Shawn King: A Deliberate Overdose?

There are few things more mind-boggling than Larry King and his ability to find gorgeous women to sleep with and marry. They all seem far too attractive for a batlike homonculous like King. Check out this video, and see if you don’t agree that he’s sadly desperate to seem young, hip and not batlike. But then the black jacket just makes it worse.

Sadder still than the jacket is the fact that wife Shawn is by his side, defending his aggressive questioning of Marie Osmond, whose son committed suicide. Now King is dealing with a suicide drama of his own: Wife Shawn has overdosed, and the rumor is she left a note implying that she wanted to die. Now TMZ, a guilty pleasure of mine, suggests perhaps Shawn wanted to die because of Larry’s affair with her sister. That’s right all-you-smart-people-who-wisely-don’t-keep-up-on-gossip-and-thus-didn’t-know-this-before: LARRY KING, A BATLIKE HOMONCULOUS, SLEPT WITH HIS WIFE’S INCREDIBLY ATTRACTIVE YOUNGER SISTER.

Shawn King Depression Triggered by Alleged Affair

Sources tell TMZ Shawn King’s depression started, continued and never stopped over Larry King’s alleged affair with Shawn’s sister.We’re told Shawn has been “extremely depressed” for more than five years … and the trigger was Larry’s alleged long-term involvement with Shannon Engemann.

As we first reported, Shawn had a showdown with Larry several years ago and as a peace offering Larry transferred title to all three of the couple’s homes to Shawn. We’re told Shawn has struggled for years, believing her husband remained involved with Shannon. One source says, “She fought like crazy to remain sane, just to take care of her kids.”

We’re told even though Shawn reconciled with Larry and put the divorce proceedings on ice, she remained deeply depressed. One source says, “Shawn’s not a pill popper, but she feels it’s her only way to deal with her depression.”

Shannon has denied having an affair with Larry.

Larry King’s Wife — Evidence of Suicide Attempt

liz | 7:58 PM | Uncategorized

Me at First Person Arts

Hey, check it out!

liz | 12:35 PM | media, philadelphia, random

Depression Confession: Megan Fox

Okay, actually, it’s not depression. But since this is a category I’ve used for a long time, it seemed like a good headline. Megan Fox isn’t depressed, though. She simply has OCD. From USA Today:

“I could go days, weeks, without talking to another human being,” she swears. “I hate receiving compliments; I hate being told I’m talented or people think I’m going to be a movie star. I always feel that it’s forced and fake.”

She admits she has obsessive compulsive disorder. “This is a sickness, I have an illness — this is not OK anymore,” she says.

She refuses to use public toilets without covers or eat with restaurant silverware. “Every time someone uses a bathroom and they flush, all the bacteria is shot into the air,” she says. “Putting my mouth where a million other mouths have been, just knowing all the bacteria that you carry in your mouth? Ucch!”

I totally sympathize. I don’t even tell people the kinds of things that gross me out because it would be so hard to understand. But the toilet is a real problem for many people with such issues. ‘Cause it’s gross!

To learn more about OCD from someone who doesn’t look anything like Megan Fox, keep your eyes peeled for the amazing movie OC87. It’s an incredibly nuanced look at this concept.

liz | 2:05 PM | anxiety, celebrities

Lost My Edge

I got a letter today from Chicago. It was anonymous, but said that since I left PW, I’ve lost my edge and have become too soft. It also lamented the fact that I post so infrequently.

Both are probably true (and certainly the latter), but it’s hard because I have a full-time job that doesn’t involve blogging. Before, when I was at PW full-time, it was part of my job to be a writer and to blog. Now it’s a luxury — it’s whatever time I can grab during a day when it would be appropriate, which isn’t very often. Doing direct services and program management in a mental health organization doesn’t exactly afford gobs of time during the day.

That being said, I am still alive and trying, trying, trying. I miss you all. I miss this forum. I wish when I got home at night I felt more like blogging and less like zoning out with a book or TV or iPhone solitaire. For those who live locally, I am going to do a reading at an upcoming First Person Arts event. So that’s a little something. Here’s the info.

It’ll be with Emily Steinberg — a graphic artist who I LOVE. Any fan of graphic arts/novels should check her out. Go here.

I wish I had more right now, but I don’t. I’ll post later, and I promise it’ll have some edge.

liz | 1:31 PM | Uncategorized

If You Do Nothing Else Today, Read This

An incredibly eloquent submission by Joe Gutstein.

