We in Michigan are dealing with yet another effort on the part of NDs, which stands for “naturopathic doctors” but more appropriately should mean “not a doctor, to achieve licensure in the form of Michigan HB 4531. As I mentioned when I first learned that HB 4531 was passed by the House Committee on Health Policy and sent to the full House for consideration, it’s a scary, scary bill. Moreover, it’s supported by the Michigan Association of Naturopathic Physicians (MANP), who are taking money from the supplement industry to lobby for this bill’s passage. It’s a bill that would grant NDs a wide scope of practice. Basically, if HB 4531 were to pass, licensed naturopaths would have a scope of practice almost as wide as primary care physicians, such as internists, family practice doctors, and pediatricians. About the only difference would be that NDs would not be allowed to prescribe controlled substances. (Imagine my relief.)
You might wonder why I’m bringing this up again. The reason is simple. Until I know that the bill is dead, any time I write about naturopathic quackery (but I repeat myself), I plan on mentioning HB 4531. If anyone searches for HB 4531 on this blog, he’ll find a whole list of examples of naturopathic quackery. It’s that simple.
Unfortunately, the supply is endless. Fortunately, there is a way to find out how naturopaths discuss medicine when no one’s listening. There’s a private mailing lists that many naturopaths belong to called Naturopathic Chat or NatChat for short. Thanks to an anonymous source going by the ‘nym Naturowhat, we have periodic access to leaks from NatChat. Naturopaths have tried to plug the leak. They’ve talked about moving over to a different platform besides Yahoo! Groups, but for some reason NatChat is still there and remains the basis for my Sh*t naturopaths say series, of which this is the latest installment. In any case, a few days ago, Naturowhat released a thread with the Subject: header homeopathy buffs - bipolar disorder and voices in head.
Before I read a single message, the thought of using homeopathy to treat bipolar disorder alarmed me. Regular readers know that many homeopathic remedies are nothing more than water because they are diluted to the point where it’s unlikely that a single molecule of the original substance, with the belief that the water, thanks to the magic shaking between each serial dilution step, is somehow imbued with the “memory” of the remedy. Of course, as I’ve described so many times before that I’ve forgotten how many, homeopathy is truly The One Quackery To Rule Them All. Worse than that in considering HB 4531, homeopathy is integral to naturopathy. Indeed, you can’t have naturopathy without homeopathy. Homeopathy is a huge part of the curriculum at naturopathy schools, and in states where naturopaths are licensed it’s on the naturopathic licensing exam, known as the NPLEX.
With that in mind, let’s see what a naturopath named Jena Peterson asks:
I have a new patient that is having an acute episode. Diagnosis coming in is bipolar disorder 1. She describes panic attacks, 5 hours sleep per night, and voices in her head constantly. She also describes feeling like the voices or entities are in her body and moving her body, moving her hands for example. PHx of sexual abuse as a child.
She has many resources in place currently, but I am hoping to start working on a remedy for her. Any suggestions anyone has would be appreciated; with such unusual symptoms I am hoping to get ideas to narrow down my search.
WTF? She wants to start making a homeopathic remedy for this patient? This patient has bipolar disorder and might be psychotic, given the voices and the delusions of entities controlling her body and moving her hands!
I can sense psychiatrists, psychologists, and anyone with bipolar disorder who are reading this cringing or even gasping in alarm. Bipolar disorder is serious business, especially bipolar I, which involves periods of severe mood episodes from mania to depression. As described by the Depression and Bipolar Support Alliance:
Bipolar I is characterized by one or more manic episodes or mixed episodes (which is when you experience symptoms of both a mania and a depression). Typically a person will experience periods of depression as well. Bipolar I disorder is marked by extreme manic episodes.
For those of you not familiar with bipolar disorder, it involves cycling between a manic phase and a depressive phase, hence its previous name, manic-depressive disorder. During depressive phases, bipolar patients suffer the same symptoms as straight-up depression, to the point where they are at risk for suicide. When they’re in their manic phase, they exhibit elevated mood, poor judgment, hypersexuality, flight of ideas, substance abuse, decreased inhibitions, excessive spending, hyperactivity, and an inflated self-image.
As you can imagine, bipolar patients in their manic phase can get into considerable trouble. As WebMD puts it, people in manic episodes may spend money far beyond their means, have sex with people they wouldn't otherwise, or pursue grandiose, unrealistic plans. In severe manic episodes, a person loses touch with reality. They may become delusional and behave bizarrely. Occasionally, they even get violent. Indeed, I remember when I was rotating on the psychiatry rotation as a medical student, the only time I was ever frightened for my safety was when a bipolar patient became agitated. The guy was huge, strong, and very, very intimidating.
The treatment of bipolar disorder involves medication, including mood stabilizers, possibly mood stabilizing antipsychotics, and possibly antipsychotics. Treating such a serious psychiatric disorder with homeopathic remedies is the same thing as leaving it untreated, with all the attendant complications that can result from not stabilizing their mood and giving them the ability to control his behavior.
