Tag: mental illness

Jun 21

Tell FBI Director to Read the Law!

The murder of nine people in the AME Emanuel Church in Charleston, NC Wednesday night was a racially motivated hate crime. It was also an act of domestic terrorism, just not according to FBI Director and war criminal James Comey

“Terrorism is act of violence done or threatens to in order to try to influence a public body or citizenry, so it’s more of a political act and again based on what I know so more I don’t see it as a political act,” Comey said at a press conference Friday in Baltimore.

Authorities arrested Dylann Roof, 21, earlier this week in connection with the killing of nine members of Emanuel African Methodist Episcopal Church.

Some have called the incident an act of terror. The FBI’s official definition of terrorism is: “The unlawful use of force or violence against persons or property to intimidate or coerce a government, the civilian population, or any segment thereof in furtherance of political or social objectives.

The Department of Justice thinks otherwise

Federal officials are investigating the shooting at a historic black church in South Carolina as a potential “act of domestic terrorism” as well as a hate crime.

“The department’s investigation of the shooting incident in Charleston, South Carolina, is ongoing,” Justice Department spokeswoman Emily Pierce said in a statement Friday.

“This heartbreaking episode was undoubtedly designed to strike fear and terror into this community, and the department is looking at this crime from all angles, including as a hate crime and as an act of domestic terrorism,” she added.

Someone needs to tell the Director to rad the law. Here is the legal definition of “domestic terrorism” from 18 U.S. Code § 2331:

   (5) the term “domestic terrorism” means activities that –

     (A) involve acts dangerous to human life that are a violation of the criminal laws of the United States or of any State;

   (B) appear to be intended –

     (i) to intimidate or coerce a civilian population;

     (ii) to influence the policy of a government by intimidation or coercion ; or

     (iii) to influence the policy of a government by mass destruction, assassination, or kidnapping; and

   (C) occur primarily within the territorial jurisdiction of the United States.

What part of that law did Comey miss? The assassin, Dylann Roof made it abundant;y clear in his manifesto what his intentions were. On, wait, it’s a white guy that’s not a Muslim.

Jun 19

You’ ve Got to Be Carefully Taught


If racism, as many right wingers are claiming, is a mental illness, there a lot of mentally ill people in the world and too many of them are given access to guns. But the Republicans who can’t seen to admit that the murder of nine black women and men in a church in Charleston, South Carolina by a 21 year old male, white supremacist is an act of racial terrorism of the black community, not mental illness. Racism is taught. You have to be taught to hate and fear, you have to be carefully taught. The United States has a problem racism that a good many prominent whites are refusing to admit.

Why the GOP Hates Talking About Hate: Conservatives Can’t Confront Racism in Charleston Shooting

By Ana Marie Cox, The Daily Beast

In the 24 hours after the massacre inside Charleston’s Emanuel AME Church, GOP politicians and members of the conservative commentariat have tried to explain Dylann Storm Roof‘s motivations on a spectrum that runs from merely murky to the explicitly anti-religious.

They have taken pains to avoid the abundant evidence that Roof was a sadly familiar figure: a young man motivated by racism to violence.

Louisiana Governor and passive presidential aspirant Bobby Jindal inserted the shruggie icon into the debate, averring that we should defer to the expertise of police detectives in sussing out the connection between Roof’s documented history of racist sympathies and his perhaps coincidental murdering of black people: “Law enforcement will figure out what his so-called motivations were.”

South Carolina Senator and presidential candidate Lindsey Graham pointed out that it’s Christians who are the serial killer flavor of the month: “It’s 2015, there are people out there looking for Christians to kill them.” His fellow campaign traveler Rick Santorum opined that the slaughter was part of a larger “assault on religious liberty.” And Rand Paul blamed the massacre on “people not understanding where salvation comes from.”

Fox & Friends couldn’t help dumbing down the debate by framing it simply as an “Attack on Faith,” while anchor Steve Doocy wondered aloud how people could “unbelievably” “call it a hate crime.”

Shooters of color are called ‘terrorists’ and ‘thugs.’ Why are white shooters called ‘mentally ill’?

By Althea Butler, The Washington Post

Police are investigating the shooting of nine African Americans at Emanuel AME Church in Charleston as a hate crime committed by a white man. Unfortunately, it’s not a unique event in American history. Black churches have long been a target of white supremacists who burned and bombed them in an effort to terrorize the black communities that those churches anchored. One of the most egregious terrorist acts in U.S. history was committed against a black church in Birmingham, Ala., in 1963. Four girls were killed when members of the KKK bombed the 16th Street Baptist Church, a tragedy that ignited the Civil Rights Movement.

