not anti meds.

Of course, not everyone who cold turkey's off of a med is going to commit homicide. But to deny this reality and constantly attributing this to people who have a crazy agenda is just plain wrong. People's lives are at stake.

Anne - There is no evidence that I have seen this guy was BP. We just don't know yet. I am inferring he was on Paxil but Philip pointed out that wasn't clearcut.

I agree with you that people with BP are not necessarily violence free although my guess is they are in the extreme minority. Don't want to give TAC folks ammunition.

Posted by: AA at February 16, 2008 01:26 PM

Rosie,

I agree with most of what you wrote. But it is important to note that just because you have a bizarre reaction to an antidepressant doesn't make you BP.

Because so many people get placed on meds due to this faulty thinking, I wanted to make this point. Fortunately, my psychiatrist never believed my bad reactions to meds were due to my being BP. I thank god for that constantly.

Posted by: AA at February 16, 2008 01:29 PM

The imporant thing to understand about mental health treatment, particularly public mental health, is that help is not really available.

Mental health advocates in Virginia are angry about chaos and disorganization on the "Mental Health Planning Council", Virginia's top statewide mental health planning body.

Since the Virginia Tech shootings, the state Legislature has prepared a spate of mental health reform bills; but the sketchy records of the Planning Council tell a story of waste and squandered opportunity.

Alvin (not his real name), a mentally ill Virginian, says the problem is not about money and, he says, Virginia doesn't need new laws, " . . . they just need to follow the laws that are on the books."

He points to the Web page of the Mental Health Planning Council, and minutes (http://www.dmhmrsas.virginia.gov/MHPC/documents/omh-MHPCMinutes122007.pdf) written by state mental health planner Jo-Amrah McElroy.

"It's all there on that page," says Alvin. "Read the mission statement."

The mission statement reads as follows:

"The mission of the Virginia Mental Health Planning Council is to advocate for a consumer and family-oriented, integrated and community-based system of mental health care of the highest quality."

But advocates claim the Council cannot even keep keep good quality minutes, or function to the minimal standards of the other public body.

"This is no mystery here", claims another advocate. "After the shootings in Blacksburg, the state is relying on the same people who created the problems to fix them. Most government agencies would replace these people. In public mental health, they get a promotion for screwing up."

A lawsuit filed in December, 2007 alleges that a patient in Central Virginia Training Center was attacked so severely by another patient that pieces of the victim's ear were found on the floor.

The suit also claims the center failed to report the incident completely, as required by law. According to Colleen Miller, executive director of the Virginia Office for Protection and Advocacy, ". . . people with disabilities in state care may be at grave risk of harm and death."

# # #

Below is a copy of Dec 5 2008 minutes written by Jo-Amrah McElroy. Notice no list of Council members present or absent.

The original is at http://www.dmhmrsas.virginia.gov/MHPC/documents/omh-MHPCMinutes122007.pdf

Mental Health Planning Council Minutes
December 5, 2007
31 attendees present
Call to order by President Jack Wood 10:00
Jo-Amrah McElroy distributed meeting dates and places.

Feb. 20, 2008 Va Assoc. of Community Service Boards
10128-B West Broad Street, Glen Allen, Va

April 16, 2008 Dept. Of Rehabilitation Services
8004 Franklin Farms Drive, Richmond, Va

June 18, 2008 Henrico CSB
10299 Woodman Road, Richmond, Va

Oct. Retreat Date and place to be determined

Dec. 3 Dept. of Rehabilitation Services
8004 Franklin Farms Drive, Richmond, Va
Jo-Amrah suggested setting meeting dates earlier to attempt standardizing meeting location. She reported it being very difficult to locate free meeting space for a group this size.

Members updated the council about recent activities in which they have been involved. These included the State Board (Mary McGowen), the Commission on Mental Health Law Reform and its taskforces (several members), the System Leadership Council of DMHMRSAS (Jack Wood and Brian Parrish), the Coalition (NAMI Virginia and others), and a conference on multiculturalism (several members.).

The Council was asked for volunteers to serve on an advisory committee for a grant to reduce seclusion and restraint in Central State Hospital and Commonwealth Center for Children and Adolescents. There being no council members who had been forensic patients, two council members without forensic experience volunteered to participate.

Election of new officers held. There were no nominations from the floor. Results for the Mental Health Planning Council2008 calendar year are as follows:
President Alison Hymes
VP Adults Lisa Moore
VP Children to be held jointly Dr. Betty Etzler and Irene Bolten-Walker
Secretary James Johnson

Mid-morning snack and Lunch was provided by new caterers. Both organizations are supportive of people returning to work in the community. The mid-morning snack was provided by Breadwinners and lunch by Positive Vibes. Unanimous decision to continue having them cater future meeting but alternate snack and lunch.

Discussion of funding was held. James Martinez was to have presented but was unable to attend the meeting. Jo-Amrah McElroy presented in his place.

Discussion of priorities was held. Quality of care was discussed, data and outcome statistics collection was discussed, lack of consensus within the council on legislative priorities was acknowledged as a reason not to focus on specific legislation as a council, standardization of CSB services was discussed, addition of new (regional?) assistant commissioner in DMHMRSAS was mentioned.

It was suggested by Lisa Moore that the Council make itself more visible by writing a quarterly letter to stakeholders on the activities and concerns of the council. It was also suggested that the council focus on areas of consensus rather than areas of division and that we have a presentation on standardization and what it will mean to CSB’s at a future meeting as well as presentations on other new priorities of the Department including multi-culturalism and local partnerships.

Meeting adjourned .
Next meeting February 20, 2008 Va Assoc. of Community Service Boards
10128-B West Broad Street, Glen Allen, Va
Minutes – Jo-Amrah McElroy 12/11/07

Posted by: Nicky at February 16, 2008 10:58 PM

AA,

You said: "If homicidal ideation is listed as a medication withdrawal side effect and it is well known that it is dangerous to cold turkey a psych meds (even GSK doesn't advocate that), it is a reasonable opinion that this guy cold turkeying his med led to homicidal behavior."

This is exactly what I mean. There is a world of difference between "reasonable opinion" and justified true belief (i.e. knowledge). What is called for here is inductive reasoning, but you don't have enough (specific, empirical) evidence at hand to justify your beliefs through induction. So instead you turn to deductive reasoning to reach your conclusions about this specific case; there would be nothing wrong with that if you were working off a set of axiomatic truths or laws, but there aren't any such "laws" to be had here. (The statements that "homicidal ideation is listed as a medication withdrawal side effect and it is well known that it is dangerous to cold turkey a psych meds" may well be true, but they have a long way to go to qualify as axiomatic truths.)

I think you must realize this on some level, which is why you turn to the vague term "opinion" to allow you to smuggle in all those non-justified beliefs of yours. So, fine, you have an "opinion," but it's not knowledge. My problem is that you fail to treat that distinction with the seriousness it deserves - something I find deeply problematic when the stakes can be life and death, as you said.

By the way, an antidepressant sent me into mania, so I am well aware of the dangers of these drugs. If I'm peddling an "ideology", it is not the gospel of Paxil and Prozac.

Garth

Posted by: Garth at February 17, 2008 10:46 AM

What the hell Nicky. Chair makes a motion to approve meeting minutes, now back to the art of debate. I'm in favor of the motion linking handy, user-friendly web-page guides at furious seasons, here's a common reference in the blogosphere:

http://www.nizkor.org/features/fallacies/

Posted by: flawedplan at February 17, 2008 11:47 AM