Before I move on, I couldn’t resist looking at Peterson’s website, Full Circle Natural Medicine. It didn’t take me long to find a whole lot of pure quackery, including the DAN! Autism treatment protocol, “detox” quackery, cleanses, acupuncture (of course!), and IV nutrients. You get the idea.
So what do Peterson’s fellow naturopaths recommend? Let’s see. Shiva Barton suggests:
Please investigate PANS/PANDAS in this patient. Ask if she has had any antibiotic use or food poisoning/stomach bugs; or strep within the last 6 months. Please do a stool culture to see if there are abnormal bacteria growing. The use of antibiotics raises the risk of panic attack and anxiety by 50% within 6 months of taking them. I've had a few patients recently who have had new onset of panic, anxiety and insomnia post antibiotic use. Improving the biome can be very helpful.
PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. The term describes a subset of children and adolescents who have Obsessive Compulsive Disorder (OCD) whose symptoms worsen following a strep infection. PANS is a newer term that describes acute OCD cases and stands for Pediatric Acute-onset Neuropsychiatric Syndrome. It includes all cases of abrupt onset OCD, not just those associated with streptococcal infections.
Here’s a hint. Bipolar disorder is NOT OCD. Seriously, it’s not. Whatever Barton is smoking, I want some. Actually, no I don’t. You never know what it might be laced with.
Another homeopath, J. Claire Green, had another recommendation:
With respect Jena, I suggest you refer this patient to someone who specializes in constitutional prescriptions. I have been practicing homeopathy and doing advance study in this area for 25 years, and I would hesitate to take on a difficult case like this.
OK, first I saw the term “constitutional prescribing” and realized that I didn’t know what that meant. Yes, even after 11 years of blogging and 18 years debunking various alternative medicine quackeries, I had never heard of this term. Live and learn. So, what is constitutional prescribing? I checked out various homeopathy sites and discovered:
Constitutional prescribing is treatment based on the whole person – that is the mentals, generals and particulars. Some methods also include a miasmatic interpretation. In the case of Homeopathic Facial Analysis (HFA) the miasmatic dominance of both patient and remedy must match to include all aspects of totality. The miasm is interpreted from facial structure while the totality is taken from repertorisation of symptoms with emphasis on generals.
The way constitutional prescribing is applied throughout the profession can be sorted into various categories – essence is a broad term that implies the “heart” or totality of the person is being taken into account and is a subcategory of constitutional prescribing
Again, WTF? I know what miasmas are. Miasmas are basically “bad air,” and represent a pre-germ theory concept that disease can result from “bad air.” Yes, it’s basically a prescientific idea that existed before Louis Pasteur figured out how bacteria can cause disease. No wonder homeopaths find it compelling. But what is homeopathic face analysis. As hard as it is to believe, I had never heard of such a thing before. So, I asked almighty Google and found this:
HFA embraces Hahnemannian principles and extends upon them by including the analysis of facial features to find each patient's dominant miasm. A miasm is interpreted as a defense mechanism which is determined by an internal energy as based on Hahnemann's three primary miasms. HFA transfers the concept of a miasm from a disease to an energetic force that is enabled during times of stress to protect the host. However like all organic systems when the host is too stressed the defense mechanism will fail resulting in chronic illness. When a homeopathic remedy (healing energy) is introduced to the system an energetic rebalance and healing occurs.
To initiate this process the remedy must have two aspects in common with the inbalanced and stressed system.
Totality of symptoms
Defense mechanism (underlying energetic response to stress or miasm)
Totality is determined through repertorisation.
The defense system (miasm) is determined by the facial structure.
As a long time Star Trek fan, I’m familiar with a term known as “technobabble,” which describes impressive, scientific-sounding verbiage that is ultimately nonsensical. Star Trek: The Next Generation, in particular, was notorious for technobabble. Well, what we have above is woo babble. It makes zero sense, but it sure sounds impressive.
Naturopathy is quackery. The very fact that homeopathy is a major part of the education of naturopaths to the point that it it is included on the NPLEX. In fact, if you want to get an idea of just how deluded naturopaths are, consider this question from the NPLEX, presented courtesy of Britt Hermes:
PATIENT: 8-year-old male
PRESENTATION: The anxious mother of the patient calls you at 11:30 p.m. because the child has developed a loud barking cough that has been preventing him from sleeping. She became frightened when she observed that he is struggling to breathe. You hear the child’s cough in the background. Onset of the cough was several hours ago, after he played outside in the cold wind; she had noticed that he had a runny nose the day before.
VITAL SIGNS: His temperature is 101.5° F (38.6° C), heart rate is 120 bpm, and respiratory rate is 60/min and gasping.
1. What is the first thing you should ask the mother?
a. “Has he been vomiting?”
b. “Does his neck seem rigid?”
c. “Is there a rash on his abdomen?”
d. “What is his breathing like between coughs?”
