Cry the antivaxers and quacks: 'Twas big pharma that led Adam Lanza to kill

Quacks despise science-based medicine in general, but there are certain specialties that they detest more than others. Arguably, the specialty most attacked by quacks is psychiatry. Many are the reasons, some legitimate, many not. In particular, Scientologists despise psychiatry, even going so far as to maintain a "museum" dedicated to psychiatry that they charmingly call Psychiatry: Industry of Death. It's so ridiculously over-the-top, a virtual self-parody, that it almost inadvertently undermines attacks on psychiatry frequently leveled by Scientologists and quacks.

Let's face it, psychiatry hasn't always had the best history. It's a very hard to study human behavior and disorders of human behavior in a rigorous fashion, but to my mind that didn't excuse the the widespread acceptance of the ideas of Sigmund Freud, which were little removed from pseudoscience in many respects. Also, psychiatry has not always had the best history, particularly in the early part of this century. Too often, psychiatry has been used as a tool of control rather than a means of helping people who are suffering. Although there is a ways to go, however, psychiatry in 2012 is much better than psychiatry, say, 50 or 75 years ago. It wasn't so long ago that I wrote about an old time radio show that gave an idea of how fast psychiatrists at a certain point in the last century were to perform lobotomies, despite the extreme lack of evidence for their safety and efficacy. Over the last half-century, better psychiatric drugs to treat different conditions have been developed, leading to their widespread use for a number of indications.

There are, of course, legitimate criticisms of psychiatry to be made, but that's not what quacks are interested in. Their hatred of psychiatry is particularly pure, to the point where they look for any excuse to attack psychiatric medications. One of the more odious byproducts of this is a depressing eagerness among the anti-psychiatry quack crowd to leap on any mass murder that occurs as an excuse to blame the crime on psychiatric medications. I first noticed this particularly disgusting phenomenon in the wake of the Virginia Tech shooting five years ago, and, unfortunately, I'm noticing it again now, in the wake of the Sandy Hook Elementary School mass shooting, in which a mass murderer, Adam Lanza, gunned down 26 people, including 20 children between the ages of 6 and 7, before shooting himself. A mere two days after the shooting, for instance, Mike Adams, the proprietor of one of the most wretched hives of scum and quackery on the Internet, NaturalNews.com, wrote a post he entitled, Gun control? We need medication control! Newtown elementary school shooter Adam Lanza likely on meds; labeled as having 'personality disorder', in which he ranted:

According to ABC News, Adam Lanza, the alleged shooter, has been labeled as having "mental illness" and a "personality disorder." These are precisely the words typically heard in a person who is being "treated" with mind-altering psychiatric drugs.

One of the most common side effects of psychiatric drugs is violent outbursts and thoughts of suicide.

Note: The shooter was originally mid-identified as Ryan Lanza but has now been corrected to Adam Lanza.

The Columbine High School shooters were, of course, on psychiatric drugs at the time they shot their classmates in 1999. Suicidal tendencies and violent, destructive thoughts are some of the admitted behavioral side effects of mind-altering prescription medications.

Then, rather incoherently, Adams switches gears to the claims that prescription drugs cause 100,000 deaths a year and arguing that guns should't be banned based on this shooting incident but rather psychiatric drugs are at the root of the violence:

For guns to be as deadly as medications, you'd have to see a Newton-style massacre happening ten times a day, every day of the year. Only then would "gun violence" even match up to the number of deaths caused by doctor-prescribed, FDA-approved medications.

Why does America grieve for the children killed in Newton, but not for the medical victims killed by Big Pharma? Are the lives of people on medication not valuable compared to the lives of children in elementary school? Will Obama shed a tear for the victims of Big Pharma, or are his tears reserved only for politically expedient events that push his agenda of unconstitutional gun restrictions?

If our goal us to stop the violence in America, we are completely dishonest if we do not consider the mental causes of violent behavior. And that starts with mind-altering psychiatric drugs which I believe have unleashed a drug-induced epidemic of violence across our nation.

This is a claim we hear frequently from quacks like Mike Adams. Of course, at the time he started making these charges he had no evidence that Adam Lanza was even on psychiatric medications, much less that they caused or contributed to his having turned a school into an abattoir. Of course, little things like facts and science never stopped Adams in his relentless quest to be the firstest with the craziest, and this was no exception. A couple of days ago, not to keep the crazy under check, Adams followed up his original article with one entitled The solution to the insanity: Ban all people on psychiatric medication from owning guns, driving cars or voting for President. In his "satire," he advocated banning people on psychiatric medications from driving, owning guns, or running for public office, proclaiming that "medication makes some people go crazy with violence."

Nice how Mike Adams so casually demonizes those with mental illness, throwing around terms like "crazy."

Be that as it may, Mike Adams isn't the only one doing this. For instance, Teresa Conrick, over at the antivaccine crank blog Age of Autism, wrote a post the other day with a title almost as charming as Mike Adams', Pharmagunddon: School Shooters and Psych Meds. After correctly castigating some media reports that the shooter Adam Lanza had Asperger's, a justified response to the implication in some of these reports that it was autism that lead Lanza to become so violent, unfortunately Conrick goes straight into an anti-psychiatry rant as bad as anything Mike Adams has done.

If there's one thing antivaccinationists are good at, it's confusing correlation with causation. After all, the entire antivaccine belief system involves correlating increasing prevalence of autism over the last 20 years with increases in the number of vaccinations in the recommended childhood vaccine schedule. So it's not at all surprising that Conrick thinks she's found a correlation:

"Despite 22 international drug regulatory warnings on psychiatric drugs citing effects of mania, hostility, violence and even homicidal ideation, and dozens of high profile school shootings/killings tied to psychiatric drug use, there has yet to be a federal investigation on the link between psychiatric drugs and acts of senseless violence."

"At least fourteen recent school shootings were committed by those taking or withdrawing from psychiatric drugs resulting in 109 wounded and 58 killed (in other school shootings, information about their drug use was never made public—neither confirming or refuting if they were under the influence of prescribed drugs.) The most important fact about this list, is that these are only the shooters where the information about their psychiatric drug use was made public. To give an example, although it is known that James Holmes, suspected perpetrator of a mass shooting that occurred July 20, 2012, at a movie theater in Aurora, Colorado, was seeing psychiatrist Lynne Fenton, no mention has been made of what psychiatric drugs he may have been taking.

She then lists 14 more incidence of violence in which the perpetrator was taking psychiatric medications. As I said, confuse correlation with causation for vaccines, confuse correlation with causation regarding psychiatric medications for this issue. So what is the actual evidence? Clearly quackery supporters like Conrick and Adams are not interested in a balanced presentation; they've cherry picked their evidence to find only studies that suggest a link. The most prominent of these studies, which is referred to time and time again by those of Adams' ilk is a study that was published in PLoS ONE a couple of years ago by Thomas J. Moore, Joseph Glenmullen, and Curt D. Furberg entitled Prescription Drugs Associated with Reports of Violence Towards Others.

Basically, this study was a review of adverse event reports from the Food and Drug Administration (FDA) Adverse Event Reporting System (AERS) from 2004 through 2009, searching for drugs with a disproportionate number of reports of AEs involving violence towards others. Disproportionality in reporting was defined as "a) 5 or more violence case reports, b) at least twice the number of reports expected given the volume of overall reports for that drug, c) a χ2 statistic indicating the violence cases were unlikely to have occurred by chance (p<0.01)." The authors identified 1,527 cases of violence reported disproportionately for 31 drugs. Some of the drugs included varenicline (used for smoking cessation), 11 antidepressants, 5 sedative/hypnotics, and three drugs for attention deficit hyperactivity disorder. Among the drugs, varenicline stood out.

Of course, those of you who've been reading my posts on vaccines will see the problem with this study. The AERS database is one letter removed from the VAERS database (i.e., the Vaccine Adverse Events Reporting System). In fact, these days, it's known as FAERS, the FDA Adverse Events Reporting System, and it serves essentially the same function as VAERS, namely to serve as a post-approval surveillance system, to serve as the "canary in the coal mine," so to speak. However, it also shares all the problems with VAERS. The biggest problem is that FAERS, like VAERS, is a passive reporting system to which anyone can report suspected adverse events:

Reporting of adverse events and medication errors by healthcare professionals and consumers is voluntary in the United States. FDA receives some adverse event and medication error reports directly from healthcare professionals (such as physicians, pharmacists, nurses and others) and consumers (such as patients, family members, lawyers and others). Healthcare professionals and consumers may also report adverse events and/or medication errors to the products’ manufacturers. If a manufacturer receives an adverse event report, it is required to send the report to FDA as specified by regulations. The reports received directly and the reports from manufacturers are entered into FAERS.

I also can't resist pointing out that what's good for the goose is good for the gander. Critics of big pharma frequently castigate studies by investigators with conflicts of interest involving big pharma; so the conflicts of interest of the authors of this study are fair game in my book. They're doozies, too:

Mr. Moore has received consulting fees from litigators in cases involving paroxetine, and was an expert witness in a criminal case involving varenicline. Dr. Glenmullen has been retained as an expert witness in cases involving varenicline and psychiatric drugs including antidepressants, antipsychotics, benzodiazepines, mood stablizers, and ADHD drugs. Dr. Furberg has received consulting fees from litigators in cases involving gabapentin.

Kind of like Andrew Wakefield being funded by trial lawyers, isn't it? Dr. Glenmullen has also written books about "solutions" to getting off of antidepressants and castigating antidepressants as causing violence and all sorts of other horrific symptoms. One wonders what Conrick or Adams would say about studies showing these drugs not to be linked with violence if any of the study authors had been paid by a pharmaceutical company to sing the drugs' praises or had written books about how great the drugs were. I think not. Of course, a COI alone does not mean that the study isn't a good one or that it should be dismissed out of hand, nor am I advocating that. I do, however, marvel at how closely the competing interests line up with the findings of the study and am pointing out that the authors do have an ax to grind, which should color your interpretation of their results, along with one's knowledge of how FAERS is like VAERS. Granted, it appears to be more rigorously administered than VAERS in that there is more medical moderation to assess potential plausibility, but it suffers from the same basic issues that VAERS does. Also, in all fairness, the majority of reports to FAERS come from health care professionals.

Be that as it may, this study is clearly based on finding correlations. It is preliminary, but that doesn't mean the authors might not be on to something. After all, given the psychotropic effects of certain drugs it's not implausible that some of them might be linked with violent behavior, and there is certainly other evidence that suggests that certain drugs can make violence more likely. On the other hand, one big problem with studies of this sort is that they rarely control for obvious confounders, such as measuring the baseline rate of violent behavior in patients with the condition who are not treated with the drug in question. As one commenter after a post about this study put it, "Did they screen for people being violent before they took medication? Violent? No, no I was neveeeer violent until I took this pill..." Again, it's all correlation in a database not well equipped to provide anything but preliminary hypotheses to test in more rigorous trials, and there is no control group. An excellent review article points out some of these difficulties:

A number of epidemiological studies suggest that drugs can induce aggression, unfortunately many fundamental limitations exist in these types of studies linking crime to drugs. Most crimes are the result of a combination of factors such as economic, cultural, genetic, environmental, and interpersonal.8,13 Even when the drug is the cause it is often one of many factors that played a part in the event.8 The definition of “drug related” varies from study to study and among individuals. Many epidemiological studies rely on urine testing for drugs of abuse. Standard urine tests are often limited to a handful of substances.16 Certain substances, such as lysergic acid diethylamide (LSD), are difficult to detect by standard urine drug testing methods.16 Additionally, reports by offenders may minimize or exaggerate the contribution of drugs to the given crime, leading to complications in reporting. Most forensic cases involve illicit drugs rather than prescription drugs. These drugs often come from clandestine sources, so the purity and authenticity of the substances cannot be certain. Direct human studies related to drug-induced aggression are limited and animal studies may provide as background information as to whether a drug can cause violence, for example cocaine.17

Psychiatric conditions associated with criminality include delirium, delusional disorder, dementias, impulse control disorders, bipolar disorder, depression, schizophrenia, schizoaffective disorder, paraphilias, and traumatic brain injury.18 It is important to emphasize that most persons with mental illness are not violent and just having a diagnosis does not create additional risk for aggression. One could extrapolate that if a drug causes delirium or delusions (especially paranoid delusions) then it could result in violence. Unfortunately, mental illness is often a confounding factor in case reports both clinical and forensic. Mental illness may or may not be addressed in epidemiological studies.

The review article also points out that many drugs have been linked with violence based on various evidence but that it's really hard to demonstrate in any given case that a specific drug contributed to a specific act of violence. Unfortunately, that's exactly what Adams and Conrick are doing: Trying to blame psychiatric medications for Lanza's rampage, even though it's not even clear whether he was on psychiatric medications, and, if he was it's not known which one(s). A previous report allegedly from Lanza's uncle that he was on Fanapt was apparently highly dubious.

Be that as it may, regardless of whether Lanza was taking medications of any kind, psychiatric or other, there is no evidence that it was medications that caused his murderous child-killing rampage, any more than there is evidence that mental illness caused him to kill. Indeed, apparently he was assigned a school psychologist because of his social awkwardness and fear that he would be bullied by others or might harm himself. At this point, we just don't know, and all too often people without a definable mental illness do truly evil things for reasons known only to themselves. While I can understand why a clueless wonder like Mike Adams is so anxious to blame evil acts on the products of big pharma. He thinks big pharma is the root of all evil and that the only answer are his "natural" cures. Conrick, on the other hand, has a special needs children. In correctly castigating writers who tried to imply that autism somehow led Lanza to kill, she turns right around and implies that it was medications associated with psychiatric conditions, thus demonizing those with psychiatric conditions as potential killers through their medications.

For shame.

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By herr doktor bimler (not verified) on 21 Dec 2012 #permalink

Orac,

Here I thought you were going to write about how vaccines are the means by which the government conducts mind control experiments, and that that is why Adam Lanza went on a killing rampage. It was all mind control, man. (Can't remember where I saw that one. Perhaps it was Adams.)

Where to start?

"I was never violent until I took that pill"

Nobody has a history of violent behaviour, until they're violent, or have been reported to be violent. None of the people who attacked me (with one exception) have official records, and none were on psych meds.

" mind-altering psychiatric drugs [...] have unleashed a drug-induced epidemic of violence across our nation."

*head tilt*

Psych meds cause 30,000 Amerideaths a year?

1. I doubt that, and 2. the UK has similar prescribing rates as our cousins over the Pond. Where are our rampages, huh?

WRT the disgusting "Mental cases are violent and will hurt you" nonsense, he couldn't be further from the truth.

Not only are most murderers/thugs/serial killers/rapists etc. not mentally ill, but mentally ill and non-neurotypical people are disproportionately likely to be victims of violence, abuse, and murder. Hear that Adams? Victims.

Often it's directly due to the stigma of being a "nutter" or a "headcase". In recent years there have been several cases over here, where young people with MIs/who were NNT were held captive, and tortured to death over a period of days. The torturers/killers? Their "friends", whole groups of them. As with the Jennifer Dougherty case in the US, the victims were dehumanised thanks to decades of propaganda, the notion that anyone "mental" is subhuman.

The police also have a history of playing "Pick the local nutter" when running out of suspects in murder cases. Again, thanks to drip-fed rhetoric insisting that mental illness/developmental delays/being non-NT are violent and unstable, the police are quick to jump to that conclusion.

Of course, the situation in the US could be helped greatly by not restricting mental health care to those lucky enough to be able to afford diagnosis and treatment, but none of the gobsh¡tes pontificating about how we mustn't blame guns will admit to that, because communism. Ugh.

So the cycle will continue, PWMI/non-NTs will continue to be demonised, victimised, and blamed for every atrocity under the sun, leading to our dehumanisation, and adding to our fear of disclosure.

A loved one of mine suffers from mental illness; it's thanks to those eeeevil Big Pharma poisons that she is now able to look after her family, work part-time and study for qualifications in a worthwhile career, instead of wandering the streets in a haze of terrors and delusions (as she was before).
I cannot express how much I totally loathe these people.

@Todd W.

Yes the despicable and moronic Adams has suggested that Adam Lanza was possibly part of a government mind control experiment in a throw away comment at the start of one of his poisonous articles in his own sh*t-for-brains website.

I usually stay away from anything the man writes because it is always such self-serving bullsh*t designed to shift boxes from his store at the expense of the credulous and under-educated, but I suspected he would stoop to using the tragedy to advance his interests, and I wasn't disappointed.

There is little to be added in terms of legitimate scientific criticism that Orac hasn't covered. As with Burzynski, all we can do is keep heaping opprobrium upon him in the hope that those unaware will be prepared to listen.

Adams is a spectacularly nasty little turd.

I missed Mike Adams' direct feed, although I believe it inspired AoA's similar post.

AoA has a reason to loathe BigP because not only does BigP produce the dreadly and damaging vaccines, some psychiatric meds are prescribed for autistics who have severe behavioral problems.

It's all a conspiracy, doncha see?

I was wondering when AoA would lash out at Autism Speaks. You see, the family of a special education teacher who died at Sandy Hook asked that donations be made to Autism Speaks. I was sure that would not sit well with AoA. Lo! A post complaining about Autism Speaks right on cue.

Predictable.

Obligatory links:
http://www.ageofautism.com/2012/12/autism-speaks-my-name-is-david-cover…

http://www.ageofautism.com/2012/12/pharmagunddon-school-shooters-and-ps…

What a waste of time and money. Money wasted on quacks would be better spent on real education/therapy for autistic children and help those with mental illness.

Healthcare for mental illness in this country is a disgrace. Two years ago, our teen had a crisis with depression. As a middle class family with 'good' health insurance, I was amazed had how little care was available. I waited with her in the ER for hours while a bed in an adolescent ward was sought. And after only 2 days she was released, on meds but not stable. I was left to cope with her condition as best I could, with 30 minute office visits as follow-up. We got through it (some property damage but no one hurt) and she is now doing very well. Many families without insurance will not get even this level of care.

I don't want to return to the big state hospitals with the abuse that did occur. But as a society we need to find some middle level of care for mental illness crises or these events will continue.

I've held my tongue on the shooting despite hearing and reading the many despicable rantings of Adams et al
over the past few days, Gary Null has of course, jumped on the bandwagon citing and re-citing his deplorable statistic that "95%" of all shootings were by people on psychiatric meds- thus attributing the cause to meds ( he has articles and films that perpetrate this idea). Which leads me to ask, "Why were they on meds in the first place?"

His answer would be that psychiatrists and psychologists "pathologise everyday life": if someone is sad, we call it depression; if kids are active, we call it ADHD...
which precisely illustrates the depth of his dis-information. A mental illness is NOT a transient, fluctuating mood that all people experience but a more persistent problem that leads to their inability to manage interpersonal relationships, learn and start a career, care for themselves or adequately plan their own future and make decisions.
However his backwards and impossibly cavalier ideas influence many followers in alt med world.

A guest on his noon-time woo-fest this week ( see progressiveradionetwork/ shows) was Rima Laibow who discussed her own take on the shootings ( link to her screed, "I am Adam Lanza's Doctor" - see Natural Solutions Foundation/ Health Freedom USA.org). She ( Mrs Stubblebine, I presume?) also implicates vaccines.

Anti-psychiatry advocates believe that better nutrition ( supplements / no junk food) would solve all mental problems and learning disabilities. If only someone would take their advice, violence and SMI would disappear. A belief that nutrition causes these condiitons only informs us about how impoverished the alt med prevaricators' knowledge and information about physiology, learning and human interaction are.

By Denice Walter (not verified) on 21 Dec 2012 #permalink

Never one to disappoint us, today Mikey manages to link the Mayan Claendar, the shooting and Mr Obama.

Sleepers, wake! he cries. You are being propagandised ( interestingly, he mentions Bernays, Freud's relation, about whom Null has ranted recently). Foresake the mainstream and follow me ( and Infowars, David Icke etc).

By Denice Walter (not verified) on 21 Dec 2012 #permalink

CALENDAR

By Denice Walter (not verified) on 21 Dec 2012 #permalink

Autism continues to be blamed for Lanza's actions, and autistics are increasingly fearful of the backlash.

I'm running a (very long) compendium list at my blog, http://lizditz.typepad.com/i_speak_of_dreams/2012/12/gun-violence-and-t…

There is no evidence that autism engenders planned violence of the sort Adam Lanza committed.

Please, if you hear a friend or colleague proposing that "autism made him do it", please refute that idea.

@ Liz:

Unfortunately, Amador who has contributed by assisting those with SMI in the past does a dis-service here for people with ASDs.

By Denice Walter (not verified) on 21 Dec 2012 #permalink

I reckon I should be savvy enough not to be astonished and dismayed by the Mike Adams-style crap around the Newtown murders. But, thanks to my Orac & my friends at RI, at least I can recognize the style from a very small sample. A credulous friend "shared" some crap on FB - someone read a snippet to me re 100,000 deaths/year from pharma & I correctly guessed the source.
But I need to toughen up a bit to be able to get through Adams' screeds & the like. My frustration and irritation interferes with my ability to read that stuff. My hat is off, to you, DW - and other Minions. (again).
I see no consideration of the likelihood that appropriate drugs reduce the incidence of suicide & personal violence.
Some drugs may lead to in increase of bad behavior, of course. People I know connected with law enforcement and the courts frequently cite alcohol (meth, too, that's a good one for correctly demonizing) yet most people I know who drink alcohol are productive and peaceful citizens. Includes my favorite Minions.
There's a lot of noise around Adam Lanza. We don't know what mental disorder he had and we don't know if he was taking licit or illicit drugs. Lots of crap around Asperger's. It was pointed out to me that his mom might have touted that "diagnosis" partly because there is the cachet of genius (mistakenly, in my opinion) attributed to that syndrome. Dig it, Asperger's as the "classy" diagnosis. I've previously heard this from a colleague whose son had that label: "it is the disease of the intellectual" Bah. So we don't know what the medical opinions truly were. There will be ample time to learn the toxicology and psychiatric reports around Adam Lanza. (His mom, she was a piece of work, gun-wise, at the very least.)
Irks me, the Lanza-Asperger's talk. There will be bad thoughts about what "those people" are bound to do. I haven't discussed this with my nephew, an adult Asperger's dude who has his focused narrow interests, does well, is not a genius, and is a wonderful peaceful human being.
I live in one of the 10 states where the death rate from firearms exceeds the death rate from auto & other traffic wrecks.

I would be quite astounded if there were NOT a correlation between mass murders and psychiatric medications. People who are mentally ill being treated for that - perish the thought!

Many of the blogs I post on have been running articles to defend the unfair depiction and association of ASDs with the committing of violent heinous crimes. (See Liz Ditz's link above).

AoA, like all the autism associations and blogs, posted a statement about that unfair association. The comments from the AoA groupies immediately *piled on* that particular blog to blame psychiatric drugs for the shooter's crime:

http://www.ageofautism.com/2012/12/age-of-autism-responds-to-newtown-ct…

Reuben Gaines at The Poxes blogged about our violent society and the availability of guns and assault rifles. I posted there as well, but a genuine ex military guy who is probably a responsible gun and assault rifle owner (he competes in shooting tournaments), started posting about locking up everyone with a history of emotional or a variety mental disorders.

Gun totin' ex-military man was called out about his mistaken belief that people who have the potential to commit these mass murders are easily "identifiable", his defense of assault
rifles for "shooting varmints" and his lack of knowledge of State gun laws. Unfortunately, Reuben had to shut down the comments, because the ex-military guy was getting rather insistent:

http://thepoxesblog.blogspot.com/2012/12/lets-arm-ourselves-to-teeth.ht…

I still have to wonder why Lanza's mother who *claimed* her son has an ASD diagnosis AND was *troubled*, legally purchased these semi-automatic guns and the assault rifle, then took her son to target ranges and had these weapons in her house.

All of the people who were murdered by Lanza were killed by the Bushmaster Assault Rifle, loaded with multiple 30 shot magazines.

It's not a major point, but neither of the Columbine shooters was on psychiatric medication, though it was reported initially that Harris was (Klebold wasn't). Harris had been prescribed Luvox, but it is now known that he had none in his system and it's not clear that he ever took any.

What we really had in that case was a psychopath (Harris) with a paranoid, depressed buddy (Klebold) who managed to psych each other up to the point where they perpetrated a massacre. But medication wasn't involved.

In regards to Sandy Hook (Adam Lanza) and the Colorado Movie shooting (James Holmes) , It takes a person on a mind bending drug to commit such a horrific mind bending act. If we don't understand these tragic events, maybe it's because we don't even understand the effects of the Psychiatric drugs they were taking. What are these drugs doing to their brain chemistry? Are these drugs damaging the brain? Who really knows? There are alot of warnings and a list of side effects that go with these drugs to indicate we don't know what the hell they really do.

The majority of mentally ill people in this country are poor and do not receive mental health care. It would stand to reason that the people committing the majority of mass murder incidents such as sandy hook, the colorado movie shooting, and other school shootings would fall under this category but they don't.

The people committing these horrific crimes always seem to be the ones who are receiving health care for mental illness and who were prescribed and were on some psychiatric drug in the past, or are on one as they commit the act, or are withdrawing from it.

The problem is the psychiatric drugs!

The epidemic of death by gunshot is a public health matter. We can at least try to take the "mass" out of "mass murderer" by eliminating civilian access to those assault rifles and, most especially, to the ammunition, since there are so many of those weapons already stockpiled. There are a lot of postings by gun aficionados with every fashion of excuse, diversion, straw man arguments, puerile fantasies of heroic intervention, etc.. Try this: ownership of those weapons is prima facie evidence of mental instability.

Well, we stopped locking up mental patients in the 60s, to the joy of everybody. The liberals saw it as an advance in civil rights even for the handicapped, the conservatives saw it as great cost savings. And a big part of it was the use of psycho-active drugs, as they enabled a lot of the out-treatment options we use today in the first place.
Now of course we get to the point where we have to either curtail the liberties of the mentally handicapped or the liberties of the gun owners, in order of stopping the the truly disturbed from shooting up schools. And in exchange for the coming assault rifle ban it will probably add another "mandatory reporting" requirement for doctors, further eroding patient confidentiality and preventing people from seeking treatment.

And congratulations THS, you make Mike Adams look brilliant. If we can take something as simple as gun ownership as sign of mental instability, taking drugs clearly is proof of potential for future mass murders. Lock them all up.

@ THS: While I posted above the spokesperson from the NRA commented at a press conference.

He wants every school in the nation to have armed guards at the doors.

It's about time that we as a nation takes a stand...I don't want to hear that the guns are *out there* and it is too late to tighten up gun laws by Federal legislation. For a start we could reinstate the Federal ban on the sale of assault rifles:

http://en.wikipedia.org/wiki/Federal_Assault_Weapons_Ban

BTW, that incorrect belief that prescribed psychiatric drugs cause people to commit violent crimes, is ridiculous. It is far more common that crimes of this nature are committed by people who refuse to take their prescribed medication. There is a problem with "compliance" for some people outside of institutional care, because programs are not in place to provide community-based care to ensure medication compliance.

They're missing the forest for the trees. After all, all recent mass shootings--even those where the shooter wasn't taking or withdrawing from medication--were committed by people wearing clothing. It couldn't be clearer that it's the clothes that's predisposing to violence.

Perhaps only naked people should be allowed to run for office, vote or buy guns?

At least we'd no longer have to worry about who's carrying concealed...

@lilady

The NRA press conference was carried live on national radio here in the UK. I was astonished that an apparently educated man could stand up and talk such obvious bollocks. The vilification of mental illness is despicable.
The tropes used by the gun lobby are more ludicrous than those used in Alt-med, and are easily disproved just by comparing gun crime statistics of the USA and other 1st world countries where logical, well thought out gun control initiatives has been introduced.
All the gun lobbyists prove is that most of them shouldn't be allowed control of sharp writing instruments let alone firearms.

Is there the slightest evidence that Lanza either had AS or took any psych medications?

Why is everyone ignoring the big commonality between virtually all mass shooters? They're virtually all men and the majority are white. If we're going to blame anything besides easy access to guns, how about white male entitlement?

Incidentally, Nancy Lanza's guns didn't protect her. Having a gun in the house drastically increases the risk to every member of the household. It's time for vastly greater gun control in the US, possibly up to and including repeal of the badly outdated 2nd amendment.

MarkL, you see, conditions in the UK, where you get locked up for shooting a burglar and prosecuted for violating the feelings of religious groups are exactly why people in US are the adamant about their rights. And don't worry, sharp writing instruments will be outlawed in the UK next time someone gets stabbed with a pencil.

@ Mu: You are mistaken in your timeline for deinstitutionalizing patients from State "mental hospitals" and State "developmental centers". Those efforts started for the mentally retarded in the 1970s and are still progressing through the Federal and State courts...because of the deplorable conditions that existed in those human warehouses. The effort has been quite successful with the establishment of group homes and supportive living arrangements.

Deinstitutionalization of "mental hospitals" was slow to begin in the 1980s and 1990s and was not implemented properly. In New York State...or in any other State. We used to call those court-ordered discharges "token discharges". People were given a subway token, a few dollars, a small supply of their prescribed medication, with *instructions* to contact an outpatient clinic for aftercare.

BTW, I find your comment directed at THS to be insulting and not based on any of the facts of deinstitutionalization of these two very different populations.

The problem IMO, is that there was no intense aftercare for these individuals who were "token discharges", no supportive living arrangements and the propensity of some patients to stop their prescribed medication. Quite a difference between the care provided in the community for developmentally disabled individuals and those who formerly lived in psychiatric centers.

All it takes is the collective will to care for our most vulnerable members of society and the money to provide effective aftercare.

Mu - you can seriously sit there with all your guns knowing that you are nearly 5 times more likely to be murdered than a UK citizen and claim that gun possession REDUCES crime?

In a country with less than 5% of the world's population and nearly a quarter of the planets prisoners?

You do know we still have guns here in the UK dont you? We didn't BAN firearms - we controlled them. In the same way they have in Switzerland, France, Germany, Australia, Sweden, Finland and a host of other 1st world nations that are statistically significantly safer than the USA?

The transcript of today's press conference is on the NRA website.

Take a look at this NRA page (right column), to see how the NRA *targets* local, State and Federal elected officials who speak out about tightening up gun laws.

http://www.nrapvf.org/

The Bushmaster Assault Rifle loaded up with 30 shot magazines is not used for "hunting varmints"...it is used to kill people.

the NRA has issued their official statement in response to the Sandy Hook tragedy, and I hope Santa replaces all of the NRAs bullets with blanks for Christmas.

Why they released that statement right before Newtown attempts to celebrate Christmas, I don't know but it was a callous thoughtless thing to do.

"The only thing that stops a bad guy with a gun is a good guy with a gun."

Of course, if we put in place reasonable restrictions that impair the bad guy's ability to get his hands on a gun he's just a bad guy, and we won't have to go to the extreme of placing armed patrolmen in every public or private nursery, elementary, middle or high school in the nation.

Just sayin'...

@mu:

you see, conditions in the UK, where you get locked up for shooting a burglar and prosecuted for violating the feelings of religious groups are exactly why people in US are the adamant about their rights

In the UK you certainly do get locked up for shooting a burglar, if that burglar was running away when you shot him.

I've been burgled twice, and I admit I kept a knife by the side of my bed for a month or so after each occasion (although I wasn't home either time), but I know I could never have used it other than to threaten. Realising that producing it would only make me more vulnerable to injury was what made me put the knife back in the loft with the rest of my camping gear. I'd also sooner someone walked away with my DVD player than have their death on my conscience for the rest of my life.

Having said that, if they tried to walk away with any of my books I'd be reaching for the cricket bat.

By Rich Woods (not verified) on 21 Dec 2012 #permalink

I do worry from the asperger diagnostic label given to Lanza; if anything, my harassers would have ran with it and caused me even more troubles.

Alain

I think I'll also say what the solution to the burglary problem was. I got my old windows and doors replaced with more secure ones, and I clubbed together with my neighbours to put a locked gate at the end of the alleyway which runs along the back of our houses. Preventative measures, even those which are mildly inconvenient and cost money, pay off in the long run: I think the current US predicament might be better reduced by paying for broader and better mental healthcare and legislating for a restriction in access to military-grade weapons.

By Rich Woods (not verified) on 21 Dec 2012 #permalink

@JGC

Agreed. And trained and armed reponders works so well doesn't it? NY police gunned down Jeffrey Johnson this summer after he had shot to death an ex-colleague - and injured 9 innocent bystanders in the process. Every one of the 9 extraneous injuries were from bullets fired by the well trained police.

I still wonder who has the adventage, the armed bad guy, who knows he wants to kill people, or the armed good guy, who only knows there is an armed bad guy when he sees the gun?

Pew Research has released yet another poll about attitudes towards gun control (they've done other polls after other gun massacres).

Take a look at the box entitled "Gun Control Opinions Starkly Divided by Party, Gender Race" to see the wide disparity of opinions, dependent on political party affiliation, gender, race...and education level, and the area of the United States where you live.

Meanwhile, the political arm of AoA "The Canary Party", a far-to-the right band of anti-vaccine activists, hasn't commented at all about the murders:

http://www.canaryparty.org/index.php/people

http://www.people-press.org/2012/12/20/after-newtown-modest-change-in-o…

Mu's got a problem here. Let's see if we can get this straight: the argument is that we want guns - especially combat-style semi-automatics with the ammo to tear these kids apart - not to be in the hands of mentally unstable people - or anyone. We set up a Catch-22: ownership of (or application to buy) these sorts of weapons is regarded as a prima facie sign of mental instability. Application denied. Application for ownership of other weaponry denied. Geez! (Hey, let them spend some time proving they are stable.) No suggestion that these nitwits be locked up, though it might help, too. And no need to hurl Mike Adams-comparison insults. So you don't think that gun violence is a major public health problem and you thin it's just fine to have these slaughter-weapons flooding our country? And you have no sense of humor or irony? Whatever. And let's just forking outlaw these sorts of guns and ammo. A lot of us ore tire of this shirt.

In regards to Sandy Hook (Adam Lanza) and the Colorado Movie shooting (James Holmes) , It takes a person on a mind bending drug to commit such a horrific mind bending act.

That's the way, dude, Reality is vastly over-rated. Don't let facts be the boss of you!

By herr doktor bimler (not verified) on 21 Dec 2012 #permalink

Take a look at the cognitive dissidence in this piece over at Natural News:

http://www.naturalnews.com/038404_massacres_gun_owners_defense.html

Groping for examples where Citizens with guns prevented murders, he proceeds to list several examples where murders were NOT prevented.

"But it could have been so much worse......"

Only in your paranoid mind Mike Adams.

BAN HANDGUNS NOW.

By Captain A (not verified) on 21 Dec 2012 #permalink

Their hatred of psychiatry is particularly pure

Only vaguely related, but I'm reminded of a question I was once asked in (near as I can tell) perfect seriousness: wouldn't it be better for all concerned if depressed people killed them themselves rather than take psychiatric medications?

Well, no. If I'd jumped in front of a train when I was depressed, rather than recovered with the help of antidepressants, my family would have been worse off, the railroad would have been worse off, Big Pharma would have been worse off, and, most likely, the taxpayer would have been worse off as I'm now likely to be a net contributor over my lifetime whereas I certainly wouldn't if I'd died in my mid-twenties. The only people who would with certainty have been better off are those for whom the very thought that someone somewhere is taking psychiatric drugs is so insufferable that a human life seems a small price to pay to avoid it. One should perhaps not be surprised if someone who feels that way is also too narcissistic to imagine anyone feels differently ...

By Andreas Johansson (not verified) on 21 Dec 2012 #permalink

@ Mu: " conditions in the UK, where you get locked up for shooting a burglar "
No, in the UK you get locked up for shooting an unarmed burglar in the back when he's outside the house and running away, using an illegal three-bore shotgun that's only available in Africa for shooting big game. Oh, and trying to claim it was justifiable self-defence.

