What also got me about the Smoking Gun autopsy report was the fact it mentioned his loss of weight, ( a sign of depression), a comment about facial hair (I would guess another sign of depression- too depressed to shave), and the taping of hands-

Also his note. And the fact he had attempted in the past.

Wallace was 7 months older than me, a fact I find unsettling. Too young to not be here, a talent snubbed out before it's time.

Maybe Kurt Cobain was right. Maybe it's better not to burn out, but to fade away. There's more to the picture, than meets the eye. Now that some of the picture is out, I don't want to know the rest. I just wish Mr. Wallace rest. And his family peace.

"But they clearly didn't help."

These drugs don't work like that and you know it... people on medications die, I've never come across research saying medications will save everyone who takes them. Psych meds, just like all the others, do save lives, just not every life.

If you do more reading around you'll discover that he and his family believed psych meds were saving his life and had done for many years. He developed some side-effects and had to come off his medication, which is what is believed to have led to his depression returning. Moving on to other drugs didn't help and he died.

I point this out because so every so often you encounter someone--a doctor, a researcher, an advocate, a patient, etc.--who will tell you most intensely that psych meds are life saving. Well, no they aren't.

Well, yes they are. You know perfectly well these medications help many people. Lithium is well known to reduce the risk of suicide and attempted suicide in people with bipolar disorder. Don't spread falsehoods around. They are what can get people killed.

The "emotionally unwell" (as opposed to mentally ill) are the easiest demographic of society to exploit. How many people under psychiatric care go on to commit suicide or self harm?
How many people under psychiatric "care" end up in a worse situation then before they entered the system?

The answer is a hell of a lot..

Why is this? If they are receiving care for their illness , if they are receiving the correct treatments (medications and ECT) from the profession which claims to have all the answers (psychiatry) , then why do most people who go through the psychiatric system end up either dead or severely damaged as a result? ..

Psychiatry is not in the business of care, that's why..
The psychiatric system is not founded on care..
But the psychiatric system can always blame the psychiatric system induced damage on the patients "original condition" ..

That's their trump card..

They get away with it because they can..

At the end of the day, casualties of the psychiatric system are merely the end result of a system without care...
ECT and Psychiatric drugs make a fortune for the pharmaceutical industry and the psychiatric profession is well funded and well paid. Its all about money, that's the truth. Patients provide the system with prey.
The dead patients, killed by psychiatric methods will always be replaced by another vulnerable human being looking for an answer to their problems and a solution to their own personal agony of human existence and in this demanding and confusing age we live in the supply of psychiatric guinea pigs is ever increasing...

It's time to end psychiatric abuse..

I think someone with a long time depression needs introspection. Introspection into the possible cause(s). Introspection to appreciate/give thanks to God for their physical health, physical health such as working hands arms legs eyes ears mouth etc. I think it is wrong of psychiatry to damage the memory and cognitive workings of the brain-mind to change a persons outlook. With brain damage the person can not learn to fish. As in "Give a man a fish and you feed him for a day. Teach a man to fish and you feed him for a lifetime."

Depression is dynamic in nature as is the human body. Individuals commit suicide with or without medications, with or without ECT and with or without adjunctive therapies. Depression and suicide are centuries of old reporting.

There is no stopping any determined individual from committing suicide.

In my opinion, medications do help some individuals as does ECT or adjunctive therapies such as talk and holistic approaches.

From my own personal experiences as a support person to my spouse there may be signs of the depressive downward spiraling which possibly signals the onset of suicidal ideations and the need to be especially vigilant. Then again I am also personally knowledgeable of one instance when all things being well out of nowhere another suicide attempt.

I find many of these articles interesting from the standpoint of anecdotal information and conjecture but devoid of any hard evidence as to the underlying causation although we do know in this instance strangulation was the cause of death. Then again, from all my years of readings both pro and con I really am left only with theories and the fact we need continued research into these mood disorders as we still lack hard evidence and at the minimum a means to effectively control these disorders.

This individual amongst many based upon the autopsy report suffered from what appears to me to be very serious recurrent periods of depression. The major difference in this particular instance is his notoriety as compared to similar deaths on a daily basis of those less distinguished.

May he rest in peace along with those others who have suffered the pains and anguish from these horrific illnesses. To those who continue to survive and struggle to find their peace and wellness I advocate for their continued education as I also encourage hope, persistence and consideration of all treatment options currently available.