2. Which of the following homeopathic preparations would best address his clinical presentation?
a. spongia tosta
b. aconitum napellus
c. cuprum metallicum
d. drosera rotundifolia
As Ms. Hermes notes, the case above sounds very much like croup. Croup can range from relatively mild to serious enough to be life-threatening. I have no idea which of these homeopathic nostrums would “best address his clinical presentation.” No, wait. I do: None of them. If the child has signs of difficulty breathing or swallowing, the correct treatment is a trip to the emergency room and might even included inhaled epinephrine and/or steroids to keep the inflamed airway from closing. Guess what? This child has just such signs. A respiratory rate of 60 is way too high for an eight year old by more than a factor of two. Indeed, a respiratory rate of 60 suggests impending respiratory failure. It's a medical emergency that mandates a trip to the ER pronto. (In fact, I'd probably call an ambulance rather than chancing a respiratory arrest during the car ride to the nearest ER, as paramedics would have the equipment and training to deal with it.) Treating such a child with homeopathic remedies could result in the child’s death, just as treating bipolar disorder with homeopathic remedies, whether “constitutionally prescribed” or not, could lead to death or at least severe consequences from untreated manic phase.
Resources for mental health care in Michigan are poor enough. We don’t need a bunch of quacks treating patients with bipolar disorder and other psychiatric conditions with magic water, any more than we need them treating children with potentially serious illnesses with the same. Naturopaths are quacks and should not be licensed in Michigan—or anywhere else.
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I see on the Full Circle Natural Medicine website that the NDs that work there refer to themselves as "Primary Care Physicians" and "Medical Practitioners".
Is this legal? Where I'm from, these are protected titles, i.e they can only be used by real doctors with real medical degrees.
How is a member of the general public meant to know that these quacks are not real doctors?
Possibly the worst thing about this whole business of Naturopaths attempting to get themselves licensed as general physicians is they're apparently not taught when to say "nope, this is waaay out of my league" - something which practitioners of conventional medicine do tend to be taught as part of their training. I suspect if this patient went in to visit her GP (or whatever the US equivalent is), she'd be referred on to either a psychiatrist (or the psych emergency team in her city/county/state) or a very good psychologist as fast as the doctor could write the letter, and then they'd be sitting in their office calling the psych practitioners in question in order to get the appointment booked for now, or sooner! And that's if they weren't just saying "get thee to the local psych ward" and calling the nice ambulance people.
HFA embraces Hahnemannian principles and extends upon them by including the analysis of facial features to find each patient’s dominant miasm.
It would seem that for some people, Hahnemann's OG Homeopathy does not contain enough magical thinking, and needs to be enhanced with additional rectally-sourced gibberish.
The alternative is that they are shameless scammers trying to create a point of difference between themselves and all the competition... and that is inconceivable.
As the parent of a bipolar child (adult), I find this absolutely terrifying; not only the obvious quackery, but the idea that these people go to a chat room to get dianostic and prescribing advice! The sheer variety of replies should be a clue that none of them know anything. I’ll ask again if this information is making its way to the Michigan legislature? Please see that it does.
On a (slightly) positive note, at least the ND mentioned that the patient in question had good supportive services in place. One wonders why the patient was seeking out the ND? This is perhaps important, because some part of the existing array of services failed this patient apparently.
It is one thing for a consenting adult to be treated by a naturopath when it will only affect that adult. But with a mental illness in which other people could be potentially be harmed it seems like criminal negligence.
@ herr doktor bimler
I would hazard a guess and say that your two alternative hypotheses are not mutually exclusive.
They got to weave their own fantasies - sorry, theories - into their Guru's Masterpiece, and they got to create themselves a business edge over their homeopathic-vanilla-flavored competitors.
@#4 darwinslapdog: patients with bipolar disorder are like anyone else. They range in educational levels, income levels, and inborn general intelligence. Clearly the patient in question is attracted to woo, for whatever reason. It could very well be the patient is desperate for something, anything to fix her because science based treatments are sadly limited.
My best friend/"sister" also has bipolar I. When she goes off her meds and gets manic, it is very scary for us because the resulting depression when she crashes sometimes leads to suicidal ideation (she's never actually attempted suicide thank God).
The only thing that works for her is Lithium. Unfortunately, she has a hard time dealing with the side effects. She comes to me every now and again, asking questions hoping for a better option but she's tried everything else modern medicine has to offer her. It's lithium or nothing for now, until someone comes up with a better drug that can get through a clinical trial. I'm not holding my breath.
I am very grateful she is very intelligent, and dismissive of woo. Otherwise she might be tempted.