Here's a copy of the transcript from the NRA Press Conference. What a pathetic attempt to blame everything but the assault rifle loaded with multiple 30 round magazines, for the murders of innocent kids and adults at the school.

LaPierre is trying (unsuccessfully) to divert our attention from the availability of these assault rifles to violence-prone people like Lanza:

http://home.nra.org/pdf/Transcript_PDF.pdf

And no, the positioning of an armed guard at every school does not work...as evidenced by the Columbine school massacre:

http://www.slate.com/blogs/the_slatest/2012/12/21/columbine_armed_guard…

Meanwhile, getting back to AoA's dreadful article that associates psychiatric medications (and "vaccine damage"), with Adam Lanza's horrific crime, I see this sole intelligent post...from a naturopath!

"I really think people need to be careful with pointing the finger solely on pharmaceutical pyschotropic medication. Look, I am a naturopath who isn't the biggest fan of big pharma and how they lobby the hell out of various governments but my personal experience with Lexapro (a SSRI) proved to be extremely stabilizing and beneficial towards my recovery from extremely debilitating anxiety and depression.

You can't solely blame meds for violent acts just as I can't solely give the credit to Lexapro for helping me deal with my extreme anxiety. I went to a great pychologist, had amazing support from my family and completely changed my way of thinking through mindful meditation and Buddhist teachings.

Life is so extremely complex and multifactorial. We need to be careful not to generalize all of these cases.

Definitely, we need to examine and question the efficacy of these drugs and mental health needs to become priority number 1 in our society. Genuine compassion needs to become the universal ethos of our society so we can properly care for very troubled individuals.

I completely understand that everyone is different and some people will respond well to SSRIs (like myself and my sister who obviously have the genetics that allow for a positive response) and some will present with serious side effects which is why these cases need to be monitored with the utmost of care and attention.

Sometimes medication is necessary to stabilize the individual but you can't solely rely on the meds to help 'fix' things. There needs to be some form of therapy put in place to help empower the individual and love has to be unconditional and constant.

Cheers

Posted by: Compassionate One | December 19, 2012 at 06:41 PM"

Oh Mu Mu Mu... Fitting that your name is an onomatopoeic representation of an animal that moves dumbly with the herd, stopping only to drop a steaming load.

You know what I love? When Americans regurgitate right-wing bilge about how awful the UK is, with it's disgusting socialism, nightmarish secularism, dislike for hate speech and discrimination against marginalised groups, and OMG CAN'T BUY GUNS AT WALMART!!!!1111eleventy

How. Bloody. Terrible. It's a sickening dystopia, where citizens have to shop, socialise, be entertained and educated, all without the adrenaline-charged thrill of wondering when the shooting will start. So boring and tedious.

The problem is, you've been inculcated with unthinking jingoism, and indoctrinated with the mantra of US exceptionalism, and it's worked. It's worked to the point that the mass slaughter of little kids, buoyed up with holiday happiness, can be brutally slain by a man with an assault rifle in a place that's supposed to be safe and nurturing, and you cry SECOND AMENDMENT! MAH FREEDUMBS!

Then Jay up there, dribbles out some execrable puke about the evil BiG pHARMa psych meds.

Jesus wept. Actually, I did too. I can't approach the American disgrace dispassionately, because it terrifies me to hear the packs of fanatics braying about how MOAR GUNZ! will fix things, how the seekrit mooslin Obama orchestrated the whole thing to attack the rights of Good!Patriotic!Americans! to arm themselves as if they were Taliban warlords.

And people keep dying. What number is sufficiently unacceptable to require action, can you tell me?

Jeez elburto, as an American I would *love* to defend your statements...but I can't. :-)

I expected the finger of blame for the Sandy Hook shootings to be pointed at psychiatric drugs, it was only a matter of time. I think it's a red herring.

As for guns in America, it seems likely that since guns seem to be such an integral part of the American collective psyche, and with 350 million guns in circulation, it will be an uphill struggle to make a real difference, but I do think the struggle will be worth it.

Automatic and semi-automatic weapons (guns in general in my opinion) do not belong in people's homes. As a Brit, I have never even touched, much less fired, a firearm, yet even my adamantly anti-gun American wife was taught to fire a rifle at 6th grade camp (she's a Michigander). Teaching eleven-year-old children to fire guns seems like madness to me!

By Krebiozen (not verified) on 21 Dec 2012 #permalink

@ lilady: Thanks.
@ elburto: yes, USA is a surreal place. I wish I could honestly dispute your note. There are major sections of big-time crazy. Even in the worst places, though, there are smart, sane, kind people.

I believe in putting my money to work for causes I believe in.

Does anyone have any information about this organization...it is dedicated to legislative action due to the readily availability of guns and assault rifles that maim and kill people. The organization was started by Sarah and Jim Brady; Jim Brady took the bullet to his brain which was meant for President Reagan:

http://www.bradycampaign.org/about

I don’t want to return to the big state hospitals with the abuse that did occur. But as a society we need to find some middle level of care for mental illness crises or these events will continue.

I see that this has been covered in part already. I have had reason in the past to daily visit (as a visitor and not a patient, that is, give me time) such a big state hospital in the past. They're a mixed bag, but "The Snake Pit" wasn't in evidence. One's fellow patients seem to be by far the biggest problem, followed by lackadaisical janitorial staff. On the other hand, the creaking administrative wheels seemed to lead to keeping people until they were really stabilized. It may not have be the greatest mental place to be stabilized at, but it was stable, and there were actually decent day programs as diversion. Private hospitals (again, this is only my experience) seem to err on the other side, leading to repeat hospitalizations.

As Lilady noted, the legal reforms in mental health codes began in the 1970s. I'd add that there was a middle level introduced, the "informal" admittance, between "voluntary" and "involuntary" (the latter basically means transport to a state hospital). This is gone and very unlikely to return. Nobody makes money on inpatient psych.

On a much lighter note

I notice that the Mayan Calendar prediction was incorrect because we appear still to be here. I had an inkling that all would be well earlier when I observed that flip ( AUS) was alive and kicking: he and Grant ( NZ) might have been the first to perish if total destruction indeed proceeded by time zone like the first day of 2000. I'm so glad that they didn't .

Oh well, I suppose the cranks will have to be content with dire forecasts of rapidly rising seas, menacing solar flares, hyper-inflation followed by deflation, chemtrails causing sterility, vaccine injury followed by autism, meds causing hiv, cancer, SMI and shootings and new scares about toxins, GMOs as world governments and aliens oversee international corporate greed and the media. Or suchlike.

Another day in Woo-topia: wish you were here!
Or second thought, I wish you weren't here- woo-topia is awful. We should go somewhere nice instead.
Happy solstice-tide.

By Denice Walter (not verified) on 21 Dec 2012 #permalink

As a Brit, I have never even touched, much less fired, a firearm, yet even my adamantly anti-gun American wife was taught to fire a rifle at 6th grade camp (she’s a Michigander). Teaching eleven-year-old children to fire guns seems like madness to me!

Oh, I had this in regular school. It's not madness. The course (part of the physical education element) was in safety training for hunters, and if you're someplace where people hunt with firearms anyway, one may as well lay down a framework. In my case at least, actually getting to shoot was reserved to the last few classes. Everything else was on the level of a heavy-duty version of driver's training.

And another incident. Four dead in PA. In a church hall. So all places of worship need armed guards too?

@THS- basically what you're reccommnending is political abuse of psychiatry:
http://en.wikipedia.org/wiki/Political_abuse_of_psychiatry
Plenty of countries have gun control laws and they manage to do so without abusing the medicial process.
And demonizing every gun owner in the United States as crazy (tens of millions of them) when the majority have never used their weapons against another human being is just plain horrible. Many of them own guns because it makes them feel safer- some have been victims of crimes themselves and feel they need the protection. Demonizing them instead of trying to convince them that would be safer with gun control is just counterproductive.

Does anyone have any information about this organization…it is dedicated to legislative action due to the readily availability of guns and assault rifles that maim and kill people.

With the prefatory statement that I have no interest in a gun-control debate, the Brady Center (and they've gotten some bread from me years ago) isn't particularly well ranked on financials by Charity Navigator.

Unless you've been living under a rock for the past few days, you may already know that the media has made note of the Newtown shooter's autism. Problem is, I'm autistic, and I've been prone to violent rages in the past (but never ones of the agnitude that made me want to shoot up a school, but I have felt mad enough to kill at times). How exactly do I keep these impulses under control? (Bear in mind I can't afford professional help.)

Well...I own a handgun. And I think I'm demonstrably sane.

Well...I own a handgun. And I think I'm demonstrably sane.

(I tend to repeat myself, but other than that....sane).

@ Lucario,

I guess that rages are sometime uncontrollable but the only recommendation I can make is that to get a psychiatrist to write you a script for Seroquel which you could use when these crisis happen. I know you can't see a shrink but this may be your only option outside of a criminal record.

Alain

So Mike Adams is a gun zealot as well as a raging, anti-science, kombuchabag. Why am I not surprised? I bet he's got quite an arsenal down there in Texas. Don't tread on him or you're gonna get familiar with the business end of his Bushmaster AR666 DeathSpitter™ MKVII real fast-like. The man has something much more dangerous than his arsenal though, his paranoid website of quack cancer cures and survivalist crap.

By Pareidolius (not verified) on 21 Dec 2012 #permalink

Here's a post I made about this:
http://exotroopers.wordpress.com/2012/12/17/responding-to-anytown/

In brief, it's my longstanding opinion that at least some "spree" shooters represent some form of autism with comorbid schizophrenia-like symptoms. A recurring and very significant feature of these cases is that the offender is evidently delusional but (unlike the typical schizophrenic) clearly able to carry out complex plans.

Another issue I think needs to be considered is that ethnic studies of violent crime (eg. among whites and blacks, Serbs and Albanians, Christians and Jews) have consistently indicated that in most incidents, the victim(s) and offender belong to the same "community". If (and admittedly it's a BIG "if") this pattern is extrapolated to those with mental illness and/or psychiatric disorders, then it follows logically that a disproportionate number of crimes committed against the mentally ill are in fact by others with a mental illness.

David N. Brown
Mesa, Arizona

By David N. Brown (not verified) on 21 Dec 2012 #permalink

@elburto,
"The police also have a history of playing `Pick the local nutter' when running out of suspects in murder cases. Again, thanks to drip-fed rhetoric insisting that mental illness/developmental delays/being non-NT are violent and unstable, the police are quick to jump to that conclusion."

Unfortunately, this kind of thing presents a perfect "positive feedback" scenario: At the least, such an individual is likely to deteriorate under police attention (which of course would seem to validate the perception that attention is warranted...) At worst, it could turn into a case of "self-fulfilled prophecy".

David N. Brown
Mesa, Arizona

By David N. Brown (not verified) on 21 Dec 2012 #permalink

Lucario: We have all been following the newscasts and the *claim* by Adam Lanza's mother the he was autistic. Even if he was diagnosed with an ASD, he was a very "troubled" young man...so "troubled" in fact that he murdered his mother and 26 other people. We may never know if he was a psychopath...but his premeditated brutal slayings point to this primary (or co-morbid) diagnosis.

About your anger issues...I would suggest that you contact your local mental health association for a referral to a counselor (psychologist or social worker). The charges for counseling at a not-for-profit mental health association will be based on your ability to pay. It is possible that you will be referred to a psychiatrist to evaluate you and to determine if a prescribed medication is indicated.

@ David N. Brown,

I did a pubmed search of (("Child Development Disorders, Pervasive"[Mesh]) AND "Schizophrenia"[Mesh]) AND "Cognition"[Mesh] with free full text and so far, I have 5 article but one important article is a meta-analysis of autism, SCZ and neurotypical control showing difference between groups.

here's the pubmed Search.

I can accept that a standard deviation of a big clinical population (such as autism) have other concurrent issues but still, we know so little about rampage shooter that we should exercise caution about drawing inference from this case.

Alain

@Alain,
Thanks, I will take a look. I have looked intermittently for information on possible "overlap" between autism and schizophrenia. So far, what I have mostly learned about is the period from ca. 1950-1970 when there were controversies about how to distinguish between autism and schizophrenia. During that interval, some took the idea of a connection too far, most conspicuously with the theory that autistic children became schizophrenics as adults. I suspect that those excesses led subsequent researchers to neglect further inquiries.

By David N. Brown (not verified) on 21 Dec 2012 #permalink

@ David N. Brown,

Neuroimaging (coupled with neuroanatomy and Z-score) look to be an important tool to determine the difference between a group of clinical population and the neurotypical and it isn't inaccessible to the common mortal; after all, I have been accepted to work on a meta-analysis after having done a single course on neuroanatomy. In any case, I suggest this book to learn more about neuroanatomy and neurophysiology.

Alain

Narad,

Teaching eleven-year-old children to fire guns seems like madness to me!

Oh, I had this in regular school. It’s not madness. The course (part of the physical education element) was in safety training for hunters, and if you’re someplace where people hunt with firearms anyway, one may as well lay down a framework. In my case at least, actually getting to shoot was reserved to the last few classes. Everything else was on the level of a heavy-duty version of driver’s training..

It's the cultural differences that interest me; I can't avoid the visceral reaction I have at the thought of children being taught to fire a gun. My wife has a similar reaction to the culture around alcohol here in the UK and in the rest of Europe (that may also be because her parents were alcoholics). It's not that unusual for children to be given alcohol at an early age, perhaps a small glass of champagne at a celebration, or a watered-down glass of wine with dinner, and it is perfectly legal as long as they are aged five or over. The justification I have heard is to educate the child in sensible drinking at an early age - to paraphrase what you wrote about hunting, if you are someplace where people drink anyway, you might as well lay down a framework.

I suppose you might compare the drinking culture in the UK to the gun culture in the US, in some respects, since both are seen as largely culturally acceptable, and both have grave public health consequences. Neither sensible drinking nor sensible gun ownership are problematic, it's the abuse that is the problem. For those not aware, binge drinking is very common in the UK, town centers after the pubs close on a Friday or Saturday night generally resemble a war zone and the social and economic costs of binge drinking are enormous.

By the way, I was brought up in a rural area of the UK where pheasant and partridge shooting, not hunting (there's a big difference), was very common. Part of the year was devoted to breeding pheasants and partridges, and the shooting season to blasting them out of the sky. The distant (sometimes not so distant) sound of shotguns was a familiar sound every season, and spent shotgun cartridges littered the countryside. However, only a certain social class of people (or desperate social climbers) went pheasant shooting, and I don't remember ever actually seeing anyone fire a shotgun, though I had one pointed at me on a few occasions along with the cheery refrain of, "Get orrf my land!"

Some of my friends would volunteer as beaters, a risky job which involved flushing pheasants out of the undergrowth into the firing line of the shooters, and were paid with cash and a brace of pheasants, but I never joined them. It seemed far too like Jeeves and Wooster for my taste. Occasionally a beater would be shot by mistake, usually by a senile old fool who couldn't tell a pheasant from a peasant, but a shotgun pellet at long range rarely did much damage, and even if it did the victim was generously compensated for the loss of their eye or whatever, probably with two braces of pheasants (I jest, but only a little).

This did mean I became quite skilled at plucking and cleaning pheasants and the occasional partridge (skinning and cleaning rabbits and hares too, though that's an even nastier job), and we often had roast pheasant, donated by a friend, for dinner, with a side bowl to spit the lead shot into. Despite this, as I said, I never fired nor even laid my hand on a firearm, which is strange really, looking back on it.

By Krebiozen (not verified) on 22 Dec 2012 #permalink

Alain, lilady, I appreciate your concern, but I already said I can't afford psychiatric counsling. What I'm looking for are ways of anger management that don't cost any money. Can anybody help me there?

If I have aggresive moods, it's mostly aimed at myself. I never hurt anyone, just myself. And well, I used to trow some stuff. Destroyed a chair, when I failed for my driving-test and beat in a small window at my parents, when I wasn't allowed to take a book to school. but well, I was very much younger then. i was still in elementary school and I still lived in Rotterdam, so it was before I was 10 years of age.

@Lucario, Sliding scale fees based on one's ability to pay do take into account people who are unable to pay anything. If you are indeed unable to afford the fee, it is typically waived. Make this clear to them when you inquire or apply for the services - make it clear that you really need the services but can not afford to pay anything. They may ask you for confirmation of income and assets, or even request a copy of your income tax returns and bank statements, if any. You must cooperate and provide this documentation, if you do indeed want the help and discount fee. I urge you to pursue this matter further.

There are ways of dealing with stress and anger management that don't cost money, but oftentimes people need to be taught such skills and the techniques may need to be adapted to the individual's needs, skill levels, and background experiences.

I am not a physician or a counselor. I suggest that people's aggressive moods, as mentioned by Renate, do in fact effect other people around them. The aggressive actions and behaviors of others, regardless of any lack of physician assault, can have a profound and devastating effect on others, especially when it continues over a substantial length of time.

To the dear person in Canada that likes to make his own beer, I do wish you would stop posting your contact information as you have done previously. You never know who could be reading these messages and what intentions they may have.

As far as guns, shooting and children go, I've known middle-aged adult, white, American men to teach 7 year old girls how to shoot by picking easy targets such as baby birds in their nest. Most girls don't like to shoot baby animals, birds or otherwise, especially in their nests. It escapes me as to how some people consider this as fun.

The aggressive actions and behaviors of others, regardless of any lack of physician assault,...

Perhaps not so hilarious, but I do believe the above would be called a Freudian slip. The above should read "The aggressive actions and behaviors of others, regardless of any lack of physical assault..."

Of course, it's anecdata, but a close friend of mine became a bit more aggresive -mostly verbally - on paroxetin (his problem is OCD, which in general not really involve aggresive behaviour). He told his psychiatrist about it, got another prescription for another medication, no big deal. And without any medication at all his life was hell. So yes, some people may react strangely or paradoxically to some medication - which is why prescribing psychiatric medication is often a hit-and-miss process. But usually in the end they get something that works for them.

And speaking of violence against innocent children-
our old friend, AJW, puts forth his own spin @ AoA with
" Patterns In Chaos: Child Psychiatry, Violence and Autism"

By Denice Walter (not verified) on 22 Dec 2012 #permalink

I have heard of several psychiatrists that claim Autism is caused by too little dopamine and Schizophrenia is caused by too much dopamine. If this were true, then I would think Parkinson's disease patients would be considered as autistic. Others claim that Lyme disease is the cause of Autism or even that Autism does not exist as it is merely misdiagnosed Lyme disease.

@ S:

I think it's a little more complivated than that.

On the schizophrenia and Parkinson's: older drugs for schizophrenia caused Parkinson-like symptoms and drugs for Parkinson's cause the converse.

People may assume that autism and schizphrenia are related because they share certain characteristics**- *supeficially* at least - that involve social interaction skills, social cognition, executive function, i.e. that these abilities are infereior to the general public's average. Doesn't mean that they're the same BUT that each condition somehow interferes with development of these capacities that occurs in adolescence and are usually well functioning in adults. So higher order skills might be affected in each but in different ways.

I think that it's better to think of them as two separate sets of characterisics. And yes, people with a SMI might also have an ASD (just as people with ASDs can also have heart disease, diabetes, cancer et al).

** and don't share OTHER characteristics.

By Denice Walter (not verified) on 22 Dec 2012 #permalink

About guns:

I think that Kreb brings up an important dimension: urban/ rural. People have entirely different attitudes about guns when they live in close proximity to- perhaps- millions of others. Obviously regional differences reflect the degree of urbanisation peculiar to that location.

But here's the big problem:
if there is not a national law ( like in the UK), it's easy for people to get around local prohibitions in cities because they can just travel elsewhere to buy weapons. Or mail-order them.
I just read about tougher regional gun laws ( NE US) being by-passed through a northern path of sales.
A new civil war is a-brewing. Mike Adams will be pleased because it gives him plenty to write about.

By Denice Walter (not verified) on 22 Dec 2012 #permalink

Lucario, I am certainly no doctor but something you could do for yourself that might help with anger management in general is physical exercise- it releases endorphins and could help overall ability to manage stress- a brisk walk, run, kick boxing...I think what we are seeing is that using meds can be helpful for some mental health problems but starting and stopping issues and alcohol interactions all have to be factored in to potential reactions (I know you didn't mention meds but I am just realizing that people do use meds to help with anxiety or depression etc.). Certain drugs do seem to have more potential for violence, unfortunately. You can look up tips for dealing with anger and there are many suggestions that are practical and cheap if you can't see a doctor. Good luck.

It's the psychotropic drugs stupid. How much more of a correlation and a body count do you need?! Do we need 50 years of evidence?
If Lanza was officially on Fanapt (why is the mainstream media silent on even discussing this?), then read the product monograph: 18% of study participants had INCREASED schizophrenia & psychosis (Fanapt = iloperidone):

o In the 46 week extended phase, SAEs were reported by 18.1% in the iloperidone group and 16.1% in the haloperidol group. Psychiatric disorders were the most common (iloperidone 16.7%, haloperidol 11.0%), of these schizophrenia aggravated and psychosis aggravated being the most commonly reported. These were also the most common SAEs associated with discontinuation.

How much more god damn evidence do we need?! And if you think it's the guns, guess again:

October 2012 - Cardiff Wales hit-and-run. Man hits 14 pedestrians with Van. On antidepressants.
http://www.bbc.co.uk/news/uk-wales-south-east-wales-20012446
AND
Anti-depressant pills are handed out faster in Wales than any other part of the UK, new figures reveal.
http://www.google.ca/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=2&ved…

AND the Nanny in New York that stabbed the two kids she was caring for in their bathtub? There are no official reports that she WAS on psychotropic drugs that I can find, but there are also no reports that she WASN'T.

Lucario, I forgot to add that there are always helplines you can call that may be really good for when you just need to be listened to and vent a bit.

Michael: Just demonizing the assault rifle crowd. There's no psychiatric medical abuse here - just a legal issue raised. I understand that there may be reasonable people who feel that they may need to employ deadly force in their personal defense. There may be reasonable people like to hunt. But, aha, I've struck a nerve. The object is to put an end to the assault rifle craze, by any means necessary. And it is a craze, driven by the worst impulses in American politics & culture. The people I've encountered who claim to own assault weapons have all been mega-creepy.

Gumbi:

It’s the psychotropic drugs stupid. How much more of a correlation and a body count do you need?! Do we need 50 years of evidence?

Actually, yes, we need the evidence. But not in the form of sensationalistic news reports, and uninformed speculation. So just produce the title, journal and dates of the PubMed indexed studies to support your statements.

@Gumbi

Nice name and strangely appropriate after reading your evidence free rant.

So you give Matthew Tvrdon and Yoselyn Ortega as proof that anti-depressants cause these shooting sprees, and yet you cannot show that EITHER was taking any form of anti-depressant. I have even tried to do your work for you and after a cursory search on both I can't even find a press report (let alone a reputable source) to back your assertion.

Even if it WERE the case, it is still not an argument against gun control because gun control has been demonstrated to work in every 1st world country where it has been applied logically.

As it isnt the case, your post is just another despicable attempt to vilify the mentally ill by a gun-nut.

The people I’ve encountered who claim to own assault weapons have all been mega-creepy.

That's perhaps correlated with its being a meaningless thing to say in the first place. The coinage was invented to demonize "scary looking" rifles, so I'm not surprised that the usage would be inverted.

(Oh, wait, I said I wasn't going to do that. Rats, sorry.)

I suppose you might compare the drinking culture in the UK to the gun culture in the US, in some respects, since both are seen as largely culturally acceptable, and both have grave public health consequences. Neither sensible drinking nor sensible gun ownership are problematic, it’s the abuse that is the problem. For those not aware, binge drinking is very common in the UK, town centers after the pubs close on a Friday or Saturday night generally resemble a war zone

The points of comparison include the point that in both cases the abuse is immensely profitable, and that government actions are not really designed to make a difference.

In both cases it would be nice if the manufacturers of the product stopped encouraging the customers to use it in a personally- or socially-destructive way; and if *they* had to pay for the damage (rather than externalising the costs). But this does not appear to be an option.

The last I heard from the UK, there was talk of extra taxes on alcohol to raise its price (and profits) to the point that only the sensible users would continue to drink. This was coming from Cameron, known for spending his habit at university of getting shit-faced with a band of equally-entitied friends, going out to expensive restaurants and trashing them... so "sensible drinker" in Cameron's definition seems to mean "upper class".

The trouble with the term "binge drinking" is that the definition is up-for-grabs. I have been to public-health meetings where academics discuss what level of drinking to set as "binge", so as to capture a large enough percentage of the population to make for impressive headlines without capturing an actual majority. Often the term is used to mean a *regular pattern* of drinking, which to my mind is *not a binge* by definitiion.

By herr doktor bimler (not verified) on 22 Dec 2012 #permalink

A pox on you Denice :-) for your reference to Wakey's blog up on AoA...you beat me to it. Andy is now making a feeble attempt to prove that it is medication manufactured by *Big Pharma* that is the cause of the massacre. I see a new career path for Andy, now that the MMR vaccine does not cause his made-up-diagnosis of *autistic enterocolitis*...and now that his theory of increased prevalence of autism in Somali children who were vaccinated with the MMR vaccine, caused a huge outbreak of measles in Minneapolis in deliberately unvaccinated Somali kids.

http://www.ageofautism.com/2012/12/patterns-in-chaos-child-psychiatry-v…

Cripes, I hope there are no further delays in Andy's lawsuit for defamation in Texas. I want Brian Deer, Fiona Godlee and the BMJ to whup his a$$.

If Lanza was officially on Fanapt (why is the mainstream media silent on even discussing this?)

Argumentation is so much easier when you can make up your own evidence and invent a conspiracy to explain the lack of evidence for the evidence.

By herr doktor bimler (not verified) on 22 Dec 2012 #permalink

@lilady

About the Brady campaign, they are passionate advocates for gun control. If the Brady act were passed and implemented when the campaign first started, I don't think there would have been access to the types of weapons used to kill those folks in Newtown.

On the Autism Speaks charitable campaign, those who would contribute if it were not funded by ASpeaks, a fund has been set up at the the University of Saint Josephs where Rachel D'Avino was enrolled in the certificate in Applied Behavior Analysis program.
http://www.usj.edu/news/in-honor.html

Cripes, I hope there are no further delays in Andy’s lawsuit for defamation in Texas.

I'd be surprised if they got another extension on the deadline to file the brief without working for it. However, the supplemental clerk's record still appears as overdue on the calendar. There are only two reasons for why this would be there in the first place, and I'm guessing it's the vexatious one.

Comment @Krebiozen re. drinking culture currently in moderation. Note to self: "sh1tfac3d" is on the list of Naughty Words.

By herr doktor bimler (not verified) on 22 Dec 2012 #permalink

@ BA: I've already made a donation to the Brady organization, which is involved in lawsuits against assault rifle manufacturers for compensation to the victims of shooters.

There was a ban on assault rifles enacted in 1994 with a "ten year sunset clause". In spite of efforts by members of Congress that ban did "sunset" in 2004:

http://en.wikipedia.org/wiki/Federal_Assault_Weapons_Ban

Valid statistics indicate that more than 30,000 people are killed by guns each year in the United States. Since the murders at Sandy Point School eight days ago, ~ 656 people died of gun wounds in the United States.

@ offtopic,

Sometime, I wish there was a function to search our own comments (or have'em into an automagically generated list) because I really don't know where I posted last night.

Alain

@Denice, I didn't have the time to explain myself very well in my previous post. I share your opinion, however, part of my point in general is that more people being directed towards mental health care, as it exists today, will not necessarily resolve many of these problems. Regarding the dopamine and Autism/Schizophrenia claims I mentioned, those were made by psychiatrists. Other psychiatrists hold the opinion that opiates are an acceptable treatment for depression, and they do indeed prescribe opiates as an anti-depressant for long-term use. Others claim such bizarre things that I will not repeat them here. There is one that claimed homosexuality was caused by infectious disease. Please understand, many of these things are not my issues, but nevertheless, I feel their patients are being profoundly misled and misdiagnosed and certainly mis- and over-medicated.

It seems quite a few physicians fail to recognize the symptoms of drug overdose, tolerance or withdrawal, and instead diagnose those effects as other diseases, mental or otherwise. I don't have many suggestions on how to resolve these problems other than the need for better education of physicians. It is tempting for me to say that if the physician doesn't understand the effects of the medications, then they shouldn't be prescribing them. OTOH, that also sounds rather ridiculous, as how could any physician really understand the effects of every medication they prescribe.

In any case, there is absolutely a need for physicians to receive better education and training on the effects of drugs that build tolerance, and I classify opiates as well as most of the psychiatric drugs in that manner - SSRIs, SNRI, typicial and atypicals, etc. The SSRIs and other psychiatric medications may not technically be considered as addictive , and perhaps "tolerance" is not the correct term, but patients do seem to develop withdrawal-like effects if they either take their regular dose late or stop the medication without adequately tapering the dosage. I have yet to meet a patient or a physician that has been instructed properly on tapering these medications. Many physicians do not seem to be mindful of the profound withdrawal effects and the very serious need for careful tapering of these dosages. Instead, they tend to dismiss these effects as further signs of mental illness.

Anecdote or not, stopping such medications too abruptly or switching between medications too abruptly causes many people to spiral out of control. I don't necessarily think that would cause anyone to go on such a advance-planned killing spree as what happened in CT, but I'm not sure. I don't know Adam's background, so I wouldn't even want to offer an opinion. I have seen patients who have been mis-medicated develop a spiraling of symptoms that were completed dismissed by the prescribing physicians, until all hell broke loose. That's a disservice to the patients, their families and society. Not enough prescribing physicians are recognizing the effects of the medications they prescribe. This absolutely must change if the mental health care system is going to improve.

I think people like Adam are not representative of the majority of psychiatric patients. Most patients seem to become the victim, rather than the perpetrator. They've been victimized by their families, by the school system, other children and many by their mental health providers. Also, in many ways I feel that people 'reap what they sow'. When you raise children in abusive and neglectful families and social environments, how can you expect to have a healthy, happy and well-adjusted adults or children? Heck, you can't abuse a puppy every day and expect it to grow into a loving, gentile dog. Social values must change, not just about treating the patient who wants to get mental health care, but 'treating' their environment as well, society as a whole.

I have a lot to say on this topic and am not able to address it adequately in these posts, plus I've holiday plans and am on limited time. Anymore, I just hold back a sense of regret whenever I refer people to physicians, especially mental health providers.

@Denice, If I may be so bold as state that I expect you once again to respond with 'Of course'. So my next question would be where do we clone you, Orac and some of the others here? (PalMD, you there?)

@lilady, More power to you!

lilady: And no, the positioning of an armed guard at every school does not work…as evidenced by the Columbine school massacre.

http://www.cbsnews.com/2316-100_162-682276-5.html

One of the first victims in the 2005 Red Lake school shooting was a tribal police officer- shot by his own grandson. So not only would armed guards not be a deterrent, they might also be put in the awful position of shooting a relative.

Lucario: I know this may be an odd suggestion, but have you considered looking into martial arts? Karate, aikido and judo are all very strong on discipline, and one of my favorite ways to blow off steam is by running karate forms- trust me, after four or five, the anger just melts away. This is not meant to be a substitute for Alain's suggestion, rather as an adjunct.

By Politicalguineapig (not verified) on 22 Dec 2012 #permalink

Gumbi,
And this statement is all we need to know about you:

no official reports that she WAS on psychotropic drugs that I can find, but there are also no reports that she WASN’T.

All you’ve got is a hammer, huh?

@Gumbi, You can't dismiss every criminal's behavior as being a result of psychiatric medications. You likely don't know the people involved, you don't know their history, you don't know if they were or weren't on psychiatric medications, you don't know if they were on other medications, you don't know if they were or weren't taking any other drugs or substances, you don't know if they had any other illness, you just don't know. Making the assertions that you make only serves to distance yourself and your opinions from the people who are doing the research and trying to study such crimes.

@Narad. What? Emotional topic. Acquaintances quarrel over shades of meaning. No sense in falling to quarreling. But I'll take the bait. Just once.
I'm not quite sure what is meaningless: "assault rifles" - a reasonable catch-all, generally accepted, publicly used term for a class of weaponry that may not satisfy nit-picking by people with an avid interest in guns; "mega-creepy", a term I coined that cannot be original with me; or the likelihood that my sample does not represent the population of people who own these weapons, which I sure do hope is the case.? You may argue all three on strict semantic terms. Its easy to concede concede the last one only.
So I have known a few creeps who claim to own those types of guns. If you argue that my small sample cannot be representative, and/or that claiming to own a gun is not proof of ownership, I do hope you are correct.
I have the personal opinion that the increased availability of these weapons (and their ammunition) per se constitutes a public health menace. These are so extremely dangerous that - supposing even if that the people who own them are representative of the general, mainstream population - it's still a public health menace. These weapons can kill too many people too quickly. We could rearrange quite a few electrons around the question of the mentality of the paramilitary survivalists, etc. who seem to be drawn to these weapons and whether "assault rifle" owners have a larger proportion of these people than there are in the general population.
Scary looking people with scary looking rifles.
Finally, I do agree on "meaningless" insofar as I doubt there will be substantial change in the gun laws. O tempora! O mores! I hope I didn't italicize the thread.

Let me get this straight. If someone commits a terrible crime and they are on medication, it was the medication that made them do it? It wasn't the condition for which they were prescribed medication?

I wonder how well anti-vax and conspiracy theorists do on connect-the-dot drawings? My guess is not good at all.

@ lilady:

Oh I aims to please!
i am expecting that Andy will soon start showing up as a regular on PRN and Natural News as well as other crankish sites. Or start his own line of supplements.

By Denice Walter (not verified) on 22 Dec 2012 #permalink

@ S:

Of course, you are correct.
-btw- I thank you for your kind words and placing me amongst such esteemed personages as a candidate for cloning.
That's quite a compliment and a new one: think I'll add it to the list.

By Denice Walter (not verified) on 22 Dec 2012 #permalink

I hope I didn't insult some of the good civic-minded RI minions with an emotionally-driven characterization of a demonized weapon style. I do have have strong opinions regarding cultural trends of the past 30 years, and I don't like para-military USA.
I actually have some sympathy with people who feel a need for deadly-force capabilities of self-protection.
I have mixed attitudes towards weapons aficionados. There are elements of human history - cultural, technical, and military - that can't be ignored. Humans have been working on weapons - what - recent evidence of bow & arrow 70,000 years ago.

I suspect that claims of psychotropic drugs driving violence or shooting sprees are nonsense. But I have not studied the matter. Can we suggest that without psychotropic drugs the violence rate would be substantially higher? There is abundant anecdotal evidence in favor of this possibility.
Also there is abundant anecdotal evidence that people concoct any manner of excuse to minimize and defer responsibility for abhorrent actions. At the very least, we know that people have been capable of appalling behavior long before psychotropic drugs were available.

This has nothing to do with guns or gun control, but the Olympic runner who was working as a very high-priced Vegas escort was on Zoloft for depression. Will Mikey Adams et al. now blame psych. drugs for her, ah, errors in judgement?

By Marc Stephens … (not verified) on 22 Dec 2012 #permalink

If any of you are around tomorrow AM...or care to record it...Wayne LaPierre who spoke at the NRA Press Conference on Friday is scheduled to do an interview with David Gregory on Meet The Press. (I Tivo the program anyway, and will be viewing it...to see if he has any more brilliant suggestions).

@Narad. What? Emotional topic. Acquaintances quarrel over shades of meaning. No sense in falling to quarreling. But I’ll take the bait. Just once.

I didn't mean to offer bait, I just started the day sluggishly and failed to remember that I had told myself not to start in. I was, however, less than clear to boot, as you point out.

