NYT article on mental illness and diabetes
The New York Times today has a lengthy article about the link between mental illness and diabetes. I’m glad to see the piece because this issue is rarely examined. But I also have some qualms about it.
For one thing, I realize it’s important to tell the story of those who are severely ill and in dire straits, but this article only talks about people who are living in group homes or who are otherwise marginalized. The people in the piece fit stereotypes and don’t give a broad view. What about people like me? They’re not at all represented. I think a better balance could’ve been struck. And what about alternative therapies? Antipsychotics aren’t the only answer, and given that they have this potential for diabetes, it might be useful to look at other options.
The article also explains the link between diabetes and antipsychotics as primarily a weight-gain issue. Once the patient packs on the pounds (ooh, delicious alliteration there), type 2 diabetes is a serious risk. But the risk is there in some patients even without weight gain, a little fact big pharma would rather you didn’t know.
In fact, I used to do speaking engagements for AstraZeneca, talking about my experience with Seroquel, until I found out the company was betraying its U.S. patients by hiding the diabetes risk from them. In Japan the bottles have a warning label. Here they don’t, despite the fact that the company well knows there’s a connection. I wish the NYT had focused more on the deception within the industry.
Still, you can’t have everything, and the NYT has been recently committed to covering both diabetes and mental illness in new ways. They’re actually providing a voice for the voiceless, and isn’t that what journalism should do?
In Diabetes, One More Burden for the Mentally Ill
Antipsychotic Drugs Raise Diabetes Risk
liz | 1:15 PM | Uncategorized
I’m certain the New York Times can be forgiven for focusing on large group homes. After all, Times reporter Clifford Levy won a Pulitzer Prize for his series on these facilities (1).
It is no secret that persons with a serious mental illness die, on average, nine years earlier than the general population – 14.1 years for men and 5.7 for women (2). Seventy-four percent of us suffer from one chronic medical condition and fifty percent suffer two or more (3).
For all the words – Integrated Care, Recovery, Wellness, and System Transformation – my peers and I continue to be treated as if our brains and our bodies were separate entities. My previous psychiatrist had a prominently displayed medical scale in his office. Despite my meteoric weight gain he never suggested that I hop on the scale. Perhaps, it didn’t work. Perhaps, it was merely cosmetic. But I do know that it was during his watch that I developed Type 2 diabetes with nary a word from him that I should watch my weight or that the medications he had prescribed could lead to diabetes.
It should not surprising that some of the worst medical care is provided on inpatent psychiatric units. One consumer I knew – who owned a business and lived very independently – suffered vision damage as the result of a suicide attempt. He complained about his vision loss while on the psychiatric unit of a large hospital only to be repeatedly told during his month long stay that it was imagined. In fact, his vision impairment was serious and real. (How easy it would have been to have him examined by an opthamologist at this large private hospital.) Subsequent to his discharge it was determined that his vision impairment required a stay at a rehabilitation center. This was followed by an aide who came to his home to help him do routine chores made difficult by his impaired vision. Later, he died at his own hand. I do wonder if the medical care, or lack of medical care, he received on the inpatient psychiatric unit played a role in his death. Did he dismiss the idea of reaching out when it was quite possible that he would only receive the same insensitive treatment he had previously experienced? We will never know.
Things were supposed to have changed. The words have been repeated over and over for so many years. Long ago, as a child in a residential treatment center I told the nurse on several occassions that I was not feeling well. My diagnosis – malingering. It was later determined that I had mono or hepatitis (I simply can’t remember which one) and spent two weeks in bed. That I spent part of the time isolated in the “seclusion room”, which was also used for punishment, made it quite the experience.
The medical care received by consumers reflects a sad paradox. On the one hand we are told that stigma arises from ignorance. On the other, we find that the too many medical professionals who should be the most knowledgeable about mental illness frequently dismiss or ignore us. But we have been educated. Too often we delay seeking medical attention until our symptoms are clearly apparent and then it can be too late.
For me, everything is working like clockwork – heart disease, now diabetes. The “Recovery and Wellness” so long talked about has yet to reach the vast majority of consumers. I’d write more but statistically I don’t have a whole lot of time left.
1. Clifford J. Levy, “For Mentally Ill, Death and Misery,”
New York Times 28 April 2002. Available for free at nytimes.com
2. Bruce P. Dembling, Ph.D. et al., “Life Expectancy and Causes of Death in a Population Treated for Serious Mental Illness,” Psychiatric Services August 1999. http://www.ps.psychiatryonline.org/cgi/content/full/50/8/1036
3. Danson R. Jones, Ph.D. et al., “Prevalence, Severity, and Co-occurrence of Chronic Physical Health Problems of Persons With Serious Mental Illness,” Psychiatric Services November 2004.
http://ps.psychiatryonline.org/cgi/content/full/55/11/1250
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