Blatantly honest on Greinke's part and I respect him for that and yeah, the med seems to have worked for him, but what does it all really mean? Sounds like he was under a LOT of pressure as a pitcher. Maybe he should have worked that out in some other way than taking a pill. I bet it's Paxil too since "social anxiety" is mentioned. Wonder if anyone ever gave him a heads up about side effects and withdrawal issues.

Huh, I don't see anything that wrong with Greinke going around buzzed on psych drugs, well assuming he doesn't hurt anybody, but to feel some anxiety and dread about playing high pressure sporting events is probably normal not a disease.

I am glad that Zack Greinke is feeling better and he is certainly luckier than the Pro-Center Barret Robbins who missed the superbowl in Jan. 2003 because he was given an antidepressant. Go to www.SSRIstories.com and go into the Index. The full media article is available and it is dated 2003-07-24. The Additional Category reads: "Football Player Misses Superbowl".

The article says tht Robbins had been "misdiagnosed with depression". It also states that "a therapist diagnosed him with social anxiety disorder and prescribed an antidepressant".

The day before the superbowl, Robbins fled to Mexico. When he was found and returned, he was diagnosed with 'bipolar' disorder. There is always a question in my mind whether these people diagnosed with bipolar disorder after going nuts on an antidepressant are truly bipolar.

Rosie, The tactic of diagnosing people with bipolar disorder after they have a bad reaction to being told they have a chemical imbalance in their brains making them anxious and/or unhappy when a "normal" person wouldn't have these feelings and then given an SSRI reminds me of diagnosing a patient sexually assaulted by her therapist with histrionic personality disorder. It's nonsense. I bet behavior changes for the worst when a "mental health professional" tells you you have "social anxiety disorder," then you add in the sketchy ssri dope and voila a burst of anxiety that is manic, a normal response to what happened to you.

Don't wonder, people who freak out on ssir's and get labeled bipolar aren't. If they never took the ssri, the argument is, they would have never "found out" they were bipolar, in other words never had symptoms of bipolar, never been bipolar (whatever that means). Bipolar label equals a lifetime of antipsychotic drugs and maybe anticonvulsants. I'm sure if he sticks to them Robbins career will be less successful and shorter.

Sara, I don't understand the difficulty you have in distinguishing normal anxiety from pathological anxiety. It's very similar to the difference between normal, temporary acute pain (say, from stubbing your toe) and severe, crippling chronic pain. Yes, anxiety is subjective, but so is pain - often neither has any "objective" cause that doctors can isolate, but both can swallow up the sufferer's entire reality. Do you think it's a moral failure when someone who can barely move because of the intensity of their pain takes painkillers? I just don't get why you feel the need to trivialize other people's suffering when you can't possibly know what they have gone through.

Garth, I am happy that Greinke is functioning well and that he found an answer to his problems. I just hope if he's on Paxil someone alerted him to the problems with it before he started -- that's all. If they had he might have chosen a different way to deal with his anxiety even if it was pathological. Also I do not believe I trivialize other people's suffering by suggesting they consider the possible consequences of their treatment options.

Sara, of course I agree that people should consider the risks and benefits of their treatment options. What I meant is your suggestion that his anxiety was mainly due to the pressure of pitching and maybe "he should have worked that out in some other way than taking a pill." To me that language strongly implies he is failing to cope with life stress and is trying to take the easy way out. If you didn't mean it that way, well, good!

And Sally, I am not sure that everyone who freaks out on SSRIs is bipolar. But there is a reason why that idea has spread, which is that the majority of people who clearly have bipolar disorder DO freak out on antidepressants, and the majority of people who clearly do not have bipolar disorder do not. So there is a correlation there and it seems legitimate for someone's doctor to take it as a sign to look more closely at their symptoms and their history and see what's really going on.

Just to clarify Garth, it does say in Philip's post that the only time he felt the acute anxiety is when he was at the baseball field. He said the rest of the time he was fine. To me this sounds like he should have opted for cognitive behavioral therapy, perfect situation for it in my humble opinion. I remember reading about someone who was "pathologically" afraid of going up an elevator and docs were trying to prescribe him a/ds. In the end he had CBT and conquered it just fine.

Garth, you may not have read enough of my comments to know that I don't accept the diagnosis of bipolar as real or meaningful. I understand that many people do think it's a real condition, a permanent genetic, biological chemical imbalance in the brain and all.

Sadly, in spite of the fact that even among people like yourself who believe that bipolar disorder exists and is a medical disease it is well known that people so labeled shouldn't take ssri's, ssri's are still widely prescribed for people labeled as bipolar. I think if someone severely deteriorates on ssri's, they should certainly stop taking them but to attribute that deterioration to a pre existing condition seems absurd to me. Oh well.