But listen to major media outlets and you won’t hear the word “terrorism” used in coverage of Tuesday’s shooting. You won’t hear the white male shooter, identified as 21-year-old Dylann Roof, described as “a possible terrorist.” And if coverage of recent shootings by white suspects is any indication, he never will be. Instead, the go-to explanation for his actions will be mental illness. He will be humanized and called sick, a victim of mistreatment or inadequate mental health resources. Activist Deray McKesson noted this morning that, while discussing Roof’s motivations, an MSNBC anchor said “we don’t know his mental condition.” That is the power of whiteness in America.

U.S. media practice a different policy when covering crimes involving African Americans and Muslims. As suspects, they are quickly characterized as terrorists and thugs, motivated by evil intent instead of external injustices. While white suspects are lone wolfs – Mayor Joseph Riley of Charleston already emphasized this shooting was an act of just “one hateful person” – violence by black and Muslim people is systemic, demanding response and action from all who share their race or religion. Even black victims are vilified. Their lives are combed for any infraction or hint of justification for the murders or attacks that befall them: Trayvon Martin was wearing a hoodie. Michael Brown stole cigars. Eric Garner sold loosie cigarettes. When a black teenager who committed no crime was tackled and held down by a police officer at a pool party in McKinney, Tex., Fox News host Megyn Kelly described her as “No saint either.”

That has been evident today on both Fox News, who trotted out conservative racist Rich Lowery, and MSNBC’s Joe Scarborough was pushing the mental illness meme. Heavens forbid, they should call Dylann Roof what he is, a racist terrorist.

Along with Rev. Dr. Raphael Warnock, senior pastor of the Ebenezer Baptist Church in Atlanta, Georgia, Ms. Butler discussed the double standard with Democracy Now!‘s Amy Goodman.



Transcript can be read here

No, people, racism in NOT a metal illness but it does have an effect on the mental state of its targets.

Racism Is Not A Mental Illness

By Julia Craven, The Huffington Post

Racism is not a mental illness. Unlike actual mental illnesses, it is taught and instilled. Mental illness was not the state policy of South Carolina, or any state for that matter, for hundreds of years — racism was. Assuming actions grounded in racial biases are irrational not only neutralizes their impact, it also paints the perpetrator as a victim.

Black people, on the other hand, do suffer actual mental health issues due to racism. Here are a few things to keep in mind as the media digs into Roof:

   Black people are often expected to “shift” away from our cultural identities, which can heighten our vulnerability to depression and other psychological issues, as well as cause us to internalize negative stereotypes.

   Racial discrimination, according to The Atlantic, increases the risk of stress, depression, the common cold, cardiovascular disease, breast cancer, hypertension and mortality — all of which exist at high rates in my community.

   Race-related stress is a stronger risk factor for mental duress than stressful life events are.

   Black people’s physical health takes a hit as well due to the perception that whites want to keep us down.

   Racism created socioeconomic barriers that also can be detrimental to black mental health.

   For black women, the common “strong black woman” trope leaves no room for mistakes, which can force black women to internalize perfectionist tendencies in terms of our professional and academic work, our bodies (which are held to European standards) and our social lives. This leads to a tendency to not seek help and, in turn, heightened suicide rates. {..]

Racism isn’t a mental illness, but the psychological, emotional and physical effects on those who experience it are very real. And I’m exhausted.

It is long past time that American and the news media stopped skating around the issue that racism has gotten worse in this country. Racial hatred needs to be confronted not buried under the guise of mental illness.

Mar 15

Sad Tidings

Recently I’ve managed to find some stories with better news among the usual fare of crap that many transpeople face.  

I knew it couldn’t keep going like that.

So tonight we have hard news out of California and Maryland.

The toll?  One dead, two injured, and a state’s transgender population worth of others left endangered.

On the bright side today is payday…and unlike many other transpeople, I actually have one.

Jan 19

The Week in Editorial Cartoons – Incendiary Political Rhetoric: Just Words?

Crossposted at Daily Kos and The Stars Hollow Gazette



Jen Sorensen, Slowpoke, Buy this cartoon

:: ::

Sorensen writes on her blog:

What really drives me nuts in the wake of the Giffords shooting is the chorus of voices — mostly on the right — tut-tutting that “we can’t jump to conclusions.”  As though they are the source of caution and reason and all things prudent and high-minded.  Well, guess what: your candidates are anything but.  I don’t really care whether Loughner is schizo, or what particular bits of tea party propaganda he swallowed or didn’t.  If you don’t find the violent language of the right utterly repugnant, then it’s a sign of how far we’ve drifted away from normalcy in this country.