I’m not quite sure what is meaningless: “assault rifles” – a reasonable catch-all, generally accepted, publicly used term for a class of weaponry that may not satisfy nit-picking by people with an avid interest in guns

I was referring to the term "assault weapon" and further suggesting that anybody who used it as intimidating verbiage was really just turning around the original coinage. My assertion is that the "class of weaponry" is based more on style than substance. The NRA isn't always wrong. Is this an "assault weapon"? How about this? They're chambered the same, have the same barrel length, are the same length, and have magazines of the same capacity. The scarier looking one is a pound heavier.

^ "are the same total length"

THS:

I have mixed attitudes towards weapons aficionados. There are elements of human history – cultural, technical, and military – that can’t be ignored. Humans have been working on weapons – what – recent evidence of bow & arrow 70,000 years ago.

Like all humans, gun owners run the full spectrum. I grew up in a "gun family." My father was an Army officer who grew up hunting, and my brother was in a rifle club in high school.

While I did not have firearms classes in school, I did shoot a gun under strict supervision as a child. The last time was in college when my brother took me to the boonies to shoot a 357 magnum handgun. He spent much of the time making sure I was holding it correctly so I did not injure myself. As it was, I ended up being projected backwards into the mountainside and way off the target. That was the last time I fired a weapon.

Neither my father nor my brother seem to have semi-automatic weapons. My dad would never hunt deer or elk with something that destroys their flesh because that is his only source of meat. He did once chase a bow hunter off of his rural property because he does not like how arrows only wound the animals and leaves them in pain. That was a very interesting Christmas day.

My brother was more into making replica kits of ancient firearms and being qualified as an Army officer (the last time I saw him shoot a firearm was from a muzzle loaded handgun he made). His son, my nephew, did offer to take my sons deer hunting, though that never happened.

All I got to do in high school was learn archery.

As it was, I ended up being projected backwards into the mountainside and way off the target. That was the last time I fired a weapon.

This is not all that dissimilar to the one time I tried to play golf.

Ah yes, I also had misadventures with golf.

My one year at Balboa High School at the former Panama Canal Zone was when the women's locker room facilities were being remodeled. There was no way to shower after athletics in that tropical area.

That was when we were given less aerobic activities like golf, archery, golf and ping pong. Unfortunately one of the arrows during girls archery went awry as some of the boys ran the track and an arrow ended up in one young man's calf. The archery range was relocated closer to the train station. Which is where we also practiced golf.

We also got to do swimming at the pool behind PanCan movie theater (across the street from the commissary), and bowling at the PanCan bowling lanes which were located between the high school and the commissary.

It was quite interesting living in a totally socialistic colonial economy run by the US Army Corps of Engineers.

@Chris

My dad was a black-powder shooter, so the first pistol I ever fired was a Colt Dragoon.

In winter, into a snowbank while standing on an ice-covered lake. I went tail over teakettle.

before the prevalence of psych meds it was "too much sugar", or "smoking reefers" or too much sex. Next up, it'll be back to "Violent Video Games"

@DLC

Moms. Ever notice how it's always the mother's fault?

@ Shay: In spite of all the false information coming out about the murders, I suspect in this particular case "mom" is somewhat culpable.

What mother who claimed to all her friends at the local bar that her son was *troubled*, buys semi-automatic pistols, an assault rifle and possibly the multiple 30 shot magazines used in the murders, and takes her son to shooting ranges for target practice?

I've been busy posting on other blogs to dispel the rumor that an ASD caused Lanza's rage and the murders. He *might* have been diagnosed with an ASD, but he was also a psychopath.

DLC,

Mikey Adams has already published a column blaming parents who let their kids play violent video games. That was right after he wrote about the conspiracy involving "a second shooter" with Lanza and that the whole thing was set up by Obama as a friendly fire incident, like the Colorado movie theater shootings.

By Marc Stephens … (not verified) on 22 Dec 2012 #permalink

(Many, many) years ago I shot an old shotgun, that was kept at a friend's camp in the boonies.

About 12 years ago I did some target shooting with a Glock 9mm (daughter's first husband was in law enforcement). The *targets* were old tin cans set up on a tree stump at another friend's camp...still in the boonies.

The Glock was very difficult to shoot as it required a lot of trigger pressure.

I'm still frightened of guns of all types and I am still very much against guns with multiple shot magazines...and all assault rifles.

I've just read that Dylan Hockley, one of the Conneticut victims, was autistic:

As we talk, Ian smiles as his wife explains the significance of the butterflies they both wear. ‘When children are on the autism spectrum, some are rockers or they roll their heads. And some are flappers. Dylan was a flapper. Whenever he got excited or happy, no matter what he was doing, he would flap up and down, up and down and over and over. It was a sign of his joy.
‘I once asked him, “Why do you flap?” Because he had underdeveloped language skills, I was not expecting an answer but he replied, “Because I am a beautiful butterfly.”

From here

Damm. Why are my eyes getting wet?

What do you think of this idea that explains how flavonoids, especially Quercetin works against cancer cells?

Quercetin is an antioxidant. It neutralizes free radicals. While doing so this quercetin changes to a radical molecule. For example it neutralizes 4 radical molecules and becomes a radical molecule with 4 radicals.

Then it sticks to DNA (covalent binding). Because there is no water present there, it stays a radical molecule.

When a cell divides, water nears this molecule so it reacts with water causing OH radicals killing the cell.

Normal cells always repair their entire DNA before cell division, so the radical flavonoid molecule is removed. So normal cells stay unharmed.

Cancer cells divide before they have repaired their entire DNA, so they die.

So it's actually a bomb.

A flavonoid molecule is like a bomb that explodes if it's not removed before a cell tries to divide. Cancer cells that divide before reperation die, because the bomb isn't removed, so it explodes when the cell tries to divide. Normal cells that divide after reperation remove the bomb so they live.

Cancer cells that do completely repair their DNA before cell division aren't cancer cells anymore (they are normal cells) because they have to wait a long time before cell division.

Normal cells that did not completely repair their DNA before cell division can pass a mutation down to daughter cells.

So flavonoids kill only cancer cells but no normal cells.

It's like this:

Normal cell -> completely repaired -> flavonoid bomb removed -> cell divides normal

Cancer cell -> not completely repaired -> flavonoid bomb detonates -> cell killed while it was dividing.

Cancer cell that completely repairs = normal cell.

Steven Chang

By Steven Chang (not verified) on 23 Dec 2012 #permalink

@Stephen Chang: Stop spamming and FUAD

Mr. Chang, what kind of dressing would you like for your wildly off topic word salad?

Dude, wrong blog post. Go troll on the Burzynski posts.

By Politicalguineapig (not verified) on 23 Dec 2012 #permalink

As if the great loss of life and the inconsolable grief of survivors weren't horrifying enough, another potential for increased suffering is being seeded by alt media woo-meisters and anti-vaccine advocates ( the latter led by fraudmaster AJW) who frighten people away from psychiatric meds which might actually PREVENT more mindless slaughter.

Orac presents a review of why we should question the link between these meds and violence that many alt med and anti-vaxxers promote: they NEED to believe this because they cannot accept pharmaceutical solutions to solve ANY problems - vaccines can do no good and neither can meds.

Many of these people believe - to some degree- in 'Nature' as being beneficent and human intervention** as being inferior and tainted. It's nature worship pure and simple- they can't imagine Nature visiting autism or SMI on innocent children- it has to be the evil designs of modern science and inductrial profiteers.
ASDs didn't exist prior to the advent of SBM, they tell us.
Neither did mental illness.

When I read some of their rants, I am surprised that they just don't attribute illness to a powerful spell, cast by a witch or wizard - perhaps the *malocchio*. Children being 'stolen away' or 'soul-less'. Their view seems to hinge on primitive emotionalism constantly stirred up by those who know how to manipulate vulnerable people in order to secure their own fame and fortune.

** although they allow *certain* interventions by other nature lovers.

By Denice Walter (not verified) on 23 Dec 2012 #permalink

INDUSTRIAL profiteers

By Denice Walter (not verified) on 23 Dec 2012 #permalink

Stephen Chang is another one of those dangerous lunatics who thinks he's come up with a better way than chemotherapy--his magic flavonoid pills mixed with Vitamin C. He's been spamming cancer discussion groups with this nonsense since 2007. He claims he "discovered" this cure but there are never any credentials attached to his name to explain why he thinks he has any skill to do this. Another moron looking for attention here.

By Marc Stephens … (not verified) on 23 Dec 2012 #permalink

** although they allow *certain* interventions by other nature lovers.

Like trying to save a kind of whale, stranded on a sandbank. Of course if the experts can't do it, they keep saying the experts should have handled things different and even go as far as threatening people who think different.
Something that happened in my home-country.

@ Grant:
@ Chris:

Thank you for that! It certainly brightens my day. It's lovely that AJW is receiving appropriate recognition for his work.

I would add my own epithet: SBM persona non grata of 2012. Perhaps 2011 as well. But the lawsuit this past year earned him extra points.

By Denice Walter (not verified) on 23 Dec 2012 #permalink

By gumbi's line of reasoning we could blame Chinese intelligence for the Sandy Hook shootings. After all there are no official reports Adam Lanza was a Chinese sleeper agent, but there are no official reports he WASN'T!

By tim gueguen (not verified) on 23 Dec 2012 #permalink

How many.people are taking psychiatric drugs, living normal lives, being happy, productive members of society? Many more than the very few that commit horrific crimes such as Adam Lanza's.

I'm delighted about Grant's and Chris' posts...such a nice holiday present for all of us.

@ bad poet: On most of the blogs where I post all the comments were defending the *maybe* ASD diagnosis of Adam Lanza and the awful false reporting that an ASD diagnosis is associated with his rampage. Most of the comments also made the observation that it is unfair to label people who are prescribed medication for a variety of emotional or psychiatric disorder have the proclivity to commit heinous murderous crimes.

Adam Lanza may or may not have diagnosed with ASD...it is immaterial, as his acts indicate he was a psychopath which is a totally different type of mental disorder than ASD is...and totally different than the disorders that people are treated for and are able to integrate themselves, quite successfully, into society.

@ lilady:

Is not Mr Wakefield's deadline for his vexatious lawsuit in Texas fast approaching? THAT being throw out would be a nice holiday present as well.

By Denice Walter (not verified) on 23 Dec 2012 #permalink

I hope I'll get a new start for the next year; I applied to work for a doctor (MD/PhD, FRCPC) in Montreal doing research work on bipolar & depressive disorder.

Alain

@ Denice Walter: An even better holiday present would be if Mr. Deer, Dr. Godlee and the BMJ attempted and prevailed, to recover legal costs under Texas' Anti-SLAPP legislation, against Wakey. (I'd be celebrating all year long).

@ Alain: I'm wishing you good luck and hoping you get that position.

@ lilady: Thanks, it is appreciated. I'm looking to move to Montreal (again...) next year to work in a lab. I have been idle (not working) for too long and the only prospect here is with my prof of chemistry doing research on beer.

While I'm passionate about beer, my psychiatrist isn't too happy about myself doing research on the domain and I also have to think about the impression left for the admission comity for med school if I had 4 years of research in beer fermentation as opposed to 4 years of research on a biomedical domain.

Alain

Is not Mr Wakefield’s deadline for his vexatious lawsuit in Texas fast approaching? THAT being throw out would be a nice holiday present as well.

January 4 for the brief, but I'd put the odds of this being resolved before Epiphany at nil.

Is it me or this is suddenly silent on the blog?

Alain

lilady: Most of the comments also made the observation that it is unfair to label people who are prescribed medication for a variety of emotional or psychiatric disorder have the proclivity to commit heinous murderous crimes.

Well, I'd agree that it's unfair, but people are still going to do it. I was thinking about consulting a psychiatrist a while ago. Between Newtown and my town's own local shooting (disgruntled worker who was rapidly deteriorating) I have yet another reason to put that off. I'd rather get by on my own then risk being found out. Besides, a few little cuts aren't going to hurt me at all.

Alain: I think everyone's experiencing a sudden glut of relatives :)

By Politicalguineapig (not verified) on 23 Dec 2012 #permalink

One of the most common side effects of psychiatric drugs is violent outbursts and thoughts of suicide.

It's amazing how prevalent this idea is. When doing 'research' back before I discovered science blogs, I fell for this one. Mostly through video testimonials and 'documentaries' on the side effects of SSRIs.

The odd thing is they blame the medications, but never seem to realise that the illness itself often includes symptoms of anger, violence and of course, thoughts of suicide.

Coming from a place where guns were banned in 1996 mainly due to a large mass murder in that year, I wonder why America still holds on to a ridiculous idea that self-defence is only an option when it involves weaponry. Like Elburto comments about UK; we have no rampages here.

A couple of days ago, not to keep the crazy under check, Adams followed up his original article with one entitled The solution to the insanity: Ban all people on psychiatric medication from owning guns, driving cars or voting for President.

And a big f* you to Adams. If this were applied here, I would not be able to drive nor vote, despite being extremely capable at both. Plus, I don't drink and drive like many 'sane' people out there. In fact, my one and only car accident was entirely the other person's fault. Oh, and I'm not violent - at least no more than the average person.

What an ass. (And I'm being mild, since I know the banhammer will apply to stronger language)

And exactly the reason why people with mental illness tend to avoid seeking help: who would, with such a stigma attached?

@Ruth/STL

Healthcare for mental illness in this country is a disgrace. Two years ago, our teen had a crisis with depression. As a middle class family with ‘good’ health insurance, I was amazed had how little care was available. I waited with her in the ER for hours while a bed in an adolescent ward was sought. And after only 2 days she was released, on meds but not stable. I was left to cope with her condition as best I could, with 30 minute office visits as follow-up. We got through it (some property damage but no one hurt) and she is now doing very well. Many families without insurance will not get even this level of care.

You have my sympathies. My hospital stay was marginally better than your daughter's, and it shocks me that even in my universal-healthcare setting mental health treatment could be so lacking. It astounds me further to see it no better in the US. I can totally understand how frustrated you must have been; and your daughter of course.

@Jay S

Who really knows? There are alot of warnings and a list of side effects that go with these drugs to indicate we don’t know what the hell they really do.

That's bull. In order to be prescribed, they have to pass testing first. The FDA, and other government oversight bodies in other countries, all ensure that any prescription medication passes muster; not to mention the scientists themselves. As for the list of side effects: they're there BECAUSE the testing had been done to discover them. Sheesh, how does one put a list of side effects on the package if they don't know what the drug does?

The majority of mentally ill people in this country are poor and do not receive mental health care. It would stand to reason that the people committing the majority of mass murder incidents such as sandy hook, the colorado movie shooting, and other school shootings would fall under this category but they don’t.

Mental health issues are not discriminating: they affect people poor or rich, politically stable or war ravaged, etc etc. The second sentence therefore does not follow, and doesn't follow even using your logic anyway.

The problem is the psychiatric drugs!

[citation needed] Especially given that people with psychiatric conditions live in other countries - where there are no guns - and don't go around shooting up schools like in the US. As pointed out in the blog post, the majority of people with mental illnesses are NOT violent.

@Mu

MarkL, you see, conditions in the UK, where you get locked up for shooting a burglar and prosecuted for violating the feelings of religious groups are exactly why people in US are the adamant about their rights.

This is the logic I don't get. Crime in other countries is taken just as seriously in the US, and yet they don't see the need to arm themselves with guns. How does having one make a person safer, or at least, less likely to be a victim of a crime? Especially in comparison to other countries where crime rates are low and even the police don't carry guns?

I also don't understand why a gun is more protective than a baseball bat, better security precautions, or seeing the criminal go to jail. Except of course, that everyone else has guns and one must keep up with the Joneses, as it were.

@Lilady

Thanks for posting that Pew survey. It showed stats were roughly were I thought they'd be.

@DW

I had an inkling that all would be well earlier when I observed that flip ( AUS) was alive and kicking: he and Grant ( NZ) might have been the first to perish if total destruction indeed proceeded by time zone like the first day of 2000. I’m so glad that they didn’t .

Fortunate actually because a very bad internet connection has made me somewhat unable to use the net properly for the past few days. To think all because I couldn't even get dial-up worthy connection, you might have thought the world was ending! ;)

And thank you - I am also glad the people here haven't disappeared into fiery depths.

Unfortunately, the local news here all started off their Mayan news stories with "predictions of the end of the world, though some scientists state it's just an end of an era". Sigh - even the good, decent news programming lead with intros that made it sound somewhat legitimate. Made me want to cry.

@Alain

I guess that rages are sometime uncontrollable but the only recommendation I can make is that to get a psychiatrist to write you a script for Seroquel which you could use when these crisis happen. I know you can’t see a shrink but this may be your only option outside of a criminal record.

Is it really wise to recommend medications to someone without actually being their doctor first?

@Krebiozen

It’s not that unusual for children to be given alcohol at an early age, perhaps a small glass of champagne at a celebration, or a watered-down glass of wine with dinner, and it is perfectly legal as long as they are aged five or over.

Whilst at school, that is, high school, we did have education about drinking; we were taught how much is an average glass of various alcoholic drinks, about different body weights and metabolisms and how it affects the consumption of alcohol, legal drinking limits, etc. This is because most of us were about to turn 18, the legal age you can drink here.

Having said that, a recent campaign from the government aims at educating both adults and kids about alcohol, including a series of TV ads that suggests that teaching your kids to fetch you a beer will likely lead to them being complacent later in life and not drink responsibly.

It's interesting how different countries deal with the same issue. (Incidentally went to the UK after graduating and had my own shock walking into pubs and seeing kids around. I was not yet 18, so at home, I would have been kicked out, let alone see kids younger than me happily sitting around the bar) In general I approve of teaching kids to drink responsibly, but I wonder if the attitude in the UK is a bit too far.

@Gumbi

How much more of a correlation and a body count do you need?! Do we need 50 years of evidence?

Did you bother to read the post? And the stuff there about correlation not equating to causation?

How much more god damn evidence do we need?! And if you think it’s the guns, guess again:

Did it ever occur to you that it is the stigma of mental illness that causes it to be mentioned in news articles? Why is it never "40 year old person with cancer kills 20 people"? Or "20 year old man with diabetes kills child"?

By the way, linking to news articles in lieu of peer-reviewed publications is not the best way to present your case. Especially when talking about statistics and medical benefits/risks.

AND the Nanny in New York that stabbed the two kids she was caring for in their bathtub? There are no official reports that she WAS on psychotropic drugs that I can find, but there are also no reports that she WASN’T.

Ah, never mind. You're one of those "conspiracy if there's no evidence of conspiracy" idiots.

Hi flip: We were wondering where you were and I'm so glad that you are back...with your usual *bang*.

I've been posted about this mass murderer ever since it was reported 10 days ago, first in defense of people with ASDs who were maligned by some reporters who claimed that people on the "spectrum" have proclivities to commit heinous crimes, then in defense of people who take prescribed medication for a variety of emotional and psychiatric disorders who were also tarred with that same brush due to sheer ignorance.

Three days ago, Wayne LaPierre representing the NRA, spoke at a press conference and managed to blame everything under the sun, with the exception of our lax/nonexistent gun control laws, for the massacre.

At first I was upset with his weaselly words, but soon realized that LaPierre's speech was so shamefully lacking in honesty, that he inadvertently did "our side" a world of good:

http://www.nydailynews.com/news/politics/full-text-nra-remarks-gun-cont…

He repeated his mistakes on a Sunday AM newscast...again helping "our side", who want stricter Federal laws enacted for issuing of permits for hand guns and a total ban on assault rifles and the sale of multi shot magazines affixed to guns and rifles.

Glad the world didn't end for you. :-)

Is it really wise to recommend medications to someone without actually being their doctor first?

No. I wish I had something to add but the only answer I have is No.

Alain

AVN tried to pin the shooting on SSRIs (evil pharma gambit, etc), only to have a fair number of their own membership object via the AVN Facebook page. It made for interesting reading. It's a pity, though, that the rest of what the AVN offers is equally bad.

Very well said. Psychiatry, like every other field of medicine, has a history of mistake. Probably seems worse than other "branches" of medicine because it is younger (and as such, the mistakes are closer to us). But it is improving and is helping lots of people to live a good life. That said it is done by human and sometime people make errors. Such is life.

I am going to be the contrary here: I do believe that some autistic people are more likely to commit violence than NT people, though I am talking about low and very low functioning autism. I have heard and read too much cases that went on the line of: "And I had to hide in my room because my brother/sister -autistic- threatened me" or "the ausiliary teacher (don't know how they are called in the US) got a broken arm because the XY student --autistic- threw a chair at her" to believe otherwise. They are less likely to cause widespread carnage due to being in less contact with the general public, yes. But not less violent (mostly low-functioning autistic men during puberty, I admit).
This violence is often hushed under the rug because it is often done towards close family (oftentimes siblings) or "professionals".
So very sorry. I know personally too many stories to believe otherwise.

@ T: Are you referring to outbursts that some kids with significant ASD impairments have? This was not an outburst, as anyone who has worked with these children can tell you.

This was a deliberate act of violence, planned for and executed by a psychopath...made "easy" for him because of the availability of assault rifles and 30 shot magazines legally purchased by Lanza's mother...and the availability of that weaponry in Lanza's home.

The other information about Lanza who "might" have been diagnosed with an ASD or who "might" have been prescribed psychiatric medication has not been confirmed.

But for the availability of these rifles/magazines and for the poor choices made by his mother, the 20 children and the six adults at the Sandy Point School, would be alive.

It's interesting how patients taking psychiatric medications are sometimes labeled, and how others sometimes blame the medications for the behaviors. Do many people not realize that essentially the same medications are used for a variety of conditions, and prescribed by other specialists?

It seems unwise to categorize or judge people by what medications they are taking. I fear that this is happening in many cases. Gastroenterologist's often prescribe medications which are basically anti-psychotics. I doubt many of their patients are informed about the side-effects of those drugs, or worse yet, labeled as taking a psychiatric medications. Patients with seizure disorders are often prescribed benzodiazepines by their neurologist. Patients with chronic pain are prescribed the SNRI Cymbalta. Are those patients labeled as having psychiatric disorders? Of course not. How will people sort out the 'dangerous' patients from the 'Ok' ones using criteria such as who is and who isn't taking which medication? They can't.

@Lilady

Hi flip: We were wondering where you were and I’m so glad that you are back…with your usual *bang*.

Sadly whilst most are enjoying their holidays, I have had a combined lack of internet plus actual work to do, making me a little behind on everything.

Glad the world didn’t end for you

And same to you!

@Alain

No. I wish I had something to add but the only answer I have is No.

Thanks. I know you meant well, I just thought it worth pointing out.

@Grant

AVN tried to pin the shooting on SSRIs (evil pharma gambit, etc), only to have a fair number of their own membership object via the AVN Facebook page. It made for interesting reading. It’s a pity, though, that the rest of what the AVN offers is equally bad.

Glad to know my fellow Aussies won't swallow anything told to them by Dorey.

@ flip: Rachel Dunlop at SBM has a post up on the AVN. The legal problems that the AVN is experiencing has provided us with an early Christmas present. Dunlop cautions her readers about going to the AVN site:

http://www.sciencebasedmedicine.org/index.php/another-blow-to-the-anti-…

"Whilst the name the AVN gives the impression they are a neutral resource for vaccination information, scratching the surface of their website and other literature quickly reveals an anti-vaccine agenda (incidentally, I don’t recommend going to their site at the moment as it has been hacked and you will likely be redirected to a cheap pills seller, or get yourself a nasty virus)."

@Lilady

I can barely keep up at RI, so I never bother to head over to SBM blog - so never would have heard this news. Thank you so much for posting the link to it.

flip,

You really HAVE to read SBM too. There's a thread right now on some salt water MLM scam called ASEA--if you think some of the posters here are blinded to science (hi Judith, Marg, DJT, etc.) you have to see the comments posted by a couple of the salt water salespeople and their Youtube links and studies supplied by the company selling the water. They say they don't need clinical evidence because the people using the sat water all swear that it works. They even hint it can cure cancer.

And of course rustichealty pops up once in a while to argue that every single health issue under the sun can be either prevented or cured with vitamins, supplements and organic food.

By Marc Stephens … (not verified) on 24 Dec 2012 #permalink

I largely do agree with this post, and believe that demonizing people with mental illnesses is horrible.

But as a factual correction I would like to note that AR-15s such as the Bushmaster are indeed used to hunt varmints such as coyotes or feral pigs in rural areas in the Midwest. And yes, coyotes are actually still a problem in these areas for livestock producers and rural people who have outdoor pets.

If they were made unavailable, I was told by a hunter that shotguns would be likely to be used instead, so whether they *need* an "assault weapon" is a different question entirely, and perhaps that would be a more useful discussion.

But they are legitimately used by some people in some locations for nonhuman targets beyond the shooting range. Please keep that fact in mind.

Farmers who want to keep coyotes from mangling their barn cats shouldn't be demonized either. But perhaps they may need to seek other options--that's a very legitimate question.

Lilady

the poor choices made by his mother

While I doubt that I would have made the same choices she did, I am not comfortable with transferring all blame from Adam Lanza to his mother, as your comment suggests.

@MSII

Oh, I would if I could. Actually I think I started reading that before coming over here. But between the 50 billion blogs I'm subscribed to, my work load, TV, sleep.... etc. It's just not feasible to keep up with everything. (This is nothing to say of my ever-growing bookmarks which must be in the hundreds or thousands by now)

And I did lurk on an old rustichealthy comment thread for a bit - once again, reading all those comments made me behind in other things.

If I could do one thing with my life, it would be to read everything and anything. :(

@ Flip,

If I could do one thing with my life, it would be to read everything and anything

I wish I could still do so, I used to read a book a day over 10 years ago and I would recall line by line a book if I read it 3 times in a row.... now, I'm lucky if I read a book a month.

Alain

lillady,

I believe the hack at AVN was closed reasonably quickly (a few days ago), so it ought to be OK -- unless a new hack is in place...!

@Alain

We suffer from the same affliction. I used to read an awful lot, but nowadays struggle with concentration issues. It's why I spend more time on blog comments than on books :(

I hope your reading gets better ... er, you know what I mean.

@ Flip,

Thanks you. In any case, I hope to be able to read at a sufficient speed to do my learning (especially in med school).

Alain

Best of luck with it Alain - I sure do hope you pass med school with flying colours!

And, in spite of tough gun licensing laws in New York State, there is this...

http://www.nytimes.com/2012/12/26/nyregion/gunman-who-shot-firefighters…

"...Chief Pickering also said that it was likely that the gunman used a semi-automatic rifle, one of three weapons recovered from the shooting scene, to kill the firefighters. He identifed the semi-automatic as a .223 Bushmaster rifle, the same weapon used in the school massacre in Newtown, Conn...."

"...Mr. Spengler had a lengthy criminal record and lived in the burning house. In 1981, he pleaded guilty to manslaughter for bludgeoning his 92-year-old grandmother to death with a hammer. He was imprisoned until 1998..."

I predict now, that Wayne LaPierre from the NRA, in addition to *addressing* the problem of not having a Federal ban on assault rifles and multi-shot magazines, by suggesting armed guards at every school, will now propose we ban hammers and other tools, so that grandmas are not bludgeoned by psychopaths.

Listen Flip, Psychiatry is not a panacea and is often ineffective. Don't oversell the Psychiatric profession because they have a history of being wrong. Look I don't know if these drugs are what caused this to happen but I want a real serious look and you are a fool to think drugs don't get approved by the FDA that are later found to produce unacceptable and dangerous side effects.

I said- The majority of mentally ill people in this country are poor and do not receive mental health care and I said it would stand to reason that the people committing the majority of mass murder incidents such as sandy hook, the colorado movie shooting, and other school shootings would fall under this category but they don’t.

Your response was - Mental health issues are not discriminating: they affect people poor or rich, politically stable or war ravaged, etc etc. The second sentence therefore does not follow, and doesn’t follow even using your logic anyway.

My Response. You made my Point Flip! Exactly! Mental health does not discriminate, but the kids committing these types of crimes are not poor.The one's committing these types of crimes are already receiving mental health (white middle class) care and most likely using medications.

“I assume short of obtaining a court order to release his medical records, only his mom would know for sure, and judging by the reports that she was trying to get him committed, then it is reasonable to speculate that he was already receiving psychiatric help from a profession who's standard operational procedures are to prescribe medications.”

In (Michael Moore's) documentary Bowling for Columbine, after looking at it from many different sides, even Michael Moore suspected psychiatric drugs may have been a cause. Jesus is it such a stretch to take seriously that when these drugs don't work that they may have horrible side effects on the mind as to engage it on thoughts and acts of violence including suicide and homicidal ideation.

READ THE BLACK BOX! IT"S NOT CANDY.

BY DESIGN IT"S CREATED TO HAVE A POWERFUL EFFECT ON THE MIND!

Orac, Stop hiding behind associations with scientology, vaccine conspirators, and quacks and address the serious issues and concerns regarding the use of Psychotrophc medications and their possible negative side effects and the billions reaped by big pharma and their connection to the DSM.

You say that it's really hard to link a specific drug contributed to a specific act of violence and I would agree but it's not quakery to bring it up and It should be investigated further.

If you want to defend Psychiatry, I would be interested to hear how the profession has changed regarding the concerns and issues raised by the thud experiment in 1973.

Orac why is it a stretch to take seriously that when these drugs don’t work that they may have horrible side effects on the mind as to cause it to engage on thoughts and acts of violence including suicide and homicidal ideation.

even Michael Moore suspected psychiatric drugs may have been a cause.

"Even" Michael Moore? Is he supposed to be a particularly persuasive expert on psychopharmacology?

Orac why is it a stretch to take seriously

Because if you had any evidence for your little Just-So story you would be giving it now rather than asking us to take your bullsh1t on trust.

By herr doktor bimler (not verified) on 27 Dec 2012 #permalink

No Proof! You bet No Proof!
Where is the brain scan to identify mental illness?
Where are the blood tests?
Where are the brain chemistry tests?
Where is the evidence that psychotropic drugs work? It's all subjective. The whole field.
What do you think they are handing out candy?
How amazingly ignorant that you will not even entertain the idea that when these drugs don’t work they may have horrible side effects on the mind as to cause it to engage on thoughts and acts of violence including suicide and homicidal ideation.

Michael Moore in bowling for columbine attempted to understand the killings in columbine and looked at all sides of the issues. He was very troubled by the Psychotropic issue which I believe exists in the sandy hook, and Colorado shooting, although good luck getting the medical records unsealed.

you will not even entertain the idea that when these drugs don’t work they may have horrible side effects on the mind as to cause it to engage on thoughts and acts of violence including suicide and homicidal ideation.

Dude, you are repeating the same sentence over and over again. It's called "perseveration". Are your frontal lobes working properly?

Michael Moore [...] was very troubled by the Psychotropic issue which I believe exists in the sandy hook, and Colorado shooting

Again, if you have so little evidence to support your prejudice that you are reduced to citing a film-maker who purportedly shares it, you will have to excuse my lack of interest.

By herr doktor bimler (not verified) on 27 Dec 2012 #permalink

@Jay S

I see no citations or links to statistics to back up your statement of "majority of mentally ill people are poor", in your country let alone elsewhere. (I'm not in the USA)

Even then, you somehow manage to skip from "not discriminating" to "affecting only white rich people". Here's a clue: scroll up and read those stats posted about the Pew poll. Take a look at the divide between thoughts about gun ownership by ethnicity and class. Did it ever occur to you that these mass murders *appear* to be done by white upper class people because
a) they have more money to waste on guns and ammunition
b) they have more inclination to disregard common safety - ie. keeping them locked up and away from people
c) if in a conservative household, they're more likely to teach their kids to protect the 2nd amendment
d) that in general mental health issues are not discussed, and in this case, perhaps the family is unsupportive and unwilling to acknowledge a problem
e) that in general the people who can afford doctors in this area (and the insurance) are going to be from white middle class families. So just by chance alone you'll be finding more mentally ill people committing more murders, simply because other ethnicities and classes won't have access to medical care

In other words, without some serious studies to back you up, there's too many variables to say "it's the meds, stupid!" It could, quite possibly, be the guns, stupid.

I have experienced both medication and mental health hospitals, and can say that I did not enjoy both. I will happily agree that there is room for improvement, and of course, I don't think meds are perfect. Of course some things get approved that are later pulled; that's how science works. You make the best judgement based on the evidence, and if further evidence arises that shows the risks are too high for the benefits, you change your mind. This is no different than any other medication, so it shouldn't be singled out as if it's only happening in regards to mental health issues. The only reason people tend to do so is to create FUD about mental health issues.

Having said that: we do not have mass murders to the scale that you do here. The last time something like that happened was when guns in Australia disappeared from home-ownership. We do of course still have murders and suicides, and numerous examples can be found during just this week; but we no longer have 20+ people dying in one place from one person.

In addition, it's very likely that what needs to be done is the exact opposite of getting rid of the medications: MORE needs to be done to discourage stigma, encourage seeking medical assistance, encourage support within families/friends/workplaces, improve and study current or new medications; and so on.

Your idea is what exactly? Leave millions of mentally ill people without medications so a handful of violent criminals can go on to do worse things because they *still* receive no assistance to curb their particular habits? Forgetting of course, that the violent people are NOT representative of mentally ill people in general? And forgetting that being suicidal is not the same as being homicidal, nor that one goes with the other at all times for all people?

The one’s committing these types of crimes are already receiving mental health (white middle class) care and most likely using medications.

Uhuh. And you're doing exactly what I pointed out in my first comment on this thread: someone who is receiving mental health care - particularly for anger management or violence - may go out and kill people and that blaming the meds are just a waving of the hand by people who don't want to admit that person X had a problem in the first place, and that society is doing f* all to help them.

As for the Michael Moore thing: I was a fan once. Before I started reading more about science. I'm a far-lefty and agreed with a lot of his stuff. But now I see him for what he is, a guy who likes to make a splash. His work is not science, it's mockumentary.

Jesus is it such a stretch to take seriously that when these drugs don’t work that they may have horrible side effects on the mind as to engage it on thoughts and acts of violence including suicide and homicidal ideation.

Actually, no it's not. When I was on meds, I felt nothing, not suicidal thoughts, nor homicidal ones. The most I had were giant migraines the size of Texas and an inability to think straight. Of course, that's anecdotal, which is why I'd prefer it if you posted some actual evidence instead of blathering assertions.

READ THE BLACK BOX! IT”S NOT CANDY.

Actually, I have read the box. I have a box of antidepressants in my room right now. Have you ever bothered to think that the insert is there more for legal purposes than for medical ones?

And shit, if you are requiring mental health treatment, and have made it far enough to both a doctor and a pharmacist, at what point does anyone treat it like candy? Not to mention that every time I have ever talked to a doctor about mental health treatment, it was always explained that meds go hand in hand with some form of talk therapy.

Why do I get the feeling I'm talking to someone who's never been around mentally ill people? You are fixated on this particular issue as if it were unique in the realm of medications.

Where is the brain scan to identify mental illness?
Where are the blood tests?
Where are the brain chemistry tests?
Where is the evidence that psychotropic drugs work? It’s all subjective. The whole field.
What do you think they are handing out candy?
How amazingly ignorant that you will not even entertain the idea that when these drugs don’t work they may have horrible side effects on the mind as to cause it to engage on thoughts and acts of violence including suicide and homicidal ideation.

Ah, sorry. Here I was thinking I was talking to someone who thinks mental health issues exist. And here I am talking to a denier.

Tests may be done for some illnesses - MRIs for schizophrenia for example have been studied quite a bit - but you are assuming that these things are all known. It takes time to develop tests, especially when causes are not yet known or well understood.
http://www.ncbi.nlm.nih.gov/pubmed?term=mri%20schizophrenia

By the way, repeating a claim over and over without backing it up is pretty much an example of a crank and does not go down well here.

As usual, meds are blamed in isolation of gun control issues, which are likely a bigger factor in preventing mass murders.

Comment in moderation... hmm, wonder if I tripped the swear word filter, or the link-spam filter...