Warmly,
Herb
VNSdepression.com

the system does not work and no, drugs don't either for a majority of folk.

most of us bloggers are pretty high functioning sort...and whether we take drugs or not we are not representative

I challenge you all to go work in a homeless shelter or in a home with the "seriously mentally ill." Tell me the quality of life of those folks suggest any of the drugs they are taking are helping? Tell me they don't look like zombies.

I worked with the sickest people in our community for 12 years and some of these people are the walking dead. It's an incredibly tragic state of affairs.

At least David Wallace accomplished something before he died, many of us shrivel away with our spirit dead hidden in homes where no one ever sees us...don't tell me the drugs are successful for those people....or the ones who end up on the street because nothing helps either...

people who believe meds work do so because they did for them. There are way too many people who die slow deaths on these drugs...whether it's a spiritual death or a suicide...

I've worked with hundreds of these people...maybe even thousands...the system fails all these people...if it works for you fine, but think about all these people who don't have a voice...who can't say "I'm dead inside" from the zyprexa because the system has beat their self-esteem out of them.

we are the lucky ones who can speak for ourselves and even we fail, like David did.

there may not be any easy answers and drugs are not an easy answer either and do make people worse often, if not always.

For many of us with depression it's really not a matter of whether suicide will be the end of it, but when.

The word 'suicide' does conjure futility, hopelessness, anger, irresponsibility, incompetence. We should, as advocates, peer into this definition and challenge it.

Perhaps DFW fought his good fight, did everything he could to make his life extend, and then made a decision based on experience and his inner strength to end his life.

If so, salute.

Our cure is over the horizon. We can see the light coming, we know what direction to steer, but it will be our children's generation which reaps our harvest.

Gabriel,
Could you please be more specific?
I'm not following you.

R,
I would really like to know what were the drugs that developed side effects and what side effects were these that even led him to stop them.
It sounds strange that a something that is saving your life has to be stopped.
I really don't understand!

I still think it was the initial diagnosis of mental illness that killed him. Of course the drugs make suicide more likely. Sadly, even TAC admits that suicide rates are increasing. Doesn't this prove that current "depression treatments" don't work?

If anyone understood the pain and complexity of modern life, DFW did. To have a purported doctor tell him that this pain was wrong, was a sign of a brain gone wrong, what a horrible burden to live with, especially when it was a fraud, when there's no evidence depression is a medical disease.

BTW, Harper's tribute to him is the reprinting of some of the work he did for that magazine.

Why are people so down on med's? I have been reading this and a few other blogs and it seems to be an ongoing theme.
Certainly there are doctors (who probably have business even being doctors) who don't treat the patient properly, throwing handfuls of med's at them and convincing the patient that is all they need. And of course there are so called "med's" that ruin your life under the guise of helping (Zyprexa ruined 5 years of my life).
Isn't the blame with the doctors for prescribing too much and telling the patients, incorrectly, that all they need to do is take these and you will be better?
Certainly the pharmaceutical companies are another evil in themselves, however, living in Canada those companies don't have the same impact here that they do in the US.
Do they save lives? It's not a cut and dry answer. I know I would not be here today if it weren't for the med's I'm on. I also would not be nearly as functional as I am. Mind you, I have a good doctor and I'm only on 3 med's (for bipolar) that work just enough to keep me "normal".
Psych drugs are definitely misused, but I don't think they should be written off. When they are prescribed properly they can save lives.

He and his family only believed that they were "life-saving" because they didn't really understand what was going on -- that's what I firmly believe. The medications were only making him worse and were doing so for years. And yes, taking him off near the end and then putting him back on something else was the final straw but that certainly doesn't mean what was going on before was right or really "life saving." It only set him up even more for that tragic end. I have never seen anyone do well on endless years on psych med cocktails. It doesn't happen; it can't happen because of their toxic effects. Anyone who believes a life long course of medication is helpful is kidding themselves and doesn't understand the psychiatric rebound (and physical) effects the drugs themselves cause and mistake it for "underlying disease." It's sad that DFW's family doesn't really understand things better because their testimonials only serve to perpetuate the problem for others.