Jan 10

Individualism is Not a Right to Be Forever Hands Off

No definitive profile of the Arizona shooter, Jared Loughner, has yet been complied.  Nevertheless, what has been released thus far shows a profoundly troubled individual in desperate need of adequate help and treatment.  Yes, medication and therapy alone are not necessarily a silver bullet in all circumstances, but something should have been done well before Saturday.  From what I have already read, it is not as though warning signs had not been present for quite some time.  Every single time a tragedy along these lines takes place, we mourn, we try to make sense of the carnage, we seek to understand the reasons why a violent act took place, but we stop short of proposing solutions to keep them from reoccurring.      

Jan 31

In Defense of Antidepressants

Regular readers will know that I have mentioned many times in many prior posts that I have bipolar disorder.  Some time ago I reached a conclusion within myself that the best way to counteract the still prominent stigma of mental illness and with it the misinformation based on fear and misunderstanding was to offer myself as a concrete example.  I must admit, though, that I never thought I’d need to speak out against anyone or any column that at least concedes that treatment would be necessary, assuming, that is, that it worked.  Most resistance I face and most assumptions I refute are mainly a product of people who, as they inevitably put it, don’t wish to be a slave to a pill or who think that anyone who has to rely on medication to solve his or her problems must have some deficiency in inner strength, independence, or both.

Begley’s article in Newsweek entitled “The Depressing News about Antidepressants” contains much truth, but its underlying assumption that antidepressants aren’t worth the risks involved and might be more harm than good only provides more justification for people of such stripes.  Fear and unwillingness to seek treatment are the biggest of stumbling blocks to health and the idea that someone whose quality of life is suffering mightily might not reach out and seek a highly available and usually quite effective means of obtaining an otherwise normal life distresses me greatly.  

Yes, the drugs are effective, in that they lift depression in most patients. But that benefit is hardly more than what patients get when they, unknowingly and as part of a study, take a dummy pill-a placebo. As more and more scientists who study depression and the drugs that treat it are concluding, that suggests that antidepressants are basically expensive Tic Tacs.

This is an unfair across-the-board characterization of psychotropic medication as a whole.  The true problem here is the typically 21st Century liberal sensibility of the back-to-basics, return-to-the earth holistic treatment movement which casts doubts regarding the efficacy of all modern medicine aside from the obviously irrefutable (and sometimes not even then) .  A misunderstanding of the basic elements of psychiatry leads many on a series of wild goose chases and frustrating avenues towards health that, in my opinion, could be better resolved through visiting a medical professional.  To wit, the brain is a very complex organ, one still frequently beholden to mysteries and theories in place of solid data.  Though we might have a good grasp on treating certain diseases, in this instance we only can work with the information and biological advances currently available.  This goes for schizophrenia, senile dementia, and migraine headaches.

We have observed recently that though many might clamor for change in the abstract, or as  long as it doesn’t happen to them personally, the prospect of individual change promises only the unknown.   That which we cannot perceive easily is often frightening and distressing, but those who know intuitively that the life they are living is not the one they need while simultaneously recognizing also that they don’t have to feel the way that they do, psychotropic medication is a godsend.  Sometimes, but rarely, one finds an instant fit with the first drug prescribed, but trial and error is necessary for those who strive for lasting health and stability.  I myself have been on twenty-four different meds over the course of roughly fifteen years, and while I take care to note that I have a very severe and very rare case, I am not completely unusual in some respects.  I long ago accepted this as the reality of the situation as to all of us who seek to find a balance between illness and health.  Finding the proper medication cocktail is a bit like visiting a psychologist.  One rarely finds a good fit the first go round, though not always.  

Even Kirsch’s analysis, however, found that antidepressants are a little more effective than dummy pills-those 1.8 points on the depression scale. Maybe Prozac, Zoloft, Paxil, Celexa, and their cousins do have some non-placebo, chemical benefit. But the small edge of real drugs compared with placebos might not mean what it seems, Kirsch explained to me one evening from his home in Hull. Consider how research on drugs works. Patient volunteers are told they will receive either the drug or a placebo, and that neither they nor the scientists will know who is getting what. Most volunteers hope they get the drug, not the dummy pill. After taking the unknown meds for a while, some volunteers experience side effects. Bingo: a clue they’re on the real drug. About 80 percent guess right, and studies show that the worse side effects a patient experiences, the more effective the drug. Patients apparently think, this drug is so strong it’s making me vomit and hate sex, so it must be strong enough to lift my depression. In clinical-trial patients who figure out they’re receiving the drug and not the inert pill, expectations soar.