The majority of mentally ill people in this country are poor and do not receive mental health care.

This doesn't follow. The population that you're trying to leverage (which you have not demonstrated to be a majority in the first place) are those who are so badly affected that they would qualify for a pittance of SSI disability, hence Medicaid, and, after two years, Medicare. This does not amount to "do not receive mental health care."

If failure to obtain treatment leads to one's living on the streets, it's kind of, you know, difficult to assemble an arsenal. Previous involuntary hospitalizations can be a problem in this regard, as well.

It would stand to reason that the people committing the majority of mass murder incidents such as sandy hook, the colorado movie shooting, and other school shootings would fall under this category but they don’t.

Uh-huh. And how about knifings, random street assaults, and other behaviors that tend to land people in state custody? The only thing really connecting these two dots (indeed, given that Holmes had left his graduate program, would likely not have been insured any more, suggesting discontinuation of treatment) is the access to the firearms.

Michael Moore in bowling for columbine attempted to understand the killings in columbine and looked at all sides of the issues. He was very troubled by the Psychotropic issue which I believe exists in the sandy hook, and Colorado shooting, although good luck getting the medical records unsealed.

Perhaps you would like to demonstrate that they actually are. (Note that random CCHR assertions do not count.) Being "sealed" is different from "not being handed out to cranks by the heirs." There certainly are some Harris medical records in the material that was seized and subsequently released. What is known is that Harris's toxicology showed fluvoxamine in his system and that he had complained that it made him feel "too normal," suggesting the possibility of erratic compliance. Klebold's toxicology was negative.

@Narad

Uh-huh. And how about knifings, random street assaults, and other behaviors that tend to land people in state custody? The only thing really connecting these two dots (indeed, given that Holmes had left his graduate program, would likely not have been insured any more, suggesting discontinuation of treatment) is the access to the firearms.

I hinted at this in my comment - still in moderation - but the issue is not just people with guns, but people who are violent or likely to be. The opportunity to use a gun just makes it quicker and easier to kill more people in less time.

In addition, because of our universal health care, you'll find fewer poor people being unable to access mental health services. Indeed, if you are on government pensions (unemployment, disability, etc) you can obtain free psychiatric treatment.

Why is it that when someone stabs someone else, it's a personal crime, and when someone shoots 20 people it's the meds?

Well it's been a while. A very busy year here. Was on my way over here for some in depth catch up and got distracted by the gun nuts. Never as much fun as the anti-vax nuts. So much fear and paranoia...poke them with even a blunt stick and they threaten to shoot you..yawn. Same old same old.

Anyway here's hoping y'all had a great Chri....no wait..

Please accept with no obligation, implied or explicit, my best wishes for an environmentally conscious, socially responsible, low stress, non-addictive, gender neutral celebration of the summer solstice holiday, practised with the most enjoyable traditions of religious persuasion or secular practices of your choice with respect for the religious/secular persuasions and/or traditions of others, or their choice not to practise religious or secular traditions at all.

I also wish you a fiscally successful, personally fulfilling and medically uncomplicated recognition of the onset of the generally accepted calendar year 2013, but not without due respect for the calendars of choice of other cultures and without regard to the race, creed, colour, age, physical ability, religious faith or sexual preference of the wishee.

By accepting this greeting, you are de facto accepting these terms:

1. This greeting is subject to clarification or withdrawal. It is not transferable unless there has been no alteration to the original greeting.

2. It implies no promise by the wisher to actually implement any of the wishes for her/himself or others and is void where prohibited by law and is revocable at the sole discretion of the wisher.

3. This wish is warranted to perform as expected within the usual application of good tidings for the period of the so called “festive season” not exceeding 4 (four) weeks from the date of issue or until the issuance of a subsequent holiday greeting, whichever comes first, and such warranty is limited to the replacement of this wish or issuance of a new wish at the sole discretion of the wisher.

Disclaimer: No trees were harmed in the sending of this message; however a significant number of electrons were momentarily inconvenienced.

If you somehow nonetheless contrive to be offended by this message, please send your complaint to the Political Correctness Minister in the governmental system of your country of choice or the country in which you currently reside.

Thank you.

Cheers everyone
Keep up the great work.

By Sauceress (not verified) on 27 Dec 2012 #permalink

No Proof! You bet No Proof!
Where is the brain scan to identify mental illness?
Where are the blood tests?
Where are the brain chemistry tests?
Where is the evidence that psychotropic drugs work? It’s all subjective. The whole field.
What do you think they are handing out candy?

Jay S seems to be straying here from his initial "medication causes mass shootings" proposition to a more general anti-psychiatry agenda.
Where is Xenu?
Where are the thetans?

By herr doktor bimler (not verified) on 27 Dec 2012 #permalink

Indeed, one might note the lack of "brain scans," "blood tests," or "brain chemistry tests" to identify body thethans.

^ "thetans"

Next thing you know, they'll be saying that mental illness is merely a fiendish plot perpetrated by the pharmaceutical companies in order to sell meds.
OBVIOUSLY before there were pharmaceutical companies, there was no mental illness. Or so they tell us.
Seems I've heard the " no scans or blood test" argument before. Many times.

By Denice Walter (not verified) on 27 Dec 2012 #permalink

Seems I’ve heard the ” no scans or blood test” argument before. Many times.

It also seems that it might be might be going demonstrably stale. (Etc.) Sorry, Laing. Sorry, Foucault. Sorry, Szasz. The most obvious wagon has proved to have the worst hitch.

Right. Seems that the folks at LONI have been taking images of the progression of tissue destruction in schizophrenia since about 2001.
I guess you might call that 'scans'.
I wonder how they missed that.

By Denice Walter (not verified) on 27 Dec 2012 #permalink

... is it a stretch to take seriously that when these drugs don’t work that they may have horrible side effects on the mind as to cause it to engage on thoughts and acts of violence including suicide and homicidal ideation.

Aside from the rest of Jay's comments, what are your opinions about the statement above? There are indeed black box warnings on many of the psychiatric medications which do list suicidal and homicidal ideations and actions as possible side effects. Do others here disagree that these possible side effects or adverse reactions actually exist? Or are your objections above mostly to the assumptions being made that the shooter's actions were solely a result of their psychiatric medication use?

This has nothing to do with guns or gun control, but the Olympic runner who was working as a very high-priced Vegas escort was on Zoloft for depression. Will Mikey Adams et al. now blame psych. drugs for her, ah, errors in judgement?

This comment reminded me of another matter. It seems to me that most people understand or can relate to how being intoxicated or taking other drugs, such as opiates or perhaps benzodiazepines, may cause some people to lose their inhibitions and engage in risky behaviors. Typically, I've noticed that such people are labelled as drug abusers or drug-seeking. Is there any recognition or awareness that others who are prescribed these same medications and take them correctly also may experience similar loss of inhibitions or restraint?

Aside from the rest of Jay’s comments, what are your opinions about the statement above? There are indeed black box warnings on many of the psychiatric medications which do list suicidal and homicidal ideations and actions as possible side effects.

I'm aware of some of these for adolescents, as well as Chantix, but you're really going to need to enumerate the "many" part first.

Documenting the "homicidal" part of the warning would be good, as well.

@ S: I think you might be concerned about the taking of prescribed medication with alcohol or the taking of medication/illegal substances that addicts buy on the street.

They are warnings provided to the patient by his/her doctor and written patient information provided by pharmacists, about synergistic effects of taking prescribed medication, with OTC medication and/or ETOH:

http://www.scientificamerican.com/article.cfm?id=mixing-alcohol-prescri…

I am rather surprised that Jay S hasn't brought up the case of Charles Whitman's 1966 sniper murders. Sure, Whitman had not been prescribed anti-depressants or anti-psychotic drugs according all the evidence at the subsequent inquiry, but surely Jay could argue with a little bit of ingenuity that he had exposed to medication through some other channel. And now his medical records are sealed!

By herr doktor bimler (not verified) on 27 Dec 2012 #permalink

Narad did you read the disclosure of several limitations of the brain scan studies, particularly the link under etc, of the experiment conducted in 2011?

1. of the 50 paitients only 8 were antipsychotic drug-naïve at the time of the scan and the rest were receiving antipsychotropic medications. I would think a more accurate test would be to have all patients antipsychotic drug-naïve

2. The 50 patients tended to have lower IQs compared to healthy volunteers, and given evidence that IQ and cognitive abilities correlate with FA and MD.

3. unable to examine other possible factors that could influence brain measurements such as nutrition

4. unable to examine other possible factors that could influence brain measurements such as antipsychotic medication.

There is nothing conclusive about this test. And The problem with even finding 50 schizophrenics with antipsychotic drug-naïve, is you'll probably never get a consensuses that the 50 truly are schizophrenic. See the thud experiment.

Herr, I'm not saying that every case could be related to the use of Psychotropic drugs. Although it should be investigated as a contributing factor where the gunman is under the care of a psychiatrist and prescribed psychotropic drugs. Again it's not candy. These drugs are powerful and sometimes have devastating side effects.

@JayS - but in a lot of cases, it is the first thing blamed, before any evidence is presented that the individual is on any drugs whatsoever or in treatment....

I really didn't want to get involved here because I have work...
First of all, studies like Thompson et al ( PMID 11573002) did control for the effects of meds and IQ. And were replicated independently in males and females.

What they found was a "wave" of grey matter loss that proceeds from the parietal lobe forwards, over time. Loss of tissue in specific regions correlates to symptoms accordingly: thus the earlier symptoms reflect parietal, later temporal, then frontal. The symptoms enumerated are the classical, devastating symptoms of schizophrenia- both positive and negative.

Here is how the woo-meisters fly with any SB studies of SMI:
first of all, most people alive today have never observed untreated schizophrenia because the advent of anti-psychotics began in the 1950s. It is also a relatively rare condition ( about 1%) Thus they attempt to attribute symptoms of the illness to medical intervention because most people with the condition today are medicated.

However, as most psychologists and historians know ( see Fuller Torrey), schizophrenia did not suddenly break upon the scene in the 1950s: it has been around for a while. Thousands of untreated patients suffered with it for thousands of years ( it has been described in Egyptian sources). It was studied medically in the Victorian era.

Anti-psychiatrists- like those I mentioned- would have you believe that people didn't have auditory hallucinations and loss of executive functioning prior to the use of anti-psychotics. But medical -and even popular literature- from earlier periods will inform us otherwise.

Secondly the type of alt med treatments advocated for this condition has no relation to what is occuring in the patients' brains. Atypical anti-psychotics target specific neurotransmitters like dopamine and serotonin ( and others, more recently) but obviously cannot affect the loss of grey matter that Thompson and others describe.

I doubt that niacin and green juices can either.

By Denice Walter (not verified) on 28 Dec 2012 #permalink

1. of the 50 paitients only 8 were antipsychotic drug-naïve at the time of the scan and the rest were receiving antipsychotropic medications. I would think a more accurate test would be to have all patients antipsychotic drug-naïve

You'll have to excuse me if am thoroughly unimpressed by an "argument" that boils down to nothing other than that an imaging test for structural alterations is actually only detecting diagnoses of schizophrenia.

Again it’s not candy

Of course not. I've been taking psychotropic drugs for years, and my teeth are fine.

First Narad, It comes from the study itself. The paragraph below identifies the limitations identified from the study of the brain scan experiment you linked.

There were several study limitations that should be acknowledged. One limitation of the classification approach is that it does readily lend itself to localizing group differences in specific regions. The methodology presented here, however, may be used as a starting point for this purpose using randomization methods (Ardekani et al. 1998). An additional study limitation is the anisotropic voxel size, which could conceivably bias FA measurements, although it should be noted these were comparable in both groups. In addition, the DTI images were acquired with NEX=2, which does not always allow for identification of artifacts especially those from cardiac pulsation. Additionally, patients tend to have lower IQs compared to healthy volunteers, and given evidence that IQ and cognitive abilities correlate with FA and MD (Fryer et al. 2008, Schmithorst et al. 2005) an additional possible study limitation is that the discriminant function may be sensitive to generalized brain abnormalities, such as those that may be indexed by IQ, and thus not actually be specific to schizophrenia per se. Moreover, we were unable to examine other possible factors that could influence brain measurements such as nutrition or antipsychotic medication and the functional significance of the classification methodology was not investigated.

Second the Psychotropic drugs themselves cause changes to brain structure. Psychiatric Medications' Effect On Brain Structure Varies It is increasingly recognized that chronic psychotropic drug treatment may lead to structural remodeling of the brain. Indeed, clinical studies in humans present an intriguing picture: antipsychotics, used for the treatment of schizophrenia and psychosis, may contribute to cortical gray matter loss in patients, whereas lithium, used for the treatment of bipolar disorder and mania, may preserve gray matter in patients.

First Narad, It comes from the study itself. The paragraph below identifies the limitations identified from the study of the brain scan experiment you linked.

Yes, I did read it. You are stuck with the problem that there was only one misclassification in the patient group, so at least seven of the eight patients that were "naive" were correctly classified. Throwing Vernon et al. against the wall accomplishes nothing, as the trial-sourced group did not include haloperidol or rats.

The transactionalist hypothesis is dead.

Ah, slight link-breakage above. There are two.

Jay S. What do these studies mean? Are they a defense of your unwarranted double-barreled attacks on Orac?

Here...

"Orac, Stop hiding behind associations with scientology, vaccine conspirators, and quacks and address the serious issues and concerns regarding the use of Psychotrophc medications and their possible negative side effects and the billions reaped by big pharma and their connection to the DSM.

You say that it’s really hard to link a specific drug contributed to a specific act of violence and I would agree but it’s not quakery to bring it up and It should be investigated further.

If you want to defend Psychiatry, I would be interested to hear how the profession has changed regarding the concerns and issues raised by the thud experiment in 1973."

And here...

"Orac why is it a stretch to take seriously that when these drugs don’t work that they may have horrible side effects on the mind as to cause it to engage on thoughts and acts of violence including suicide and homicidal ideation."

What do we actually know about Adam Lanza?

1. His mother "claimed" he had an ASD diagnosis...not confirmed yet.

2. His brother *claimed* he had an ASD diagnosis...and also claimed he had a "borderline personality disorder"...not confirmed yet.

3. His mother removed him from school and home-schooled him...confirmed.

4. His mother legally purchased the assault rifle and other guns used in the massacre. He committed suicide with a hand gun...confirmed.

5. His mother stated to a number of her friends that his "condition" was deteriorating...confirmed.

Have you found any reliable source to confirm that was under the care of a psychiatrist and/or taking prescribed medication? Surely Orac and the posters here would like you to share that information.

Do you believe that anti-vaccine parents and their quack hero Andrew Wakefield have the qualifications to comment on psychotropic drugs...when the information about Lanza's state of mind, diagnoses, possible psychiatric care... and the prescribing of any medication is still lacking?

BTW, what are your qualifications to comment about psychotropic drugs, their purposes and their side effects?

There is nothing conclusive about this test. And The problem with even finding 50 schizophrenics with antipsychotic drug-naïve, is you’ll probably never get a consensuses that the 50 truly are schizophrenic. See the thud experiment.

I skipped this before. As you seem to prefer intoning "the thud experiment" repeatedly rather than actually identifying what you're talking about, I will note that it is none other than old friend "On Being Sane in Insane Places." Great paper. It also does nothing whatever to support the underlying contention that schizophrenia is not an organic disease.

@lilady,
I think the strongest indication that Lanza was or could have been "on the spectrum" is a news story (unfortunately I don't have a link offhand) that briefly quoted someone who claimed to have worked with him in science classes. Per this individual, he required supervision in the lab because he did not react when he touched open flame, and there concerns that he might literally set himself on fire without noticing. It's not well-known (the article author seemed to make nothing of it), but evident insensitivity to pain is well-documented, if not necessarily common, in autistic people. I believe it's one manifestation of a wider pattern of abnormal sensory perception in ASDs. I also suspect it could be a rare case of a secondary "condition" being OVERreported.

Another interesting angle on this is that there is a case of a spree shooter who was shot, and seemed unaware of his injury when taken into custody. At the time (a LONG time ago), he was declared "schizophrenic".

David N. Brown
Mesa, Arizona

By David N. Brown (not verified) on 28 Dec 2012 #permalink

@ David N. Brown: The ASD diagnosis has not officially been confirmed...that is the same *claim* made by his mother, his brother and by others who have been interviewed. In any case it is immaterial to his crime.

The mass murders were committed by a psychopathic killer...whether or not he was under treatment and whether or not he was prescribed medication.

Sorry, Laing. Sorry, Foucault. Sorry, Szasz.

I liked Laing back in the days, but read him for the poetry rather than the psychology. Sanity, Madness and the Family left me wondering, if familial mixed messages and convoluted miscommunication are so toxic, how anyone ever survives childhood without schizophrenia.

By herr doktor bimler (not verified) on 28 Dec 2012 #permalink

Because I really enjoy addressing the lurkers, I'll have a go:

our critic above lists some of the ((scary)) side effects from psychiatric meds, e.g. a loss of grey matter, structural changes in the brain.

These objections are common enough from anti-psychiatry advocates, e.g. Gary Null will list each and every side effect and exaggerrate its importance HOWEVER ( big however) he and his ilk do NOT bother is list any benefits of taking the drug.

Now why do you suppose he does that?

Because he doesn't want you to know that the drugs are efficacious in reducing unwanted symptoms in many people. So much so that patients are willing to suffer side effects in order to get symptom relief.

These drugs often have serious side effects like weight gain, higher blood sugar and other problems BUT patients tolerate them because the SYMPTOMS of the illness itself are so much worse for them:

they hear voices that insult them or tell them what to do
they suffer delusions that may be frightening
they may be unable to live independently
they may have to give up their studies or jobs
they often have difficult relationships with family and friends
they have problems planning and sticking to a task
they may lose interest in things they used to like
they have little control over their thought process, memory and cognitive abilities, like learning.

This is by no means a complete list- just what I can write off the top of my head.

In short, these people suffer; they usually first become disabled by the illness as late adolescents/ young adults- a time when most people are planning their future: preparing for a career, completing their education, becoming independent of their parents, earning money and starting serious relationships.

The symptoms of SMI interfere with everyday life across the board and cause SUFFERING. Many patients find meds acceptable DESPITE the side effects because they are then enabled to live a more average life and have a greater chance for living as independent adults. With a REDUCTION of disabling and uncomfortable symptoms.

By Denice Walter (not verified) on 28 Dec 2012 #permalink

Orac why is it a stretch to take seriously that when these drugs don’t work that they may have horrible side effects on the mind as to cause it to engage on thoughts and acts of violence including suicide and homicidal ideation.

Saying we don't "take it seriously" is a strawman. We do indeed take the possibility seriously. However, we take it seriously and we examine it from a scientific perspective. And when we examine it from that scientific perspective, we observe that it has a very, very serious problem: it is unfalsifiable.

Let's do a thought experiment. You are granted one visit to an Oracle, who knows the answer to everything and will answer one single question for you with absolute truth. So let's say you go to the Oracle and you ask him "Do psychiatric drugs play any role in these homicidal incidents?" And he answers (to your surprise) "No; every single person who has gone on psychiatric drugs and later committed one of these atrocities would have committed such an atrocity even if they'd never been placed on medication."

Now here's your question: knowing now that this is the truth of the matter, how would you prove it to anyone else? No one's going to believe you just because the Oracle told you, because they weren't there to hear him. And anyone you try to tell, "No, those people didn't kill because psychiatric drugs made them homicidal; they were already homicidal" will just throw at you the same arguments you're throwing out now: "How can you tell?? Maybe those people were put on psychiatric drugs for non-homicidal mental illness but psychiatric drugs turned that into homicidal mental illness; why is it such a stretch to take that seriously??" They keep insisting that their hypothesis must be very meaningful, because it fits so well with the evidence. They don't realize that it would also fit with any evidence (except for the very unlikely situation where rampage killers were only rarely prescribed drugs for mental issues prior to going on homicidal rampages.) Evidence can only support a hypothesis to the extent that evidence could have failed to support it.

When you can't subject a hypothesis to reality testing that will show whether it is false, that doesn't mean it's not false. As our thought experiment showed you, you might know for a fact that an unfalsifiable hypothesis is completely false, but be unable to demonstrate it to anyone who has chosen to believe it.

By Antaeus Feldspar (not verified) on 28 Dec 2012 #permalink

I liked Laing back in the days, but read him for the poetry rather than the psychology.

I have previously recommended Conversations with Adam and Natasha, and I will do so again.

David Brown:

t’s not well-known (the article author seemed to make nothing of it), but evident insensitivity to pain is well-documented, if not necessarily common, in autistic people.

And in people who do not have autism. People like me. I am not sensitive to pain as much as others, so I did get injuries without knowing how they happened. I am not totally insensitive, it is just that I don't feel it unless it is at a certain level. Fortunately I do react quickly to burns, but not to cuts and scrapes.

I am not sensitive to pain as much as others, so I did get injuries without knowing how they happened.

IT'S LEPROSY!

Also known as an anesthesiologist's nightmare.

Also known as an anesthesiologist’s nightmare.

I have been told by said crowd that my anatomy is some sort of stuff of intubational happy dreams.

I have been told the exact opposite. Apparently getting the recessive gene for both blue eyes and red hair (only child in my family) affects other systems.

The dreaded "Black Box Warning" ...there are a slew of drugs prescribed and OTC) where the FDA has ordered the manufacturer to place "Black Box Warnings" on.

They are definitely NOT drugs prescribed by psychiatrists. Some of the "Black Box Warnings" are placed on these drugs because they may be totally ineffective for what they are prescribed for, due to a mutation in one gene:

http://www.genomeweb.com/blog/fdas-new-plavix-black-box-warning-could-t…

BTW, what are your qualifications to comment about psychotropic drugs, their purposes and their side effects?
A computer, an internet connection and google searches. LOL! I'll admit they are weak.

And Orca, I finally got around to reading your article on Cry the antivaxers and quacks: ‘Twas big pharma that led Adam Lanza to kill and I
I can't disagree with anything you said, as you even mentioned some of the concerns I have about Pychotropic medications, but I would add that there are new studies out today, that question the effectiveness of antidepressants.

Bottom line, I'll admit my initial responses to your blog were sparked primarily by the tile of your blog because I see nothing wrong with a healthy skeptisism of Big pharma.
I can't be the only one that responds to a blog based on the heading, after all isn't it the title that is suppose to grab the readers attention? Anybody else admit to this?

Jay S:

And Orca, I finally got around to reading your article

I am worried about the fact that:

1: You just got around to reading the article you are commenting on. Actually most people actually read the articles before commenting and do not just go by the title. The title is there to get you to read the article!

2: You have his 'nym wrong. He is not a whale (okay, more accurately a very large carnivorous dolphin), but an advanced computer from an old UK scifi show, Blake's 7. Oh, and he is also not a vacuum cleaner.

But at least you recognized that you needed to read the article. But do get to know his name! You might try clicking on the link in his name under the title of the article.

anaesthesia nightmare: I remember waking up during a throat surgery when young. during the later days, I was so sick I didn't want to die but close.

Alain

@ Jay S. I'm rather surprised that you admitted to not reading the article BEFORE you posted, and that you are owning up to your (non) qualifications about the topics discussed here.

In the future, please read what Orac has stated and what other posters, who actually have "credentials" have stated, and the links they have provided.

I would add that there are new studies out today, that question the effectiveness of antidepressants.

Which, I suppose, somehow ties into your can't-quite-actually-cite-it repeat invocation of Rosenhan, which is 30 years old. What next, Adler et al.? (Note: not what the title claims.)

@Jay

I can’t be the only one that responds to a blog based on the heading, after all isn’t it the title that is suppose to grab the readers attention? Anybody else admit to this?

No. I never comment unless I've actually read at least part of the blog post, and even then I don't like to comment if I've only read partially because I can miss out on important context that way. I even don't like to comment before reading *all* of the blog comments that follow it because I can repeat what someone else says, or miss another important contextual point.

The whole idea of blogs is to READ first.

But hey, I'll give credit where credit is due: at least you went and read it (a bit late in the game, but nevertheless...) and was willing to be more open minded.

JayS

Anybody else admit to this?

No.

I can’t be the only one that responds to a blog based on the heading, after all isn’t it the title that is suppose to grab the readers attention?

Yes, it's supposed to get the reader's attention. So you read the article!
Thank you for admitting that you didn't.

It's really easy to be arrogant, and it's really easy to point out the arrogant attitudes of others. It's not as easy to admit when you've been wrong. Thanks.

Jumping in to ask - wasn't there something on Science-Based Medicine several months ago about a study which found that anti-depressants weren't as effective in mild-moderate depression as in moderate-severe? (I tried searching, but my google-fu is weak today and SBM isn't loading for me for some reason). That might be the study Jay S is talking about.

And Jay S: the title is meant to get you to read the post -especially in Orac's case. And you might enjoy reading the other blog (referenced above) where his alter-ego and other friends post very interesting things.

@lilady: I'd have cut him a break on the Orac/Orca ...could have been a typo (so says the one who has to correct them often...) and he had spelled it correctly in previous comments.

@ MI Dawn: Chris brought up Jay's Orac/Orca mistake, but I might have not given Jay "the break"...because of the personal attacks he launched against Orac up thread.

MI Dawn: Jay S. stated "I would add that there are new studies out today, that question the effectiveness of antidepressants"...yet did not provide link(s) to those new "studies".

I guess it's an honest mistake- Orca blogs over @ whale.to.

By Denice Walter (not verified) on 29 Dec 2012 #permalink

@ lilady:

A prof of mine ( also a therapist) questioned Rosenhan as being evidence of the inefficacy of psychology:
people said (lied) that they had a serious symptom ( hearing voices) which was then investigated.
Now suppose it was a physical symptom instead being presented- the subjects said ( lied) they they had dizziness or bleeding- wouldn't it be correct to further investigate and seek out the source of the dizziness or bleeding? Wouldn't a cautious practitioner order tests and perhaps observe the person? To rule out serious illness associated with dizziness or bleeding-( and lying).

That's just what the institution was doing: they were observing the person *who heard voices* and probably testing as well. With psychological symptoms, it isn't as cut and dry as the other more directly medical case. They observe how the person behaves and answers questions which doesn't take as little time as blood tests and scans for the other- more obviously- medical case.

By Denice Walter (not verified) on 29 Dec 2012 #permalink

@ MI Dawn:

I searched around SBM and found a few on the topic: the most likely being "Anti-depressants and Effect Size" by Harriet Hall, July 2011.

By Denice Walter (not verified) on 29 Dec 2012 #permalink

MI Dawn:

@lilady: I’d have cut him a break on the Orac/Orca

That was me.

I am also glad that Jay confessed to not reading the article. I sometimes take a great deal of day to read the whole thing, and will often have to go up and read parts again to make sure that I have not remembered something wrong (and sometimes go and delete the comment I was making).

The point being is that neurology and psychology are very complicated and always evolving. I have personally benefited from talk therapy when I was twelve years old after a trying year following my mother's death. Plus I have known people who have had help from both talk therapy and medication. And others it did not.

Next quarter my daughter will be taking bio-psychology, its description:

Examines the biological basis of behavior, the nervous system, how it works to control behavior and sense the world, and what happens when it malfunctions. Topics include learning and memory, development, sex, drugs, sleep, the senses, emotions, and mental disorders.

I should have some very interesting conversations with her, much like I did when she took an American history class last quarter.

That’s just what the institution was doing: they were observing the person *who heard voices* and probably testing as well. With psychological symptoms, it isn’t as cut and dry as the other more directly medical case. They observe how the person behaves and answers questions which doesn’t take as little time as blood tests and scans for the other- more obviously- medical case.

@Denice, There is a major difference in the methods of observing patients for physical problems like nosebleeds or dizziness, as compared to holding and testing a person to observe their behavior. It seems clear that perhaps the latter would require more observation and assessment time, however, in the case of nosebleeds and other more overtly physical symptoms, the patients are not typically required/forced to take medications which might directly effect their symptoms, if any.

A prof of mine ( also a therapist) questioned Rosenhan as being evidence of the inefficacy of psychology:
people said (lied) that they had a serious symptom ( hearing voices) which was then investigated.

There is also the small matter that it wouldn't work in the modern day, in which inpatient psych admissions are hard as hell to come by, outside of luxury operations such as Duncan Lodge.

It seems clear that perhaps the latter would require more observation and assessment time, however, in the case of nosebleeds and other more overtly physical symptoms, the patients are not typically required/forced to take medications which might directly effect their symptoms, if any.

The Rosenhan patients trivially evaded medication. The simple fact of the matter is that the only way you're going to be forced to take medication in a psych unit is if you're so out of control as to need physical restraints otherwise. One can be intimidated into compliance, of course, with suggestions of having a longer stay or even being transferred to a state hospital, but this is no longer in the realm of somebody who is just around for a look-see.

The simple fact of the matter is that the only way you’re going to be forced to take medication in a psych unit is if you’re so out of control as to need physical restraints otherwise.

No, this is not always the case. One does not have to be physically aggressive or so out of control as to need restraints or otherwise in order to be "forced" to take medications. Perhaps that is the manner or intent of the laws governing such treatments, but it is not the reality of the happenings at certain hospitals unfortunately.

Aside from the rest of Jay’s comments, what are your opinions about the statement above? There are indeed black box warnings on many of the psychiatric medications which do list suicidal and homicidal ideations and actions as possible side effects.

I’m aware of some of these for adolescents, as well as Chantix, but you’re really going to need to enumerate the “many” part first.

Chantix was the drug I had in mind, which mentions homicidal thoughts or actions as an adverse type of reaction.

@Narad, It is for adolescents that many psychiatric medications list suicidality as an adverse reaction. Seroquel, Prozac, Cymbalta, and Effexor just to name a few, but even Klonopin lists it as a potential adverse reaction for everyone. I doubt that suicidal thoughts or actions are a typical reaction, but my impression is that it is possible since it is listed. No? What type of information would you like in order for me to enumerate the "many" part, a list of drug names?

What I don't quite yet understand is the nature of the distinction between adolescents taking those medications as compared to adults. Why might a particular drug cause an adolescent to be suicidal, but not an adult? If it is the tendency for adolescents to be more impulsive in their actions, then couldn't many adults also fall into this category? Personally, I don't think enough consideration is given towards the side effects and interactions for patients who are being prescribed multiple drugs. The possible interactions are listed in the monographs and elsewhere, but it seems physicians overlook and dismiss those warnings almost as a matter of practice. I've known people to be on 5 to 6 different psychiatric types of medications all at the same time, and many for off-label uses. It seems to me that such a cocktail would be completely unpredictable, as the potential for serious adverse reactions with such combinations has never been tested.

Perhaps that is the manner or intent of the laws governing such treatments, but it is not the reality of the happenings at certain hospitals unfortunately.

Well, if it's going to come down to actual experience vs. vague assertions, the anecdata is going to win. And I've spent more than my share of time visiting psych wards.

@ Narad: My friend's sister *manages* to get herself admitted to a non-public psych hospital, regularly (*faux* suicidal ideations). The psych hospital is a separate division of a large not-for-profit hospital.

M. also lives in a spacious expensive 1-bedroom rental apartment, has a car and has private medical coverage (~ $1,200/month), in addition to Medicaid and $ 800/month SSI. All of her expenses are paid for by her parents' considerable assets that were left to my friend. A special needs trust was not appropriate for M...because she would be ineligible for Medicaid and SSI and because she would blow through her inheritance in record time. She's not eligible for SSD, as she never worked a day in her life.

Her diagnosis IIRC is schizophrenia...diagnosed around age 20...and is well managed by medication prescribed by her private psychiatrist.

She is very intelligent, knows how to "game the system" and is very manipulative...no different than someone with a physical condition who used her physical condition to control and manipulate her parents and her surviving sibling.

@ Narad:

About securing admissions- I counselled parents of individuals with SMI :. I could tell you stories!
( ACTUALLY I can't- for obvious reasons)

But a friend with an adult child who has SMI found that because the people his son lived with did not attempt to get him further treatment, he languished for a long time. He was medicated ( Zyprexa) which didn't do much about the hallucinations/ delusions/ odd activities he engaged in . Only when another family member became frightened when he talked about killing the guy who lived next door- by burning his house down with him locked inside- were the police finally called ( despite objections from other family members!) and the long, arduous process was set into motion resulting in- 2 weeks at a facility, a month of week-day day hospital and ( recommended - not followed) long term day treatment and monitored clozapine ( the latter,accepted).

This is a person with severe positive and negative symptoms ( from a family with an extremely high rate of schizophrenia and schizophreniform illness) who is indigent, can't care for himself, has other health issues and is terribly in need of assistance. In a sophisticated city.
Only 2 weeks. And this was several years ago- it might be 10 days now,

By Denice Walter (not verified) on 29 Dec 2012 #permalink

@ S:

Here is a possibility that meds may make a person who has had ideation like this in the past, more active -thus more able to carry through- or more likely to talk about it.
It's also possible that they're being given meds without counselling to follow up on these thoughts.

Drugs like Abilify might help negative symptoms a bit BUT if the person's executive functioning isn't so great, the increased feelings of energy might not go into productive activities like self-care or work but into increased habitual actions like recreational actvities or buying things.

By Denice Walter (not verified) on 29 Dec 2012 #permalink

@lilady, I'm not an attorney, but from what you describe, that is the type of situation that a Special Needs Trust would best address. The Trust assets would not be in the name of the child/patient, but in the name of the Trust, and thus would not impact her SSI or Medicaid benefits. If the Trust is set up correctly, the disbursement of funds would be controlled and monitored to make it impossible for her to blow through the money.

If she has Schizophrenia and is not able to work due to her disability, why do you think she is gaming the system? Is it because of the assets of her parents? Those are not her assets, but if she has indeed inherited a large sum of money and is hiding it so as to collect public assistance, then I agree that would be considered 'gaming the system', or fraud.

Chantix was the drug I had in mind, which mentions homicidal thoughts or actions as an adverse type of reaction.

Chantix isn't a psychiatric medication.

@Narad, It is for adolescents that many psychiatric medications list suicidality as an adverse reaction.

Yes, I noted this in the very comment that you're replying to.

Seroquel, Prozac, Cymbalta, and Effexor just to name a few, but even Klonopin lists it as a potential adverse reaction for everyone.

"Even" Klonopin? The problem that I have here is that you're indiscriminately mixing drug classes and dumping them all in a single basket. To say that clonazepam isn't exactly like venlafaxine would be to grossly understate the case. (The former, in two challenges, provoked a "make this stop now" reaction, FWIW.)

I doubt that suicidal thoughts or actions are a typical reaction, but my impression is that it is possible since it is listed. No?

Sure, it's from a review of trial data. Suicidial ideation isn't a great outcome, particularly from a patient perspective. This is the great frustration of seeking relief with SSRIs and SNRIs; by the time one is looking for medical attention, it's entirely likely that the relief desired is immediate, which isn't how it usually works.

What type of information would you like in order for me to enumerate the “many” part, a list of drug names?

If the idea was merely to refer to the blanket warning on antidepressants use in adolescents, feel free to skip it. I was talking about adults, which is why I carved this out in the first place.

What I don’t quite yet understand is the nature of the distinction between adolescents taking those medications as compared to adults. Why might a particular drug cause an adolescent to be suicidal, but not an adult?

Note also that there's reduced suicidality in the 65+ population. I would be cautious in asserting causation. The very warning that you're invoking quite clearly notes that suicide "is a known risk of depression and certain other psychiatric disorders, and these disorders themselves are the strongest predictors of suicide." Suicidal ideation and suicidality are not the same thing.

If it is the tendency for adolescents to be more impulsive in their actions, then couldn’t many adults also fall into this category?

Again, shooting one's mouth off and shooting one's head off aren't the same thing. The impulsivity of adolescents may as well go to the method of reporting the symptom; I don't know how these data break out.