Let’s imagine for a moment that you are long into the public mental health system. You have been in the hospital multiple times, in a couple of partial hospitalization programs, and have spent years in sheltered workshops and day programs. You’ve received the Prophecy of Doom, “Too sick for too long to get any better.” You’ve heard plenty of statements beginning with “You can’t, You won’t, and You will never.” You’ve been told endlessly that something is intrinsically (genetically) wrong with you and the only thing that will truly save you is a medication yet to be discovered. You’ve also been told that the most important thing you can do is get on SSI or SSDI in light of the prolonged and persistent nature of your illness. You’ve been told to engage in meaningful activities generally limited to walking, listening to music, and reading. You’ve been told countless times to avoid any stressors which might be associated with more rewarding activities and these stressors will doubtless lead to yet another hospitalization. You’ve been told so many things.

You’ve lived through several successive Eras: Psychosocial Rehabilitation, Evidence Based Practices, Transformation, Recovery and now Recovery and Wellness but the only thing that actually changed was your medication. You’ve been referred to as a patient, a recipient, a client, a consumer, a prosumer, a self advocate and now a “person with ….” but everything is the same at the hospitals, the sheltered workshops, the partial hospitalization programs and the very day program you now attend. You are now told pursuant to the Recovery model that you are suddenly empowered but what evidences your empowerment? What is it in your life that is now different? When did you last hold a meaningful job, live in decent housing, go on a date, attend to a party which wasn’t held at 3 pm or have friends over to your place? Has your health improved? Has your circle of friends and acquaintances changed? Has your income increased to provide for more options? What activities do you now engage in which you wouldn’t have before you were empowered?

Are you empowered? Not really, nothing has changed in your existence. What you do have is a familiar long standing delusion in which you are empowered. You imagine, it is part of your symptomatology, that you can provide anyone anything and everything with a CGI script. This is an empowering belief within your disempowering reality and among all the other folks at the day program it gives you a unique identity, a unique story where being unique in other areas might not be highly regarded. Fortunately, there is no impact on your role as a person in the day program unless you chatter away about it. (No more so than your peer who believes he is being watched by friends on another planet. After all, he is no longer alone all the time. Someone is watching over him where no one else might otherwise care about him.)

What is going to replace this powerful delusion and that which accrues to you by virtue of it? Let’s consider your options and the system of supports and services which will assist you in replacing it. Knowing that it is best not to ask for anything specific which might fall beyond the groups found at the day program, You say, “I want to be empowered.” The reply is “Of course, we can help you with this. Did you know that the day program has an Empowerment Group?” (You knew there was an Empowerment Group.) Consequently, you are signed up for the day program’s Empowerment Group. It meets in the same room as the Socialization Group which was going to help you get a date on Saturday night and the Pre-Vocational Group which was going to help you get a meaningful job. But you know the folks in the Empowerment Group. Not a one has become empowered. (The group meets weekly and all the chairs are in a therapeutic arrangement. There are handouts and members of the group so inclined read aloud from the handouts.)

So in the final analysis, you have the delusion and the Empowerment Group. The delusion is empowering but the Empowerment Group isn’t. Sadly, no one asked you the right question in the Era of Wellness & Recovery. Now – for the first time – the very question he or she would want to be asked in the same circumstances is being asked, “What do you need to thrive?” What is it that would lead you to hope for a life where the delusion has no value and might be patently detrimental. And for once you truly know that your answer shouldn’t be limited to something that happens in another group but involves real skills, fostered and facilitated in the real world with services and supports which promote a life. And just maybe you’ll now believe in the possibility of that date on Saturday night and a meaningful job for this new reality is more satisfying and empowering then any long held delusion.

liz | 11:05 AM | DISABILITY, SCHIZOPHRENIA, anxiety, bipolar disorder, depression, hospitals / hospitalization, meds, politics, stigma

Does Diagnosis Matter?

In the recovery movement, which is the zeitgeist in the delivery of mental health services at this time, we are supposed to look past someone’s diagnosis. I am not “a bipolar” or “depressive” or “schizophrenic.” I have been diagnosed with such, but the relevance of that diagnosis is highly suspect. Because aren’t I just Liz? Liz who is addicted to Dunkin Donuts hazelnut coffee, Liz who likes chihuahuas in sweaters, Liz who tries to do gluteal exercises to increase her butt’s circumference — without success. So many things make up my Liz-ness, right? So who cares what some doctor said?

Generally speaking, I agree with this approach. For many years we have been labelling people in an attempt to treat them, and the results aren’t exactly stellar. So why not change protocols, DSM by damned?