On another note, I took the time to read HB 4531 and Orac is right. It is truly terrifying. Basically, naturopaths would gain not only the right to perform their own quackery, but they would gain access to other lucrative services like botox injections, or teeth whitening. This is not specified in the bill but if you read it carefully, the "Naturopathic Board" is authorized to decide what treatments not specified in the bill can be offered by naturopaths. It's basically a license for naturopaths to set their own rules: whatever is not forbidden could be permitted.
Worse, naturopaths are not prohibited from consulting from unlicensed quacks who are free to continue their quackery unabated . . . they just can't call themselves naturopaths unless they have a license.
This shit is scary indeed.
So basically it's a form of phrenology?
Likewise, the description of "constitutional prescribing" looks like a game of naturopathic buzzword bingo. The words are impressive-looking, but there is no content.
Silly me, my first thought was that "someone who specializes in constitutional prescriptions" might be an ND euphemism for real doctors, and that at least one ND recognized that this patient needed real treatment. But if course not - instead the reaction is "this case is far too serious for our usual BS - bring on the extra strength BS!"
I sure hope that reference to the bipolar patient having "many resources in place currently" means that she's receiving real psychiatric treatment concurrently with this nonsense.
I'm surprised at how level-headed the first part of the question from the NPLEX appears. I'm curious, is the correct answer among the options? Or is it more along the lines of "e. Do you have a car to drive to the ER, or have you called an ambulance?"
I've seen this exact scenario go horribly wrong, first-hand. An acquaintance of mine has bipolar disorder, and managed to keep it in check for many years with lithium and occasionally some other psychoactive medication . Then he got a new girl friend, who convinced him that he should stop taking 'all that poison' and 'treat' his disorder with herbs, high doses of vitamins and (yes) homeopathic stuff.
It was really, really scary to see this poor guy flying off the rails in a matter of weeks -- exhibiting all the classical signs and behaviors, as per the DSM 5 description. The first two weeks, he became increasingly manic and hugely energetic, in spite of persistent insomnia. This was followed by very seclusive behavior, probably due to a depressed phase. At the final stage, he exploded into extreme violence, smashing literally everything in the house because of purported 'spying devices', with his girl friend fleeing the premises, barely escaping with her life. Next stop: forced institutionalization, and a very heavy medication regimen. And he's still not fully back on track. He lost his house, his dog and his girl friend -- and only the latter can be considered a good thing, as it was her stupidity that caused the former.
The worst thing was that I and several other friends saw this coming miles away, from the moment he stopped his medication, but were powerless to do anything about it. The man himself of course wouldn't take advice -- completely understandable, as the manic phase is often accompanied by huge bouts of euphoria, and yes, lithium takes that away. His girl friend of course wouldn't listen to us at all -- she considered us 'poison peddlers', and insisted that he was doing very well with 'natural remedies', thank you very much (the woman had no medical knowledge whatsoever, but that of course goes for many naturopaths as well). So no, you most definitely can't treat bipolar disorder or any other severe mental illness with homeopathy or herbs or vitamins.
Orac, it looks like this was written, in part, for you by a group calling themselves "Naturopaths for Vaccines": http://ndsforvaccines.com/nds-say-think-no-one-listening-part-wtf/
The test questions are ludicrous and leave me in doubt that the people who wrote them understood that what they described was a potentially life-threatening situation. They heard about about epiglotitis, did they?
"Treating" acute, possibly psychotic, bipolar patient with homeopathics IS criminal, IMHO.
Richard@11: Oy, that's a horrible outcome. And no doubt the ex-girlfriend blames your acquaintance for the breakup She's not entirely wrong about that--she's lucky to be alive, and I'd get out of Dodge if I were in a similar situation--but she was messing with things she didn't understand. As do most people who are into woo, though usually not with results this tragic.
@14, Eric Lund:
The girl friend actually saw the error of her ways in the end, and even blamed herself for what happened. Apparently, barely escaping death at the hands of someone you love and trust but for a severe psychosis can do that to a person.
Anyway, this is definitely something that I don't ever want to witness again. It felt like being players in a classical Greek tragedy: we all saw doom building up from the very first moment, rolling forward to its inevitable conclusion, leaving all of us helpless and frustrated.
Like most quacks and their believers, the girl friend wasn't particularly evil, merely ignorant, with only the usual arrogance when defending her beliefs. She never thought that things could go so horribly wrong.
I think this naive mindset is also a prevalent characteristic of many quacks: they somehow never face the fact that people can get really, really bad diseases and disorders, things that absolutely won't go away with just a few 'erbs and some handwaving. And yet, when things do go very seriously wrong, they appear blind for even that reality...
Belief must be a really powerful force.
"I have a new patient that is having an acute episode. Diagnosis coming in is bipolar disorder 1. She describes panic attacks, 5 hours sleep per night, and voices in her head constantly. She also describes feeling like the voices or entities are in her body and moving her body, moving her hands for example. PHx of sexual abuse as a child."
Ummm, I'm not a fan of interweb diagnosis, but there is a very big elephant in this particular room, namely that last sentence.