Personally, I don’t think enough consideration is given towards the side effects and interactions for patients who are being prescribed multiple drugs. The possible interactions are listed in the monographs and elsewhere, but it seems physicians overlook and dismiss those warnings almost as a matter of practice.

Do you think this is on a whim, or that the subjective reportage of the patient might have a role here?

I’ve known people to be on 5 to 6 different psychiatric types of medications all at the same time, and many for off-label uses. It seems to me that such a cocktail would be completely unpredictable, as the potential for serious adverse reactions with such combinations has never been tested.

Skipping the "types of" bit, one does not wind up taking five or six psychiatric drugs out of the blue. In fact, I'm having a hard time even coming up with what such a recipe would be, and I'm wondering whether you might be confusing the presence of prescription bottles with actual current use. In any event, my anecdata points to watching such patients like a hawk, including frequent lab work.

^ "reaction in my case FWIW", sorry. Ditto for the blown blockquotes.

@ Narad: My friend’s sister *manages* to get herself admitted to a non-public psych hospital, regularly (*faux* suicidal ideations). The psych hospital is a separate division of a large not-for-profit hospital.

With respect to Rosenhan, though, whatever the motivation for the behavior you're describing, there's an existing diagnosis severe enough to warrant SSI. Rosenhan's pseudopatients appeared out of the blue (aside from Rosenhan himself, who presented with the knowledge of two staff members).

Just a few notes before I go:
altho' I wouldn't want to entangle things any more- perish the thought-

People can have a SMI and be unable to care for themselves and STILL learn how to manipulate others.
Just as small children can manage to wheedle what they want out of parents who had vowed that they would never give in to their demands.

So a person can be legitimately disabled ( to a DEGREE) and play it up in order to get more perks. Secondary gain. Just like a child can play at being sick or being unable to do a chore to get out of doing what they're supposed to.
Manipulators don't need to be high functioning adults.

And people can spot their game ( as lilady has).

Woo-meisters might implicate all psychiatric meds for suicidal ideation. Most of us have heard about SSRIs. Typical and atypical anti-psychotics work differently from anti-depressants.

About the poly-pharmacy:
perhaps to control side-effects from the primary meds? But still, 5-6 sounds excessive. (Recently they have been adding anti-psychotics to anti-depressants in cases of difficult to treat depression).

Chantix isn't a psychiatric med:
I believe the reports I heard about it implicated it in the case of a musician WITH A HISTORY of mental illness who attempted to kill another person.
That's different - if the person already had a history which makes THAT a risk factor;
Although I'm sure that it has frightened some smokers ( without a history) away from the med.

By Denice Walter (not verified) on 29 Dec 2012 #permalink

@Chris and lilady: my apologies for mixing up who said what. I should have withheld my comment - a lot of stuff going on here and I wasn't paying full attention. I agree Jay was wrong with not reading the post before commenting.

@Denice: thanks, I think that was the post I was thinking of. I thought Steve Novella had written it, not Harriet Hall. Could have been why my Google search didn't find it! SBM is finally loading for me tonight. I don't know what was wrong earlier but I've had computer issues all day.

@ S: About Special Needs Trusts; M's parents did set up a Special Needs Trust, which was unfunded. Parents of disabled dependent children set up that Trust and leave it unfunded, with provisions set up to fund it, upon the death of the last surviving parent. I had an unfunded Trust set up for disabled son and had he survived both of his parents, it would have funded with enough money to "throw off" ~ $ 20,000/yearly income to pay for his physical therapy. Under Federal regulations, Special Needs Trusts money cannot be used for housing or food:

http://www.disabilityrightswa.org/special-needs-trusts

"How does a Special Needs Trust preserve SSI and Medicaid eligibility?

SSI pays for food, clothing, and shelter. Medicaid covers basic medical care. A Special Needs Trust allows funds to be used for anything not already covered by SSI or Medicaid. For instance, money from a Special Needs Trust cannot be used to pay the rent, because SSI already pays for housing. But money from a Special Needs Trust can be used to pay for furniture or a computer, because SSI and Medicaid do not cover these expenses. Other expenses a Special Needs Trust may fund include education, equipment, transportation, entertainment, travel, and out-of-pocket medical and personal care expenses.

A Special Needs Trust must be irrevocable. This means that once the money goes into the trust, the beneficiary cannot remove it. If the beneficiary has the ability to remove the funds, SSI and Medicaid will count the money in the trust as an asset belonging to the person with a disability."

Yeah, M. went to an attorney to try and get her hands on the money, and lied to her attorney about "her inheritance which was 'stolen' by my friend".

My friend's sister M. is 60 years old and I have known her and her parents for 35 years...and she is manipulative, with many elements of a Narcissistic Personality Disorder. What makes you think that a person diagnosed with schizophrenia cannot have a personality disorder, as well?

I believe the reports I heard about it implicated it in the case of a musician WITH A HISTORY of mental illness who attempted to kill another person.
That’s different – if the person already had a history which makes THAT a risk factor;
Although I’m sure that it has frightened some smokers ( without a history) away from the med.

I suspect that you're thinking of Carter Albrecht. I'm not aware of a preexisting psychiatric history. He did, however, have quite the BAC at the time of the incident. A more practical problem with Chantix may be that partial nicotinic receptor squatting can also increase smoking as a compensatory maneuver in some individuals (I seem to recall that this was a single-digit percentage, but I'm not finding it readily), Once again, there aren't many magic bullets.

@ MI Dawn: No apologies necessary...as long as you mixed up my "nym with Chris! Besides, Denice Walter located an Orca who blogs at whale.to; perhaps "Jay S" confused his sources. :-)

Chantix isn’t a psychiatric medication.

Yes, thank you for the correction. I had mentioned it in thinking about how it might be possible for someone to be to taking a medication that when combined with their other medical conditions, if any, might cause them to lose control and possibly commit homicide.

Seroquel, Prozac, Cymbalta, and Effexor just to name a few, but even Klonopin lists it as a potential adverse reaction for everyone.

“Even” Klonopin? The problem that I have here is that you’re indiscriminately mixing drug classes and dumping them all in a single basket.

I was taking about 'psychiatric medications', and I misused the term as describing medications prescribed by psychiatrists. Yes, I was dumping all of the typical psychiatrist-prescribed medications, which may cause suicidal thoughts, desires or actions into one basket. According to the monographs, those medications do span drug classes. I will try to chose my words more carefully, as best I can.

To say that clonazepam isn’t exactly like venlafaxine would be to grossly understate the case. (The former, in two challenges, provoked a “make this stop now” reaction, FWIW.)

I'm not sure what you are referring to in the "make this stop now" reaction. I am not indiscriminately mixing drug classes, and the monographs both mention the same adverse reaction of suidicality, which was my point.

If the idea was merely to refer to the blanket warning on antidepressants use in adolescents, feel free to skip it. I was talking about adults, which is why I carved this out in the first place.

It was to offer my opinion and experience. I think certain psychiatric medications, especially when used in combination can indeed cause adults to think about suicide, want to commit suicide, and actually commit suicide, as well as lose control of their emotions where had they not been on the medications, they would have had better control. I think too many people assume physicians appropriately and responsibly dispense such medications, and that is not my experience or observation.

Personally, I don’t think enough consideration is given towards the side effects and interactions for patients who are being prescribed multiple drugs. The possible interactions are listed in the monographs and elsewhere, but it seems physicians overlook and dismiss those warnings almost as a matter of practice.

Do you think this is on a whim, or that the subjective reportage of the patient might have a role here?

Not a whim. Subjective reporting from patients, personal experiences and observations of physicians, combined with the reports and/or findings of some investigations and medical board cases.

I’ve known people to be on 5 to 6 different psychiatric types of medications all at the same time, and many for off-label uses. It seems to me that such a cocktail would be completely unpredictable, as the potential for serious adverse reactions with such combinations has never been tested.

Skipping the “types of” bit, one does not wind up taking five or six psychiatric drugs out of the blue. In fact, I’m having a hard time even coming up with what such a recipe would be, and I’m wondering whether you might be confusing the presence of prescription bottles with actual current use. In any event, my anecdata points to watching such patients like a hawk, including frequent lab work.

Remove the words "types of" as a correction please. Sadly, I'm not confusing the presence of prescription bottles with actual current use. I presume from some of the responses here that it is not typical or accepted practice that patients take 5 or 6 different psychiatric medications concurrently. Are medications for Alzheimer's disease considered as psychiatric medications or neurological? If they are considered as psychiatric, then I'd need to up my count to 6 or 7. I'm not messing with you and I'm not trying to argue, this is just my experience. I agree such patients should be watched like a hawk, but I suggest that moreso about the the physician prescribing such cocktails. In my opinion, based on direct observation and experience, too many physicians are irresponsibility prescribing excessive drug cocktails, and not enough physicians are speaking out about it on behalf of shared patients. BTW, that's why I like this blog. At least Orac is speaking up about bogus treatments. Gotta give him a lot of credit for that. I don't think I've ever heard a physician call another physician a quack, even when they are diagnosing a shared patient by pushing their arm down (ART) or doing other justly described quack treatments.

Not a whim. Subjective reporting from patients, personal experiences and observations of physicians, combined with the reports and/or findings of some investigations and medical board cases.

I meant the prescribing itself.

I meant the prescribing itself.

You mean the prescribing itself as in whether patients are being actually being prescribed that many medications? That's not a whim opinion either, but a documented fact in certain specific medical records.

Please pardon me for working piecemeal; I apparently have a habit of blowing the markup with longer form replies.

I’m not sure what you are referring to in the “make this stop now” reaction.

I meant that I have attempted venlafaxine twice, spaced by over a year, and on both occasions, I wanted it out of my system immediately. Took about two days to baseline. Mileages vary.

I am not indiscriminately mixing drug classes, and the monographs both mention the same adverse reaction of suidicality, which was my point.

You were in fact mixing drug classes indiscriminately. SSRIs and SNRIs aren't benzodiazepines, which work on GABA receptors. You have also been mixing suicidal ideation with suicidality.

You mean the prescribing itself as in whether patients are being actually being prescribed that many medications? That’s not a whim opinion either, but a documented fact in certain specific medical records.

No, whether the prescribing is based on patient reporting of inadequate response. You seemed to be suggesting that tossing five or six agents (which, again I'm having a hard time coming up with on a menu of plausibility; dragging Alzheimer into the mix is absurd) at a psych patient was a routine approach.

Even though these meds are embraced by society today, until you've lost a loved one due to these drugs, you will never know how much I loathe the mass drugging of American society. The new DSM is now medicalizing just about every human emotion. American society has been told we are all nuts in need of medication. It's an 80 billion dollar a year windfall for Big Pharm. Children in foster care are so drugged, they are condemned to a life of cognitive disorders and drug induced psychosis. I lost a loved one to these drugs, a sensitive, wonderful person who would never have hurt himself or anyone around him. You can loathe the drug critics all you want, but we've become a psychotropically altered society!

@S

What I don’t quite yet understand is the nature of the distinction between adolescents taking those medications as compared to adults. Why might a particular drug cause an adolescent to be suicidal, but not an adult?

How does one distinguish between symptom - suicidal thoughts - and side effect - more of same?

I had mentioned it in thinking about how it might be possible for someone to be to taking a medication that when combined with their other medical conditions, if any, might cause them to lose control and possibly commit homicide.

I'd like to see some stats that shows that mentally ill people are more 'out of control' or more likely to be out of control, than anyone else.

Or why only mentally ill people on meds are more likely to commit murder than your average person on meds. Why does being on an SSRI make you more likely to kill someone than being on a blood-thinning med?

I think certain psychiatric medications, especially when used in combination can indeed cause adults to think about suicide, want to commit suicide, and actually commit suicide, as well as lose control of their emotions where had they not been on the medications, they would have had better control.

As compared to thinking about suicide, wanting to commit suicide, trying and/or succeeding whilst both *not* on meds *and* already being depressed?

I think too many people assume physicians appropriately and responsibly dispense such medications, and that is not my experience or observation.

My experience and observation has largely been the opposite. Actually, my experience has been that the nurses were less responsible than the doctors who did the prescribing.

@ flip:

Perhaps people might be mixing up problems with impulse control and mental illnesses per se. Some people with a mental illness might have problems with impulse control but others might have quite the reverse problem. The two concepts are not synonomous. Again, the idea of executive function/ dysfunction comes in handy here- being able to manage and control response to impulses... or not.

And how do you differentiate a symptom from a side effect?
I don't know exactly but I would tend to think that a symptom exists prior to any medication- and is part of a constellation that defines the syndrome- and a side effect transpires only after starting on a med and should cease when the meds aren't taken any longer, with some exceptions.

Because we're discussing mental conditions, we sho]ould note that some symptoms/ side effects might be internal, private and perhaps, not discussed.

Thoughts and actions are not the same thing, although some religious folk might say otherwise.

By Denice Walter (not verified) on 29 Dec 2012 #permalink

I am not indiscriminately mixing drug classes, and the monographs both mention the same adverse reaction of suidicality, which was my point.

You were in fact mixing drug classes indiscriminately. SSRIs and SNRIs aren’t benzodiazepines, which work on GABA receptors.

I think I need to clarify some things. IIRC, this was my original comment:

There are indeed black box warnings on many of the psychiatric medications which do list suicidal and homicidal ideations and actions as possible side effects. Do others here disagree that these possible side effects or adverse reactions actually exist?

In the statement above, it was not my intent to make any distinction between drug classes, SSRI, SNRI, benzodiazepines or otherwise, but rather only to state that many psychiatric medications and/or drug combinations may either cause such tendencies or actions, or effect someone with a pre-existing condition in such a way as to result in those same thoughts, tendencies or actions. This opinion seems consistent with the monographs of the specific drugs I did eventually mention. I am quite clear on the differences between the drug classes for many of the most commonly used medications, particularly those in the psychiatric, pain management, and neurological fields. I was confusing the term suicidality with suicidal ideations, and again, thank you for the clarification.

In any case, I don't necessarily care what group or class of medications one may describe - if any medication has the potential to produce those effects/behaviors in certain patients, then that is the issue. To the best of my knowledge, other groups of medications don't have as many such warnings as do the psychiatric medications.

@flip, it is not my opinion that mentally ill people are more dangerous, or more out of control than others. My opinion in general is that mental health patients tend to more frequently be the victim, rather than the perpetrator of crimes. In no way am I defending or dismissing the actions of Adam Lanza as being a result of medications, nor do I consider him a typical mental health patient. I do consider him as having been mentally ill. Surely psychopaths are considered as being mentally ill? In any case, I don't know anything about him, his history, his family, etc., and so I prefer not to speculate about him as an individual.

You seemed to be suggesting that tossing five or six agents (which, again I’m having a hard time coming up with on a menu of plausibility; dragging Alzheimer into the mix is absurd) at a psych patient was a routine approach.

This is an absurd approach to treatment towards any patient, not only psych patients. It is reassuring to see that you seem to agree. What is really absurd is that this is indeed a routine approach amongst a certain group of practitioners for a certain patient population, whose primary condition is not even necessarily in the mental health area. The time will come when I can more openly discuss this absurdity. (Now, that last comment is probably clear as mud, but will have to do for now.)

How does one distinguish between symptom – suicidal thoughts – and side effect – more of same?

A good, well-trained, experienced, and skilled practitioner should be able to do this under the right circumstances. We need more of them. In general, physicians need better training and continuing education regarding the effects and interactions of the medications they are prescribing. They need to be able to more readily recognize drug interactions, adverse reactions, overdoses, and the like. Considering the number of practitioners dispensing herbs and other alternative remedies, it only serves to complicate and heighten this concern. IMO

Thoughts and actions are not the same thing, although some religious folk might say otherwise.

Now that's funny, and so true.

I have previously recommended Conversations with Adam and Natasha, and I will do so again.

Laing had an enviable ability to defamiliarise the familiar,* and to expose the wonderful weirdness that we take for granted in ordinary human existence. In my ideal alternative universe he was a playwright.

* As well as the family.

By herr doktor bimler (not verified) on 29 Dec 2012 #permalink

To the best of my knowledge, other groups of medications don’t have as many such warnings as do the psychiatric medications.

Right, but you're counting a single blanket warning on antidepressant use in adolescents as multiple instances.

I'd like to point out that the brain is the most complicated organ of the human being; it's not by coincidence that some of the meds have significant side effect but we manage to do well for a standard deviation of the earth's population. However there will always be outliers to the rule; always keep that in mind when discussing mental illnesses and their associated medication.

Alain

@S

Thanks for the clarifications.

How does one distinguish between symptom – suicidal thoughts – and side effect – more of same?

A good, well-trained, experienced, and skilled practitioner should be able to do this under the right circumstances.

My point is you seem to be combining the two together and assuming they are one and the same. You are assuming that the meds are making people suicidal, and yet not seeming to allow for the fact that the meds might not be working for that person, and so it 'appears' as though a side effect for that person is further suicidal thoughts. You don't seem to be accounting for the fact that suicidal thoughts are one of the symptoms of the illness, and therefore you have to come up with some extraordinary evidence for psychiatric meds=suicidal side effects.

If these drugs were the answer to our mental illness ills in society, we would have seen a drastic decrease in the SSI disability claims filed each year. Instead what we are seeing is an astronomical increase in mental illness disability claims after the introduction of these drugs. You only have to connect the dots. Big Pharm would have you believe that 1 in 5 adults is mentally ill in need of medication. It's a mass marketing strategy that is paying off big time. I would suggest that you read Robert Whitaker's book, "Anatomy of an Epidemic" to see just how much the psychiatric and drug company's lack of progress has done for society since the induction of these psychotropics. Again, many people are losing their loved ones to these drugs. Unless you have been one of those as I have, you will never know the agony of it. What's worse than that is society's disgust at people who question these medications. We have an imbedded drug culture now and getting back to learning true coping skills has been lost.

@Joan: do you see anyone in this thread saying the drugs are the entire answer? We are saying that drugs can *help* people function. Not that they are ideal for everyone, or that everyone needs drugs. And certainly I think you will find most of us think you need to use the drugs in conjunction with counseling.

So...define what a "true coping skill" is for someone who is so depressed they can't get out of bed, wants to die, and won't eat? Someone who is in the manic phase? Someone who believes aliens are beaming instructions into his/her head? Please tell us how you would teach them a true coping skill.

Here's one more fact that the drug manufacturers have been required to expose. These drugs DO cause suicidal and homicidal thoughts in people who would never have considered it. These drugs can cause serotonin syndrome, a deadly reaction that has taken the lives of many. These drugs have black box warnings on them for a reason. Many many people getting these drugs from their ordinary doctors who would never have had a thought of suicide consider it on these drugs, my loved one being one. They mention serotonin deficiencies in the brain. Most of the body's serotonin IS NOT in the brain, it's in the gut. There is no way to measure serotonin in the body and when pressed they have no choice but to admit they don't even know if serotonin has anything to do with mental illness. When questioning the medical community, they will admit that they do not really know how these drugs actually work, what they do to the brain and many many have very little benefit, need more drugs to combat the side affects and they begin a road to psychosis hell just like my loved one did.

@Dawn ......... you are mentioning an extreme case. These medications are being given for grief, job stress, menopause, relationship break-ups, you name it. They are no longer confined to the true mentally ill, that's what I'm saying! If you've done any research at all, you would know that there is huge evidence, even televised on major news networks that these drugs work no better than a placebo for mild to moderate depression or anxiety and instead, in many cases, do the opposite and may cause what they were intended to fix.

@ Dawn ..... and one other thing. My loved one who had NEVER EVER had a manic episode in his life, became manic on these drugs. Instead of looking at the drugs, his physician then diagnosed him with bi-polar, something he NEVER had before taking them and prescribed him more drugs, a vicious cycle that took his life.

flip: How does one distinguish between symptom – suicidal thoughts – and side effect – more of same?

S: A good, well-trained, experienced, and skilled practitioner should be able to do this under the right circumstances.

flip: My point is you seem to be combining the two together and assuming they are one and the same. You are assuming that the meds are making people suicidal, and yet not seeming to allow for the fact that the meds might not be working for that person, and so it ‘appears’ as though a side effect for that person is further suicidal thoughts.

I am not combining the two or assuming that they are the same, as I clearly state that it sometimes takes a skilled practitioner to distinguish the differences. However, I did assume that it was unnecessary in this particular discussion to emphasize that some mental health care patients are suicidal, or may suffer any number of mental health concerns without it being a result of their medication(s). That would seem to be stating the obvious.

flip: You don’t seem to be accounting for the fact that suicidal thoughts are one of the symptoms of the illness...

Not so. I am not dismissing anyone's illness, thoughts or other medical needs as always or only being a result of medications, but, again, only stating that more recognition (education, training, awareness) must be given to recognizing and distinguishing the effects of medications from the effects of illness. Otherwise, patients' side effects and adverse reactions/interactions may be treated with more medications resulting in a cascading effect of more symptoms, and then more medications to treat that increase in symptoms, and so forth.

I don't think that anyone can reliably predict what effect substantial polypharmacy may have on any given individual. There are inherent risks associated with polypharmacy. I stand by my opinion that prescribers in general need more education, training and awareness as to the effects of the medications they prescribe.

Joan...So what is your impression of people such as Mike Adams and Teresa Conrick immediately blaming prescribed medication for the mass murders?

Do you even know what qualifications Adams and Conrick have?

Do you have information that Lanza was diagnosed with a mental, not a developmental disorder? What medicine was he prescribed?

Here’s one more fact that the drug manufacturers have been required to expose. These drugs DO cause suicidal and homicidal thoughts in people who would never have considered it.

It is entirely impossible to assert that someone "would never have considered" suicide otherwise.

These drugs can cause serotonin syndrome, a deadly reaction that has taken the lives of many.

Mortality due to serotonin syndrome appears to be about 100 ± 10 deaths per year, which is about 0.004% of all causes. It is "potentially life-threatening," not "deadly."

These drugs have black box warnings on them for a reason.

Yes, mainly referring to use in adolescents and advising close observation.

Many many people getting these drugs from their ordinary doctors who would never have had a thought of suicide consider it on these drugs, my loved one being one.

Once again, impossible to assert. Tacking on "many, many" does not help in this regard.

They mention serotonin deficiencies in the brain.

Nobody who knows what they're talking about refers to "serotonin deficiencies" in major depressive disorder. This follows immediately from the observation that SSRIs do not provide prompt relief, despite having prompt action.

Most of the body’s serotonin IS NOT in the brain, it’s in the gut.

Is this observation supposed to have a point?

There is no way to measure serotonin in the body

Of course there is. Perhaps you mean "in the brain."

and when pressed they have no choice but to admit they don’t even know if serotonin has anything to do with mental illness.

You yet again are grossly overstating your case. The fact that the way SSRIs treat depression is not fully understood does not mean that one has "no choice but to admit" that serotonin might not have "anything to do with mental illness." The 5-HT transporter gene is well implicated in psychiatric illness. (See here for an open-access review.)

When questioning the medical community, they will admit that they do not really know how these drugs actually work, what they do to the brain and many many have very little benefit, need more drugs to combat the side affects and they begin a road to psychosis hell just like my loved one did.

It can be extremely difficult to have a loved one with severe mental illness; I've been there. But you appear to simply be looking for a scapegoat.

@Joan: if you had read more of the comments, you would have seen my post where I acknowledged that meds were not as effective in mild-moderate depression.

You still didn't answer my question as to what "true coping skills" are for the depressed, the manic, the schizophrenic...

^ Insert obligatory grumble about the lack of preview.

I have no direct evidence of anything regarding Adam Lanza but along with everything else that the media is coming to conclusion about, his medication should be looked at. Most of these mass shootings have been done by individuals on meds and that's a fact and to assume they would have done it anyway is merely an assumption. It's a question that no one wants to broach on a respectful level. It's about time we went after the cause, not the method. I can't tell you how many stories I've read, how many agonized parents I've read about that have lost their children to these drugs, recovered individuals with horrific horror stories about what they were like on these meds. It's hidden beneath the surface because of the prevalence of these drugs. The drug trials never publish the real outcomes of these drugs ..... they hide the adverse documentation and publish what they consider the good and that's what the doctors are getting. If you went to the doctor and he had all the data and told you what the true clinical trial results were, I can almost bet many would choose not to take them. There are senators that have tried to address the issue of the over-medication with these drugs, but the Big Pharm lobby shuts them down right away. Many many FDA reps have direct ties to the pharmaceutical companies and have blatant conflicts of interest when trying to set any government regulations which still to this day there are none! We cannot solve any problems if we are not willing to look at all possibilities.

@ Dawn, there have been trials done of people using conventional psychotherapy, cognitive behaviorial therapy and the like, and in the group trials, the ones not on drugs who used these therapies recovered at a much more increased rate that the ones on the drugs, even the bi-polar and schizophrenic group. Did you ever see the movie, "a beautiful mind"? John Nash recovered drug free. The movie did not depict that because the producer's spouse was a psychologist and was worried that if they filmed the truth, everyone would go off their meds and agreeably, that would create huge problems since it's almost impossible to get off of some of these meds unless done very carefully. The bottom line is, people will believe what they want to believe and justify what they have become convinced of and true facts have very little to do with it!

@Joan ..... also, we are now seeing some very well educated psychiatrists who currently treat and are writing for well known medical journals coming forward to dispute drug therapy and it's claimed effectiveness. They are everywhere but they are vilified by their compatriots in the field.

@ Narad .... until you are willing to read some of the true clinical trial documentation on the true effectiveness of these drugs, I will not respond to your comment. You are contradicting the new evidence that is coming out about these drugs, so unless you are a neurologist who studies the effects of these medications, to me you are not willing to consider anything but your own point of view. Therein lies the reason why we have this problem.

@ Narad .... and apparently you didn't read my previous posts. I've been there as well with a family member. Your comment about me wanting to find a scapegoat is typical. It's the vilification of the ones who would dare to question. I have nothing else to say to a comment such as that!

Autism is now 1 in 88 children. This is frankly unbelievable. Does anyone even question that maybe the reason could be the psychotropic drugs used by the mother during pregnancy? No, no one ever considers that. They go after vaccines (which may or may not be the cause) but they never question the head meds.

Most of these mass shootings have been done by individuals on meds and that’s a fact

Alas, it is a fact that has not yet been documented in this thread, despite repeated requests to Jay S and Gumbi when they came out with the same assertion.

By herr doktor bimler (not verified) on 30 Dec 2012 #permalink

@ Joan: You still haven't answered my questions posed above:

Joan…So what is your impression of people such as Mike Adams and Teresa Conrick immediately blaming prescribed medication for the mass murders?

Do you even know what qualifications Adams and Conrick have?

Do you have information that Lanza was diagnosed with a mental, not a developmental disorder? What medicine was he prescribed?

Does anyone even question that maybe the reason could be the psychotropic drugs used by the mother during pregnancy?

Joan, trolling is more effective if you pace yourself. Give the other commenters a chance to take you seriously, then reel them in slowly. Don't fly your Crank Flag so soon after your initial appearance.

By herr doktor bimler (not verified) on 30 Dec 2012 #permalink

I can’t tell you how many stories I’ve read, how many agonized parents I’ve read about that have lost their children to these drugs

I can't tell you many scientology whackjobs I've read spouting similar source-free bullsh1t.

By herr doktor bimler (not verified) on 30 Dec 2012 #permalink

Gee Joan, do you have any studies that the prescribing of psychotropic drugs during pregnancy is responsible for the 1 in 88 children being diagnosed with ASDs?

How about studies that prove vaccines cause ASDs?

Most of these mass shootings have been done by individuals on meds and that’s a fact

It's a "fact" when you document it, not when you merely assert it. What is indisputable is that mass killings existed well before SSRIs and SNRIs. What you have is a frequent thread of mental illness. You then proceed to beg the question and declare that it's obviously the treatment (which is also assumed to exist) rather than the illness that is the causal factor. If you would like a list to start working through, you can start here. It would be more appropriate to work back at least to 1966, though.

and to assume they would have done it anyway is merely an assumption.

I take it you don't see the irony here.

@ Narad …. and apparently you didn’t read my previous posts.

You mean the ones I responded to in detail?

@lilady ......... ugh ..... didn't I just say that they don't look at head meds as a possible cause for autism? How can I have studies on it when they won't study it? Did you read my post? I said they won't consider it. If they wont consider it, obviously they aren't doing any studies on it! Duh!!!! I merely suggest that maybe it's time to consider that and do some studies on it. Wow, this topic is such a threat to people, it amazes me!

@ Narad …. until you are willing to read some of the true clinical trial documentation on the true effectiveness of these drugs, I will not respond to your comment.

You just did.

You are contradicting the new evidence that is coming out about these drugs, so unless you are a neurologist who studies the effects of these medications, to me you are not willing to consider anything but your own point of view.

Given that you are plainly not a neurologist, this seems like an odd standard. Another tip: if you're going to insist that something be read, it helps to actually identify it rather than waving your hands frantically.

@Narad ...... scientology? I'm amused! The following is just the beginning of the documentation about antidepressants. I don't suspect you will ever read an of them since you find questioning these drugs so offensive, but these documents and studies preformed and written by many in the psychiatric community is a start!

http://www.robertwhitaker.org/robertwhitaker.org/Depression.html

Well, I have to congratulate my fellow and sister minions for dealing with the *psych meds destroy civilisation* meme whilst I was away enjoying Japanese food, Dr Who, the gentlemen's largesse and cousins-on-the phone. I think you did a bang-up job.

Remember I mentioned that parents of children with ASDs might blame external causes - like vaccines/ doctors- for autism as a way of escaping blame for 'bad genes' or 'bad parenting' as well as the fact the probability/ uncertaintly can be a b!tch?

Similarly blaming violence on meds is a way of dis-avowing responsibility/ implication in the actions of a family member:
genetics would taint the family name
parental actions ( like lack of monitoring) could implicate them
chance being responsible is an uncomfortable feeling.

I am NOT saying that these causes are directly responsible for violence- I'm talking more about BELIEFS about causes ( it's more complicated than that) but placing blame on pharmaceuticals or doctors absolves the parent as well as the child. So would blaming "Society" at large.

Evil comes from somewhere else; violence and disability come from somewhere else. Problems don't exist in our family. We're fine, it's the REST of the world, I tell you.

Joan's objections about meds might have been lifted intact from the usual suspects that I survey. See "The Drugging if Our Children", "SSRIs, SSR Lies", CHRC, ad nauseum

By Denice Walter (not verified) on 30 Dec 2012 #permalink

Dammit. Both links still work.

@Narad …… scientology? I’m amused!

You're also demonstrating having a certain amount of trouble keeping straight who you're actually attempting to reply to. I haven't mentioned $cientology.

Joan:

"ugh ….. didn’t I just say that they don’t look at head meds as a possible cause for autism? How can I have studies on it when they won’t study it? Did you read my post? I said they won’t consider it. If they wont consider it, obviously they aren’t doing any studies on it! Duh!!!!"

Duh!!!! Joan...

They have studied pregnancy outcomes of women who are on psychotropic drugs:

http://kennedyinstitute.georgetown.edu/secondwave/members/readings/Wisn…

D'oh Joan they have studied...and debunked...the *theory* that vaccines cause autism:

http://www.autismsciencefoundation.org/autismandvaccines.html

Robert Whitaker has been a guest on the Gary Null Show ( August 2011) and the Peter Breggin Show ( June 2012) both @ PRN.
I rest my case.

By Denice Walter (not verified) on 30 Dec 2012 #permalink

FTFY. Here, , and forward references

"Medical Hypotheses" to the rescue once again!

By herr doktor bimler (not verified) on 30 Dec 2012 #permalink

“Medical Hypotheses” to the rescue once again!

Indeed. One may also note that Whitaker has published in MH.

IIRC the paper by Croen &c -- looking at maternal use of antidepressants as a potential contributor to ASD -- was discussed on this very blog only six months ago (with Liz Ditz first mentioning it a year earlier).

But apart from all the people researching it, Joan's right, no-one's researching it.

By herr doktor bimler (not verified) on 30 Dec 2012 #permalink

Robert Whitaker has also written for the Boston Globe, The New York Times, The Huffington Post, The Harvard Medical Journal and many many others. Articles which he as written have won the George Polk award for Medical writing and his articles have been nominated for Pulitzers for public service, so to discredit him and his research by trying to connect him to anyone in particular is just ignorant. He's one of many that are now investigating and researching what the public has not been allowed to see. Dispute the research all you want, the evidence is coming to light on these drugs whether people like it or not! I'm done here.

"My loved one who had NEVER EVER had a manic episode in his life, became manic on these drugs."

Was this as fictitious as Joan's other claims?

By herr doktor bimler (not verified) on 30 Dec 2012 #permalink

Robert Whitaker has also written for the Boston Globe, The New York Times, The Huffington Post, The Harvard Medical Journal and many many others.

The "Harvard Medical Journal"? (Hint: doesn't exist.) HuffPo? Face it: To the extent MH is a standout on a list of publications, it's not for a positive reason. It's of no consequence in any event, as his only role here is as your go-to for a list of journal articles.

And your reliance on "many many" as a truthifying intensifier is getting annoying.

I think that appearing -not once but- twice on PRN speaks for itself
.
Why would any serious scientist want to be associated with coomercialised pseudo-science and possibly have his/ her name tossed about for imparting respectability to a poseur? You would expect that your own work would be used to bolster anti-SBM rants and tirades.

Before appearing anywhere, wouldn't you google who the host is ? These two are rather well-known but not in a good way. Breggin should be familiar to anyone writing about psych.

Oddly enough, a well-known economist was once a guest; perhaps he didn't realise what he had gotten himself into because the outlet masquerades as a liberal radio station. He sounded taken aback. Later on, yours truly informed him ( by e-mail) what PRN was really about.
He thanked me and hasn't ever been back there.

A well-known naturalist was also taken by surprise ( no return visit). I can only think of two other SB guys who appeared but they were there to challenge or scoff.

You're known by the company you keep.

By Denice Walter (not verified) on 30 Dec 2012 #permalink

That should be COMMERCIALISED (or woomercialised)

By Denice Walter (not verified) on 30 Dec 2012 #permalink

The “Harvard Medical Journal”? (Hint: doesn’t exist.)

This may be Joan's garbled misunderstanding of Whitaker's oft-repeated claim to have once worked as "Director of Publications at Harvard Medical School". I do not know if such a position actually exists.

By herr doktor bimler (not verified) on 30 Dec 2012 #permalink

I looked at some of Robert Whitaker's citations. The studies found that patients with the worst depression were more likely to be prescribed medication and also had the worst outcomes, therefore patients prescribed medication had the worst outcomes. As one study put it, "The most probable explanation for these results is confounding by indication and/or severity: members of the general population who are taking antidepressants probably have more highly recurrent and more severe mood disorders." (I'm tempted to add, "Duh!")

By Krebiozen (not verified) on 30 Dec 2012 #permalink

People can be critical of meds for psychiatric conditions because they would hope to improve how meds are used, replace less effective drugs with better ones, develop new ones, be more careful about interactions: in other words to be MORE SB. ( like Ben Goldacre)
The anti-psychiatrists critique meds because they would like to eliminate their use altogether. They usually give themselves away rather quickly.

By Denice Walter (not verified) on 30 Dec 2012 #permalink

Here's Robert Whitaker's rant against psychiatrists and psychotropic medications on the Gary Null radio show August 18, 2011 (at 42.00 minutes into the broadcast). Thanks, Denice.

http://prn.fm/2011/08/18/the-gary-null-show-081811/#axzz2GZzpjnac

Whitaker, in order to publicize his book "Anatomy of an Epidemic"...defines what an *epidemic* is...thus giving new definitions to *epidemic*. He states...

- The publication of the DSM III in 1980, enabled psychiatrists
to define mental illnesses and *push* psychotropic drugs.

- Psychiatrists are in essence a *trade organization* and they have an *economic incentive* to prescribe medicines.

- According to the psychiatrist-controlled DSM III and subsequent editions of the DSM, 35 % of the population has a psychiatric diagnosis.

