Not Now — I am Hypnotizing the Chickens

Chickens.  Lots of chickens.
The poor things don't even have their own cubicles!
I kept cracking up as I read this New York Times piece on the use of PowerPoint in the military. Who knew that there was such an apt phrase for the act of dazzling and boring a credulous audience into submission?

On a slightly more serious note, if you’d like to start your day with the lash of indignation, you have only to read this exercise in arrogance by psychiatrist Daniel Carlat, who is proud that he now spends a few moments talking to his patients before whipping out his prescription pad even though doing so reduces his profits slightly. Be still my heart. I’m fascinated by how he pairs an unquestioning faith in the psychiatric Diagnostic and Statistical Manual with a cheerful willingness to slap a patient with fiercely addictive uppers and downers without apparently mentioning the substantial long-term risks. Even more interesting — and, frankly, discouraging — is how many of the comments praise him for for his insight. If this is an example of refreshing modesty, then our standards for psychiatrists must be very low indeed.

I have been considering what the heck to do with this blog now that I am apparently not bipolar. I don’t really see closing up shop, and he idea of launching a campaign against the psychiatric establishment makes me more weary than an hour of PowerPoint. I have a lot — a lot — to say about the evils of the 21st Century, so don’t be surprised if I hare off in that direction.


I’m Not the Only Mental Chick Off Her Meds

I’m intrigued to note that the author of The Secret Life of a Manic Depressive has gone off of her meds, and is questioning a diagnosis for which she’d been treated since age 12. Hm. I sense a movement starting.

I must note with regret that I’ve lost five of the 10 pounds that I gained on Zyprexa and Remeron. I felt mighty cute at 109, and was almost giddy at the prospect of being able to buy clothes off the rack. Alas, I’m back to regarding food with mingled indifference and suspicion, and my uncannily tiny clothes are growing baggy once more.

In Which I Rise Like Lazarus

I’ve been off all medication for two weeks now, and I have the strange sensation of turning back into the mercurial 19-year-old that I’ve missed so. It’s as if I’ve come back to life and the burial cloth shrouding my senses is falling away. When you combine this with the evidence from Robert Whitaker’s Anatomy of an Epidemic, it looks very much like the past 20 years of crushing mental illness may have been iatrogenic.

You would think I’d be vibrating with horror at that possibility, and, indeed, a part of me feels very angry indeed. However, I’m mostly grateful to have escaped. I’m not entirely recovered, and it’s not realistic to expect to undo two decades of damage in weeks or months, or perhaps ever. I’m hardly perfect now — I do have this alarming temper, for example — but I’m so much better than I ever hoped to be. It really does take my breath away, and I feel profound and unforced gratitude.

There is a moral here, however: It rarely pays to be a good patient. The more conscientiously I followed medical advice, the worse my situation became. A more rebellious or skeptical soul might have stepped off the merry-go-round years ago. Until six months ago, with each downward turn I actually redoubled my commitment to the medical model. If I can just get the meds right, I can whip this, I would think. And the worse I got, the more I doubted my own perceptions. I knew I was getting the best possible treatment, so I blamed my slow disintegration on imagined deficiencies of character. I felt that I must be lazy, sloppy and downright ungrateful. The meds are so good, I thought, and I’ve certainly tried them all. I must be the weak link here. The truth, though, is a textbook example of irony (Dad take note): The more faithfully I followed orders, the worse I became. I felt so horrible precisely because I was so very, very accomplished at being “good.”

I’ve run out of writing time — I’m finding all of this very difficult to imagine and express — so I’ll close now and return later to what is, after all, the key question: Why was I so desperately obedient? And what drove me to this lifesaving rebellion?

Most profound love to all.

I Hate the 20th Century: Email Hack Edition

Here's the Archbishop Cranmer being burned at the stake in 1556. He seems to be taking it pretty well, all told.
During the Elizabethan era, the state executed unfortunates who were convicted of treason as follows:

1. Half-hanging (which I believe is an erotic practice in these degenerate times);

2. Disembowlment while conscious (not, to my knowledge, an erotic practice);

3. Burning at the stake.

If your friends felt sorry for you, they would pay to have a bag of gunpowder hung around your neck for the last step; it would decapitate you relatively painlessly as soon as the flames reached it.

An inventive bunch, the Elizabethans. But nothing they could dream up is too harsh for the jerk-off who hacked my email yesterday, thereby inconveniencing me at the end of an exhausting day of PowerPoint-driven meetings.

Speaking of the death penalty, when I am named dictator, I must dream up and enforce a grisly punishment for people who utter any variant of the following during a PowerPoint presentation: “I’m not going to read this whole chart to you….” To which I say, “No? Well bless you, since the wretched thing is written in single-spaced six-point type.”

Final note on the history of capital punishment: For the Elizabethans, murdering your husband was punished as treason, since, after all, your husband was your lord and master for legal purposes. I believe that murdering your wife drew a fleeting frown of disapproval from the bench before the court moved on to more serious matters, like sheep-rustling.

Final note generally: I’ll be cutting back to two sessions a week for my intensive outpatient program, so I should be able to creep back into this space.

Book Review: Robert Whitaker’s Anatomy of an Epidemic

If you’re taking psych meds or care about anyone who is, click here and order Robert Whitaker’s Anatomy of an Epidemic right this minute. Better yet, hie thee to your local big box bookstore, buy it today, and start it tonight. You’ll want an emergency appointment with your shrink the next day.

I am prone to exaggeration, I suspect, but I’m not indulging that sin when I tell you that this is the most important book I’ve read about psych meds. Whitaker argues that, far from fixing “broken brains” or relieving symptoms, psych meds — antipsychotics, antianxiolytics, antidepressants, and mood stabilizers — cause the very illnesses that they purport to cure.