I would like to know that the possibility of a dissociative condition, secondary to the history of abuse, has been excluded. Having worked with a few too many (i.e. any) bairns who'd been sexually or physically abused, this sort of thing is more common than many realise and allows for mis-diagnosis by the unwary.
I would hold the girl friend less responsible than I would internet quacks who frighten people away from SB meds.
Given his RR and the gasping respirations I'd say this kid needs to get to the ED. 60 is not a good RR at any age and is more than twice as fast as this kid should be breathing.
This is silly. You already have that information: 60 and gasping. Unless this idiot who wrote this question was counting respirations during a coughing episode, which is dumb but I wouldn't put it past them. Actually, how do you even have that information on a phone call?
Yes. But as far as information about the patient goes, mental status would be by far the most important so they didn't get that correct either.
Totally agree. There's another thread that Naturowhat posted on managing insulin. It's like they think that they're only a thread or webinar away from whatever specialty they fancy. An actual doctor would have done exactly as you said.
Funny that she didn't mention suicidal or homicidal ideation. Those are pretty important things to ask psychiatric patients and lack of them is still a pertinent negative. But combine that with the test question and I question whether naturopaths even learn proper H and P.
@17, Denice Walter:
The problem here has two prongs: first, we have people who are convinced that their kindergarten magic is comparable with mainstream medicine. Second, there are lawmakers who allow and in some cases even endorse his course of affairs, often based on personal beliefs.
Here in the Netherlands, we have a similar problem. We used to have a law that required anyone practicing health care (or claiming to do so) to be able to prove their knowledge and competence, i.e. an official medical degree. But as New Age woo and quackery started to gain momentum in the 70's, this law was not really enforced any more. Some 20 years ago, a new law was adopted, which explicitly states that anyone can provide 'health care', with only a a limited number of medical interventions off-limits for non-doctors. For the rest, it's quack heaven. Anyone who wants, can claim to be a 'therapist' of sorts, and start treating patients, no credentials required. Only when people die do the authorities intervene.
The really bad thing is that even our highest judges are supporting quackery. Some months ago, our 'Hoge Raad' (supreme court) decided that a pig farmer who turned to a career as a magnetizer and 'energy healer' was allowed the same VAT exemption normally reserved for the medical profession, because in their esteemed opinion 'The therapeutic services offered by Plaintiff are qualitatively comparable to those of psychiatric professionals'. The roar of indignation among the real professionals still hasn't died away... Yet the verdict was upheld, and this quack now enjoys a 21% tax cut scamming people out of their hard-earned money. And oh, his fellow quacks are now of course queuing up to get the same tax exemption, all 40,000 of them (we now actually have more quacks in this country than trained doctors).
I'm afraid things really have to go wrong large-scale before this tide will turn...
I admire your cool Orac and don't know how you can keep your sanity intact while confronting magical thinking, which is no problem for literature, but a disaster for science. Is this XXIst century America or are we in a dream? There is an actual bill that will license quacks as physicians? It's OK if they license them as stylists or witches or human farriers or whatever, but physicians? Not as dangerous, but I want a licensed engineer to build bridges, buildings, street-legal cars, etc.
However, I must admit I enjoy reading about their claims through your blog, because it makes for great tragicomedy and because your writing style is perfect for the topic.
That said, who is sponsoring this medieval bill in the MI legislature?
I would love to tell that ludicrous bunch of NDs about my mother who was bipolar.
She had been depressed all her adult life and thought she has adequate medications. But then she started getting manic phases. She was euphoric, expansive, telling her life to strangers in the street. She also racked up a vertiginous amount of debt in a short time. When she was diagnosed and started taking lithium zero things got much better. Well, for a time.
The thing is, my mother experienced a lot of side effects. She also longed after the intense elation she felt during the manic phases. She was stubborn, and her relations with the medical profession started deteriorating. Oh, she didn't go so far as to embrace alt-med, no, but she stopped taking her medications.
We all know where this is going: one day, she took her life. The letter she left was incoherent, a mixture of "I die happy" and of fears for the future. Anyway, she die, and her refusal of medicine features heavily in the causes. A bipolar disorder can get very bad, very fast – and insidiously. Naturopaths don't know what they're tinkering with.
*When she (...) started taking lithium, things got much better.
Our family has also lost someone whose death was accelerated by choosing the naturopath over the real psychiatrist after being diagnosed with bipolar.
Holy shit. I just looked at that managing insulin thread.
One guy is poaching patients. Another is references *Medscape* (while I find their articles good refreshers, they're not meant to be tutorials for non-medical people) for dosing information. Yet another pitches her webinar. The original poster calls himself a "physician," but he's an ND.
None of them seem to have the first clue as to what they are doing. One guy even asks for a prescribing template.
I'm just stunned.
Since she said "the diagnosis coming in is bipolar disorder 1"...I hold a tiny bit of hope that the patient's disorder is being treated by the correct medically trained professional, and is not substituting homeopathy is an appropriate adjunct to real treatment, not a substitute for."