Yet as a person who works on the frontlines of mental health care, I sometimes do find myself stymied by a person’s behavior, and a diagnosis can (infrequently) help. Because there certainly are definable characteristics of certain illnesses that can help me understand where a person is coming from. It also helps in distinguishing substance abuse from simple illness.

Here’s what I mean. Say I meet a guy who talks to me about his power over floating CGI-enhanced rabbit-shaped angels — who says he can get me anything I want by talking to them and persuading them. This is not true. By any measure we use to determine reality, the CGI-enhanced rabbit-shaped angel is clearly a fiction. But what if he slurs while he tells me this? What if he leaves that day and I have to understand what’s going on so I can advocate for him? Wouldn’t many people think, “That guy is on some serious crack.”

Now, we’d like to think a mental health professional would be more sophisticated than that, but then, you’d be assuming a level of knowledge that some MHPs simply don’t have (I say that with love). So if you look at this guy’s medical records and it says he has been diagnosed 10 times by 10 different doctors in the last 10 years as a person with schizophrenia, that might be good knowledge to have. Additionally, if his records state that he has never used drugs or alcohol, that’s also good to know.

I’m not saying that guy is only his diagnosis. I’m saying that hearing what psychiatrists have labeled him with for a decade might be useful information for me to have if I’m going to help him.

Similarly, the search for diagnosis can be a good road to travel. In today’s Washington Post, a mother asks Marguerite Kelly what her depressed daughter should do — meds or exercise? Kelly gives an answer that anyone should get in the absence of clinical assessment:

It’s time for your daughter to find an experienced board-certified internist who listens well and is curious enough to test her for viruses, low thyroid, high cortisol, candida and many other conditions that can cause depression. If she’s healthy, she then should be evaluated by a psychologist or a psychiatrist, who will ask her about any trauma or loss that she’s had, any history of depression in the family, any bad PMS occurrences or any sadness in the winter, all of which can trigger depression.

This is a good protocol in search of a diagnosis. That being said, my psychiatrist reminds me again and again he doesn’t care what my label is; he just wants to help me feel better. And it’s true that it doesn’t matter if you call it OCD or bipolar of DID or PPP (for Poo Poo Poo), if you’re counting every crack in the sidewalk, it’s probably time for some help.

These are my thoughts for today, messy though they are. I’d love to hear your thoughts.

liz | 10:58 AM | BIG PHARMA, D.I.D., SCHIZOPHRENIA, bipolar disorder, depression

The New DSM

As you’ve no doubt heard by now, a revision of the Diagnostic and Statistical Manual of Mental Disorders is underway. Public comments are being solicited One of the doctors who worked on the last version, Allen Frances, tells Judy Woodruf on the PBS Newshour that the last changes, though well-intentioned, caused an epidemic of overdiagnosis of autistic disorders, childhood bipolar disorder and ADD.

But new changes must be made. As anyone who follows this subject knows, many, many children have been aggressively diagnosed with bipolar disorder, a label that often subsequently confers the blessing of antipsychotics. Antipsychotics, don’t forget, have never been tested on children. We have no idea how such harsh medications affect the developing brain. The drugs increase risk of diabetes, metabolic disorder and tardive dyskenisia — among other mishegas — in adults. God only knows what we’ll discover a generation from now, when these kids are grown up.

So how did we get here with childhood bipolar? There’s a great report on NPR.org you should read in its entirety, but I’ll give you some excerpts:

Since the mid-1990s, the number of children diagnosed with bipolar disorder has increased a staggering 4,000 percent. …

… many of the kids now categorized as bipolar were, once upon a time, diagnosed as having conduct disorder. Kids with conduct disorder are seen as very combative, aggressive, and prone to destructive behavior. But the treatments for conduct disorder are woefully limited, says Carlson. …

Which is why when every day psychiatrists were told that they could now think of this set behaviors as manic-depression, not as conduct disorder, they got so excited, says Carlson. “They thought, ‘Heck, if that’s what it is, we have a bunch of medicines that are supposed to be helpful for mania — maybe I can make it better,’ ” she says. This has deep appeal to doctors face to face with parents who are heartbroken over the difficult time their child is having.

Another advantage to the bipolar label, Carlson points out, is that the insurance industry saw bipolar as a biological or medical problem, while conduct disorder was seen more as a parenting problem, so insurance companies were reluctant to reimburse for it.