- Psychiatrists are prescribing *preventive psychotropic medications* for *at risk populations*. *At Risk populations* include those who have a sibling diagnosed with a psychiatric disorder.

Hey Joan, when are you finally going to answer my questions posed to you twice, up thread?

Joan…So what is your impression of people such as Mike Adams and Teresa Conrick immediately blaming prescribed medication for the mass murders?

Do you even know what qualifications Adams and Conrick have?

Do you have information that Lanza was diagnosed with a mental, not a developmental disorder? What medicine was he prescribed?

Hey Joan, have you read all the studies in the two links I provided up thread about pregnancy outcomes while on psychotropic medications and the thoroughly debunked vaccine-autism link?

Tell us Joan, about your case study (n=1) of your *loved* one. Be specific. Your "loved ones" original psychiatric diagnosis, the medications prescribed, the "manic episode" and...the cause of death.

Missed this:

Did you ever see the movie, “a beautiful mind”? John Nash recovered drug free. The movie did not depict that because the producer’s spouse was a psychologist

No, the screenwriter's mother, as the story goes. Nash, of course, didn't exactly "recover"; he was provided surroundings that allowed him to ride it out to what seems a lot like an age-related partial remission. This is hardly going to fly as a population-wide approach, the Philadelphia Association notwithstanding. And one might well ask whether this improvement might have been hastened with treatment.

Hey Joan, when are you finally going to answer my questions posed to you twice, up thread?

She flounced. It's at the end of the "Harvard Medical Journal" comment.

Whitaker has a blog @ Psych Today and a free-standing one**. Many of the topics he writes about are dismissive of meds, speak of treatment sans meds and he's critical of Fuller Torrey's criticism of his book.

People in his camp are extremely depresssing as well as highly predictable.

I have to ask: " What's in it for them?"

Why would you get so riled about psychiatric meds? What's it to you? Why not get upset about meds for CV or arthritis?

** Mad in America.
I'll say.

By Denice Walter (not verified) on 30 Dec 2012 #permalink

@Joan

If these drugs were the answer to our mental illness ills in society, we would have seen a drastic decrease in the SSI disability claims filed each year. Instead what we are seeing is an astronomical increase in mental illness disability claims after the introduction of these drugs. You only have to connect the dots

What? If you take the meds, claiming disability kind of makes sense, so of course claims would increase as more people are treated.

Here's an idea: reduce stigma, keep people out of 'asylums' and in the community, and encourage people to see doctors when they need help. What happens? More people get diagnosed and treated ...

Unless you have been one of those as I have, you will never know the agony of it.

Er, yeah. In this case the "be in my shoes" trope backfires... I have been 'one of those'. Except I'm not a family or friend, I'm a sufferer. So I guess I "trump" your experience.

The rest of your comment is typical SBM bashing and not worth responding to.

These drugs DO cause suicidal and homicidal thoughts in people who would never have considered it.

Why is it every time someone posts this they never provide any citations to back it up?

Most of the body’s serotonin IS NOT in the brain, it’s in the gut

What is it with the gut?

When questioning the medical community, they will admit that they do not really know how these drugs actually work, what they do to the brain and many many have very little benefit, need more drugs to combat the side affects and they begin a road to psychosis hell just like my loved one did.

I'm sorry your loved one suffered. But I'd need more evidence to be convinced it was the meds that made him worse not better.

If you’ve done any research at all, you would know that there is huge evidence, even televised on major news networks that these drugs work no better than a placebo for mild to moderate depression or anxiety and instead, in many cases, do the opposite and may cause what they were intended to fix.

Well, if it's on the news, it must be true. /end sarcasm

... Ah never mind. Your later comments show you to be nothing more than your average conspiracy theorist. And (face palm, quite literally) a person who thinks fictionalised movies based on real people are relevant when compared to scientific trials. And an autism nut. And uses arguments from authority and "brave maverick" tropes. And mentions hidden new research that goes against the mainstream... but never links to it.

Geez, we need new trolls here.

@S

I am not dismissing anyone’s illness, thoughts or other medical needs as always or only being a result of medications, but, again, only stating that more recognition (education, training, awareness) must be given to recognizing and distinguishing the effects of medications from the effects of illness.

Thank you again for the clarification. That was my impression based on what you were writing; I stand corrected.

However, you seem to be moving from "psychiatric meds have extreme side effects" to "polypharmacy has huge problems" which aren't the same thing.

Can I suggest you better define what your concerns are, and not weave many concerns together? Plus, I still see no evidence of either as a contributing factor to violence.

--

On a side note, I wonder if the people who go on about over medication only exist in the USA, where universal health care exists. I've never had anyone 'push' anything on me, and even actually has had to bring up the issue of medication myself a couple of times. (Of both psychiatric meds or anything else) I don't doubt over medication is an issue here as it is elsewhere, but wonder if the worry is more prevalent in a country where prescription meds are happily advertised on the TV; as compared to here where they're not.

http://www.apa.org/monitor/2012/06/prescribing.aspx

I could post new evidence about the dangers and ineffectiveness of these drugs for many until I'm blue in the face, but it has become clear that some posting here wouldn't even for a second entertain the idea that it could even be possible that these studies are actually true and the medications have proven to be mostly ineffective over the long run and are totally unnecessary for many! Happy drugging all!

Unless you have been one of those as I have, you will never know the agony of it.

I thought it was more charitable that having fabulated about so much else, Joan is simply making up this supposed family crisis as well. The alternative is that there *has* been a mental-illness case among her relatives, which she has seized upon for a chance to peddle her own agenda; and that would be generally less flattering.

By herr doktor bimler (not verified) on 30 Dec 2012 #permalink

I could post new evidence about the dangers and ineffectiveness of these drugs for many until I’m blue in the face

You could try posting *any* evidence. That would be a nice start.
Blueness of the face? Time to cut down on the chlorpromazine.

By herr doktor bimler (not verified) on 30 Dec 2012 #permalink

Uh...flip....the USA doesn't have universal health care. Did you mean perhaps another country? Or did you mean where universal healthcare *doesn't* exist? And our benefits for mental health care, even with insurance, are lousy. I can see the possibility of doctors pushing meds to "cure" the patient and get them out of the office before their benefits for services run out. But, of course, the doctor doesn't make any more money from prescribing.

One thing I really don't understand. Do the alties really think doctors get rich off of writing prescriptions and giving vaccines? Most doctors I know would make a lot more money being able to charge for unlimited office visits for mental health and sickness, rather than prevention by vaccine and more rapid return to wellness (or mental health) with medications. But then, I take the meds I need to (blood pressure, vitamins, calcium), try to eat well, exercise, and try to avoid other medications unless really necessary.

But then, I have the income and the ability to stay home and rest when ill. I'm not a minimum wage worker with no benefits, desperately trying to keep my job so I show up even when ill. And I like and respect my coworkers so I don't want to infect THEM, either.

@herr ...... you are nuts! That's obvious! Why on earth would I give a crap about any of this unless I had suffered the tragedy that I did, but your comments show your true insensitivity to what some really suffer. I honestly feel sorry for you. It takes an extraordinarily callous human being to suggest that I would make any of that up but believe me, your opinion means little in the face of the overwhelming evidence coming forth.

Joan: you say it, you give the evidence. Don't expect us to spoon feed it to you or do your research. Did you read the links posted above? And, we want peer-reviewed literature. HuffPo, Medical Hypotheses, and similar things don't count. We want to see reproducible, verifiable data.

Thanks. Or, you could just stick the flounce this time...

Joan: you are not the only one who has either suffered yourself or had a family member suffer (see flip's comment). So, your n of 1 falls simply under anecdote. Research, please.

Why on earth would I give a crap about any of this unless I had suffered the tragedy that I did

I have no idea why you are making up so much stuff. I don't do diagnoses over the internet.

By herr doktor bimler (not verified) on 30 Dec 2012 #permalink

@ herr doktor bimler:

Right. We'd better watch ouselves with diagnoses.

There's only one AoA crying "NPD".

By Denice Walter (not verified) on 30 Dec 2012 #permalink

It takes an extraordinarily callous human being to suggest that I would make any of that up

Not really, no. Moreover, you certainly don't seem to give a shıt when someone tells you that they've been in similar situations if they fail to fit your narrative.

I may have mentioned this before BUT-
in all of the rants I've heard against psychiatric meds ( & similar for LD) I've never heard heard anyone address the issue of PATIENT DEMAND:
people suffer anxiety, depression, sleeplessness; they have family members who suffer hallucination and delusion as well as mood disorders and obsessions/ complusions; children have problems paying attention and learning...

They seek medical solutions for these issues that affect how they and their families live. I doubt that prescribing is based purely on doctors' and pharma's whims.

By Denice Walter (not verified) on 30 Dec 2012 #permalink

@herr doktor bimler

Blueness of the face? Time to cut down on the chlorpromazine.

No - I suspect she has been self-medicating with colloidal silver.

@Joan, Take a deep breath, take a break and come back later when you can be more polite and reasonable. Meanwhile, before responding again, look back at the comments from the beginning, before you started being rude to people here.

Did you notice the following responses to your previous comments?

This may be Joan’s garbled misunderstanding of Whitaker’s oft-repeated claim ...

I looked at some of Robert Whitaker’s citations.

I'm pointing out those comments to show you that it was after you started being rude to people here that their tone changed as well. People were giving you and your possible misunderstandings the benefit of the doubt by asking you questions and trying to educate you a bit. The consistent theme here has been to ask you for supporting references for your assertions. In general, you have made mention of studies and names of authors and books as evidence. One thing I have learned is that just because a physician or journalist has done a study or written a book it does not necessarily mean that their opinions and interpretation of any actual evidence are accurate. Opinions and study findings are always open for discussion and critique as well as comparison to other studies and observations from other professionals.

I suggest that you will continue to meet resistance if you don't change your tone. You can't simply make assertions as if they are fact and refuse to provide any evidence. MI Dawn and others have explained this to you, but instead of responding with the requested information, you are insulting, and then seemingly offended when the same is thrown back at you. Suck it up and try to do the research so that you can give constructive feedback. You're not the only person who has gone through these types of experiences.

@joan

[citation needed].

I posted all the research references that were used in the author's research. It was one study after another. If you did not take the time to read through them, then you would not know what they said. Suck it up and do the research? If you can't read the studies posted by the author that wrote the articles, I don't know what to say.

@joan

Then provide the research. If not, we can assume that you are lying or just faking it.

Show us actual links, not just your assertions. We are not here to do your work.

I posted all the research references that were used in the author’s research.

No, you didn't. You posted a page of 22 links disgorged by Whitaker, some of which are genuinely apropos of nothing. Seriously, did you even read Van Scheyen? Leaving aside that it's 40 years old and deals with tricyclics, which are a third-line therapy in the modern day, the payoff, as it were, is that they shortened cycle duration. This is pointless. Whitaker, however, thinks it's a sign of "the chronicity problem."

If you would like a complete list of footnotes from Anatomy of an Epidemic (including how-was-I-to-know-that-45-grand-was-coming-from-CCHR Breggin, natch), I can provide it in about 30 seconds.

It was one study after another. If you did not take the time to read through them, then you would not know what they said.

Perhaps you could have taken the time to make a single intelligent comment about a single one of them.

I already did that, you are choosing not to use your finger and click on the links to the actual studies to read them. This is stupid. I thought this blog was intended to be an unbiased discussion, it's not. If you are unable to click on the links referenced in the author's research, then there's nothing that can convince some of you people. I have no intention of doing your work for you. You are not only ignorant, you are insolent. It's unbelievable that links to research articles based on clinical trials, one after another, can be ignored by you because you cannot figure how how to click on them within the author's research documents. This is a stupid blog full of singleminded people who refuse to accept other sides of an issue. I've wasted enough time on this blog.

This is a stupid blog full of singleminded people who refuse to accept other sides of an issue. I’ve wasted enough time on this blog.

So much for "true coping skills."

@Joan, you posted a link to an APA article and to journalist Robert Whitaker's web site.

About the APA article you stated,

...the medications have proven to be mostly ineffective over the long run and are totally unnecessary for many!

http://www.apa.org/monitor/2012/06/prescribing.aspx

The APA article specifically states that "inappropriate prescribing can cause serious harm", and that "we haven't gotten to a point where a pill alone can resolve most people's depression or anxiety."

Those take-home points from the APA article are hardly news, but it is a stretch to interpret those comments as saying that medications are ineffective over the long run and totally unnecessary for many. No one here has stated that only a pill could resolve most people's depression or anxiety. Furthermore, there are patients with more serious conditions such as Schizophrenia who experience disturbing hallucinations and other symptoms for which medications are their only reprieve. I think you are making some assumptions from the article that the authors did not intend. Of course, medications are ineffective when "inappropriately prescribed", and it seems that in some patients with mild to moderate depression or anxiety other treatment methods may be equally effective or preferable. No one here is discounting the potential effectiveness of counseling, regular exercise, and other coping skills. What this article does not state is that medications are bad for all patients, which seems to be what you are trying to imply.

I was going to write more for you, but you just lost me on this last comment.

This is a stupid blog full of singleminded people who refuse to accept other sides of an issue. I’ve wasted enough time on this blog.

I think you are making some assumptions from the article that the authors did not intend.

Particularly given that the payload is a call for increased prescribing powers for psychologists.

@Narad, I was just gonna say that.

@S, on the Whitaker website, did you bother to look at his research documents, actual trials done? Actual articles and clinical studies done by psychiatrists? (snorting in disbelief at the ignorance). Or did you just dismiss it because you had a biased opinion about him in general? There are tons of them. They are all there. Whitaker is one of many of that have done this kind of research. Ugh, this is so stupid!

I read his book, Joan. Or is that equally as stupid as reading his links? I'm biting my tongue here, else my comment will be held back in moderation.

Flounce not stuck, parto du. Anyway, check out note 9 from chapter 1 of Anatomy of an Epidemic. The contention being "supported" is this: "The Food and Drug Administration approved Prozac in 1987, and over the next two decades the number of disabled mentally ill on the SSI
and SSDI rolls soared to 3.97 million."

9. Social Security Administration, annual statistical reports on the SSDI and SSI programs, 1987–2008. To calculate a total disability number for 1987 and 2007, I added the number of recipients under age sixty-five receiving an SSI payment that year and the number receiving an SSDI payment due to mental illness, and then I adjusted the total to reflect the fact that one in every six SSDI
recipients also receives an SSI payment. Thus, mathematically speaking: SSI recipients + (.833 × SSDI recipients) = total number of disabled mentally ill.

Nice cipherin', Rob.

Joan, I wonder, have you read any of the studies in detail?

I have, and I have more than a few questions with Whitaker's interpretation of them. Here's a standout example from Whitaker's reference 18:

Whitaker cites this study in the following way:

In a five-year study of 9,508 depressed patients in Canada, medicated patients were depressed on average 19 weeks a year, versus 11 weeks for those not taking the drugs. The Canadian investigators concluded that their finds were consistent with Giovanni Fava’s hypothesis that “antidepressant treatment may lead to a deterioration in the long-term course of mood disorders.”

However, Whitaker conveniently leaves out the next line of the actual paper, where they authors say:

This hypothesis, although not widely accepted, predicts that episode duration and incidence would be higher in those reporting antidepressant use than in those not using these medications.

Whitaker is putting words in the author's mouth. The author's own conclusion based on the data was:

The most probable explanation for these results is confounding by indication and/or severity: members of the general population who are taking antidepressants probably have more highly recurrent and more severe mood disorders

Again, I ask you, Joan, are you sure that all of those citations say exactly what Whitaker says they do?

@MI Dawn

Uh…flip….the USA doesn’t have universal health care.

Uh... yeah... that was a typo. Serves me right for typing before having my morning coffee.

I meant that screaming about meds being pushed is more likely to occur in a country where medical advertising is everywhere and where UHC *doesn't* exist.

I can see the possibility of doctors pushing meds to “cure” the patient and get them out of the office before their benefits for services run out.

Actually, I've had very few meds pushed on me whether in private/public health care settings. Most meds are covered out of pocket anyway, except on certain goverment pensions, and given more common meds are price-moderated by the government, you're not likely to be pushed towards a med just to get you out of using up your benefits. There's no 'limit' that I can think of, just a sort of co-pay system to make things cheaper.

At least that's my experience of UHC here anyway.

I’m not a minimum wage worker with no benefits, desperately trying to keep my job so I show up even when ill.

And yet another reason why it might be different. UHC isn't tied to employment, so you're not getting meds so you can 'manage' through a work day.

@DW

in all of the rants I’ve heard against psychiatric meds ( & similar for LD) I’ve never heard heard anyone address the issue of PATIENT DEMAND:

I kind of did in my comment to Joan, re: decrease in stigma, increased encouragement to receive help, etc. But I don't think I'm the type of person you meant ;)

@Joan

You are not only ignorant, you are insolent.

Evidently someone who hasn't bothered to read the title of this blog...

Would you care to reply to any of my points or questions? Or would you simply rather scream "close-minded"?

@joan

So no evidence, just name calling?

You're just another ignorant troll, yelling "closed-minded", when in fact, you are the closed minded one.

But please, try with more insults. I'd like some more laughs at your silliness.

tricyclics, which are a third-line therapy in the modern day

Hey, they work for me. IIRC they are out of favour these days only because of the greater potential for overdose.

I’ve wasted enough time on this blog.

Flounce #2!

Why on earth would I give a crap about any of this unless I had suffered the tragedy that I did

No doubt there is some interesting and heartwarming story behind Joan's decision to parachute into this comment thread with an account of personal tragedy. Possibly involving links from elsewhere, or a truly outre combination of search terms. Evidently it did not involve reading Orac's original post, or any of the subsequent comments.

By herr doktor bimler (not verified) on 30 Dec 2012 #permalink

Joan, this one thing is bugging me among all your assertions (my emphasis) :

Many many people getting these drugs from their ordinary doctors who would never have had a thought of suicide consider it on these drugs, my loved one being one.

How could you possibly know?

Would you be willing to consider that you don't actually know every single thought that your loved one ever had?

Joan:

You are not only ignorant, you are insolent.

Did you happen to notice the title of this blog?

It takes an extraordinarily callous human being to suggest that I would make any of that up

People probably do not want to know about the extensive series of double-blind experiments that have taught me the difference between
(1) someone p1ssing on my boots and
(2) actual rain.

By herr doktor bimler (not verified) on 30 Dec 2012 #permalink

it is so obviously fluoride in tap water

What is it with the gut? I've read of people saying the gut is the real deal for thought, while the brain is still in beta...

By al kimeea (not verified) on 31 Dec 2012 #permalink

It takes an extraordinarily callous human being to suggest that I would make any of that up

Or someone with a finely-tuned BS meter.

Last Christmas a woman here in central IL shot and killed her two children, her 18 month old, her husband, and then herself. She had stopped her (prescribed) drug therapy and was feeling much better, according to her family.

The two children attended the school where the spousal unit teaches. As a result of Newtown they are now grimly grateful -- it could have been a great deal worse.

I'm seeing a lot of parallels between Joan's arguments and those offered by anti-chemo and anti-radiation groups. It seems to be all about the side-effects.

@ Shay:

Exactly. The anti-pharmaceuticalists oppose SB treatment for mental illness, cancer, hiv/aids, VPDs and virtually every other conditions that people might suffer. Most of them dwell in an intellectual dreamland wherein the healing phytonutrients naturally occuring in vegetables, fruits, herbs and supplements prevent or cure all ills to which humanity is heir.

To argue their case, they meticulously omit mentioning any benefit which might arise from meds and simultaneously exaggerate any side effects that might happen- including very rare or unlikey events. They also lie like rugs.

The anti-vaccinationists are a highly specialised example of the anti-SBM/ anti-pharmaceutical cartel. Hiv/aids denialists, anti-chemotherapy and anti-psychiatry advocates are other groups under the same pseudo-scientific umbrella..

Saying that because psychiatric meds don't work perfectly, or have been over-prescribed or that the pharmaceutical companies aren't exactly your cup of tea is not evidence that their products don't work.

I expect them to really get going when the DSM-5 comes out.

By Denice Walter (not verified) on 31 Dec 2012 #permalink

If you can’t read the studies posted by the author that wrote the articles, I don’t know what to say.

Joan has, after all, read every article ever published in the "Harvard Medical Journal".

By herr doktor bimler (not verified) on 31 Dec 2012 #permalink

I detect a certain similarity between the notion that mental illness is made worse (or even caused) by medication, and the idea that people die of cancer treatment not cancer, and also the idea that vaccine-preventable diseases weren't so bad, and were preferable to the side-effects of vaccines.

Just as some people have forgotten how nasty untreated cancer and vaccine-preventable diseases can be, perhaps some people have forgotten that not so long ago there were mental hospitals full of untreatable patients in varying states of "mania", "dementia", or "melancholia".

By Krebiozen (not verified) on 31 Dec 2012 #permalink
The “Harvard Medical Journal”? (Hint: doesn’t exist.)

This may be Joan’s garbled misunderstanding of Whitaker’s oft-repeated claim to have once worked as “Director of Publications at Harvard Medical School”. I do not know if such a position actually exists.

The Wikipedia "source" for this claim is to... a review of Mad in America. The purported role, by this account, didn't last very long. Assuming that the position existed at the time,* this reads to someone with experience in the racket as implying nothing other than catastropic failure in the (purported) executive position.

However, the actual publishing arm of the Harvard Medical School is at present far too small to warrant any such position, boasting, for example, a single copy editor. It's headed by a faculty editor-in-chief. Notably, Whitaker's current Harvard bio does not make any such claim. In fact, it claims no affiliation whatever with Harvard aside from the current "Lab Fellow" position.

* There is also an affidavit floating around (PDF) in which the claim appears. This relates to the apparently drawn-out case of one William Bigley of Alaska, who died November 21, 2012. One would hope that it wasn't on the streets thanks to the "assistance" of James B. Gottstein with a little help from Whitaker.

The book review / interview cited by Wikipedia has Whitaker leaving his Director of Publications position and then co-founding CenterWatch. In his affadavit, however, Whitaker states that his roles as director and CenterWatch founder were simultaneous. Murky.

My cursory search didn't turn up any trace of anyone else on the Internet claiming to have ever been "Director of Publications at Harvard Medical School", but of course absence of evidence is not evidence of absence.

By herr doktor bimler (not verified) on 31 Dec 2012 #permalink

As a comparison to Mad In America, I am curious if anyone here has read Dr. Daniel J. Carlat's book "Unhinged", and their thoughts on it. It too discusses the problems with psychiatric medications and calls for reform of the psychiatry profession as a whole.

Murky.

Particularly curious, given that his current fellowship is in the Safra Center for Ethics. Perhaps I'll drop the public affairs office a line if I find myself in a bad mood.

@Chemmomo

You are not only ignorant, you are insolent.

Did you happen to notice the title of this blog?

I literally just said that five comments above you. Like minds, and all that :)

@Krebiozen

Just as some people have forgotten how nasty untreated cancer and vaccine-preventable diseases can be, perhaps some people have forgotten that not so long ago there were mental hospitals full of untreatable patients in varying states of “mania”, “dementia”, or “melancholia”.

I think a lot of it stems from
a) "if I can't see the symptom, it doesn't exist"
b) a "pull yourself up by your socks" mentality, where life is tough and the denier can get through it, so why can't you?

I've dealt with a lot of both.

The book review / interview cited by Wikipedia has Whitaker leaving his Director of Publications position and then co-founding CenterWatch. In his affadavit, however, Whitaker states that his roles as director and CenterWatch founder were simultaneous. Murky.

The first page of the Foreward of Mad In America mentions Whitaker's work history, but makes no mention of Harvard Medical School.

He wrote "In 1994, after having worked a number of years as a newspaper reporter, I left daily journalism to cofound a publishing company, CenterWatch, that reported on the business aspects of the clinical testing of new drugs."

He does, however, mention research findings "by Harvard Medical School investigators, who in 1994 announced that outcomes for schizophrenia patients in the United States had worsened during the past two decades and were now no better than they had been a century earlier."

The first page of the Foreward of Mad In America mentions Whitaker’s work history, but makes no mention of Harvard Medical School.

The claim occurs elsewhere, but the affidavit renders everything else moot. It's a jurat notarization.

Is Rob Whitaker any relation to the Infamous Quack M.D. Julian Whitaker?

By Militant Agnostic (not verified) on 31 Dec 2012 #permalink

Whitaker letting it all hang out.

Without spending months to research and check all the facts asserted in this article, how is the average person to know what is truth and what is fiction? Whitaker does seem to accurately describe at least some of the effects of these medications, such as the neuroleptics.

The biggest problem as I see it is the misuse of these medications by physicians, as it is my experience that they are being too readily prescribed and for too many off-label conditions. The effects of the medications are indeed profound, as Whitaker describes, perhaps that is because patients are being prescribed too high a dose? Or, their conditions are being misdiagnosed and they are being put on the wrong medications? I don't know. There's too much conflicting information out there for the average patient to be able to easily come to any conclusions.

There are indeed instances of pharmaceutical companies misrepresenting the side effects of their drugs, which have caused harm to patients. There have been major settlements with the federal government over certain neuroleptics such as Seroquel and Zyprexa. What I would have a problem with is if Whitaker is in fact misrepresenting any information, including his alleged employment at Harvard Medical School.

What I would have a problem with is if Whitaker is in fact misrepresenting any information, including his alleged employment at Harvard Medical School.

I'd certainly like to see some documentation that the causing of tardive dyskinesia was used as a marker of "good dosage." This fails the smell test big time, the "tardive" being helpful here.

Whitaker letting it all hang out.

I am impressed by the explicit claim that no-one had ever heard of lobotomies and ECT until Whitaker came along to remind everyone of psychiatry's dark suppressed past. He seems to have re-written history to erase Valenstein and "Great & Desperate Cures".

His claims about insulin coma therapy -- that it was believed to cause brain damage, and that the damage was intended, as a way of reducing the patient's faculties -- are not suggestive of an over-scrupulous attitude to truth.

By herr doktor bimler (not verified) on 31 Dec 2012 #permalink

What I would have a problem with is if Whitaker is in fact misrepresenting any information,

As I've pointed out above, Whitaker has a habit of twisting legitimate studies to fit his own narrative. I suggest reading one or two of the PDFs at Joan's Whitaker link above (most of the articles are actually quite readable even for a non-expert) and decide for yourself if you feel he is accurately representing the authors' findings. I've found that in many instances this is not the case.

flip: Happy New Year!

And, yes, like minds, and all that :-)
I missed your in my first pass in my own rush to post.

His claims about insulin coma therapy — that it was believed to cause brain damage, and that the damage was intended, as a way of reducing the patient’s faculties — are not suggestive of an over-scrupulous attitude to truth.

I was not funnin' around above with that calculation he advanced. I wasn't even able to get it to land right at 3.97 million, nor do I have much interest in redoing with data from earlier years; he proceeds from the assumption that everyone under 65 receiving SSI is doing so because of "mental disability" and then adds five-sixths of the people who are receiving SSDI. If anyone can figure out a way in which this is neither grossly dishonest nor mind-bogglingly stupid, I'm all ears.

^ "are receiving SSDI" under the "mental" heading, excluding "retardation."

Happy new year Chemmomo, and everyone else!

Robert Whitaker has been a guest on the Gary Null Show

Mercola featured him as well.

Whitaker lists Science-Based Medicine as a resource on his website for Mad in America.

@Narad

For us non-murkans - what are SSD & SSDI?

By Militant Agnostic (not verified) on 01 Jan 2013 #permalink

For us non-murkans – what are SSD & SSDI?

They're parts of the U.S. social safety net. SSI is "Supplemental Security Income," which gets paid to the aged, blind, and disabled who meet certain income thresholds. SSDI is "Social Security Disability Insurance," which provides supplemental income to everyone disabled.

What Whitaker is counting everybody under 65 in the first group and then topping it off with extra from the second. This is inexplicable. SSDI figures are already broken out by ailment; the number of people in the "other mental" category for 2008 was about 120,000. This doesn't sound as impressive as "3.97 million," I suppose.

^ "What Whitaker is doing"

When perusing any criticisms of mental health ( or for that matter, any treatments advocated by SBM ) I survey whether the article mentions a few facts which history has revealed to us-
medicine and psychiatry are vastly improved in comparison to their mid- 20th century counterparts- in industialised societies.

This is a stark fact:
vaccines had virtually eliminated childhood VPDs ( until AJW), a diagnosis of cancer is no longer considered a death sentience, people who suffer SMI are no longer automatically confined to institutions and ( late century) being hiv+ is a much less horrifying state of existence than it was. I could also mention improvements in treatments for CVD and diabetes.

Because most of their audience are not historians and are too young to remember the bad old days, realistic critics note that SBM and psych have indeed made strides *before* going on the attack. Ben Goldacre is a good example of this, so is Orac.

The type of critics I run into usually do not acknowledge the gains that SBM has made. I sometimes imagine a timelessness that places say, 1950s and 2000s issues together- e.g. anti-psychotics regardless of era are portrayed as uniformly awful . Broad brushes paint an un-inviting image of what SB treatments offer people.

As my collegue Kreb notes above, people have no idea what *untreated* cancer ( and I might add untreated SMI, aids or VPD ) looks like because of the advances that have come about.

A person who mentions the flaws in SBM without discussing the advantages is presenting dishonestly - unless of course his or her material is aimed purely at experts and historians- and this stuff is not.

By Denice Walter (not verified) on 01 Jan 2013 #permalink

@ Militant Agnostic:

Here, from the Social Security Administration own website:

http://www.ssa.gov/disability/

SSD means "Social Security Disability" and SSDI means "Social Security Disability Income"; they are the same.

You are only eligible for SSD/SSDI if you have been gainfully employed and have paid into the system. IIRC, working 40 "quarters" (10 years cumulative) qualifies you for SSD/SSDI.

SSI is a "needs-based" program for those who become disabled before age 21 or are born with disabilities (like my son) My son was not eligible for SSI when he lived at home, because I was responsible for his care, based on my income. Other families with disabled younger children at home, can apply for SSI for their disabled kids...based on parental lower income.

Had my son continued to live at home past the age of 18, when I was no longer responsible for his care, then he would be eligible for SSI (not SSD/SSDI). The application for SSI, would be complicated, because my "overhead" (rent/mortgage, food bill, utilities) would be figured into his expenses and his share of the "overhead" (as if I provided room and board for him).

My son did become eligible for SSI, (and for Medicaid), when he went to live in a Medicaid-funded Intermediate Care Facility). His monthly SSI payment was $35/month, because he was in a Medicaid-funded Intermediate Care Facility.

(Quite complicated, and even more complicated when you are dealing with Medicare for health insurance, as well.)

IIRC, working 40 “quarters” (10 years cumulative) qualifies you for SSD/SSDI.

Actually, it's 40 "credits," half of them earned in the past 10 years. A "credit" varies from year to year and was $1130 in wages in 2012.

Great freaking system.

They’re parts of the U.S. social safety net. SSI is “Supplemental Security Income,” which gets paid to the aged, blind, and disabled who meet certain income thresholds. SSDI is “Social Security Disability Insurance,” which provides supplemental income to everyone disabled.

I'd like to offer a little more information on the above. SSDI is an insurance benefit program in the U.S., which provides monies to the those who are disabled and meet certain qualifications. The amount of monies it provides to any given individual are based on a percentage of the amount of prior employment-related earnings and contributions from said individual. The calculation for benefits also includes consideration for the number of years the individual was employed and contributing into the system.

As an example, if a beneficiary had a good paying job prior to becoming disabled and had contributed significantly to the SSD "insurance" program by means of payroll deductions, then their monthly SSDI benefit would be much greater than that awarded to someone who had had a much lower paying job and had paid much less in the way of contributions into the system. It is my understanding that every disabled person is not eligible to SSDI. You can roughly think of SSDI as being similar to other insurance plans; the more you pay in, the more you potentially get out. Social Security Disability Insurance monies are handled differently than earnings from employment (income) monies as far as income taxes go. Being disabled does not in itself entitle anyone to receive SSDI, AFAIK.

I thank lilady and S for correcting me that SSDI is for disabled "workers."

Back to the Whitaker calculation, the only way I can figure to get a reasonable estimate of SSI status by disabiliity is going to be through the 2001 microdata sample, something I may or may not do.

improvements in treatments for CVD

This was exciting until I realised that Denice did *not* mean "colour-vision deficiency".

By herr doktor bimler (not verified) on 01 Jan 2013 #permalink

OK, I did. (Man, is my grep rusty.) Out of 320,473 representative SSI recipients as of December 2001, 73,628 have DIAG = 2, "Mental disorders, other than retardation."

@Narad, I plan to re-read Chapter 1 of Whitaker's book more carefully thanks to your pointing out those statements.

Whitaker: "To calculate a total disability number for 1987 and 2007, I added the number of recipients under age sixty-five receiving an SSI payment that year and the number receiving an SSDI payment due to mental illness, and then I adjusted the total to reflect the fact that one in every six SSDI recipients also receives an SSI payment."

I am wondering if Whitaker merely used poor sentence structure in writing that paragraph, and instead intended it to mean that he added the number of recipients under age sixty-five who were receiving SSI due to mental illness, and those under age sixty-five who were receiving SSDI due to mental illness. Previously in that same chapter he seems to indicate that he only considered those receiving SSI as a result of mental illness, not all SSI recipients.

Based on his statements, some people receive both SSI and SSDI, so he then adjusted his figure so as not to count those individuals twice. Just a thought. Without having access to the actual data, I would have no way of checking for sure.

@ herr doktor bimler:

I truly hope that you have someone nice to take you clothes shopping.
Oh and that you've gotten that traffic light pattern learning under way.

By Denice Walter (not verified) on 01 Jan 2013 #permalink

I truly hope that you have someone nice to take you clothes shopping.
Personal colour vision is good -- there is no excuse for my clothing choices except bad taste -- but it is my research field.

By herr doktor bimler (not verified) on 01 Jan 2013 #permalink

@Joan, Some people claim that Lyme disease rather than psychiatric medication was to blame for Adam Lanza's mass murder spree.

http://host.madison.com/ct/news/opinion/mailbag/jessica-bernstein-check…

As a doctor of psychology with Lyme disease I wanted to raise the question of whether Lyme disease might be a contributing factor to the horrible shooting in Connecticut. Newton is located in a highly Lyme-endemic area. Although most people or animals with Lyme or other tick-borne diseases are not violent, a small percentage have demonstrated violent behavior.

Many may remember the chimpanzee named Travis who attacked the woman and tore off her face. That chimpanzee had Lyme disease and lived in Connecticut.

Psychiatrist Robert Bransfield, M.D., estimates that aggressive behavior has been a significant issue for approximately 100 to 200 patients with Lyme disease that he has evaluated or treated.

Based on his statements, some people receive both SSI and SSDI, so he then adjusted his figure so as not to count those individuals twice. Just a thought.

This is a reasonable correction to apply to the SSDI data (whether the value he used is reasonable, I don't know), but the problems are that (1) that sort of SSI breakout does not appear to be publicly available aside from the 2001 microdata and (2) if one actually looks at the data as of December 2007 (Table 7.A1), there's no other way to get 3.97 million.

Many may remember the chimpanzee named Travis who attacked the woman and tore off her face. That chimpanzee had Lyme disease and lived in Connecticut.

An intelligent, social primate is isolated from its species, enslaved for entertainment purposes and finally turns insanely violent? I can think of more parsimonious explanations than a blood-borne spirochaete infection.

By herr doktor bimler (not verified) on 01 Jan 2013 #permalink

OK, wait, that 120,000 may be wrong, coming from Table 37, which, although labeled "All Disabled Beneficiaries," may mean "All Disabled-Worker Beneficiaries." This only clouds things further for me, but let me rework it.

Oh, no, now I see what I did. That's awards.