It wouldn't excuse the ND, but the patient would be better protected.
above needed better proofing. sorry.
I mean to say, I hope the patient isn't exclusively seeing the ND.
mho: "I mean to say, I hope the patient isn’t exclusively seeing the ND"
That is what our relative did. She refused to go to the outpatient clinic after her release from the psyche ward (where she was taken after her mother called 911 when she had a psychotic breakdown), and actually told us that the naturopath was smarter than the psychiatrist.
@13, "....They heard about about epiglottitis, did they?"
Yeah, this was a scary second thought in a population less likely to be immunized against HIB than the average population.............
I have bipolar type II disorder, the kind where I have had deep depressions interspersed with moderate periods of hypomania (a less serious form of mania). Thankfully I’ve found the drug lamotrigine to be a godsend, and I’ve been stable for several years. That all being said, getting the appropriate psychiatric care has been a real challenge, much more so than for other medical conditions that I’ve had. Some of these issues might be playing a role in how the person in the original post has ended up seeing a naturopath.
1. Most psychiatrists do not accept health insurance. A 20 minute office visit can easily cost $100-150 in these cases. And even with out-of-network insurance benefits, these visits may still not be covered, if the insurer demands a treatment plan from the psychiatrist, and the psychiatrist won’t provide one, since he/she won’t deal with insurance companies.
2. Newer psychiatric drugs are very expensive, and may not be covered by insurance. The insurance companies will likely make the patient try numerous older drugs before covering a newer one. And a lot of psychiatrists won’t submit appeals or pre-authorization paperwork for drugs to the insurers, since they won’t deal with insurance companies.
3. The stigma of mental illness can still be an issue to getting the right care. My ex-husband would not accept that I had bipolar disorder (there’s nothing wrong with you, he’d say). Fourteen years later he still doesn’t accept it. When we were married, he actively discouraged me from getting help. If the person in the OP has family members who are not supportive and/or pushing the naturopath way, that could be a real disincentive.
4. Sometimes none of the current medications work for a person, so they are really left bereft of options. Not that naturopathy will work, either, of course. But it’s still an awful place to be. It took 15 years until I finally found a medicine that worked, and it was long hard slog all the way.
“But Professor van Os argues that the classification is complicated, particularly for psychotic illness.
Currently, psychotic illness is classified among many categories, including ... depression or bipolar disorder with psychotic features, and others, he explains.
But categories such as these "do not represent diagnoses of discrete diseases, because these remain unknown; rather, they describe how symptoms can cluster, to allow grouping of patients."
… If your psychotic symptoms disappear we may reclassify it as bipolar disorder. If, on the other hand, your mania symptoms disappear and your psychosis becomes chronic, we may re-diagnose it as schizophrenia.”
Renee: "It took 15 years until I finally found a medicine that worked, and it was long hard slog all the way."
We have friend who is bipolar (as is her child). Her hubby was ecstatic when they finally found a medication that worked for her, because she no longer destroys keyboards with an ax (she did that twice). A sense of humor is one way that family copes.
There is so much wrong with mental health services, that we could go one for hours and hours. My favorite bit of news is this:
Apparently they are threatening to put a the CEO of a state mental hospital in jail for refusing to let someone cut in the waiting list line. There are simply not enough beds, and there are other people who need help, plus there are not enough outpatient services. From the article:
Renee, medicine by insurance co is great isn't it.
I can just think of what happens when a NAD (not a doc) reads the following (I am assuming they don't get past this paragraph).
Study: Fatal Ebola associated with age, fever, and … hiccups
Among characteristics that might be predictive of death in Ebola patients are older age, presence of fever, and the occurrence of hiccups, according to a retrospective study by Chinese researchers of patients in Sierra Leone published yesterday in the American Journal of Infection Control.
If you are over 45, have a fever and have hiccups you are going to die from Ebola. I wonder what they will prescribe to prevent this?
Quoted from an ND facebook post on October 2014
“Ummm..ebola is a VIRUS! Why aren't hospitals willing to use a well-proven anti-viral just because it is a vitamin and not a drug??? The[sic] is plenty of research out there about !VC being used to cure polio in 1940's...very frustrating when there is an obvious treatment that gets ignored because it is not a new expensive drug...ugggh!”
followed by a link to a Mercola article “High Dose C found useful for Terminal Swine Flu, Vitamin C can help fight infectious diseases as high dose vitamin C ...”
She's obviously PTS III. She needs to disconnect from SPs and do the Purification Rundown.
mho, I was thinking that if you were over 45, had a fever and the hiccups; a NAD might diagnose you with Ebola.. Of course being diagnosed with Ebola would probably scare the crap out of you and cure the hiccups.