The word 'suicide' does conjure futility, hopelessness, anger, irresponsibility, incompetence. We should, as advocates, peer into this definition and challenge it.

Perhaps DFW fought his good fight, did everything he could to make his life extend, and then made a decision based on experience and his inner strength to end his life.

If so, salute.

I agree Renaud!

Perhaps because religious traditions - suicide is a sin - and many other reasons someone who decide to commit suicide is seen as weak, someone who gave up living.
They gave up suffering instead of living.

I only hope that it was him who made the decision and it was not a drug-induced suicide.
I would really like to know what psych-meds he had to withdraw.

Sara,
I agree with you.

I only would like to stress that all we can do is speculate.
We will never know for sure what has really happened.

Joanne re "Why are people so down on med's?"
Because the reported scientific success rate has been purchased by the Pharma Co.
Because the meds can be addictive.
Because the meds can be harming people and not helping them in the long term.
In normal illness you take medicine for the duration of the infection/disease. Psychiatry has the belief meds are for life.

I'd like to know what David felt about how his life was on meds; for example, would he say his life was extended due to being helped by meds, or would he say life was torture, meds or not. No one will ever know.

Klonopin is what kicked off my latest, most serious and nearly lethal suicide attempt. I was NEVER told benzos cause disinhibition. Never. I had no idea what was happening to me or why I was doing what I was doing. I was behaving in ways that made no sense to me, that were entirely out of character. And I nearly died because of it. The behaviour stopped when the drug was out of my system.

12 ECTs? No wonder he killed himself. That leaves you with nowhere to go.

Sherry

Well, I think people do know that his life was helped by meds. He took Nardil for twenty years--a very long time--and, by many accounts, he was thriving. In those years, he wrote some of the most important literature of his generation. He wrote Infinite Jest on Nardil. He wrote a great deal. Of course medication is not everything--no one would suggest that--but it has a place. It does help people, and it did help him. As his father stated in the New York Times obituary, the drug stopped working for him a year or two ago. This is tragic. He clearly suffered a great deal and they worked to find a replacement, which didn't happen in time.

Please try to get your facts right, and don't be reductive about psych medication or this particular case. I agree that drugs are not everything, but in many cases, they are something.

your use of wallace's suicide as anectodal evidence (and that's all it is) is pretty ghoulish, i gotta say, and while your notions of pharmacia seem to be rooted in honest skepticism, your motives smack of personal satisfaction rather than genuine concern for the lives of others. your arguments are logical fallacies, basically amounting to "pills are bad and big pharma is out to get you!" which is a fine starting point for this mess, but certainly not an ending.

studies of heart and brain medicine are also rife with bias, but you don't immediately start railing against people who take such medication to keep on living. you may argue that one science is better than the other, but the notion that any science of physiology believes itself to be all-knowing is just... just really retarded, as everyone knows that any field will have some unreasonable people and a good deal of people who understand that science is always developing.

i don't love the pills. i recommend people don't take them unless nothing else is working. and if it seems like they are starting to work i don't recommend people put too much emphasis on them as a "cure". but i also hope they don't listen to crank misanthropes like you who are more interested in pushing an agenda than easing the agony and suffering in others.

and i'm pretty sure DFW would puke if he knew you were using him as an "example" for your own very-strong dillusions. have a nice day, though!

"Because universities and hospitals float on a sea of drug company money, few seem keen to raise critical questions about unethical research practices. Moreover, when researchers demonstrate moral courage by going public with evidence of harmful side effects, they may find themselves sued by the company (Toronto doctor Nancy Olivieri for example, was threatened with legal action by a pharmaceutical company after she told her patients of the potential dangers of a drug she was testing on them. Others risk termination)."
From a review of Healy's "Let them eat Prozac

Sorry for the off-topic.
But I don't think that in Canada Pharmas have less influence.
It's everywhere.
DSM is global, psych-drugs are global, side effects, withdrawal, suicides, homicides... the whole package...
GLOBAL!

I agree with markp.s.2: "I think it is wrong of psychiatry to damage the memory and cognitive workings of the brain-mind to change a persons outlook. With brain damage the person can not learn to fish. As in "'Give a man a fish and you feed him for a day. Teach a man to fish and you feed him for a lifetime.'" Before I agreed to ECT, my therapist played down the memory loss I would be subject to if I would agree to it, saying it's not really great remembering being depressed anyway. How the hell am I supposed to learn from what I can't remember? The ONLY positive thing you can get out of a horrific experience is learning how NOT to do it again. Actually, that's not the only thing. But depriving me of that is certainly not "teaching me to fish."

