What Do We Do About Insanity?...And other fascinating articles this week concerning mental health

Dear Family,

There's a church near us that just hosted a forum on Supporting Families Dealing With Mental Illness. The announcement read: "Clinical Depression, Bipolar Disorder, Schizophrenia, and Anxiety Disorders ...one out of five families are affected by these illnesses, and family members need a great deal of support and education in order to help their loved ones. Here in Ithaca, NAMI-FL or the National Alliance on Mental Illness - Finger Lakes Affiliate sponsors a free 12 week Family to Family Course as well as bi-weekly support groups..."

Did you notice that crazy figure? _One in FIVE families_!!! Is Tompkins County somehow worse-off than anywhere else? If this statistic proves anything to me, it's that families need a lot more options besides support groups, talk therapy, and psychiatric medications, important as they may be in the short term. We are dealing with an epidemic, and as my friend says--using the metaphor of the Titanic--we need all the lifeboats we can get.

http://www.wired.com/magazine/2010/12/ff_dsmv/all/1

Jeff and I recently read this article(in “Wired”, concerning the currently-in-progress revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM), and I have to admit, it was kind of scary. (Wikipedia offers a brief overview of modern psychiatric offerings: http://en.wikipedia.org/wiki/Psychiatry .)

The implication to me, as additionally illustrated by the brouhaha surrounding this latest revision of the DSM, is that modern medicine is not standing in the wings with very many (even palliative) solutions for mental illness. As you know, I just can't help getting worked up about this. Especially when most doctors don't even mention the role of nutrition in mental health disorders and treatment.

The “Wired” article begins:

"Every so often Al Frances says something that seems to surprise even him. Just now, for instance, in the predawn darkness of his comfortable, rambling home in Carmel, California, he has broken off his exercise routine to declare that 'there is no definition of a mental disorder. It’s bullshit. I mean, you just can’t define it.' Then an odd, reflective look crosses his face, as if he’s taking in the strangeness of this scene: Allen Frances, lead editor of the fourth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (universally known as the DSM-IV), the guy who wrote the book on mental illness, confessing that 'these concepts are virtually impossible to define precisely with bright lines at the boundaries.' For the first time in two days, the conversation comes to an awkward halt.

"But he recovers quickly, and back in the living room he finishes explaining why he came out of a seemingly contented retirement to launch a bitter and protracted battle with the people, some of them friends, who are creating the next edition of the DSM. And to criticize them not just once, and not in professional mumbo jumbo that would keep the fight inside the professional family, but repeatedly and in plain English, in newspapers and magazines and blogs. And to accuse his colleagues not just of bad science but of bad faith, hubris, and blindness, of making diseases out of everyday suffering and, as a result, padding the bottom lines of drug companies. These aren’t new accusations to level at psychiatry, but Frances used to be their target, not their source. He’s hurling grenades into the bunker where he spent his entire career..."

Some thoughts I had, while reading the rest of this article:

--Maybe it wasn't so bad to be obsessed with Freudian psychology even half a century ago, when people's gut flora and nutrition were both not quite so compromised. But I do think it's pretty insane to constantly claim causation in the instance of correlation in the way it's currently happening. Because I no longer buy all this stuff about "having a bad childhood," and "getting to the bottom of emotional issues.” Of COURSE people have bad childhoods--probably even worse than I can imagine. And of course there are traumatic situations, happening all the time. But it doesn't make sense that these would be the cause of mental illness. (How did the dysfunction begin?? Just magically one day, out of nowhere?) Or depression. And we humans get SO hung up on noticing psychological patterns that might actually be caused by entirely other factors than psychology itself...

--The gut flora hypothesis adds such an element of understanding, even though I know the research is in its infancy and can't even begin to give us complete answers. But A. it allows us to understand a way to heal (huge!!! Why aren't people knocking down the doors of Natasha Campbell-McBride's clinic??), and B. it sheds light on the dizzying ways that even the diagnostic tools used to define mental illness are becoming insufficient with each passing year. (Even if the drugs WERE working, it seems like the mental state of the average person is getting so complexly strange that we can't even define it easily anymore.)

--There's a sidebar to this article, that sort of gives a broad overview of the different ways that diagnoses have evolved over the years, for four conditions: autism (used to be defined as "Schizophrenic reaction, childhood type", now is autism spectrum disorder, encompassing myriad symptom-sets); depression (used to be called a "depressive reaction" or a "depressive neurosis", now a category of disorder); "hysteria" (used to be called a "hysterical neurosis," then became "histrionic personality disorder" for a couple of decades, before it finally got removed from the DSM); ...and a "new" condition, freshly-discovered in time to be published in this upcoming DSM-5: "Sexual Interest/Arousal Disorder." ("That's great!" Jeff said when we came to that part. "Wouldn't it be fantastic to sit around at a party, and then when somebody asks how you are, say, 'Well, much better since I've been trying this new med to help deal with my SIAD'!...")