I believe that both Sally and Rosie believe the same thing -- that SSRIs induce mania (and psychosis) in a lot of people and that it really has nothing to do with whether they are "truly bipolar" or not. Yes, if someone is "truly bipolar" they probably do freak out on antidepressants but there are also lots of other individuals who aren't "truly bipolar" (whatever that really means!) who do as well. This is what the mental health profession seems to be missing.

Sara and Sally-
I want to comment on both of your comments. First off, Sara, the fact that you brought up CBT in lieu of medication is a great idea. I just spent a whole term in school writing about the benefits of CBT over anti-depressant use and you are right on the money. Good Post!!!

Sally-you need to read up on the diagnostic criteria for generalized anxiety disorder and social anxiety disorder. It is very real and often linked to activities like school or sports (which is clearly states in the DSM-IV-TR). (APA, 2004).

I am not attacking your comments, I just want you to know that it really is an issue for a lot of people.

Angie

Angie, I don't claim that anxiety isn't a serious problem for lots of people. What I am saying is that anxiety is not a biologically based medical disease unrelated to activities like school or sports. Regardless of what's in the DSM, anxiety is related to life experiences. Different people may well be born with different personalities some more anxious than others and different people may have different experiences causing them to become more or less anxious in certain situations and these same people might even find it pleasurable to take drugs to reduce their anxiety, but this in no excuse for considering such conditions medical diseases. Go to a hospital, enter the cancer ward, meet people who really do have physical diseases. Anxiety and unhappiness are real. They're not medical diseases.

Sally

OK, Sara, you've got a point there. Maybe CBT would have been a good option for him if his anxiety is really focused on this one specific thing.

Sally, just to be clear: I don't believe anything so simplistic as "bipolar disorder exists and is a real medical disease." But it is a real illness - a particular variety (or related varieties) of suffering that exists and is recognized under a certain name in our society. In other societies, that kind of suffering might fall under different concepts and different boundaries. It might also be triggered or exacerbated by conditions that are specific to our society. And it definitely carries meanings and interpretations that are specific to our society. It's not just a "disease" that is purely biological in nature.

I do think it's highly likely that people who share what we call bipolar symptoms have a similar vulnerability that is based in their brain structure. (You might say the same for people who share all sorts of mental and behavioral traits.) Maybe that vulnerability wouldn't be as easily triggered in another kind of society, but barring total social revolution, this is the society we've got. So then you get the illness - the experience of suffering, which has actual physiological components and is very concrete for the people who suffer from it. Do we need to know all the neurological ins and outs of what goes on in a sufferer's brain in order to say his or her condition is "real," or that it fits a pattern we can see in other people as well? I think that is a pretty extreme position.

So no, bipolar disorder - or any number of other conditions - does not simply "exist" as something independent of social reality. But it doesn't have to be in order to be a valid diagnosis of illness (or if you don't like the term "illness," find some other word). Hardcore bio-psychiatrists can't admit that, which is why they keep on leaping ahead of themselves and making pronouncements they can't back up with evidence. I think it's important for their critics not to make the same mistake.

There is an old fashioned phrase for this: "stage fright". Ask any performer, whether be an athelete, singer, public speaker, and they will confirm they are most always having anxiety before performing, because it is human nature. The fact that he could recognize where, why and when the anxiety was happening, is the key, whether its CBT or self-discovery, this type of anxiety exists. I speak from experience as a person who has figure skated, ballet and spoken in public and was suffering major anxiety. Off the stage, off the ice etc., of course the anxiety reduced. Back then I drank Peptobismol straight from the bottle, and learned how to cope by exposure to the fear itself. Maybe that is self taught CBT who knows.

Stephany-
You are truly an inspriation. Your lifelong quest for wellness is something all us should take note and listen careful to when you post. There was an article in the New York Times about a month ago called "Doctor have you been to Psychotherapy" you might be interested in reading. It talks about how a doctor who has been through psychotherapy can be more understanding than one who has not been. I think I may have bookmarked it if you are ever interested.

Thanks for all your insightful posts over the year(s).

A true fan-

Angie

Angie,

Thank you for such a kind note, that is so nice of you to say, I'm very touched by this.

I read that article too,and it is a good one, and I've asked my psych (a lot of questions if you can imagine!)and one has been "what do you do when you need a therpist?" because when a person deals with psych issues all day, one can get burned out and are in fact human beings themselves. It's been my question to many ppl I've been in contact with the last year, namely even for myself, when I talked with a DBT specialist while I was in the midst of mental health court advocacy, I ran into her office and said, "Look at me, I'm advocating daily and well, who do I talk to? no one else says they've met anyone like me, and then I call around and they don't know what to do with me!" (I needed someone to help sort things out in logical and efficient manner) we had a good laugh because we couldn't find a group or any one who could relate to me, I think the laughing part gave me another boost to keep on keeping on.

Anyway, thank you :)

Stephany