I don't know anyone here, whether pro-drug or skeptical about them who is not interested in easing the agony of others...

that's one place we all meet here and it's a pity most people don't see it.

of course with people so often being nasty here it's clear that sometimes people want to hurt individuals on this site and that too is a shame.

I'm pretty sure that DFW is glad that Rolling Stones has done the article detailing his last days.
As a person who has been fighting depression for so long he must be happy that his death can lead to some good discussion on mental health problems.
I hope Rolling Stones don't take too long to put the article online because I want to read.
Unfortunately some crucial details will never be revealed.
RIP David Foster Wallace

From the print edition: October 30,2008 Rolling Stone, page 104:

"Wallace published stories in the Amherst literary magazine.One was about depression and a tricyclic anti-anxiety medication he'd been on for two months.The medication "made me feel like I was stoned and in hell," he told me. The story dealt with the in-hell parts:

You are the sickness yourself....You realize all this...when you look at the black hole and it's wearing your face.That's when the Bad Thing just absolutely eats you up, or rather when you just eat yourself up. When you kill yourself.All this business anout people committing suicide when they're "severely depressed;" we say "Holy cow, we must do something to stop them from killing themselves!" That's wrong. Because all these people have, you see, by this time already killed themselves, where they "commit suicide," they're just being orderly."

Oh, you know the Scientologists are just having a field day. Was it only a year or two ago their anti-psychiatry videos were on YouTube?

So, a decade ago, the doctors told my boyfriend and best friend that I was one of the worst cases they'd seen. That they should prepare for the fact I would die soon. I had a serious, life-threatening illness, one that I most likely die from. The odds were against me.

I'm alive now, not because of the twenty something Electro-Shock-"Therapies", which failed to stop my depression. (Although I couldn't remember why I was slicing open my wrists). No, there are three reasons why I'm here today.

My best friend, who kept me off the streets and a roof over my head. Cognitive Therapy. And medications.

I read all the time of people who are able to live without meds, which is enviable. Me? Not so much. I have a serious mental illness which needs to be holistically addressed. I need to watch my sleep, eat well, not drink booze and take my meds.

It's possible that I'll go back in the hospital. But I've been out for eighteen months. The longest time in ten years. I'm on top of my moods and alert my doctors when I notice down slides.

All this is fine and good, but it is only one person's story. I do know this: Without the meds, I would have been dead long ago. Like any potentially fatal illness, there are many approaches.

For now, mine works. I'm 42. Maybe if I were famous, people would have heard my story of survival. Should I die by my own hand, they might actually discuss it.

I agree that we will never really know one way or the other about David's treatment in terms of how he viewed it over the years and whether it ultimately made him better or not for large portions of that time. We are just speculating and it's true he wrote some great stuff while on Nardol so I guess we can't knock it completely. Did he really write brilliantly because of Nardol or in spite of it? I'm not sure we can make that assessment without more information despite what family members say and what price was he really paying to be on it even if it did work for a period of time? I have to wonder how all the years of treatment played into what happened at the end. The trade-offs involved in using these drugs are not always obvious from just a superficial account of the sequence of events.

I guess I'm lucky that I have a good doctor whose goal is to get me OFF my drugs, and it was the same with my previous doctor. I'm on a bare minimum and it works for me. Going below my current doses has very bad results.
I think the blame should be fairly placed on the doctors, not the med's. Yes some of the med's are absolutely horrible and should be used by no one (Zyprexa), but others can be very helpful in conjunction with good care.
Although I'm sure the drug companies here (Canada) have some influence, it is nothing like the US, and possibly other countries. The availability of generic drugs takes some of the sting out of that.

You can't blame Big Pharma this time ... all three of those medications have been generic for years ... so instead you're blaming psychiatry in general?

Even though Nardil (being, as you mentioned, a MAOI) and ECT are treatment options that are reserved for only the most severely treatment-resistant patients? These are not drugs or therapies that are prescribed lightly. MAOIs have never been aggressively promoted by pharmaceutical companies due to the dietary restrictions and contraindications associated with taking them. ECT carries such a stigma that a potential vice presidential candidate was forced to step down (in the 1980's) when it was revealed that he had received electroconvulsive therapy. Most people have no idea what modern ECT even looks like.