--An unfortunate thing is that political discussion about "lifestyle choices" get polarized on Good/Bad, and Moral/Immoral, legal/illegal etc. etc. Which is kind of problematic. I know there are autism-rights groups out there, I've read about them, filled with people who have autism and feel shunned by the rest of their culture, and feel like there need to be more rights for autistic individuals, and respect for their unique functioning... And I am not even going there for a moment, to say that these folks aren't saying valid things.

But...there's another way to think about it, although I can't articulate it too well. Kind of like...saying that I want to heal Ben does NOT mean that I want to stop him from being him, or stop his sometimes-genius artistic abilities. Healing him doesn't negate the fact that his illness has created some silver linings as it runs its course. I don't deny that sometimes, it seems like the disabling parts of autism can cause an individual's brain to compensate and function extremely highly in some days (i.e. Temple Grandin, etc.). Some people argue that this is reason enough NOT to try to "change" people who are "mentally ill."

And then of course, there are people who are calculatedly hellbent on trying to change anyone and everyone's "deviant behaviors" by force or other means...and this, of course, is less than useful too, because STILL no one's talking about _underlying cause._

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http://www.utne.com/Politics/Straddling-A-Fault-Line-Schizophrenia.aspx

[This article, concerning the challenges faced by so-called “mentally ill” persons within our current culture, was honestly and truly scary. And it reminds me why I am obsessed with the possibility of healing sick bodies and brains.]

I could have told Moira Blum, the girl in my dorm who believed in astral projection and traveled to other planets on weekends, but she would have just congratulated me. I thought of telling Candy Weiland, who always said “Hey” to me, the girl who let me know on day one of college: “This here Kentucky--it’s God’s country.” She was the size of a jockey and swore she’d own a horse farm some day. “My granpappy’s got some land and a passel of horses,” she’d say, twirling her mane of hair into a bun. But how do you explain to anyone that something wispy and curling is crawling beneath your skin?

Or that I could not understand my clock anymore. Little arrows pointed to numbers, but I had no idea what they meant. To get to class I had to go down the stairs, and the stairs were revolving the way they do in spy flicks after the hero gets poisoned. I groped for the floor with my foot and clung to the handrail. Everywhere I went a ruckus throbbed in my head. Shadowy images of helpless victims in guillotines snapped in my mind. And my spring term papers were due...

...Today, not one person around me thinks I have any reason to live in fear two decades after my first hospitalization at college, but I have not told them about the years of free-floating anxiety, depersonalization, borderline personality, and dissociative disorder. I definitely have not told them about my roommate.

Eighteen months after my first hospitalization, I lived in an apartment with a quiet, plump girl who went to school with me. She paid her own way; voc rehab paid mine. I don’t remember her name, just that she had freckles, but the rest of the memory goes like this: She knows nothing about my guillotines or that my pills are not vitamins. Even though she spills Frosted Flakes on the floor every morning and does not clean them up, I still do not want to obey the voice telling me to kill her.

I have swirling, drooling sleep thanks to medication, but for some reason my eyelids pop open in the middle of the night. My body feels pumped with air. In the darkness, a voice speaks, a male voice, I think.

“Kill her. Get a knife and stab her now.”

I am schizophrenic, but I have enough sense to know something is wrong. Even while I’m medicated and dopey, I know stabbing is a point of no return. The voice sounds authoritative, though, and my body feels pushed upward, against my will.

“Do it now,” says the voice.

Out of the corner of my eye, I look at my roommate, a white-skinned fattened lamb, and hope she makes it through the night. I resist the pressure to get up, breaking into a sweat from all my effort.

“Help me,” I try to shout. Only a raspy whisper emerges. Images of police and prison and the end of the world flash and twirl in my mind. My body shudders. I can’t believe my life will end this way. I can’t believe this is me.

The pressure on my body ceases and I slump into my mattress, exhausted. I do not know how long the episode lasts, but as suddenly as it began, it ends. I stare at the ceiling and pant, scared to budge...

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http://www.wildestcolts.com/index.html

While he doesn't make the gut flora-human brain connection, John Breeding is a psychologist who is an activist against the use of psychiatric drugs on kids. From his website, discussing the e-list he maintains:

“The purpose of the Wildest Colts Listserve is to inform members honestly of the state of bio-psychiatry's invasion of our nation's schools, through mass drugging of millions of children with psycho-stimulants and a plethora of other psychiatric drugs. This crisis has become a true epidemic, with at least 10 million American school aged children taking these drugs for bogus psychiatric 'illnesses' and 'disorders'. ...These drug 'treatments' are harmful, having caused death in a multitude of instances, and can and do cause psychotic reactions in some persons who take them, causing such violent outbursts as the school shootings in Columbine and other areas recently. Due to these factors, we consider the mass psychiatric drugging of up to 15% of this nation's school age children to be an abomination and the most dangerous factor in their lives at this time. As responsible adults, and professional members from various fields of health, mental health, law, advocacy, education, politics and other fields, it is therefore our obligation to speak up and fight this great injustice, until it is no longer occurring in this country. Join the Wildestcolts listserve by sending a blank email to: wildestcolts-subscribe@yahoogroups.com.

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Thanks for reading, and I'd love to hear what you think about the topic of mental illness, or any other. :)

Love,
Sarabeth