“If you’ve got something that says it’s not a medical problem,” says Carlson, insurance is not going to pay for it. “Conduct disorder is bad parenting, lousy environment, poor supervision, you’re a bad seed. It ain’t a medical problem. Bipolar they’ll pay for.”

Finally, Carlson argues, parents themselves were relieved on some level. Because this set of behaviors was no longer seen as conduct disorder, the psychiatrist sitting across the desk from them was no longer blaming them for the terrible things that were happening to their child.

So clearly there are some real advantages to using the bipolar label. The problem, says Carlson, is that because bipolar disorder is understood as a chronic lifelong problem, you really want to be very careful about how you apply it.

“If you have a child who’s got this behavior but you’re not sure how it’s going to evolve, to say to somebody, ‘You’ve got to be on this medication for the rest of your life’ is sentencing someone to something that’s premature. And in the case of some of these medications, where we’re not sure of some of the metabolic side effects; you may be exposing them to a risk that they don’t need to have.”

Of course, many advocates, activists and journalists have been saying for years that the childhood bipolar diagnosis is highly problematic. And there’s been no one more vocal than Philip Dawdy of Furious Seasons. Check his site for his take on the proposed revisions, including the one on childhood BP.

liz | 8:43 PM | Uncategorized

Video: Suicide, Death and Other Goodies

liz | 10:54 PM | Uncategorized

Effexor to Cymbalta: Not So Bad

You know, if you rely on the Internet to inform you about medication side effects, you might have a panic attack before you’ve even got the Ativan in your system to calm you down. When I started Effexor, I read such horror stories that I was absolutely terrified, and though some of the info was true, that drug pulled me out of an unbearable abyss. I was truly losing it — the depression was becoming psychotic and I was contemplating suicide. And who knows why, because such things are mysterious, but it worked.

The thing about Effexor that I didn’t like was my dependence on it. For instance, if I miss a night of Lamictal, I’m okay. I do get some facial twitching, but that’s more amusing than bothersome. It’s not like I’m going to vomit my face off.

With Effexor, I was unable to even be off by an hour. I’d start to get really dizzy and nauseated, and it was just awful. I felt like a slave to it. In fact, when I was on Seroquel and Ativan, I could easily (though sleeplessly) miss doses for one night. Not so with Effexor.

Recently I realized I haven’t been happy for a while. I haven’t been depressed, exactly, but seriously dysthymic. And I was having some intrusive PTSD stuff — I kept flashing back to awful times in my life when I was psychotic and very ill, and it would make me want to crawl into bed. So I told my doctor about it, and he suggested bumping up the Effexor, given that it worked so well. I pretty much always listen to him, because he’s brilliant and kind, but this time I put my foot down: no more Effexor.

He was fine with that. He said, let’s just switch you to Cymbalta and do a slow withdrawl of the Effexor. And I panicked. Everyone has told me that withdrawal from Effexor is a living hell. Brain zaps, vomiting, shaking, sweating — it sounded like my withdrawal from Klonopin, which was only achieved with the benefit of phenobarbital, and only after about 10 years of trying.

But the thing about having a chronic condition of this sort is that you go through a lot of shit and you come out the other side. So my attitude when I’m confronted with a med challenge is this: Bring it on. And in my bluer moments: You don’t know who you’re fucking with.

Funny thing, though: Nothing’s happened. I’ve cut the Effexor in half and added the Cymbalta and I am utterly without withdrawal symptoms. If I believed in God, which I don’t, I might say it was divine intervention. But it’s not. It’s just that things aren’t as bad as you think they’re going to be.

So that’s my story these days. The PTSD stuff has lessened a little, but it’ll take time. I’m feeling more obsessive lately, which I’ll write about later. But hey, as I always say, I can handle anything. As Seneca remarked at dinner last night: “Fire is the test of gold; adversity of strong men.” And women, too.

liz | 11:16 AM | Uncategorized

Bizarre New Hobby

I don’t know what’s come over me, but I’m newly fascinated by the websites of businesses that craft furniture for psychiatric facilities. I often think about how different that furniture is than the chairs, tables and beds in the “real” world — no hard edges, nothing you can use to kill yourself.

Yet despite the depressing reality of the nature of their business, these websites sell their products as though they’re just like any other product. It’s kind of surreal. Many such companies also make furniture for correctional facilities, and some have transitioned into exclusive manufacturing for prisons and jails — which in the States, is a growth industry of collossal proportion.

Check these sites out if you have a morbid fascination, as I do:

Norix
Glasspec
PSI LLC
Max Secure

liz | 6:11 PM | Uncategorized