Saying that medication contributed to his death is like saying that someone with severe treatment-resistant cancer who underwent multiple radiation and chemotherapy procedures - procedures that prolonged this person's life but ultimately could not save his/her life - CONTRIBUTED to the death of this hypothetical cancer patient.

As far as the DSM being "global," according to a poster above? Um, actually, it's not. The World Health Organization's ICD-10 criteria is employed in most countries and - even among psychiatrists in the United States - is considered a superior diagnostic measure. The DSM serves the purpose of expanding health insurance coverage for those who may not otherwise be covered ... FOR PSYCHOTHERAPY. You know, that alternative to the "evil mind-controlling drugs" you hate so much?

It's really unfortunate that 99% of the anti-psychiatry faction throw around highly-charged words without having any idea about their interrelationships or implications.

a general response to some of the criticisms: it's hardly ghoulish of me to use the dfw story. he's a public figure and his story could be replicated many, many times each year, sadly and tragically. personally, i am rattled by his story and it would be difficult for me to not talk about him. the sad truth that defenders of the current psych paradigm fail to acknowledge is that our supposedly advanced treatments simply aren't working any better than therapy and other treatments circa 1965.

I had an episode of severe depression in my 20s with symptoms worse than Plath, Wallace, and many others who became poster children for the psychotically depressed among us. I then had recurrent acute episodes that were a little less terrifying each time because I had , so to speak, "been there" and maybe knew what I was dealing with. I was always treated with old-style Tricyclics but resisted them long-term. {One side effect was that sexual ejaculation felt like shards of glass rupturing through more than anything else.) Well, that was twenty-five years ago and despite medicating for the increasingly rare but inevitable episode in its acute form, that's it. Diet, exericise, and lifestyle changes seem to work best for me. Can't drink for example. Can't stand to spend money or use credit. Must have work in which I am in control of my own schedule (this has gotten worse with age, leading me to change jobs frequently unless I work for myself).
However, this is an individual difference I relate here, not my life as prescription. Every genome is different.

Stephany, thanks for citing that quote from Rolling Stone from Wallace's own writing. That is quite illuminating. It does seem to indicate the medication wasn't all a bed of roses, maybe not life saving in ways one would normally expect, that's for sure.

Sadness at the death of someone who inspired his generation like, well, Kurt Cobain is not an excuse for a sloppy slap that medicines never help anyone. That's false on its face.

More ominous is the idea I've seen on here from one or two people that since, in their opinion, medicines don't help anyone, medicines shouldn't be allowed, period. Even if it were scientifically proven that medicine could only help a small amount of people (and I'm not saying I believe that), the Hippocratic oath would not allow doctors to deny medicines in those cases.

So why, in our presumed empathy and shared humanity, would we dare to even suggest doing so?

Philip, I gotta say, using this one anecdote to imply that psych drugs don't actually save lives is falling far short of the level of logical rigor you'd need to convince anyone. I don't think it's clear the drugs and ECT didn't help, nor is it clear they didn't make him worse. That Wallace's apparently exemplary compliance with years of 'treatment' did not prevent his death may knock a chip off the dogma that the big problem in psychiatry is 'patient' noncompliance rather than that the treatments generally suck. But when I read this post in which you use an anecdote of a horrible tragedy as fodder for your argument, it really struck me — and I don't mean this overly harshly — as a TAC-y way to go. Just one reader's impression here.

The big question that I infer from this post and that you blazoned, to some commenters' dismay, in the Isiah Thomas post, is why a person who has tremendous success and an enviable life would want to kill themself.

We can recognize the most terrible depression pushing a person to the edge of the precipice, but we usually define this in a tautological way (i.e. suicidal depression is the state of feeling suicidally depressed) that I think really misses the point. People do not kill themselves out of desperation simply because they are depressed. People kill themselves because they feel totally hopeless, that things are never going to get better. Human beings seem to have an almost limitless capacity to suffer and to keep going — I'm thinking for instance of the concentration camp survivors — as long as they can believe that there is some light at the end of the suffering.