Oh, dear, if they didn't use so many consarned tables, this would have been much easier.

It's sitting right there in Table 68. He still needs nearly 600,000 age 0–18, but it doesn't require what I thought he was doing. All in a day's work.

Travis the chimpanzee was kept in captivity and there have been *reports* that he contracted Lyme disease.

Lyme disease does not cause psychosis...nor does is cause ADD, ADHD, ASDS or any other developmental or psychiatric disorder. There are a number of criminal cases where the human perps and their attorneys claim "Lyme disease psychosis" as an "excuse"...that defense has never prevailed.

Nor does Lyme disease require long term IV treatment for "chronic Lyme disease"...as some quacks allege.

Lyme diagnosis is based on past exposure in a B. burdorferi-tick infected/history of bite from the deer tick in the Northeastern United States. In other areas of the Country (Midwest and Pacific Northwest), other types of infected ticks can transmit the bacterium.

There are several types of neurological manifestations of Lyme disease, including meningitis, which is easily treatable by several weeks IV treatment (ceftriaxone, most commonly). Treatment is begun in the hospital and continued at home with the insertion of a PICC IV line.

Radicularneuropathy is another type of neurological Lyme disease...same IV treatment as for meningitis.

Rarely, Lyme encephalitis is diagnosed, and treated the same way.

The diagnosis of neurological Lyme disease is confirmed by paired sera and CSF testing for Lyme disease via an ELISA antibody test and pleocytosis within the CSF. Serum ELISA that is IGM/IGG positive is then sent for Western Blot testing.
(Lyme ELISA tests have high sensitivity but low specificity...hence the need for the 2-step ELISA-Western Blot).

"Psychiatrist Robert Bransfield, M.D., estimates that aggressive behavior has been a significant issue for approximately 100 to 200 patients with Lyme disease that he has evaluated or treated."

Bransfield was the former president of ILADS..."International Lyme and Associated Diseases Society"...the organization where the so-called LLMDs (Lyme Literate Medical Doctors) are associated. These same LLMDs prescribe IV treatments for "Lyme Disease" using a bogus Lyme Urine Antigen Test. They also prescribe long courses of IV treatment...months and years...and they also *treat* Lyme disease with "pulse IV treatment" (on and off IV treatments).

Many of the LLMDs have lost their medical licenses because their patients' PICC lines became infected, the patients have experienced serious side effects of continual or "pulse" IV treatments and because they set up their own "home care IV treatments companies". (Defrauding insurance companies is their specialty)

Lately, these LLMDs have set themselves up as DAN! doctors, offering bogus *biomedical treatments* that are dangerous, invasive and not-medically indicated to *treat/recover/cure* autism.

That chimpanzee had Lyme disease and lived in Connecticut.

Newspaper reports at the time stated that the chimpanzee was receiving some unspecified treatment for Lyme disease, but these speculations from "a doctor of psychology with Lyme disease" are unencumbered by any evidence of an actual diagnosis.

Two things we do know is that the correlation between "actual borreliosis" and "treatment for chronic Lyme disease" is very low; and that the owner of the chimp was sufficiently deranged that she could have had Munchausen-by-proxy and no-one would have noticed.

By herr doktor bimler (not verified) on 01 Jan 2013 #permalink

Whoops, lilady got there first.

By herr doktor bimler (not verified) on 01 Jan 2013 #permalink

Just to wrap it up, the 2001 SSI sample yields 14,791 of 320,474 aged 0–17 with the correct DIAG. Applying this 4.6% multiplier (which still seems like the only option) to the SSI data corresponding to the SSDI data above gives one an additional 51,740, which would leave Whitaker with an overestimate by 524,890.

This was exciting until I realised that Denice did *not* mean “colour-vision deficiency”.

CVD stands for chronic venereal disease* such as tertiary syphilis, which was a significant cause of dementia in the good old days.

* It doesn't really.

By Krebiozen (not verified) on 01 Jan 2013 #permalink

Happy new year everyone. Best wishes for money, fame and everything you want.

Alain

@Herr Doktor Bimler

If I recall correctly, Travis' owner was giving him Xanax, so there is material there for those who want to blame psych meds while ignoring the fact that Travis was a chimpanzee (the most belligerent of the non-bipedal great apes), had been removed from his natural socialization at a young age and was living with a complete loony. The latter however is pretty much a tautology as only a complete nutbar would keep an adult chimp as a pet.

By Militant Agnostic (not verified) on 01 Jan 2013 #permalink

@ Alain:

Et bonne annee.

I hereby declare Saturnalia officially over.

@ Kreb:

Well, we both know what CVD stands for but I never write it out in order to enable the obligatory VD reference. I aims to please.

@ Narad

re an over-estimate of 524K +:
which possibly puts it in the same league as the infamous 784.9 K iatrogenic deaths in "Death by Medicine".
Impressive.

By Denice Walter (not verified) on 01 Jan 2013 #permalink

typo:
783.9K

By Denice Walter (not verified) on 01 Jan 2013 #permalink

S: In my opinion, based on direct observation and experience, too many physicians are irresponsibility prescribing excessive drug cocktails, and not enough physicians are speaking out about it on behalf of shared patients.
That is fair enough. I had a friend, who in high school, was taking more meds than a boy in her year who was undergoing chemo.
Joan: Generally speaking, women who are expecting are discouraged from using many medications, including SSRIs. You appear to believe that doctors will give out meds at any time to anyone- that's not how the real world works, hun.

By Politicalguineapig (not verified) on 01 Jan 2013 #permalink

Flip: Here’s an idea: reduce stigma, keep people out of ‘asylums’ and in the community, and encourage people to see doctors when they need help. What happens? More people get diagnosed and treated.

Reminds me of a conversation I had earlier this week. I was telling a parental unit that while the depression had been bad this fall, I didn't feel like bothering to get treated for it.
Him: That's like not getting treated for flu.
Me: No one judges people for having the flu.
(I have been treated for depression in the past, but that was when I was a minor.)

By Politicalguineapig (not verified) on 01 Jan 2013 #permalink

One might also note, if, say, one couldn't shut up, that the coarse mental-disorder categories Whitaker is talking about, which exclude mental retardation, include not just demonstrable organic disease but also... "autistic disorder and other pervasive developmental disorders" under the so-enumerated Section 12.

"The apples-to-apples comparison proves that something is amiss," intones Whitaker. The introduction of the DSM-IV is awfully close to the middle of his 1987–2007 apple cart, so, no, not without finer-grained data or a better analysis.

@Militant Agnostic, The woman was a nut and I suspect any wild animal being held under such circumstances could easily turn on a person. Any animal or person taking Xanax needs to be careful about dosage changes, particularly any decrease in dosages and especially full withdrawal. I could easily understand how a too rapid withdrawal from Xanax could send a wild animal into a so-called rage; they wouldn't understand what is happening to them regarding the effects of the drugs or even that they are merely experiencing temporary state of acute withdrawal. That ignorance of the unknown and the loss of control associated with such an acute withdrawal might put them into a fear and panic frenzy.

Political Guinea Pig, That is indeed a fair statement. I'm compelled to add that there needs to be more awareness as to the effects of the medications that are being prescribed, especially among the opiates, benzodiazepines, neuroleptics and other drugs used primarily for psychiatric and neurological conditions. Too many symptoms of drug dependence, tolerance and withdrawal are being misinterpreted as symptoms of various diseases, disorders, illnesses, or syndromes. Patients are often asked what medications they are taking. Rarely are they asked what medications did they recently stop taking; effects of withdrawal are too often overlooked and 'under-appreciated'. I think Narad mentioned Effexor previously. I've known physicians to take patients off Effexor cold-turkey. I wonder what that would do to an already angry primate?

^ LOL.Speaking of Travis the primate, of course.

@ Politicalguineapig:

Please be so kind as to explain to me:
how do you feel that you would be judged if you got treatment? By whom? Are they important?

If you decide that you do want treatment and you do try meds and/ or counselling- you don't need to discuss it with anyone other than the providers.

Also I wouldn't put much creedence into the judgments of those who judge others for trying to improve their lives or because they want to feel better. It's possible that you live in a very un-enlightened area but still..

Finding the best meds for you might be a trial but many people who try find improvement..

By Denice Walter (not verified) on 01 Jan 2013 #permalink

the infamous 784.9 K iatrogenic deaths

Heating patients to that temperature is definitely negligence deserving the label of infamy.

By Militant Agnostic (not verified) on 01 Jan 2013 #permalink

@PGP

No one judges people for having the flu.

I hear you. I believe outside of immediate friends and family, no one knows about my condition, mostly on the premise that the other people wouldn't understand.

Dealing with my own family, who are woo-oriented, and not particularly supportive in any useful way, is hard enough.

@DW

If you decide that you do want treatment and you do try meds and/ or counselling- you don’t need to discuss it with anyone other than the providers.

Whilst this idea is nice in an ideal world, having family and friends who support you and don't ditch you for being "too hard to handle" is something that affects everyone. Personally, I've never been without the thought that no one cares for me, and this is why I don't discuss my illness. It's not because of stigma. It's because I truly don't believe anyone wants to listen to my problems or share the burden.

Although a handful of friends know, they have hardly been supportive and there has never ever been anyone I could feel comfortable calling up when I've had a particularly bad day.

I know you were aiming the question at someone else, but it's worth mentioning that stigma is not just about what other people think of you; but about what you think about your relationships with other people.

In addition, it's even harder when you have spoken up, and asked for assistance, and found in wanting. If I had gone to hospital with slit wrists I would have received less condesention from the treating doctor; the procedures were never followed up (I could tell you some stories); and it's hard not to be afraid of your fellow sufferers (even if you rationally know better). This is on top of family ignorance and an unwillingness to get over any idea of victim blaming. The fact that I hinted at needing help at an early age and it was ignored is a perfect example of why your concept of keeping it to yourself doesn't work; even if you gloss over the fact that keeping it to yourself is the exact opposite of reducing stigma.

@Politicalguineapig .... respectfully I will have to disagree with you about doctors not giving these meds out to people who don't need them. I, myself was given numerous free samples of Lexapro from my GYN when I started through menopause. I never took them after I did some research on the side affects. I have 2 friends that received the same type medication from their GP's after a 10 minute visit. My loved one was given his first script for a psychotropic by his GP and told they will help with his "job stress". My friend's pregnant daughter was prescribed an SSRI during her pregnancy because of hormonal mood swings and my husband had a friend at work who's dentist (after a personal discussion with him) prescribed the same type drug, so to imply that these drugs are not given by unqualified doctors is just not true. True mental illness should be treated better than this and taken more seriously than this. The mass drugging of individuals who do not need these drugs diminishes the seriousness of the condition of the ones that do. My original intent in posting here was to express that point. I may not have done it right because our family still reals from the loss, but to say that unqualified doctors are not handing out these drugs right and left is just not true. My hope for the future would be that truly mentally ill patients get the full benefits of all the treatment available by qualified therapists, not just the drugs.

@Joan

So basically your comments amount to anecdotes?

Here's a hint: anecdotes don't count as evidence here. Find some actual statistics done by researchers and post it.

Oh, and responding to *all* comments and questions asked of you is also good. Not that I expect you to acknowledge mine...

The mass drugging of individuals who do not need these drugs diminishes the seriousness of the condition of the ones that do. My original intent in posting here was to express that point.

Joan, how exactly did you expect to convince us of this point? You came in here with anecdotes and misinterpreted studies, refused to engage in a reasoned discussion, and expected us to just believe what you claimed with no skepticism. I suggest in the future you try a little harder.

@ flip:

I'm very sorry to hear about your experiences.

One of the reasons people go to counselling is because they have NO support in their family or are totally alone; sometimes they make choices for which there is no support or that may be a stigma in themselves. Believe me, I know about this: I 've worked wih people whose families wanted nothing to do with them. I currently work with women whose plans for the future break tradition.

I am hinting that you might have to 'go it alone' and work on yourself and change your perceptions about people in general. This can be a long, hard and lonely road.

Eventually you might have to sift out people you feel aren't behaving in your best interest or are working against you. Sometimes this means you have to be quite alone but you can't allow others to have such power in your own evaluation of your own self. Your own opinion counts most.

This can be a work-in-progress and take a long time.

I imagine that you feel badly that your family and associates don't seem to care much about you- is that really because you are deficient or that perhaps they can't see how valuable you are? If you have a series of relationships where you aren't valued or treated well, it doesn't automatically mean that YOU are the problem! It might mean that you have to learn how to select confidants more carefully and see less of your family. People seem to like you @ RI because of your abilities and personality.

Right now I have 2 cousins who work for rather well-known people- both of whom are prima donnas- although they're men ( different fields, different countries) - in a situation like that, they have had to develop harder shells because of the nastiness that surrounds them. As one puts it:," Mr S is horrible but I will never be fired because I do the job better than anyone else could". And he pays her well. She likes the work. Thus she separates his power as a employer from his personal power to affect her beliefs about herself ( he is a manipulative, perfectionist, entrepreneur physicist) on a certain level he and she are equals. He can't make her feel badly about herself. She might even feel a bit superior to him as a PERSON.

You only have one life ( even if you believe in an afterlife)- you have make the best of it and rally yourself against the slings and arrows of others' self-interest at your expense.

As I've noted previously, I have a tendency towards depression that I've so far managed to stave off ( no kudos to e for that-perhaps it'smild) ; a few people I care about have similar issues which are lifelong. What you think about yourself and your own abilities can affect how badly your condition affects you- nothing is written in stone and you are not a bystander in your own life and your own psychology.

By Denice Walter (not verified) on 02 Jan 2013 #permalink

My friend’s pregnant daughter was prescribed an SSRI during her pregnancy because of hormonal mood swings and my husband had a friend at work who’s dentist (after a personal discussion with him) prescribed the same type drug

This is such an excellent way for a dentist to lose prescribing privileges that I'm calling BS. (And, yes, it's a conversation that I've had with my dentist of 14 years.)

(Apparently, very low dose tricyclics are occasionally used for TMJ, but SSRIs would be a red flag and are known to cause TMJ.)

@Joan, I can relate to your comments. Part of the problem lies with knowing when, where, to whom and how to express anger and frustration about the problems that you mentioned. I too have known physicians who should have known better than to prescribe the most outrageous of potent drugs for even more outrageous pseudo-conditions. These are details I can't discuss here, but I suggest that you try to document your anecdotes, perhaps by obtaining medical records and other information. Reasonable people will listen when you have some evidence of your claims.

It's easy to be angry at everyone who doubts your assertions. This is why I said 'take a deep breath'. Read more on this blog, go back through old posts and comments and you will see that most everyone here just wants some evidence that what you are saying is indeed true. If one strikes out at everyone who doubts or questions them, then it would only serve to alienate and further distance others from even attempting to understand your point of view. Not everyone is great at communication, and it seems most of the people here are more educated and experienced in these areas than most. So, again, suck it up, listen to the criticism, take a deep breath, and come back again later and try to better explain your point of view.

AdamG offered an excellent bit of advice about going back and reading the original studies as written by the original authors. Compare the original study findings to how they are represented in the book. I've only had time to do this with one study, and I did find that Whitaker represented it fairly in his book, but one is just not enough to form a opinion on the accuracy of the book as a whole. Others here have pointed out some statements in the book that need to be questioned as well. It certainly does appear that there may be some exaggerated comments in the book. Those could mislead certain patients; I don't like that.

There have been other studies discussed on Respectful Insolence that have been terribly misrepresented in the media and by unscrupulous practitioners so as to reel in customers to their respective businesses. The acupuncture study is one of them. As an exercise, try reading that original study, compare it to the comments here, and then further compare those to the way the study's findings were portrayed in the media and by many acupuncture specialists. It is almost like everyone was reading a different study. In any case, this will serve as practice on reading and interpreting studies. It may help in understanding how easily people can be deceived merely by how a given study is portrayed. Here's two articles about the acupuncture study,

http://scienceblogs.com/insolence/2012/09/12/can-we-finally-just-say-th…

http://www.forbes.com/sites/sciencebiz/2010/08/25/acupuncture-infiltrat…

The title of this blog clearly refers to a well-known quotation, but I can't for the life of me remember what it is. I thought it would come to me eventually but it hasn't. Could someone please put me out of my misery?

By Krebiozen (not verified) on 02 Jan 2013 #permalink

Twas the Night Before Christmas blended with Cry Peter Wolf?

Twas the Night Before Christmas blended with Cry Peter Wolf?

I see where you're coming from, but I don't think that's it.

By Krebiozen (not verified) on 02 Jan 2013 #permalink

Krebiozen, clicking on Orac's name in each header takes you to what used to be the "About" information. The quotation is in there.

Chemmommmo,

The quotation is in there.

That confused me for a while, but it's my fault for not making myself sufficiently clear. I meant "Cry the antivaxers and quacks: ‘Twas big pharma that led Adam Lanza to kill", not "Respectful Insolence".

By Krebiozen (not verified) on 02 Jan 2013 #permalink

In other words, I meant "this blog post", not "this blog".

By Krebiozen (not verified) on 02 Jan 2013 #permalink

Also, sorry about the surfeit of "m"s in what should have been "Chemmomo".

By Krebiozen (not verified) on 02 Jan 2013 #permalink

Krebiozen: my mistake. I guess I was hung up on Joan's name calling the other day. No worries on the extra Ms.

There's also all the "'Twas a dark and stormy night" references, but prior obligations prevent me from exploring them all until later.

Thanks for the suggestions - I've wandered through King Kong (It was beauty killed the beast"), "'Twas pity that stayed his hand", and even been distracted by "lions and tigers and bears, oh my" - but no, none of them are right. I'm suffering terrible tip-of-the-tongue torture over this.

Unless Orac made up something that sounds like it should relate to a quotable quote, and my brain has made up the rest, which wouldn't greatly surprise me.

By Krebiozen (not verified) on 02 Jan 2013 #permalink

lilady: I sat through a Lyme/EEE lecture every year I was in school right before it let out for the summer. The main problem with untreated Lyme infection seems to be rheumatoid arthritis-like issues, most of which clear up after treatment.

By dedicated lurker (not verified) on 02 Jan 2013 #permalink

I’m suffering terrible tip-of-the-tongue torture over this.

Amazing Grace?

(I'm presuming that Felicia Heman is off the table.)

Krebiozen,

I continually read the post title as a paraphrasing of Carl Denham's line in King Kong (written, I believe, by Merian C. Cooper).

By Mephistopheles… (not verified) on 02 Jan 2013 #permalink

Everyone's suggestions sound right, but don't quite hit the target. I'm starting to think it's the lexical equivalent of a Rorschach inkblot test. And I've failed.

By Krebiozen (not verified) on 02 Jan 2013 #permalink

Could be a mental hybrid of the Lays of the Scottish Cavaliers.

DW: If I sought treatment, that'd make me vulnerable- to my employers, insurance companies, significant others and friends. I am aware of confidentiality laws, I am also aware that information can and will leak.
Also, I have tried SSRIs in the past. They do diddly-squat for me.

By Politicalguineapig (not verified) on 02 Jan 2013 #permalink

@ Kreb:

Twas brillig and the slithy toves?
.. only joking

By Denice Walter (not verified) on 02 Jan 2013 #permalink

Could be a mental hybrid of the Lays of the Scottish Cavaliers.

Or perhaps Gangnam Style?

By Krebiozen (not verified) on 02 Jan 2013 #permalink

Twas brillig and the slithy toves?
.. only joking

I already checked that! I'm going to have to sleep on it.

By Krebiozen (not verified) on 02 Jan 2013 #permalink

@ Politicalguineapig:

Well, that's truly a shame.
There are med-free alternatives that occasionally help ( CBT and similar) and the beauty of them includes the possibility of learning what their essentials consist of and applying them to yourself.

I'm not saying that any of this stuff is easy BUT it can make a difference. People can either self-talk themselves up or down. Why not give yourself the benefit of the doubt?

Real therapy focuses on human interaction as well as self-concept and examines where we get the ideas about interpersonal/ personal functioning that we have. Sometimes you need to ask yourself: "How did I get that idea?" about a person or how the social sphere works.

If I find a resource that condenses CT, I'll certainly write it up for your and others' benefit.

By Denice Walter (not verified) on 02 Jan 2013 #permalink

@ Kreb:

Oh wait. Are you just perhaps just catching the meter... Twas + some rhythm?

In Xanadu, did Kublai Khan, a stately pleasure dome decree

OR

This is the forest primaeval, the murmuring pines and the memlocks, bearded in moss, like druids of old...

By Denice Walter (not verified) on 02 Jan 2013 #permalink

HEMLOCKS

By Denice Walter (not verified) on 02 Jan 2013 #permalink

HEMLOCKS

[Examines split ends and possible moss growth.]

@Me, myself and I

condesention

Seriously forgot to spellcheck. :P

@DW

One of the reasons people go to counselling is because they have NO support in their family or are totally alone; sometimes they make choices for which there is no support or that may be a stigma in themselves. Believe me, I know about this: I ‘ve worked wih people whose families wanted nothing to do with them. I currently work with women whose plans for the future break tradition.

I agree. But this assumes one has friends and family in the first place. It is very hard to convince yourself that people care when the only way to get anyone to do so is to pay for it.

I know that's not right nor rational... but then, why should it be rational? ;)

I am hinting that you might have to ‘go it alone’ and work on yourself and change your perceptions about people in general. This can be a long, hard and lonely road.

I came to that conclusion when I was 10. And trust me, "going it alone" only works for as long as you can manage by yourself. At which point, having friends and family to support you is necessary. (Suffice to say that the point at which I could not do it alone anymore was my fairly sudden and unexpected trip to the hospital)

Eventually you might have to sift out people you feel aren’t behaving in your best interest or are working against you. Sometimes this means you have to be quite alone but you can’t allow others to have such power in your own evaluation of your own self. Your own opinion counts most.

And here I believe it would be best suited to take this discussion to a more private place. However, suffice to say that I have yes come to that conclusion too.

I imagine that you feel badly that your family and associates don’t seem to care much about you- is that really because you are deficient or that perhaps they can’t see how valuable you are?

I will never know. Part of my frustration is that talking about my problems with the people I care about has not resulted in them acknowledging, let alone assisting, in the situations at hand. I am 'high functioning' in that I *appear* ok, and have always been proactive, so part of it might be an unwillingness to accept I am anything other than how I appear to them. I am a consummate actor in some aspects of my life. Again, this heads into an area I'd rather not discuss publicly.

If you have a series of relationships where you aren’t valued or treated well, it doesn’t automatically mean that YOU are the problem! It might mean that you have to learn how to select confidants more carefully and see less of your family.

I have had no trouble thinking that. The interesting thing about reading science blogs is that it allowed me to take a more statistical approach to past relationships. And this has been exactly what I've been thinking for about a year or so. More than that, it allowed me to realise just how much the other people are a larger part of the problem.

However, in an ideal world, this is an easy fix. For personal reasons I'd rather not get into here, it's not.

People seem to like you @ RI because of your abilities and personality.

My unfortunate lot in life: my ability to sound intelligent is relegated to written text. I open my mouth and sound like a 5 year old. This is probably a big part of why I'm not properly taken seriously. I am a far different person in text than I am in person.

What you think about yourself and your own abilities can affect how badly your condition affects you- nothing is written in stone and you are not a bystander in your own life and your own psychology.

To reply to this would truly require a life story of magnum opus kind. I agree, and yet I disagree. Right now, I'm just concerning myself with a few life problems, which are greatly affecting my illness. It sounds like I'm putting it on the backburner, but in fact the issues that I'm dealing with have a huge impact on how well I cope anyway. However, these are also things I have little control to change, and I am pretty much reliant on the universe being nice to me for a bit.

Again, we come back to "in an ideal world..."

However, thank you for the kind words and support. Since we've headed into complete off-topic territory, I suggest if you wish to reply you do so to flippingflipperburgers @ gmail.

Denice,

Are you just perhaps just catching the meter… Twas + some rhythm?

I think so, though it's not an iambic pentameter, and sleep and distraction didn't help.
Time to apply my brain to more useful tasks.
da diddly diddly dum
da diddly diddly diddly dum

By Krebiozen (not verified) on 03 Jan 2013 #permalink

There are med-free alternatives that occasionally help ( CBT and similar) and the beauty of them includes the possibility of learning what their essentials consist of and applying them to yourself.

The book "Feeling Good" by Dr. David Burns is highly recommended in this context.

By Antaeus Feldspar (not verified) on 04 Jan 2013 #permalink

Flip -- that is too bad. I am married to an extremely clever man who has a) a slight speech impediment, and b) the handwriting of a low-functioning nine year old*. I don't need to tell you how that affected his job search after he got his teaching credentials.

(*he belongs to the generation of southpaws who had their left hands tied to the school desk to "force" them to use their "correct" hand).

Shay: I wonder if bad handwriting is common for lefties. I'm a fellow southpaw (though I belong to a much, much different generation) and my handwriting is horrible.

By Politicalguineapig (not verified) on 04 Jan 2013 #permalink

OT: This article presented an intriguing hypothesis - a link between lead exposure and crime - but ironically, the claims that the data follows the hypothesis SO precisely are part of what makes me suspicious. Can anyone comment? http://t.co/9BdmyNw0

By Antaeus Feldspar (not verified) on 04 Jan 2013 #permalink

Well, my handwriting is bad as well and yes, I'm a southpaw too. Even my parents went to my school, to tell them I was a southpaw, but still I needed to write with the other hand. When I finally was allowed to use my left hand, I wasn't really able. I still do drawing with my left hand, just like everything else, exept writing. And my handwriting is nothing to write home about. I often had troubles to read my own notes. Either I couldn't keep up with the teacher, or I couldn't read what I wrote down.

@ Antaeus Feldspar: I can only provide you with some information about the "phase out" of lead in gasoline...which was a gradual process...

http://www.epa.gov/history/topics/lead/02.html

This is a recent MMWR about lead in water supplies, but it also gives you some background information about elevated blood lead levels in children...including a nice bar graph...

http://www.cdc.gov/mmwr/pdf/other/su6104.pdf

(continued below with a third link)

This article presented an intriguing hypothesis – a link between lead exposure and crime

IIRC it's not a new hypothesis -- the theory has been around for long enough for a lot of the research to be predictive / hypothesis-testing ("*this* is what we expect to see as lead burdens diminish. *This* is what we expect from these kids with high blood-lead levels, compared with these other kids"). That carries some weight.

It's worth calling attention to the theory -- as a reminder that the petroleum industry is sufficiently intent on profits that it will fight for its right to destroy children's brains, with its spokesmen concealing the evidence, politicising the issue into a conservative culture war, and accusing the pro-brain lobby of being communist economic saboteurs. Climate change? Been there done that.

By herr doktor bimler (not verified) on 04 Jan 2013 #permalink

Antaeus Feldspar,
It is indeed an intriguing hypothesis, and a lot more plausible than anxiety about mercury, food additives and pesticide residues. I don't quite see the mechanism for elevated lead levels causing an increase in crime. Lead lowers IQ, but a low IQ doesn't necessarily lead to criminality, or teenage pregnancy for that matter, though I'm sure it helps. Maybe lowered intelligence maintaining social deprivation which leads to criminality is more plausible, in which case lead is responsible for far wider problems than just crime. Some suggest it was lead poisoning that did in the Roman Empire IIRC.

I like the Freakonomics idea, mentioned in the article, that is was liberalization of abortion that led to fewer unwanted children, which led to a decrease in crime when those unwanted children would have been old enough to become criminals. There is a certain irony that the same people who stand up for the human rights of fetuses seem to be happy to allow an unwanted child to grow up to become a criminal and perhaps face the death penalty as an adult, having caused countless people untold misery in the meantime.

By Krebiozen (not verified) on 04 Jan 2013 #permalink

lilady, This one's especially for you - Bransfield's opinion on school shooters, violence, sexual 'dysfunction' and eating disorders as caused by Lyme disease.

http://www.mentalhealthandillness.com/Articles/AggressionAndLymeDisease…

If anyone looks carefully at the facial expressions of the teens who committed the school shootings, most of them had facial asymmetry which indicated the presence of Bell’s palsy (7th cranial nerve). This finding usually indicates an infection has affected the nervous system. Although Bell’s palsy is a common finding in the general population, the prevalence of this finding is much greater in these youthful offenders. This suggests an infection of the CNS may be a contributing factor in these school shootings.

The main page, http://www.mentalhealthandillness.com/lymeArticles.htm

I wonder if bad handwriting is common for lefties. I’m a fellow southpaw (though I belong to a much, much different generation) and my handwriting is horrible.

Oh, I had very precise, small left-handwriting (not cursive) back in the day. That was before developing editor's elbows and ulnar nerves to match.

S: I'm a layperson, and I'm already beginning to suspect you hit a rich vein of bullshit. I had Bell's Palsy. It isn't that common when you're young- and most of these shooters were pretty young. It also usually resolves pretty quickly. I had one week on anti-virals and steroids. It took two weeks for the paralysis to completely lift.

By Politicalguineapig (not verified) on 04 Jan 2013 #permalink

@Shay

I'm not sure if I was using hyperbole or not. I did not mean it in a literal sense, only that my social skills are not that good and I'm naturally shy, especially around more than one person. I just come off as immature orally, as compared to in writing. (Also, see below)

@PGP

I'm a leftie too, but I'd guess that my handwriting is fairly good. But then I'm *not* of a generation who was taught it was evil. I tried doing that once at a colonial-era theme town, and I can understand why it would make handwriting look worse. It not only felt unnatural, but made my writing look ridiculous.

I’m a leftie too, but I’d guess that my handwriting is fairly good. But then I’m *not* of a generation who was taught it was evil.

Now that I think back, I have been told that my maternal grandmother tried to cure me of the sinister affliction. That would have been too early for the ink smudges to have been the reason.

@flip, re ...having family and friends who support you and don’t ditch you for being “too hard to handle” is something that affects everyone.

I too have an illness that makes me "too hard to handle." I gave up on a group of acquaintances recently after I was given the "just try harder" and "you're pushing us away" and "it's your own fault" speech again. With a side of accusations of throwing a "pity party."

Yes, they knew I have clinical depression. For some reason they think I can control the chemicals in my brain by ... positive thinking? Magic? I don't know. They weren't ever quite so specific on that.

When you have cancer, only a woo-meister tells you positive thinking will fix it.

When you have depression, *everyone* does.

@Denice, re: Why not give yourself the benefit of the doubt?

... well, yes. That would be the problem, wouldn't it. :(

Bransfield’s opinion on school shooters, violence, sexual ‘dysfunction’ and eating disorders as caused by Lyme disease.

(1) Sadly, Bransfield's article does not include photographs of the facial expressions of the teens accused of school shootings, these supposedly demonstrating facial asymmetry. We are expected to take his word for it.

(2) Bell's Palsy is the classic example of "diagnosis of exclusion" -- you use the label once you have ruled out more specific causes for unilateral facial paralysis. Anyone not doing this is a quack.

By herr doktor bimler (not verified) on 04 Jan 2013 #permalink

herr doktor bimler: There is a high degree of "suspicion" for Lyme disease when a patient presents with Bells Palsy and resides in...or has a history of recent travel to...a Lyme disease endemic area. Two-step serum testing is warranted to R/O Lyme disease.

Even though Bells Palsy is considered a neurological symptom...it responds to treatment with oral antibiotics...taken for 14-21 days...dependent on the antibiotic prescribed.

The patient should undergo neurological evaluation to R/O Lyme meningitis and the patient should be questioned about meningeal symptoms (headaches) and examined for meningeal signs. Some doctors will do a lumbar puncture for analysis of CSF looking for pleocytosis...even in the absence of meningeal symptoms/signs.

Lyme disease Bells Palsy patients who also have Lyme disease meningitis are started on IV antibiotics (ceftriaxone usually) in the hospital and discharged to home care to complete their course of IV treatment.

http://www.idsociety.org/uploadedFiles/IDSA/Guidelines-Patient_Care/PDF…

Correction...

"Even though Bells Palsy is a neurological SIGN...."

@Narad

Now that I think back, I have been told that my maternal grandmother tried to cure me of the sinister affliction. That would have been too early for the ink smudges to have been the reason.

Incidentally, smudges by left-handers can be reduced if you simply adopt a different language, such as hebrew. ;)

@Khani

You practically wrote my experiences - I'm sorry you've been going through the same thing.

@ Khani:

Depression has both biological and social implications. You obviously cannot change the "chemicals" by thinking.
Learning strategies and changing attitudes can sometimes help people to deal with others and manage problems with everyday living more effectively.

People are sometimes isolated by their condition or have family and so-called friends who make matters worse. I meant that first of all, don't doubt your own experience: if people criticise your choices/ ideas, for example, don't automatically believe that they are correct and you aren't. Your ideas and choices are as valid as anyone else's.

Unfortunately, not all those with whom we interact have sophisticated concepts about others' states of being and procliivities- you might consider this a form of prejudice and it very well may be- they may expect conformity- for you to do and feel as they do. I have no idea whether this is due to lack of education about the issue or an apparent lack of compassion. You would know that better than I do.

Depression affects a substantial portion of the population. It can be difficult to treat. I personally know quite a few people who have suffered ( non-clients): some who have fared well and others, not so well. Similarly, their experiences with meds run the gamut.

I have a tendency towards moroseness myself: like a few other family members, I seem to have escaped the worse of it- I have no idea whether this is because we have effective means of coping OR that we merely have a milder form- perhaps dysthymia. I suspect the latter is true.

Invoking "positive thinking" is often another way of blaming the victim: if only he or she acted or thought in a more effacaious manner, he or she would be alright. Not true.

However SB psychology has shown that people who attribute causes, comprehend social interaction, understand others' motivation( and other facets of social thought) in particular ways often feel worse. I would venture that the fact that you have little support IN ITSELF might affect how you think about yourself- that you are somehow less valuable than people who have support- not at all, people can be WRONG. Others' judgments have nothing to do with your value.

I truly believe that there are important assets about assisting people with depression ( or that people can access on their own) that have developed through research. CBT helps many people. There are other methods of dealing with stress that may also assist people with depression. I also venture that finding a calling or an engaging interest may change how you look at the world and yourself.

Take care of yourself.

By Denice Walter (not verified) on 05 Jan 2013 #permalink

@flip We're out there. Remember when people talk to you, you're often getting their highlight reel, so there are more people like us out there than you'd realize. I tend to seem rather perky in real life most of the time myself.

@Denice I understand what you mean. Strategies I do learn. Changing my attitude isn't quite as easy, I have found, and it's somewhat dependent on circumstances.

I was dealt a rather nasty social blow about seven months ago and it's coloured things heavily for me since. I lost nearly all my friends as a result of it. I have not been successful in finding a new group in all that time--with something like four significant efforts since, all of which failed. I have become very dependent on my work environment for support--I am so, so lucky that they are all so wonderful.

My depression is not actually that severe, so I am quite lucky, relatively speaking. I have never tried to kill myself, nor had serious suicidal thoughts.

I don't find people are not educated about depression per se, nor that they lack compassion. Mostly, they simply don't believe its effects are real, or that they are not totally within your control.

These are highly educated people who do believe in science otherwise, but they do not seem to grasp that I have an actual illness and am not capable of thinking my way out of it.

They don't *say* "depression isn't real." They express sympathy when I say I have it and they seem to think it's an actual problem. But then when I manifest a symptom, they say "Dude, no pity parties here," or "Well no wonder no one likes you." There's a huge disparity between "you have depression" and "depression does x." That connection is not made.

It's fair enough that people dislike me, I suppose. Eeyore is not everyone's favorite character. Some people like a Piglet or a Tigger. That is okay.

But it has been exhausting throwing myself up against the social wall over and over again only to get nowhere because of an illness. Or is it because I have a bad personality?

I believe the latter so often, but is that because I am rational and have examined the evidence at hand, or because I am ill? I hate not being able to trust my own brain.

But I like this site very much, and its commenters.