As for the clinical trials of varying effectiveness mentioned in the article, I had a much different experience.  Beginning in late 2008 into last year I spent nearly six months in-patient at the National Institute of Mental Health (NIMH) in Bethesda, Maryland.  I can’t say that I ever doubted the antidepressant effect of any or all of the existing trials and protocols that were being performed on site.  My reservations mainly were that the process of research was so minutely calibrated and overcautious that psychiatrists and researchers took huge pools of patient data samples before publishing their studies.  Individual results were secondary to examining a whole cloud of results and then proceeding warily from there.  Often long-term studies ran not just for months, but for years.  The focus of each was equally narrow, examining a relatively small number of variables on a very particular desire effect.  This makes for safe science and prevents results from being challenged or questioned, but it doesn’t exactly advance the discipline and the available scholarship at anything more than a snail’s pace.

A particular study I observed as a patient comes to mind.  Participants were given the drug ketamine, known to vets as a tranquilizer and anesthetic and a few generations of recreational drug users as Special K.  The drug was administered in the form of an IV infusion.  The injection was given, mild hallucinatory and/or dissociative side effects subsided after a few minutes, and then almost every patient who underwent the protocol experienced a very pronounced anti-depressant effect.  The effect lasted only four or five days in a row, and each day that passed promised less and less of an impact at counteracting depression.  Only a single active injection of ketamine was given during the entire study as a whole.  The point of the study was to measure how long one treatment achieved its stated purpose, to what degree, and at what point the patient returned to a state of full depression.  After the first and only injection that quite clearly wasn’t placebo wore off, patients naturally went back to being depressed.  Those who felt a pronounced lifting of mood and depressive symptoms knew instantly that the next injection was going to be placebo, regardless of what the nurses or doctors informed them to the contrary.  

Those who wish to vent at the pharmaceutical industry for its role in nixing health care reform have a worthy target, but I find more deplorable the means by which it artificially inflates cost of medication, meaning that without insurance, the price of a month’s worth of prescription drugs start at the hundreds of dollars and sometimes are priced in the thousands.  I myself would have to pay $1000 a month minimum if I didn’t have basic coverage and in prior posts I have noted the needless complexities I encountered achieving even that.  Certainly it sets prohibitive cost and pushes product, regardless of quality, effectiveness, or grounding in solid research to make money.  This is a travesty of the highest order, but I have never in my own life encountered more than a bare minimum of people with mental illness who were not substantially improved by medication, once they found the optimum possible cocktail.

What I have found much more prominently among those with mental illness who have gone off their meds altogether or have only given them a cursory trial is that they couldn’t handle the initial side effects or felt discouraged that a single medication either didn’t work well, or worked up to a point and then petered out.  I am always suspicious of people who push diet regulation or therapy or some combination thereof in place of pills because I can count on one hand the number of people that have adopted that routine and found it wholly sufficient.  I have known scores of people who have mental illness over the years because I have been hospitalized at least thirteen times myself, have participated in support groups, and have ended up being curiously inclined to seek company with people who also have mental illness, whether I knew it up front or not.  I am a big proponent of therapy in addition to medication because it has helped me out tremendously over the years, but I know that I can never stop taking my meds, ever, for any reason.  It is for this reason that when I encounter any article like Ms. Begley’s that I feel a compulsion to tell the whole story as I understand it to be.    

So, having seen for myself the tedious and sometimes unnecessary safeguards employed, I recognize that much of this delay and frustratingly incremental progress is unavoidable.  The existent understanding of brain function and its impact upon mental illness is measured in inches, rather than miles.  It is accepted that certain chemicals and neural pathways associated with them determine emotional well-being and mental health, but aside from that, medications have often been developed that use existing treatment regimens to treat disorders, but aim to lessen side effects than try new chemical structures or neurotransmitters.  I suppose one could obsess about the unforeseen consequences that daily medication use promises, negative impacts upon the body as a whole that we might not recognize for decades to come, but I’m much more interested in being able to go about my daily tasks unhampered by my disease.  Three hundred years ago, after all, the conventional treatment to address physical ailments was bleeding the patient white to release toxins.  We laugh now at how primitive and even barbaric a practice that was, but for those who lived in those times, that was all they knew.  We can only go with that which we know, and returning to the past or refusing to embrace the newest solutions promises nothing any more or less solid.  All of our choices are half-chance, the same as everything else.