But for someone reaching the pinnacle of their profession, still feeling bad (because their problems aren't susceptible of fame, money, and adoring fans) seems like it could engender feelings of pretty profound hopelessness. I'd bet Virginia Woolf, Kurt Cobain, etc., got a little tired of people telling them that they ought to feel on top of the world when they were still feeling the pain from their pasts, which their successes couldn't dull.

In Wallace's case, add to that years of what was presumably about the best psychiatric 'care' available, which may or may not have worked well for a while, but wasn't enough in the end, and I think I can see how he may have felt that nothing brighter was in his future to suffer through the present for.

Or, alternately, maybe human experience doesn't mean shit and it's all just defective jeans and imbalanced chemicals.

What scares me the most about the death of Mr. Wallace?

There before the grace of you go I.

Kat, you said:
"Saying that medication contributed to his death is like saying that someone with severe treatment-resistant cancer who underwent multiple radiation and chemotherapy procedures - procedures that prolonged this person's life but ultimately could not save his/her life - CONTRIBUTED to the death of this hypothetical cancer patient."

Actually, cancer treatments really DO kill people, and more often than most people realize. Chemo and radiation are powerful toxic forces and yes, they do kill the patient sometimes.

Thresh, you said: "Human beings seem to have an almost limitless capacity to suffer and to keep going — I'm thinking for instance of the concentration camp survivors — as long as they can believe that there is some light at the end of the suffering."
Thanks for pointing out that truth.

By the way, have I asked you before where you got your handle? I love it. I never know if it's referring to the farm implement thresher or the tragic nuclear sub the Thresher. I assume the former.

Once you've been through the psych mill of incarceration, many different drugs, the sympathetic (and useless) head nods of talk "therapy", ECT (or, in my case, manage to dodge that one), you know the profession has nothing to offer except more of the same--especially incarceration. So there's nowhere to go when the clouds roll in.

You can't even talk about it, especially not to any therapist because of the legal issues they face if they don't lock you up. And you know being locked up doesn't help and leaves you further weakened, stigmatized and feeling like crap (while the docs break their arms patting themselves on the back because they "helped" you). It's too big a burden to lay on your friends and family. So you're left to deal with it on your own. It becomes your dirty little secret, festering inside you. There's nowhere to go with it.

I, personally, would find it helpful if I could stop hearing about how "treatable" depression is. That has not been the experience of most people I know who deal with it. We know it tends to be cyclical so even when it leaves it mostly comes back, so how many "cures" can be honestly claimed by the mental health professions?

A little honesty would go a long way and give us a starting point. I think all Philip's trying to do here is encourage that honesty.

Sherry, my thoughts exactly. Beautifully written.

I agree with Lisa, beautifully written Sherry. Thanks!

Because the media is covering it and public presumption is that depression made him do it, it has to be discussed. The way it is written, “he took Nardil for years and then it just stopped working” makes it sound like his “illness” worsened. However, Nardil stopped working for a lot of people; there was a reformulation, a change in manufacturing and bad batches that were recalled. All of which, consumers were not forewarned about. I won’t be surprised if more recent problems with Nardil are disclosed soon.

http://www.stratguitar.com/nmember/symptomology.php
http://www.consumeraffairs.com/rx/pfizer_nardil.html

Sherry, you missed my point when you wrote: "Actually, cancer treatments really DO kill people, and more often than most people realize. Chemo and radiation are powerful toxic forces and yes, they do kill the patient sometimes."

The key point to my analogy was this: "procedures that prolonged this person's life but ultimately could not save his/her life." Again, I was discussing a SPECIFIC CASE with similarities to the case presented on this blog.

I am not denying that radiation and chemotherapy can be toxic. They can be extremely toxic and they can shorten, instead of prolong, some people's lives. I specified that these procedures prolonged the hypothetical cancer patient's life but could not ultimately save it; I was not making a generalized comment about cancer treatment in general, I was describing a scenario where someone may have been given an extra 10 years of life due to chemotherapy and radiation but who eventually died from cancer IN SPITE OF - not BECAUSE OF - the treatments.

This is the problem with generalizing so broadly about anything: each individual case somehow becomes representative evidence for ALL cases involving that condition or that treatment.

It reminds me of this political election. Everything on this blog is reduced to talking points. As though they mean anything.