@ Khani:

Thanks for the response. I think that it might be useful for you to familiarise yourself with the ideas that form the basis of SB therapies: you might take a look at wikipedia's articles on CBT and cognitive therapy as a start. Obviously this is just scratching the surface BUT you can see that there are methods that do help many people. And believe it or not, some types of self-help are available free of charge via the internet.

The main idea is that although depression has a physiological basis how you think about social interactions and the abilities and motivations of others as well as about how your own self fucntions can affect how you feel and behave- i.e. you can exacerbate or diminsh your depression.

I don't work ( formally) with depression now but have experience and training in the area.

By Denice Walter (not verified) on 05 Jan 2013 #permalink

Pretty familiar with the therapy options already.

I've never tried any woo, actually, with the sole exception of Zicam, which I hadn't realized was homeopathy until I brought it home and saw the x for dilution on the label. Oops!

I became suicidal and felt very homicidal after the psychiatric drugs I was given were piled on .

I have both the medical and criminal records to prove it.

Hoping someday for an expungement of my criminal record after the night I was waving a gun around looking for suicide by cop cause my feelings were so messed up by the pills.

@Alex,

I'm sorry for your misfortune. Can you tell us what drugs were involved? Thanks.

By Mephistopheles… (not verified) on 14 Jan 2013 #permalink

@ Denise Walter's silly and oblivious ramblings:

"Anti-psychiatry advocates believe that better nutrition ( supplements / no junk food) would solve all mental problems and learning disabilities."

This is hyperbole, and with regard to psychiatric drugs, it ignores the fact that nutrition does indeed affect neurotransmitter systems like dopamine and serotonin that are simultaneously implicated in "mental disorders". Will you at least acknowledge this one basic fact (that specific foods can affect serotonin and dopamine levels), or do I have to cite studies in order to loosen the grip of your egomaniacal intransigence?

"If only someone would take their advice, violence and SMI would disappear. A belief that nutrition causes these condiitons only informs us about how impoverished the alt med prevaricators’ knowledge and information about physiology, learning and human interaction are."

Not only does this arrogant remark imply that you've done or seen conclusive research that rules out nutrition deficits in "mental illness", something I highly doubt (feel free to prove me wrong though) but it also implies that there are known and definitive causes of "mental disorders", which there aren't. Infact, DSM-IV - the foremost authority on "mental disorders" - is completely atheoretical as to their explicit cause. So how does a nutritional argument at face value indicate "impoverished knowledge"? If you just mean lack of clinical studies/scientific evidence, then I concede the point but that by itself isn't a valid reason to completely dismiss any and all speculation, though.

"Next thing you know, they’ll be saying that mental illness is merely a fiendish plot perpetrated by the pharmaceutical companies in order to sell meds"

Wrong. Most people against psychiatry posit that what is called "mental illness" is largely or entirely social deviance and psychological distress. That's the crux of Szasz' early critique of psychiatry, which was pre-Big Pharma. The chronicity and expandability of "mental illness" as medical pathology requiring drugs IS heavily influenced by pharma, though. A few examples:

-The New York Times says more than half the psychiatrists who took part in developing the current DSM (DSM-IV) have financial links to drug companies, including every single contributor to the section on "schizophrenia." A study discussed in the piece said "the connections are especially strong in those diagnostic areas where drugs are the first line of treatment for mental disorders" and the author of the study (psychologist Lisa Cosgrove) says there's no acknowledgement of this conflict of interest in the manual and refers to it as an "outrage". On the upcoming DSM-5 she says: "70% of the task force members have reported direct industry ties—an increase of 14% over the percentage of DSM-IV task force members who had industry ties" and that “pharmaceutical companies have a vested interest in the structure and content of DSM, and in how the symptomology is revised.” Citations: www.nytimes.com/2006/04/20/health/20psych.html
A Comparison of DSM-IV and DSM-5 Panel Members’ inancial Associations with Industry: A Pernicious Problem Persists
Lisa Cosgrove, et al Plos Medicine March 2012 Volume 9 Issue 3 e1001190

-The American Psychiatric Association has come under a U.S. Senate Finance Committee investigation in recent years over its financial links to pharmaceutical companies. A 2008 New York Times report says roughly 30% of the organizations funding comes from drugmakers. The report says that, according to individual state data (a sample from Minnesota) psychiatrists receive more income from drug companies than any other medical specialty and that, "...on average, psychiatrists who received at least $5,000 from makers of newer-generation antipsychotic drugs appear to have written three times as many prescriptions to children for the drugs as psychiatrists who received less money or none." The article also says this occurs despite the fact that many prescribed drugs aren't FDA approved for children and have dangerous side effects.
Citation: http://www.nytimes.com/2008/07/12/washington/12psych.html?hp&_r=0

-A New York Review of Books essay by Dr. Marcia Angell, Harvard lecturer and former editor of the New England Journal of Medicine, says drug companies eager to sell pharmaceuticals have a strong influence over key opinion leaders in psychiatry. These leaders, according to Dr. Angell, "influence how mental illness will be diagnosed and treated. They also publish much of the clinical research on drugs and, most importantly, largely determine the content of the DSM. In a sense, they are the best sales force the industry could have, and are worth every cent spent on them." Psychiatrist Daniel Carlat, quoted in the essay, says psychiatry leads the pack in accepting money from drug companies because "our diagnoses are subjective and expandable, and we have few rational reasons for choosing one treatment over another." Citation: http://www.minyanville.com/mvpremium/2011/07/25/harvard-expert-links-ou…

Dr. Paul Appelbaum, a past president of the APA and director of Columbia University’s Division of Law, Ethics and Psychiatry says, according to research, only 34% psychiatrists believe that receiving food or gifts affects their own prescribing patterns, while 53% believe that it influences that of their colleagues. Time's Healthline says research shows that this type of thinking, that "everyone else is prone to biases and social factors, but not me!", is common and hinders attempts at addressing conflicts. "At least some of our colleagues are wrong," Appelbaum said of the research.
Citation: http://healthland.time.com/2012/10/05/psychiatrist-contends-the-field-i…

-Zipkin and Steinman (2005) state that there's evidence that both patients and professionals are influenced by advertisements and patients may get prescribed medicines when other interventions are more suitable.
Citation: Zipkin DA, Steinman MA (August 2005). "Interactions between pharmaceutical representatives and doctors in training. A thematic review". Journal of General Internal Medicine 20 (8): 777–786

-Pharmaceutical companies frequently ghostwrite articles for psychiatrists in medical journals attesting to the biological nature of "mental illness" and the efficacy of pharmaceutical products - articles that are veiled marketing campaigns yet have direct influence over the medical community and clinical practice, including the way "mental illness" is viewed by doctors. The Harvard Crimson reported in 2011 that a group of psychiatrists, including an associate professor at the Harvard Medical School, signed their names to an academic paper written by a communications firm hired by a major pharmaceutical company, suggesting that the "antidepressant" Paxil can help treat some cases of "bipolar disorder."Bosch et. al. (2012) state that "paying guest authors of ghostwritten papers may influence clinical judgment, increase product sales and government health care costs, and put patients at risk by misrepresenting risk-benefit." In an PLoS Medicine essay illustrating how pervasive this practice is, they note "Some editors, fully aware that ghostwritten manuscripts are submitted to their journals, refuse to police their content". Further, they state: "Complaints about the ethics of medical ghostwriting have increased in the last decade, but little has changed. Corruption of the scientific literature through ghostwriting persists in medicine due to the enormous profits for all stakeholders, including the pharmaceutical industry that creates the publication strategy, academic researchers acting as key opinion leaders (KOLs) for industry, universities employing KOLs, medical journals and their proprietors, including medical societies and publishers, and medical communication companies employing ghostwriters. Ghostwriting openly infringes academic standards and, in many cases, as recently argued by Stern and Lemmens in PLoS Medicine, contributes to fraud." They further state that cases relating to several specific drugs are well-documented "while many others, relating to rosiglitazone, olanzapine, quetiapine, valdecoxib, and celecoxib, remain under seal by the courts. These cases demonstrate the dangers inherent in permitting pharmaceutical companies to maintain the status quo." Olanzapine (Zyprexa) and quetiapine (Seroquel), are of course two of the most highly prescribed, and highly dangerous, "antipsychotic" drugs on the market. Citation: Bosch X, Esfandiari B, McHenry L (2012) Challenging Medical Ghostwriting in US Courts. PLoS Med 9(1): e1001163. doi:10.1371/journal.pmed.1001163

It's astounding that you can't see the direct correlation between drug profiteering and the rapid expansion and chronicity of "mental illnesses" over the last several decades. Even former APA president Stephen S. Sharfstein admitted back in 2005 that the whole field of psychiatry is dominated by what he called the "biobiobio" model which is directly related to to what he called industry-wide "kickbacks and bribes" from "big pharma". You can read his column, which he titled ""Big Pharma and American Psychiatry: The Good, the Bad, and the Ugly" here: http://pn.psychiatryonline.org/cgi/content/full/40/16/3
.
"OBVIOUSLY before there were pharmaceutical companies, there was no mental illness. Or so they tell us.

More oversimplified nonsense. The fact is that fake, unscientific diagnostic categories have rapidily increased since the advent of psychotropic drugs, as has the chronic nature of these 'disorders'. What do you think all the fuss over DSM-5 is about? And much of that controversy is from WITHIN psychiatry/psychology, so your dismissal of critics as if they're all flying saucer, UFO-worshipping scientologists and bohemian earthies is nothing but a desperate ploy. Here's a Reuters piece quoting several prominent psychologists/psychiatrists who admit that the field wrongly pathologies understandable problems in living: http://www.reuters.com/article/2012/05/10/us-psychiatry-dsm-idUSBRE8490…

I'd also like to see some sort of explanation of who you claim "they" are that "tell us there was no mental illness before pharmaceutical companies". This is an obvious and rather weak strawman argument. "Mental illnesses" were indeed formulated pre-psychopharmaology, however, the profitability of psychotropic drugs (which are some of the highest-grossing meds in the industry despite the fact that people labeled with "psychotic disorders" make up just a tiny percentage of the population) has created the incentive to encourage doctors to overdiagnose, overmedicate and of course prescribe off-label.

"Seems I’ve heard the ” no scans or blood test” argument before. Many times."

So it's okay that there's no objective criteria used to diagnose "mental illnesses"? It's fine for people to be coerced and indoctrinated into believing they suffer from an "incurable brain disorder" that's inherently stigmatizing and which requires long-term brain-disabling drug use, with mere rhetoric? That's scientific to you? Can you do me a favor and remind everyone reading this site of how many cancer patients routinely go into chemo or other risky treatments based solely on a paper questionaire? Oh, that's right...none do. They get an objective test done first, as do patients in every other field of medicine but psychiatry. Not only are "mental illnesses" unprovable hypothetical constructs which have socially/politically-determined boundaries that shift with every new edition of the DSM (see homosexuality taken out of DSM-III, Asperger's taken out of DSM-5), but they are completely unfalsifiabile and postulated using circular reasoning, as comically illustrated by British psychologist Lucy Johnstone: "Clearly, the reason people hear voices is because they have ‘schizophrenia’. And how do we know they have ‘schizophrenia’? Because they hear voices, of course!"
http://www.madinamerica.com/2013/01/time-to-abolish-psychiatric-diagnos… utm_source=rss&utm_medium=rss&utm_campaign=time-to-abolish-psychiatric-diagnosis

"Right. Seems that the folks at LONI have been taking images of the progression of tissue destruction in schizophrenia since about 2001.
I guess you might call that ‘scans’.
I wonder how they missed that."

First of all, brain scans investigating psychopathology are almost always done on people who were already diagnosed and prescribed the brain-altering neuroleptics beforehand (i.e. researchers are more likely studying iatrogenic injury than organic pathology). Here's several abstracts proving neuroleptic "antipsychotics" cause brain atrophy and other structural changes:

http://archpsyc.jamanetwork.com/article.aspx?articleid=211084

Dorph-Petersen, K-A, Pierri, J, Perel, J, Sun, Z, Sampson, A-R and Lewis, D (2005) The Influence of Chronic Exposure to Antipsychotic Medications on Brain Size before and after Tissue Fixation: A Comparison of Haloperidol and Olanzapine in Macaque Monkeys. Neuropsychopharmacology, 30, 1649–1661.

Ho, Beng; Andreasen, Nancy C.; Ziebell, Stephen; Pierson, Ronald; Magnotta, Vincent (Feb. 2011). "Long-term antipsychotic treatment and brain volumes: a longtitudinal study of first-episode schizophrenia". Archives of General Psychiatry 68 (2): 128–37. doi:10.1001/archgenpsychiatry.2010.199. PMID 21300943. Retrieved 5 April 2011.

Lewis, David A (Feb. 2011). "Antipsychotic medications and brain volume: do we have a cause for concern?". Archives of General Psychiatry 68 (2): 126–27. doi:10.1001/archgenpsychiatry.2010.187.

Dorph-Petersen, K-A, Pierri, J, Perel, J, Sun, Z, Sampson, A-R and Lewis, D (2005) The Influence of Chronic Exposure to Antipsychotic Medications on Brain Size before and after Tissue Fixation: A Comparison of Haloperidol and Olanzapine in Macaque Monkeys. Neuropsychopharmacology, 30, 1649–16

Also, here's a New York Times interview with Nancy Andreasen (former editor of the American Journal of Psychiatry and one of the foremost authorities on "schizophrenia") where she admits that the drugs indeed cause brain damage:
http://www.nytimes.com/2008/09/16/health/research/16conv.html

And here's another piece from that pesky Robert Whitaker, where he points out the fact that Andreasan had previously attributed the brain atrophy found in her "schizophrenic" test subjects to a mythological disease that was supposedly eating away at their brains (an obfuscation of cause and effect that is very common in psychiatry): http://www.psychologytoday.com/blog/mad-in-america/201102/andreasen-dro…, http://www.nytimes.com/2008/09/16/health/research/16conv.html

Second of all, neuroimaging in general has vast limitations and studies of psychiatric "disorders" are completely dubious, which is why your beloved LONI scans never have and never will translate to widespread clinical diagnostic practice. Here's a look:

-Bell (2012) states: "Neuroscientists have long been banging their heads on their desks over exaggerated reports of brain scanning studies...This misplaced enthusiasm often stems from a misunderstanding about what brain scans tell us. The interpretation seems straightforward according to the popular press – the coloured blobs represent a "pleasure centre", an "art centre" or perhaps a "love centre" – but none of this is true." Bell explains how constant changes in the brain are often attributed to experimental tasks measuring positive responses rather than routine brain activity, due to uncorrected sampling bias: "Imagine you are playing two roulette wheels. Clearly, the result of one doesn't affect the outcome of the other but sometimes they'll both come up with the same number just due to chance. Now imagine you have a roulette wheel for every point or voxel in the brain. A comparison of any two scans could look like some areas show linked activity when really there is no relationship. Ideally, the analysis should separate roulette wheels from genuine activity, but you may be surprised that hundreds if not thousands of studies have been conducted without such corrections." He further cites an example of how easily false positives can be made by pointing out a group of researchers, led by University of California scientist Craig Bennett, who used an fMRI to produce an image of positive "brain activity" in a dead salmon. Citation: http://www.guardian.co.uk/science/2012/may/27/brain-scans-flaws-vaughan…

-Farah and Gillihan (2012) point out why there's no brain scans used in routine clinical psychiatric practice when they state that structural and functional psychiatric neuroimaging studies reveal a high degree of variability within groups of "healthy" and "ill" subjects, often with considerable overlap between the two groups. They assert that imaging studies are generally not highly sensitive to the difference between illness and health, that according to meta-analyses the studies fail to mark clear and consistent diagnostic boundaries for specific conditions, and that there is hardly any standardization of protocols across studies, meaning positive findings of underactive or overactive parts of the brain are merely relative to tasks performed and that this "adds another complexity to the problem of seeking consistently discriminating patterns of activation for healthy and ill subjects." On the future of psychiatric neuroimaging, they state: "few believe that brain imaging will play a role in psychiatric diagnosis any time soon. The forthcoming DSM-5, expected in May of 2013, will include reference to a variety of biomarkers for psychiatric disease, including those visible by brain imaging, but their role is expected to be in the validation of the categories themselves rather than in the criteria for diagnosing an individual patient." Citation: http://virtualmentor.ama-assn.org/2012/06/stas1-1206.html

Third of all, the "positive" findings of neuropathology in psychiatric "disorders" are usually a obscuring of cause and effect:

Harrop et. al. (1996) challenge the psychiatric obfuscation of cause and effect in the onset of "mental disorders" (that "clinical symptoms" are a result of neuropathology), arguing instead that mind and behavior influence brain chemistry as much as the reverse: “it is possible for physiological differences associated with the condition to be the result of the condition and not the cause...relationship between the psychological problems and the physiology should be viewed not as a simple cause-and effect relationship, but more as a reciprocal and iterative relationship where psychological effects can affect the physiology that can in turn affect the psychology." (p. 641). Similarly, a 1993 study using PET scans in depression proved that significant changes in blood flow in the brain, sometimes associated with causation, could occur when researchers simply asked patients to imagine something that would make them feel sad. Citations: http://www.columbia.edu/cu/psychology/courses/1010/mangels/Uttal.html.
Jose V. Pardo, Ph.D et al "Neural Correlates of Self-Induced Dysphoria", American Journal of Psychiatry, May 1993, p. 713).

"our critic above lists some of the ((scary)) side effects from psychiatric meds, e.g. a loss of grey matter, structural changes in the brain. These objections are common enough from anti-psychiatry advocates, e.g. Gary Null will list each and every side effect and exaggerrate its importance HOWEVER ( big however) he and his ilk do NOT bother is list any benefits of taking the drug."

On exaggeration - there is none, and I'll use my own diagnosis of "schizophrenia" as an example. The psychiatric journal Schizophrenia Bulletin says 80% of "schizophrenia" patients treated with standard antipsychotic medications relapse within two years of hospital discharge, and the majority of relapsers become sick again while reliably taking their medications. Stein Institute for Research on Aging at UC San Diego says people with "schizophrenia" diagnoses have a life span 20-25 years shorter than those without. Oxford University researchers in England say the risk of premature death in medicated "schizophrenics" was 60% higher than the general population in the UK in 1999 and more than double in 2006. The British Journal of Psychiatry says suicide rates among "schizophrenics" is 20 times greater than before the introduction of neuroleptic drugs. In a 2003 study of Irish patients taking the "antipsychotic" drug Zyprexa, 25 of 72 patients (35%) died over a period of 7.5 years, leading the researchers to conclude that the risk of death for "psychotic" patients had doubled since the introduction of the "atypical antipsychotics" Citations:
Weiden, P., (1995). The cost of relapse in schizophrenia. Schizophreia Bulletin, 21, 419-428.
Morgan, M, et al. “Prospective analysis of premature morbidity in schizophrenia in relation to health service engagement.” Psychiatry Research 117 (2003):127-35. Weiden, P., (1995). The cost of relapse in schizophrenia. Schizophreia Bulletin, 21, 419-428.
http://psychcentral.com/lib/2012/premature-death-rates-rising-in-schizo…
http://www.madinamerica.com/2012/06/nimh-awards-4-million-to-study-prem…

On the "benefits" people recieve - first of all, these aren't scientifically measurable and can be chopped up to placebo effect as much as true drug effect. Most SSRI clinical trials have to run "placebo washout" periods because so many people are responsive to dummy pills. Irving Kirsch's meta-analyses on SSRIs, which have been replicated, also prove they have no clinically significant efficacy relative to placebo except for people with severe symptoms: http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.00500…

Wiith "schizophrenia", a 2009 systematic review and meta-analysis of trials in people diagnosed with "schizophrenia" found that less than half (41%) showed any therapeutic response to an antipsychotic, compared to 24% on placebo, and that there was a decline in treatment response over time, and possibly a bias in which trial results were published. A 2010 Cochrane Collaboration review of trials of risperidone (Risperdal) found only marginal benefit compared with placebo and that, despite its widespread use, evidence remains limited, poorly reported and probably biased in favor of risperidone due to pharmaceutical company funding of trials.Citation: http://www.nelm.nhs.uk/en/NeLM-Area/Evidence/Drug-Specific-Reviews/Coch…

Another point I'd like to make is if/when the drugs are efficacious against "psychotic" symptoms it's only because they supress people's entire mentality, hence the doped-up, zombie-like effect. Psychotropics aren't disease-specific. They don't correct any specific underlying cause of "mental illness." They diminish "positive" attributes like personality and intelligence as much as they do "psychotic" symptoms.

"Now why do you suppose he does that?
Because he doesn’t want you to know that the drugs are efficacious in reducing unwanted symptoms in many people. So much so that patients are willing to suffer side effects in order to get symptom relief."

No one denies the drugs *can* decrease unwanted symptoms - but they do this by turning people into docile drones. Also, this completely ignores the people who are coerced, pressured, blackmailed and literally forced by court order to take psychotropics. What about them? I myself was nearly forced medicated less than a year ago and had to bring all my Szsaz/Foucault/Breggin/Valenstein/Caplan etc. conceptual and scientific argumentation to court to prevent a forced Haldol injection. Antipsychiatry advocates are more against the lack of informed consent regarding adverse effects, the false impressions of disease-specifity given to patients, the rapid diagnosis-and-prescribing, the unhinged high dosage prescribing and routine polypharmacy, the off-label prescribing (particularly to children) for unappoved and non-serious uses, the unethical and reprehensible marketing to children, and the coercive/forced drugging than they are the drugs themselves. Szasz in particular emphasized that although psychiatry is a pseudoscience, it's the right of the individual to pursue whatever "treatment" options he wants as long as it's his consentual decision, and is an informed decision.

"These drugs often have serious side effects like weight gain, higher blood sugar and other problems BUT patients tolerate them because the SYMPTOMS of the illness itself are so much worse for them:"

Some patients do (maybe). Many do not. But the data above proves that whether people tolerate them or not, they often die early when they take them long-term. Giving people something that's proven to be dangerous just because they demand it isn't the hallmark of a reputable medical science, and is as flat-out idiotic as giving a kid buckets of sugary, diabetes-causing junk food to eat every day just because they want it. I'd also wager there's as many or more "schizophrenics" that take the drugs because they're under the pressure of family, social workers, the legal system and the authority of doctors (and sometimes the authority of police and courts) as there are people who take them because they really want them (and you are awate that once people are put meds to begin with, they can become so chemically supressed that they're more passive to external parties pressuring them to continue taking them, right?).

In any event, psych doctors playing "expert" and prescribing psychoactive drugs based on assumptions and guesswork is still a pseudoscientific sham. And as Steve Balt, MD (current Editor-in-Chief of The Carlat Psychiatry Report ) has said, pseudoscience can deliver results too. Some healthcare plans willingly pay for acupuncture and other "traditional" medicines and their may still be a valid scientific basis for the benefits professed by advocates. They're still pseudoscience though, because they're postulated as efficacious while being completely unproven *and* unprovable in an objective sense. Psychopharmacology is a legitimatized form of Traditional Chinese Medicine or Ayurvedic (Indian) medicine.

"they hear voices that insult them or tell them what to do
they suffer delusions that may be frightening"

This is a generalization. "Mental disorders" like "schizophrenia" have heterogenous symptom profiles and do not always require voices or other prominent symptoms. I've been diagnosed twice in the last year (long story) and I've never heard voices in my life.

"they may be unable to live independently
they may have to give up their studies or jobs
they often have difficult relationships with family and friends
they have problems planning and sticking to a task
they may lose interest in things they used to like
they have little control over their thought process, memory and cognitive abilities, like learning."

Statistically speaking, psychiatry doesn't help people with any of those things. Actually, it can and does make a lot of them worse. Most "schizophrenics" end up permenantely disabled and on neuroleptics for life. And what medicated "schizophrenics" are there with serious careers? Very few I know of. I know I couldn't be working at all or going to college this fall if it wasn't for my adamant refusal of risperidone in a psych ward last year. The Andreasen data above sayst brain damage caused by neuroleptics is associated with cognitive impairement, so your argument that the drugs help people become more functional and capable of learning makes no sense.

"This is by no means a complete list- just what I can write off the top of my head.
In short, these people suffer; they usually first become disabled by the illness as late adolescents/ young adults- a time when most people are planning their future: preparing for a career, completing their education, becoming independent of their parents, earning money and starting serious relationships.

The symptoms of SMI interfere with everyday life across the board and cause SUFFERING. Many patients find meds acceptable DESPITE the side effects because they are then enabled to live a more average life and have a greater chance for living as independent adults. With a REDUCTION of disabling and uncomfortable symptoms."

Again, this is a generalization. And diagnosing people with a hypothetical and stigmatizing "mental disorder" that they (shock!) may not actually have and then pushing brain-disabling drugs down their throat isn't really treatment, it's a masking, (and sometimes pile-on) of the persons real problem(s). People are much more complex and variable than the oversimplified diagnostic boxes shrinks slot them into. There's nothing inherently wrong with people taking neuroleptics or SSRIs at base for acute episodes of distress, but anyone being coerced/forced to take them, anyone taking large dosages of them, taking them long-term or taking them without full disclosure of both the true drug effect and potential adverse effects is a victim of quackery. Most people with what you call "SMI" are victims of quackery.

"A prof of mine ( also a therapist) questioned Rosenhan as being evidence of the inefficacy of psychology:
people said (lied) that they had a serious symptom ( hearing voices) which was then investigated.
Now suppose it was a physical symptom instead being presented- the subjects said ( lied) they they had dizziness or bleeding- wouldn’t it be correct to further investigate and seek out the source of the dizziness or bleeding? Wouldn’t a cautious practitioner order tests and perhaps observe the person? To rule out serious illness associated with dizziness or bleeding-( and lying)."

Yes, that would be correct but that isn't what the institutions did in the Rosenhan experiment. They postulated that the pseudo-patients were "mentally ill" and offiically diagnosed them with, I believe, "schizophrenia." There were no (objective) tests ordered, because if there were the practitioners would have known they were lying and discharged them instead of comitting and diagnosing them. Comparing the Rosenhan experiment to a person complaining of dizziness is ridiculous. Dizziness is pure, self-reported subjective phenomona, "schizophrenia" is a disease-construct that is *projected* onto the person externally by a clinician (based on bogus DSM guidelines and personal bias).

"That’s just what the institution was doing: they were observing the person *who heard voices* and probably testing as well. With psychological symptoms, it isn’t as cut and dry as the other more directly medical case."

InstititionS (plural - the pseudopatients were sent to different medical centers around the US)

"Isn't as cut and dry" is another way of saying that the "symptoms" are subjective. Yes, they are - which is why it's a pseudoscientific sham to formulate them into a disease-construct that has no individually provable biomarkers.

"They observe how the person behaves and answers questions which doesn’t take as little time as blood tests and scans for the other- more obviously- medical case."

Observations and questions aren't the gripe of anti-psychiatry advocates. Psychiatrists moving from making observations to explaining those observations without empirical evidence is. Hearing voices is just that - hearing voices. No one constructs dizziness into a biomedical classification of disease that can be diagnosed by mere observation. That would be considered a joke - as psychiatric diagnoses are.

"I may have mentioned this before BUT-
in all of the rants I’ve heard against psychiatric meds ( & similar for LD) I’ve never heard heard anyone address the issue of PATIENT DEMAND:
people suffer anxiety, depression, sleeplessness; they have family members who suffer hallucination and delusion as well as mood disorders and obsessions/ complusions; children have problems paying attention and learning…"

This still ignores the un-demanding coerced/forced-medicated patients (44 states having "involuntary outpatient committment" and "assisted outpatient committment" laws like NY's Kendra's Law is indicative of this populations existence, as are psych wards), and is still pseudoscientific since the therapeutic efficacy of the drugs can't be objectively measured. This is a falsifiability issue Steve Balt has talked about on his blog: "...Finally, the whole idea of falsifiability is absent in clinical psychopharmacology. If I prescribe an antidepressant or even an anxiolytic or sedative drug to my patient, and he returns two weeks later saying that he “feels much better” (or is “less anxious” or is “sleeping better”), how do I know it was the medication? Unless all other variables are held strictly constant—which is impossible to do even in a well-designed placebo-controlled trial, much less the real world—I can make no assumption about the effect of the drug in my patient’s body." Citation: http://thoughtbroadcast.com/2011/10/24/is-clinical-psychopharmacology-a…

You are aware that falsifiability is one of the cornerstones of any good science, right?

"They seek medical solutions for these issues that affect how they and their families live. I doubt that prescribing is based purely on doctors’ and pharma’s whims."

It often is. And you're forgetting that both patients and doctors are influenced by ads. Those misleading Zoloft commercials, for example, undoubtely breed peoples psychological "need" for meds when they feel sad as well as doctors prescibing patterns (don't forget those smoking hot female drug reps, either). Since the drug efficacy and the "disorders" themselves are elude objective meauring tools, antipsychiatry advocates call it for what it is - bullshit psychological gaming by pharma for money.

By Shitznoexplainia (not verified) on 25 Jan 2013 #permalink

@Shitznoexplainia

Was there a tl;dr version of that? Or a summary in two sentences of what you're arguing about?

Apparently typing #458's name into the comment box will cause the spam filter to go to work... A reply to said # is in moderation.

@ flip

My argument is essentially the same as Joans, but better expressed and with citations.

BTW, I may need to change my name if I'm gonna continue posting here. LOL.

By Shitznoexplainia (not verified) on 26 Jan 2013 #permalink

@458:

tl; dr.

As far as I can tell, the tl;dr of SNE's rant is:

1) Denise ridiculed the premise advanced by alt-med extremists, that all or most mental illness is caused by nutritional deficits.
2) However, there may be evidence to show that some mental illness might, in fact, be caused by nutritional deficits, and anyways, even if no one can come up with evidence that shows it to be actually probable, no one has yet proven the negative that no mental illness ever is caused nutritionally.
3) Therefore Denice is wrong.
4) And by extension Big Pharma is wrong.
5) Here, have a Gish gallop.

SNE will doubtless protest that this is an utterly unfair characterization of his/her argument, to which my answer is learn to focus your argument. You don't need thirteen screens of text to get an argument across - unless you don't actually have any argument and you're trying to cover up the fact.

By Antaeus Feldspar (not verified) on 27 Jan 2013 #permalink

My argument is essentially the same as Joans, but better expressed and with citations.

Heh.

My argument is essentially the same as Joans, but better expressed and with citations.

My argument is essential the same as Antaeus Feldspar’s final paragraph, but not as well expressed and on the Wakefield thread.

^ essentially

#458 has several arguments. Taken together, they are a head full of ideas...
Regardless of the possible validity of some arguments buried within that screed, I take issue with the characterization of DW's comments as "silly and oblivious ramblings". But #458 seems to be taking things very personally, plowing 458's own experiences into a larger, sweeping commentary which has several arguments, mostly around evaluations of current & past psych practices & conflicts of interest. I can't tackle all of that. I'm glad that 458 has got it together to work and go to college. There's a lot to learn.
Any information on the life expectancy of people with SMI who receive no treatment?

@ THS:

It's a complicated issue : what proportions of negative outcomes for SMI are due to the condition itself or are indirectly related because of lifestyle issues ( smoking, alcohol, street drugs, accidents etc). Fuller Torrey tackles it in "Surviving Schizophrenia".

Overall- SMI is a huge, expensive problem with both physiological and socioeconomic components. It's difficult to generalise but SBM has some strategies ( meds, counselling, living arrangements etc) that help some people to live better lives. No easy answers; no cures. Assistance is not all-or-nothing. Saying it doesn't exist won't make it go away.

Because what is available is not perfect does not mean that alt med solutions are true or realistic. From my standpoint, I see people without experience, education or training in any serious medical or psychological profession ( e.g. Null and Adams) dismissing ANY use of psychopharmacology as useless and/ or dangerous. This is cavalier grandstanding and does a dis-service to people who suffer and are searching for real solutions as well as professionals who are trying to find solutions that help more than harm. I doubt that either one of these charlatans has ever dealt with a person with untreated symptoms of SMI for any period of time. They don't know what they're talking about.

However it is part of their general agenda to scare people off of meds and pharmaceutical/ medical products ( including vaccines and screening/ imaging procedures; there's parallel anti-med positions re hiv/aids, cancer etc).
It's illustrates their particular business model of providing so-called "natural" choices over meds.

-btw- I don't work with people who have a SMI but have counselled family members in the past.

And about Laing: I believe that he had a daughter with a SMI. Imagine that.

By Denice Walter (not verified) on 27 Jan 2013 #permalink

Disclosure - I changed my name to stop the "in moderation" stuff.

@ Antaeus Feldspar - my argument is that Denise Walter's ridicule of "alt med" is both hyperbolic and hypocritical. Psychopharmacology is just as pseudoscientific and potentially harmful as any of the magic potion peddlers she gets her rocks off on poking fun at. Actually it's more potentially harmful because people are indoctrinated into it by professionals and sometimes lawfully forced into it. I'm not here to go out all defending "alt med" though I think at least some of it might be helpful but is blatantly ignored/ ridiculed by allopaths who are desperate to maintain their professional power.

@ Chemmomo - "My argument is essential the same as Antaeus Feldspar’s final paragraph, but not as well expressed and on the Wakefield thread." You have no argument. Your repsonses are all ad hominem attacks. I'm against the harm of psychiatry, and want to see what its proponents think about the information I posted above. That's it. Save all the petty bantering for someone who cares. I don't.

THS - I do take it personal because I'm a victim. On untreated "mental illness", the World Health Organization published two separate studies years ago that indicate prognosis for "schizophrenia" goes up sharply when you live in a developing country with limited or no access to psychiatry/drugs: http://www.searo.who.int/en/Section1174/Section1199/Section1567/Section… A. Jablensky, et al, "Schizophrenia: manifestations, incidence, and course in different cultures - A World Health Organization ten-country study," Psychological Medicine 20 monograph suppl. (1992): 1-95. J. Leff, et al, "The International Pilot Study of Schizophrenia: five-year follow-up findings," Psychological Medicine 22(1992)

@ Denise Walter -"SBM has some strategies ( meds, counselling, living arrangements etc)" - So you're gonna just ignore the data I posted which proves the meds cause brain damage, increased symptoms, early death etc? Really? Are you a psychologist or psychiatrist? Yes, street drugs and lifestyle contribute to the stats but so does neuroleptic-induced diabetes, suicide, brain damage etc.

"Because what is available is not perfect does not mean that alt med solutions are true or realistic."

They're both equally unscientific, unproven and potentially harmful. That said, I think it's safe to say that however efficacious, niacin is probably a lot safer than Zyprexa.

"From my standpoint, I see people without experience, education or training in any serious medical or psychological profession ( e.g. Null and Adams) dismissing ANY use of psychopharmacology as useless and/ or dangerous. "

Experience, education and training hasn't improved prognosis for "schizophrenia" or any other major "mental disorders" in 100 years. It's quackery. And here's a study proving that untreated "psychosis" isn't neurotoxic: Is There an Association Between Duration of Untreated Psychosis and 24-Month Clinical Outcome in a First-Admission Series? Thomas J. Craig, M.D., Evelyn J. Bromet, Ph.D., Shmuel Fennig, M.D., Marsha Tanenberg-Karant, M.D., Janet Lavelle, M.S., and Nora Galambos, Ph.D.

"This is cavalier grandstanding and does a dis-service to people who suffer and are searching for real solutions..."

...of which psychiatry isn't, statistically.

" as well as professionals who are trying to find solutions that help more than harm. "

If this were the case they'd investigate nutritional and psychosocial causes of "mental illness" with more rigor instead of postulating chronic biological pathology and using meds as a front-line and primary source of "treatment".

"I doubt that either one of these charlatans has ever dealt with a person with untreated symptoms of SMI for any period of time. They don’t know what they’re talking about."

Since people medicated for "SMI" rarely end up anything more than professional vegetables, it's obvious that you don't neither.