Jan 03

The Mental Illness Stigma Takes a Sexist Dimension

As I myself struggle with a chronic disease of the brain best known as mental illness, I am constantly aware of discriminatory practices towards those who suffer with the same disability as I do. To make a long story short, some years back I befriended a woman who attended the same support group as I did.  She and I have maintained close contact ever since then and I frequently serve as a sympathetic ear when she needs someone to talk to about how her illness complicates her daily life and complicates her understandable desire to be the best mother that she can to her kids.  At times she is deeply reluctant to share with me the issues most pressing and more distressing, but today she opened up and talked at length about a matter that had been troubling her for quite some time.

My friend deals with Generalized Anxiety Disorder and depression, two conditions I struggle with myself. For many reasons, money being one of them, she’s been off her meds for the past several months and is unwilling to seek further treatment. Since she has recently separated from her soon-to-be ex-husband, she is reluctant to go to a psychiatrist and be prescribed new meds because she fears losing custody of her three children.  I believed her worry to be justified, but it wasn’t until I did some research to bolster my argument that I realized just how commonplace a problem this is.  The below passage spells out the matter in detail.

Some state laws cite mental illness as a condition that can lead to loss of custody or parental rights. Thus, parents with mental illness often avoid seeking mental health services for fear of losing custody of their children. Custody loss rates for parents with mental illness range as high as 70-80 percent, and a higher proportion of parents with serious mental illnesses lose custody of their children than parents without mental illness. Studies that have investigated this issue report that:

   *

     Only one-third of children with a parent who has a serious mental illness are being raised by that parent.

   *

     In New York, 16 percent of the families involved in the foster care system and 21 percent of those receiving family preservation services include a parent with a mental illness.

   *

     Grandparents and other relatives are the most frequent caretakers if a parent is psychiatrically hospitalized, however other possible placements include voluntary or involuntary placement in foster care.[1]

The major reason states take away custody from parents with mental illness is the severity of the illness, and the absence of other competent adults in the home.[2] Although mental disability alone is insufficient to establish parental unfitness, some symptoms of mental illness, such as disorientation and adverse side effects from psychiatric medications, may demonstrate parental unfitness. A research study found that nearly 25 percent of caseworkers had filed reports of suspected child abuse or neglect concerning their clients.[3]

The loss of custody can be traumatic for a parent and can exacerbate their illness, making it more difficult for them to regain custody. If mental illness prevents a parent from protecting their child from harmful situations, the likelihood of losing custody is drastically increased.

Having mental illness is bad enough, but for women with mental illness, the repercussions are far more severe.  A lethal combination of sexism and Paternalism is to blame.  Recent history records the most extreme cases, instances which were blown out of proportion and sensationalized to such a degree that they tainted our understanding of brain disorders, particularly regarding women with children.  The image in most peoples’ minds likely flashes back to the negative publicity surrounding the Andrea Yates case, in which a mother suffering from post-partum depression and psychosis drowned her children.  A second example is Dena Schlosser, who, suffering from postpartum psychosis, killed her eleven-month-old daughter believing she was sacrificing her to God.  A less well known example is that of Assia Wevill, Ted Hughes’ second wife, a depressive, who killed herself and her four-year-old daughter in a murder/suicide.  Extreme cases like these have led many to believe that children must be uprooted and taken away from mothers who suffer from any degree of mental illness, no matter how minor.  If only it were that simple.  Yet again, women are deemed not responsible enough to handle their personal lives, the state (and we, by proxy), jump the gun and assume that keeping children safe is more important than understanding the crucial nuances of the situation.

I severely dislike the term “mental illness” because the phrasing makes it seem as though all brain disorders are similar.  Mental illness is an umbrella term, but it is not a precise diagnosis.  Brain disorders vary in severity and in their physical manifestation.  Many assume that mentally ill means psychotic or schizophrenic, when those are merely the most severe forms of a vast spectrum of related, but not identical disorders. I cannot emphasize enough that many people who are treated properly with medications lead otherwise normal lives with the need for a few modest changes in lifestyle here and then as the case may be.  This goes for mothers in the same way as for fathers.  In being so draconian about custody rights, government overreaches, assuming a child must be protected from a parent who is likely to abuse her child.  