Renee, my experience is much like yours, but I was finally diagnosed more recently, in part on the testimony of someone who recognized it while I was too close to it to see it. Lamotrigine is also my wonder drug. A nice side effect is that added to nortriptyline my migraines went from several times a week to a few a year, mostly just prodromal without full-blown symptoms. I still get mood swings, but much damped down.
I do wonder whether acupuncture for Bipolar II uses shorter or duller needles than for BipoIar I.
I moved in with my cousin, about 4 minutes walk from my previous place where I was and still is tenant (I still have that responsibility even though I'm no longer living in my own apartment).
Said apartment is occupied by two flatmate: my brother and a good friend.
The brother is hell bent on destroying me because I have a metric ton of obligation to fulfill, mostly financial ones but also, answering with due diligence his 140~160 questions per day, doing the apartment cleanup each day for which he'll harass me for an hour to two per day despite agreeing to it (he feel the need to punish me endlessly), being a living Wikipedia & google maps for him (I suffer from amnesia and have you ever calculated the number of streets in Montreal?...).
Each day, every f*ck!ng day, 8 to 10 hours per day of this, non-stop. Have I said that his wake to sleep schedule range from 3pm to 3am (wake cycle) and 3am to 3pm (sleep schedule, aided by 450mg of Seroquel before sleep).
during these past 3 months and a week, I had to wake up at 7am; to wake up the other flatmate and discuss (bit more intelligent conversation) but usually, for 30 minutes to an hour max. Rest of the day was finding solution for all three (me, a job; flatmate, depends but usually legal topic; oldest brother....) until 3pm hit.
I moved in with my cousin and because of that, oldest brother reported me to welfare agency because I was in the process of moving back to Sherbrooke city for therapeutic purpose and had my paycheck sent there and I did move there but have been back to Montreal for work purpose (I was called in on the day I was scheduled to go into therapy).
Brother reported me because I failed to stay at my place and failed to fulfill my obligations (which include the 3pm to 3am gist).
Last Monday, we get into an argument over email which ended up by him reportedly calling the cops against me (he didn't but I knew after the fact). I recognize that I bottled up too much, way too much (matter of fact, it was a protracted 3 months of total meltdown for which it took me a week to recover from) and I ended up dotting the i and crossing the t's in that email exchange (me: 30 emails, him 45 emails).
Today, I became aware that he crossed the street on a red light (voluntarily) and was en-route to the psychiatric ER. I'm at loss for how I should feel but one thing's for sure, I can't compute or process. I just have no clue.
Oh Alain, I am so, so sorry that you're having such a hard time. That sounds like a horrible, impossible situation.
My psychologist once told me that "You are allowed to feel any way you feel. They are *your* feelings."
May I offer an internet-hug?
Thanks for the hug, it's very much appreciated.
I put some order in my thoughts and could see the issue dating back a few years. There are 3 issues with the brother: the first, he told repeatedly that he can count on the family for the most help (we are all ill equipped to deal with that). Second, he dropped out of high school level three special ed. Third, I'm the second autistic (he's an aspie with 3 diagnoses of asperger out of a confirmed 6 diagnoses) in the family and I went to university.
Nearly forgot about a 4th issue, restricted interest into winning all the "combats" he fight for and it's a major case of OCD and thus, even if we declare defeat within 5 minutes, he'd pummel over anything for 1 hours 25 minutes more, on average. Probably to ensure that we never have the will to say no, ever; which is pointless because when it happen again, we declare defeat within a split-second and still, we're in for another 1:30 (yes, that's hour) of pummeling again.
The only time it doesn't happen is when I need to call the paramedics (via 911) because he's suffering from either, asthma, cardiac or epileptic issues and this happened 13 times (paramedics that is, there has been other, less emergent times for which we still had to go to one of the hospitals here) since last March. Each and every times of those occurrence, I went with him and didn't get out of the hospital until I had assurance that he was took in charge and discuss his medications history among other details.
The 4 aforementioned issues are engraved on a diamond plate in his head. No one has a clue how to make him loosen up, be less strong and rigid in his convictions. No one, period.
On my side, I'll be back to work on Tuesday next week and tomorrow night, I'm having supper with my financial planner, her husband & son :)
I feel better.
That questionnaire at the end is downright frightening. Naturally, the correct answer to question 1 is secret option e: Why haven't you taken your kid to a #$%@ing hospital yet!?
If I could I would lend you one or both of my dogs I would. They are a pain in the butt but they give more love than they take. One is a big yellow lab named Jade (about 130lbs only slightly overweight and the other one is a ranch dog (Kodi). I kind of inherited them from a friend with brain cancer.
Oh, once they become your friend they are very protective.
From Monty Python: Look on the Brightside of Life.
Oh I so love dogs and they love me to the point that people rain on me a massive bunch of suggestions to become a vet. Even one of my first year at bishop's university, my biology lab instructor always had his dog in his office and when he let the dog out in the lab, I was always the one the dog went for a kitzle or petting despite having over 80 people in the lab. No exceptions.