As Kat notes toward the end of her post, there are so many nuanced issues here that are being aggressively proposed as either-ors that a lot of needless battles are being waged and a lot of points missed.

If anyone cares, I've explored the underpinnings of the general clamor of the last few days here.

I wonder why are there so many people drawn to this blog that think in such black and white terms. As far as I can tell Philip does a very good job of staying in the grey area and admitting that sometimes meds help, sometimes they hurt and that a lot of the time they are touted as being much more safe and effective than they actually are. I see that as being niether pro or anti-meds. It's the commenters who add this level of pro and anti meds, black and white type thining to this blog.

Philip - I think you get accused of thinking in ways and promoting points of view that you simply are not. I think you are a very good writer and you make your opinions very clear. Why people take them out of context so often I simply don't understand.

Maybe they get confused when it comes to comments, after reading those black and white views of other commenters, about who's opinion they are really reading. Then you get blamed for the opinions and sometimes outright bullying and meanness of the postings of your commenters. It's too bad that it happens that way. I do wish more people could take what you write in the way you mean for it to be taken...could really understand your actual POV. At least you have a thick skin about these things, if it were me and I had to deal with these sorts of arguements and missinterpretations of things that I had written, I would have a hard time keeping myself detached enough from it that I wouldn't get embroiled in the arguements.

I'm glad your able to keep going with your posting of the news and not end up feeling the need to work out every arguement that happens on this site.
It's strange but it seems like in the past few months the arguements in the comments have been becoming more and more common. I never noticed it until these past few months. I have to wonder what has changed.

Kat,
I'm saying something different. I'm saying that chemo not only fails to save the person, it actually KILLS some people. They don't die of the cancer, they die of the chemo or radiation tx. I know several people who were actually cured of their cancer but died of the chemo/radiation txs.

That scenario is exactly what many people here often talk about--the psychiatric "cure" actually kills instead of curing. My understanding was you were comparing this argument to cancer tx and that you were saying people aren't killed by the tx, but merely fail to be cured by them. I"m saying some people actually ARE killed by them.

Let me know if I'm not hearing you correctly, but I think I did.

Sherry, you're hearing me wrong.

You're making generalizations. Does psychiatry do harm? Absolutely. So does surgery, cardiology, pediatrics, oncology, and osteopathy.

But do these professions also help? Unquestionably.

My analogy was this: David Foster Wallace, from what I understand, struggled with mental illness for more than 20 years. He was maintained on Nardil for about two decades until, in 2007, his doctors persuaded him to taper it and try something else (>). Nothing else worked. Not even ECT. And when he re-initiated treatment with Nardil, it was no longer the miracle drug that he had credited with keeping him alive for two decades.

I compare this to a specific case of cancer where (for example) several rounds of radiation and chemotherapy were remarkably effective - for, let's say, twenty years - until this person experienced a recurrence of the cancer. But this time, multiple rounds of chemo and radiation were ineffective, and the patient died. The chemo and radiation did not "kill" this patient. In fact, the chemo and radiation gave this person twenty years of symptom-free life.

This is exactly what I mean about making black-and-white generalizations. If you take the stance that "all psychiatry is bad," then of course it couldn't possibly have been NARDIL that kept David Foster Wallace alive all of those years! But if you take a balanced view, like me, you would be infuriated that any physician would dare to withdraw a patient from a medication that had been effective for two decades in favor of a shiny brand-new (and brand-name) medication because of Nardil's "potential" to cause high blood pressure and the "possibility" that he may have had been a Nardil-food interaction (highly doubtful if you know anything about MAOIs, because if he was having a hypertensive crisis, he'd be experiencing more than mere stomach pains and he'd already know all of the warning signs quite well).

Bad psychiatry is bad. Not all psychiatry is bad. But if you want to rail ignorantly against Big Pharma and the evils of psych meds, then you can't possibly admit that maybe Nardil kept him alive for twenty years. You can't possibly distinguish between lifesaving treatment and a decision that, in my opinion, turned into a death sentence.

I find it utterly weird that this long RS article -- and none other about DFW's suicide that I've seen -- mention his story, The Depressed Person. It is perverse, boring, and most of all just plain mean. It was almost enough to make me stop liking his work, which is saying a lot. But it's especially strange that he wrote it in the middle of all those years of swallowing all those pills, of being so very "depressed." I find it really difficult now to see the story, in context, as anything other than almost a scream of, well, self-hatred. So sad, so very sad.