I wish we would learn that policies implemented out of a fear of bad publicity and a resulting media firestorm have many times created major problems often more severe than the ones they’ve sought to address.  To be fair, while specific legislation has been passed to address this matter, laws are only as effective as those who follow them and those who enforce them properly.  The letter of the law does not address the stigma which exists in the minds of those who do not understand the peculiarities and particulars of a still very misunderstood and still taboo subject.  To best address this travesty of justice, it will take more exposure and more visibility to bring an end to this.

Nov 16

Building a Name-Brand Health Care System, Not a Low-Cost Generic Alternative

Much as credit card companies have charged exorbitant interest rates in the period leading up to the passage and enactment of reform, so too have prescription drug companies added more cost to their already prohibitively expensive products.  Afraid that health care regulatory legislation will cut too heavily into their soaring profits, the industry feels no shame, nor any compulsion to give heavily burdened consumers much of a break.  This is a side of the debate that has not gotten the same attention as other areas and one that I have tried to bring to light quite frequently, being that I myself stand to lose quite a bit if out-of-control price increases are not sharply curtailed.  I do not deceive myself into thinking that I am the only one who stands to lose.  Though I do not mind invoking personal experience if it facilitates greater understanding and urgency, I wish it didn’t take the anecdotes of the chronically ill to impress upon a skeptical public the importance of health care reform.          

On the subject of psychotropic medication, something of which I am an amateur expert, I have closely monitored new classes, types, and formulations of prescription drugs in a desire to find the best way possible to treat my condition.  For every new medication that breaks new ground, wins approval by the FDA, and is then prescribed by GPs and psychiatrists across the country, it is a never-ending source of frustration for me to observe the three new offerings which are merely slightly different formulations of existing medications.  This is a covetous process undertaken mainly to reap maximum profit when older scripts are on the verge of losing patent status and thus being offered as generics.  For example, the anti-depressant which is the most recent addition to a family of medications known as SSNRIs has been marketed under the name Pristiq.  Pristiq has a very similar chemical structure and as a result works only slightly differently from an existing drug in the same school, Effexor, that has been around for over ten years.  Sometimes, however, even generics occasionally have limitations.  Though a lower-cost equivalent to Effexor exists, the less-expensive form has been reported to work not nearly as effectively as the name brand formulation.

An article in today’s New York Times reports on Big Pharma’s side of the story.

But drug companies say they are having to raise prices to maintain the profits necessary to invest in research and development of new drugs as the patents on many of their most popular drugs are set to expire over the next few years.

That may be, but before one gets misty-eyed listening to the woe-is-us violin, rest assured that the pharmaceutical industry isn’t exactly hurting for business.  Conveniently they don’t mention the larger picture.  Another example of this kind of infuriating slight-of-hand is the sleep aid Ambien, which has had a sufficient generic alternative for a while.  A relatively new formulation dubbed Ambien CR produces an only a slightly different reaction, mainly by time-releasing the absorption of the drug into the blood stream.  The drug is the same, but the gimmick is different.  Returning to psychiatry, it is either a testament to how little we know about the function of the brain or how unwilling we are to risk radical change that the medications used to treat depression, anxiety, bipolar disorder, and schizophrenia have broken only relatively limited ground in decades.  The best treatment for depression are still a class of powerful anti-depressant known as a MAOI inhibitors, which are close to fifty years old.  They are rarely prescribed, however, because taking them requires strict dietary restrictions that, if not adhered to, can result in serious damage to the body and, in extreme cases, even death.  In treating bipolar disorder, some patients still respond best to Lithium, which has been used in treatment for over a century, but extensively since the Fifties.    

Newer medication often cut down side effects and make the period of adjustment less painful, but do little to increasing the stated objectives of the drug, namely to drag people out of depressive episodes and set them on a course towards health and functionality.  Experimental trials are often plodding affairs proceeding at the pace of a snail, targeting a relatively limited area of the brain, and unwilling to take any unnecessary chances.  Despite this, some medications do pass muster and do end up being taken by who are suffering in the hopes of providing relief.  Even so, the drug makers and those who formulate them sometimes fail to take into account such crucial details as major side effects in a rush to get out the next big thing.  SSNRIs like Effexor, for example, are infamous for producing absolutely awful issues when someone stops taking it.  Though not strictly classified as such, one might even say that such drugs are addictive because the brain acts violently when the medication is discontinued.  These serious matters somehow never find their way onto the commercials on television or the ads inside glossy magazines.  