I don’t want to believe Whitaker. I want to plug my ears and hum, put out my eyes rather than read the words on the page. The evidence is irrefutable, though, and it’s pulled from a staggering variety of unimpeachable sources.

A crude summary:

1. Clinical studies have shown again and again that antidepressants, for example, are no more effective than placebos in relieving depression. This is well-established, and has even been discussed in the general press, including my beloved New York Times. The few studies that do show efficacy do so because they were crudely manipulated by the sponsoring drug companies.

2. It’s also long been accepted that psych drugs do not work the way that conventional wisdom says that they do (I read about this debate most recently in The New York Review of Books, but if you’re interested in these things, again, this will not be news). That is, they do not supplement a serotonin deficiency. Whitaker takes this debate to its logical conclusion, demonstrating that powerful evidence exists that psych drugs actually damage the brain’s ability use the neurotransmitters available. The science is not based on speculation, and this is not a hypothesis. The mechanism of action of antidepressants is old news, and Whitaker’s argument simply presents long-available information in a lucid, step-by-step fashion.

3. But what about those hordes of crazy people who got their lives back when psych meds were introduced? Um, that didn’t happen. Depression, anxiety disorders, and manic-depression were all vanishingly rare in the centuries before the 1970s and 1980s. Systematic examination of the studies available shows that all three have reached epidemic levels in the last 30 years.

4. More horrifying still: Large-scale outcomes have deteriorated significantly significantly for all of the mental illnesses for which drug treatments are available. In the 1950s, about half of the few people who suffered a manic, psychotic or depressive episode remitted spontaneously. When patients did experience repeated episodes, they enjoyed long interim periods of stability and high functioning — they married, had children, held jobs, and lived largely normal lives. People who are diagnosed with a mental illness today are much more likely to be permanently disabled, and much less likely to function well enough to get an education, hold a job, marry, or care for any children they may have. By objective and subjective measures, their lives are a misery.

Have I mentioned that I am one of them, and that my life has sucked?

5. It’s always been acknowledged by enlightened practitioners that psych drugs are, at best, a bargain with the devil. When doctors weren’t just telling you to shut up and take your meds already — do you want to be a burden on society? — they were apologetically explaining that side effects ranging from humiliating to life-threatening are a small price to pay for the privilege of living a normal life. Psych drugs can kill you quickly, through, say, a serotonergic reaction or a fatal spike in blood pressure. They can kill you slowly by causing dangerous weight gain, diabetes, and metabolic syndrome. And, of course, they can render your life pointless by making you impotent, for example, or robbing you of your intellectual and artistic gifts.

That’s the quick-and-dirty version. There’s a lot more, including cogent responses to all of the objections that are bubbling up on your lips right now. Read it. I dare you.

A Fantastic Article on Mental Health and Finances from The Simple Dollar

I really recommend this brief article from Trent at The Simple Dollar. It’s so funny — I know intellectually that bipolar people face specific financial difficulties, but I experience tremendous shame and frustration about my relationship to money. I’ll take the time to write a full-length post about this later today. For now, I invite all of you to think about how mental illness — or even just normal emotional ups and downs — have affected your financial life.

Guest Post: The Health Care Bill Might Not Be As Trivial As I Thought

A lawyer friend recently sent me the following and gave me permission to publish it here as a guest post:

The health care bill is very, very complex. Wrapping one’s fingers around the health care costs of employers, the government costs of subsidies and tax breaks, the societal benefit of low-income citizens having access to health care, including the economic savings as a result of prevention, early detection, and quicker treatments that allows people to get back to work, the savings of hospitals who will have fewer patients who can’t pay, the additional revenue of new taxes, changes in medicaid, the potential changes in insurance premiums and costs, as well as the economic efficiency and new jobs created from allowing people to spend their money on homes and cars and vacations instead of health care- and comparing that to the cost of doing nothing- is next to impossible. I have a degree in economics, and I have no clue what the costs and trade-offs are going to be. But I do know it’s complex.

Who likes things complicated? Nobody. So Republicans, to their credit, have done a fantastic job of manipulating the debate. The “debate” became one about death panels, big government, socialized medicine, and huge tax increases. These things are easier to understand. As a result, people turned strongly against a health care bill that will benefit many of them. Republicans have scored major points by opposing and blocking anything and everything. Sadly, it seems likely that some Democrats may lose their seat in congress because they wanted their constituents to have better access to health care.

I am sending this to you, because you know more about health care than I do, and you have a blog. People who care about the welfare of others and favor health care need to share our thoughts with the world.

Here is HR-3950 in condensed version:

1. Tens of millions of Americans who didn’t have health insurance before will now have access to affordable coverage.

2. The biggest part of this program will be paid for by closing a tax loophole that only the super-rich could exploit, and by taxing the profits the super-rich reap by letting their wealth earn interest for them.

3. Insurance companies will no longer be allowed to massively raise premiums and co-payments while denying claims simply to boost their profits.

4. Families with good insurance will have an easier time keeping that insurance, even if they change jobs or even change states.

5. Because families will have more choices of insurance, they will be able to pick a plan that saves them money.

6. Most middle-class families will spend less of their money on health care, freeing them to spend it on houses, cars, vacations or big-screen TVs, giving a boost to the economy and creating new jobs.

Interesting. I guess I had lost perspective and come to think that (without seeing the new law) the reform that passed was no reform at all.

Love to all. I’ll be off for the next four days, but will take up my pen again on Friday.