Weighing in from the "I myself am on Nardil" side of the aisle, I just want to say that if anyone reading this thread is themselves depressed and nothing seems to work, Nardil, though not a miracle drug, probably did save me from at the very least an entirely dysfunctional life. Compared to the experience of depression, the side effects of Nardil are nothing. Certainly they're more tolerable than the side effects of ECT, a choice I was also offered. According to people I know who have undergone it, at the very least you lose your entire memory of the 6 months preceding treatment. I have been on Nardil for 7 years now, since I was 21. Before that I had built up to the point of taking 7 medications at once. I was even prescribed Thorazine (a genuinely dangerous drug with irreversible side effects that I escaped because I was on it too briefly to be affected) for a while by a doctor who didn't know what to do with me. Now I'm on one medication, Nardil, plus Valium when I need it, which is not daily. After dropping out because I was too depressed to focus, I returned to college and graduated college magna cum laude. I completed a Master's degree at an Ivy League school. I say this not to toot my own horn but because it's a terrible shame that Nardil is considered so dangerous and is so rarely prescribed. Do you know what's dangerous? Decades of depression. I first considered suicide when I was 6 years old. Nardil hasn't ended my depression, but along with therapy, it has attenuated it. The easily avoidable risk of eating the wrong food is laughably unimportant compared to the benefits of Nardil for those it can help. Medicine can't keep anyone alive, but it can make you more buoyant. Like any depressed person, I am grateful for any buoyancy I can get, however imperfect.

Gee, stub your toe?

You see, if meds help (like me, unless i find differently), then i'll continute taking them. Do i believe that modern medicine is a sham, for the most part? Yes! But, it's an ILLNESS!! Funny how no one who's against these pills never address the fact that our brains are being pumped full of all kinds of chemicals by what we breathe, eat or drink. He was ILL. If you read the Rolling Stone article, it might help describe the life of a sick person. RIP, David. You are free. Oh, and cancer is all in the mind too........you morons.

OMG, I agree to so much that I have read about meds making life worse. I have been suffering from debilitating depression for 5+ years now. I was on every drug from the SSRI's to MAOI's, the atypical anti-psychotics and I just got worse and worse until I couldn't work any longer and I went on disability.

What a miserable existence and it wasn't until I fired my dr. and weened myself off lithium, lamictal and seroquel (for depression mind you) that I started to really see what the hell happened to my life.

My family was convinced too that I was bi-polar which my depression was then turned into by my dr. probably as a reason to continue on with the myriad of medications thrown my way. I was told that every side effect, adverse reaction was due to my "illness" and heard constantly from family that all I needed was the right combination of meds. The number of combos was over 65 over the 5 years with my psychiatrist.

I was on lithium and it ruined my thyroid and it DID NOT do anything to stop me from trying to commit suicide eight times myself from the ongoing agony of failed meds and continued depression.

I had 4 trials of ECT and that didn't work either.

Now, as I'm tapering off the klonopin that I've been on for 6 years I'm realizing that the klonopin was probably making my depression worse.

I am still surviving, unlike Mr. Wallace, and I feel for him and his family. I don't know his situation totally. I'm not "living" yet, just existing, and I feel b/c I was one of the ones willing to feel a little bit better I fell into the lab-rat trap armed with nothing but the trust I put into my dr.

I have trouble forgiving myself for not being better informed, but thanks to websites and personal accounts I have learned so much that I think through a lot of therapy I may be able to keep on surviving and ultimately to live.

Amy

Amy,
Honestly, you really have to dig around to be informed at all and who has the energy or cognition to do that in the throes of a depression? Actually, many people will never have the requisite cognition. Don't waste your energy kicking yourself over this, just keep moving forward.

Your thyroid will wreak havoc on you--depression, memory loss that's almost indescribable, fatigue--the list goes on and on. I still have PTSD issues, but the chronic depression that dogged me for my entire adult life lifted radically once I finally was correctly diagnosed and treated. It still can creep up on me at times without my realizing it. The effects are pervasive and slowly creep up on you when your meds need adjusting. But the attitude of the docs when you have a "physical" problem is totally different, I must say.

Good luck, keep learning.