The difference in cost between name brand and generic drugs is quite vast.  Often it is a matter of several hundred dollars for a one month supply, though it can be as high as a thousand dollars or more.  As one might expect, those with employer-based or individual plans paid for out of pocket have to pay substantially higher co-pays for name brand drugs.  When I had private insurance, the co-pay for generic medications was $10 and for name-brand drugs, it was $60.  Sometimes I had no choice but to take a name-brand medication, which are often treated by insurance companies as something bordering on cosmetic and not essential, when the fact of the matter is that they are highly necessary and highly unavoidable at times.  

Those who don’t have the luxury of private insurance, of course, have it rougher.  Those who have to rely on Medicaid find that they have no choice but to settle for generic medications when a name-brand drug would be a much better fit and work much more effectively.  Medicaid programs vary, but in the state of Alabama, the most expensive medications are only covered if a doctor or specialist one can provide proof that at least two lower-cost alternatives have failed or been insufficient to treat the condition.  Not only must they have failed, one must also work within the confines of a 90 day coverage window.  If a claim to cover a more expensive medication is not filed within 90 days of failing the requisite two medications, then coverage is not granted.  This is ridiculous in lots of ways, mainly that few medications used to treat mental illness work quickly, and many take weeks upon weeks before any psychiatrist or doctor can make a judgment either way.  It’s also ridiculous because it uses a broad brush of convenience, painting all illnesses as basically the same and all treatment regimens as similar.  Some name-brand medications, regardless of the need are not covered at all, since whomever set up the system decided that covering it would unnecessarily drain the General Fund and that it was an unnecessary prescription in the first place.      

Returning to the Times column,

But the drug makers have been proudly citing the agreement they reached with the White House and the Senate Finance Committee chairman to trim $8 billion a year – $80 billion over 10 years – from the nation’s drug bill by giving rebates to older Americans and the government. That provision is likely to be part of the legislation that will reach the Senate floor in coming weeks.

But this year’s price increases would effectively cancel out the savings from at least the first year of the Senate Finance agreement. And some critics say the surge in drug prices could change the dynamics of the entire 10-year deal.

Those who trust Big Pharma do so at their own peril.  

Additionally, The news broke today that, quite unsurprisingly, much misinformation exists surrounding the Public Option™.  As Politico points out,


The debate has placed disproportionate emphasis on the creation of a government insurance plan, raising the expectation that everyone could ditch their employer-provided coverage and enroll in the public option.

But that won’t happen, at least not at the start. The reality is that only about 30 million Americans – 10 percent of the population – would even be eligible.

It could be accessed only through a new insurance marketplace known as an exchange, where consumers would shop for plans. Only certain categories of people could use the exchange: the self-employed, small businesses, lower-income people who qualify for tax credits to purchase insurance and those who are otherwise unable to find affordable private coverage.

This might deflate the hopes of supporters and pacify opponents, but since so much of this debate has been a three-ring-circus based on raw emotion and faulty logic, I sincerely doubt it.  However, as proposed, it is interesting to note that the Public Option™ would be more like Medicaid than anything else.  My hope is that we do not make the same mistakes with the current bill as we do with existing systems it seeks to augment or replace, particularly those in red states who likely would opt-out altogether if provided the opportunity to do so.  Though at least red state residents would presumably have the fall-back of Medicaid, provided they could qualify, the framework is based on ignorance and tunnel-vision of an almost incomprehensible degree.  One cannot simplify the complexities of humanity, nor its diseases, which are as multifarious as its people.  

Returning to the treatment of mental illness, what is often not cited is the disconcerting fact that often African-Americans and Latinos respond much less favorably to medications used to treat the condition.  This is a contentious topic with lots of disagreement, but the argument some advance is that cultural stigma factors in to a very large degree.  If minorities feel shamed or guilty about seeking help for psychiatric needs, they are much less likely to engage in medical research.  Furthermore, many believe that therapy is a more viable option than medication.  Often it is difficult to make any kind of pronouncement when the truth is obscured by so many different interrelated factors.  And though one can easily make a case for mental illness, one could also make a case that minority and low-income residents might be less inclined to visit a doctor for a more run-of-the-mill ailments as well.    

The lifetime prevalence of major depression in the United States is estimated to be 16.2 percent, with considerable social and role impairment evident in the majority of patients. Previous studies found only minor differences in depression rates among African Americans, Latinos and whites. But various studies have found patients from lower social economic groups often have less access to mental health care, are less likely to be prescribed and to fill prescriptions for new antidepressants and are less likely to receive care beyond medications when compared to whites.  