Some day, want to buy a mountain in the countryside and have a house built on the very top (I like the polished concrete and glass style) but I don't know if such a land will be dog and horse friendly.
Fave dogs: blue Great Danes :) http://www.mesdanoisbleu.com/
Remember TrueHope, the family company of the Stephans (the parents of poor Ezekiel?). Not only do they provide a cautionary tale of what happens when you trust your child's well-being to quackery, but also one of what happens when you try and treat serious mental disorders with snake oil:
I read the questionnaire too quickly and thought the theoretical child was at the ND's place. But it's all over the phone, so yeah, they may want to assess their sense of priorities.
Enough with the brother (it would be on-topic had I spoke about the possibility of him under the "care" of a not-a-doctor). Regarding the topic of this post, I just wonder WTF ND's are thinking if they are allowed to treat patients with mental issues as severe as my brother's case or any cases found in the news.
Futhermore, even outside the care of ND's, I'd advocate the inclusion of more brain based biology courses in the fields of social workers, psychoed and the allied health professions serving mental health patients.
The reason behind this is because I see too many of these peoples (exception made of neuropsychologists) treating the brain as a black box with an observable set of behavior and we need to get past that. As Orac say, Medicine will never be a science but need to be as science based as possible and as I say, those professions should fulfill the same criteria because, they are part of medicine in that they treat patients according to the medical doctor's guideline.
I don't see that yet and likely, would never see it in the realm of not-a-doctors...
Could you show us on this anatomically correct doll just how 'Nasty Nate' touched you???
SWIM (someone who isn't me) has developed 'Parkinsonian tremor' from taking loxapine. The doctor told him to initiate a protocol of benztropin (Cogentin) which works like atropine.
The shakes are not that bad and don't really bother him. My question is "does the atropine-like pill prevent whatever damage is being done by the loxapine or does it just cover up the negative effects of antipsycotics?? Constipation is a bitch and a half as well as visual acuity being somewhat off.
Any thoughts? I'd like to tell SWIM one way or the other.
Homeopathy is part of naturoapthic medicine because naturopathic medicine teaches all major forms of healthcare. You are required to study it, but you are not required to believe in it or to use it in practice. I do not use it in practice because I am not convinced by its rationale or by any science that it is as good as other choices for treating patients. I would like to see it offered as an elective, but there are too many naturopaths that "believe" still. I don't think they are dangerous if they follow what is taught in naturopathic school because we are taught not to use it when conventiional medicine is required.
And in regard to examples such as those I have seen given from Natchat etc, I don't know if they are taken out of context (example: if a psychotic patient is also receiving care by a psychiatrist and is seeking adjunctive care from a naturopath)?? But I can tell you that the naturopathic classes and rotations in naturopathic school taught us to rule out the need for conventional medical care before attempting to approach the patient with homeopathy. In naturopathic medicine, it is malpractice to fail to treat with conventional medicine or to refer if beyond your level of competence, if conventional medicine is required by the diagnosis or if there is any sign of danger and a clear medical diagnosis cannot be reached within your level of training. Same as a PCP would refer to a specialist. As a naturopath we are not trained to treat patients for severe mental illness. As a naturopath, I am most disturbed by a any doctor naturopath or acupucuturist or chiropractor or MD who does not abide by their limitations. I am also disturbed by arrogance of one profession over another. Reminds me of partisan politics and doesn't feel like real 'science'. Naturopathic medicine has some serious strengths in its quality of training. It feels politically driven to draw a gross caricature of naturopaths in order to defame the profession. It is disingenuous for someone claiming the mantle of sciene to build a strawman argument against the profession to undermine its advancement. It was ugly when MDs did it to osteopaths the first half of the twentieth century -- and it is ugly to see to see it done to naturopaths now. It would be better for the safety of the public to encourage license of naturopaths and to support improvement of naturopathic education/training than to attack all of naturopathy as if we were all the same. Naturopathy as a profession is not going away, so throwing the baby out with the bathwater is only going to help the quack natruropaths and slow the improvement of CNME trained naturopaths.
Mr. Barnett, if you want naturopathy to be taken more seriously then you should campaign that they abandon the parts of it that are not bound by reality. We will know you are serious when you tell the naturopathic schools to stop teaching homeopathy, acupuncture, reiki and other non-scientific things.
"As a naturopath we are not trained to treat patients for severe mental illness."
Except many actually do that. We have a relative buried in a cemetery up the street because she decided her naturopath (whose office was then called a "Homeopathic Clinic") was better than the real psychiatrist she saw in the county psyche ward and then refused to go to the outpatient clinic.
Wow, lots of people with problems in this post. I'm a easy going person and if homeopathy helps you then I'm all for having the freedom to use it. The government tries to control our lives way too much. Freedom of choice is best. Many people on multiple drugs today, under a doctors care, die or their medications are causing their death. I think I will check out homeopathy and see if it works for me. Take care all. :-)