 

This fear and anxiety so many have that resembles to these eyes a case of St. Vitus Dance may not have any basis in reality.  Doesn’t matter how good the system is if no one uses it.  God forbid everyone in this country have a high standard of living and good health.  As the article points out, minorities and low-income citizens often have the highest need for quality care and are apt to put off seeking help until the pain becomes intolerable.  That these are the people most likely to be eligible for enrollment in the government-run (gasp) option, those now building it from the ground up would do well to consider its target audience.  We speak out of our own privilege when we assume that somehow the Public Option™ will directly affect us for better or for worse, when the poor and less fortunate will be the ones who either reap its rewards or suffer from its limitations.  While it is true that middle class individuals and the reasonably affluent have struggled under the yoke of skyrocketing health care costs, I recall going in that I assumed the changes needed and intended were meant to appeal to our tired, our poor, our huddled masses yearning to breathe free.  Somewhere along the way this became all about us.        

Feb 12

“You’re a p- – -y and a scared little kid”, 3rd Installment of “Coming Home”

The subject title above is the third installment of a week long series of reports being run at Salon.com.

The first two installment reports can be found in links below or with this link of what I posted previously

Feb 10

“The Death Dealers took my life!”

Salon.com has a series running all this week called “Coming Home”, researched and written by Mark Benjamin and Michael de Yoanna.

The following is the description and lead in information on the series:

May 31

Societal Murder

Last night, as I sat at my computer, an unholy stench came into the house and offended my olfactory nerves.  It smelt of sewage, and something worse, but it seemed to come from outside.  We have skunks in the neighborhood, and raccoons, so I assumed one of them had died or otherwise made some kind of mess.  As it turns out. it was something far worse, and profoundly sad.

A few minutes ago I learned that Ernie, the crazy hermit who lived across the street, died some time between Wednesday and yesterday.  I’m betting Wednesday or Thursday, judging by the odor.  The coroner had to be called in after a neighbor called the police to check up on him.  Ernie had been a shut-in, one of those mental cases that collects shit, unopened mail, and assorted garbage over the decades.  It was likely Ernie’s corpse I smelled last night as the process of decay took hold-though according to my mother it was more likely the stench of Ernie’s collected feces.  Funny thing is, the coroner didn’t arrive until after midnight, and by then I was asleep.  I tend to be woken up by sirens and flashing lights, but I guess the sleep of ages had taken hold of me because I dozed right through it.  They all must have come right around the time I turned in for the night, which was after eleven.

I imagine this shall make the newspaper: “Crazy old guy dies in his own filth on Cleveland’s West Side.”  What a depressing train of thought.  This man, who probably should have been institutionalized decades ago, instead lived in the same house he lived in with his mother and became that most awful of social outcasts, the sort that just becomes the harmless yet deranged individual that maybe a neighbor treats with compassion and sympathy, but everyone else ignores.

How low have we sunk as a society to let this go on?  How many Ernies shall die, undiscovered for days, weeks, months-perhaps even years, having spent their entire lives in squalor and the hell of mental illness?  How long will the Ignored be forced to go without the care they need, before we wake up and start providing it?  They are the Outcast, the Ignored, the Least Among Us.  They are the people Jesus implored us to look after, for we are judged by how we treat them.  Jesus…what would He say to us if He were to return today?  This country, which lies to itself that it is a Christian nation, what would Christ Himself say of us?

But we’re not supposed to ask ourselves these questions.  We’re not supposed to acknowledge just how cruel, unforgiving, depraved, greedy, selfish, without compassion, apathetic, materialistic, and oblivious we are.  Because if we do, then we accept that at some point we must take responsibility for our crimes, and for those who cannot take care of themselves.

In the meantime, Ernie-and all those like him-go on, needing help but not getting it.  We let them die; we let them expire alone, unloved, uncared for.  We are all guilty of this form of societal murder.

Apr 01

My “April Fool” — the black hole of mental illness health care

All kidding aside, it’s true. My former husband had his first psychotic episode on April 1, 1984. Ever the punster/joker, he later referred to himself in a conversation with me as an “April fool.” Would that it were so–for one can live with a fool.

Diagnosed at that time with bipolar illness, for ten years he kept his demons at bay, continuing with his 25-year career as a full professor at a respected university in Boston. His brilliance dimmed but he continued writing and publishing books and articles.

Why was he able to maintain a certain normality in his life for those ten years? Are all those who suffer such illness afforded that opportunity? No, and there are 5.7m Americans with this illness. That’s why I’m writing today, democrats. The story might move you, I don’t know. It’s long, but skim it or skip it, and get to the bottom line, okay?

Crossposted on Orange.