Bipolar child: follow-up
From Charles:
There has been a remarkable increase in the awareness of bipolar disorder recently. This is partly due to pharmaceutical/academic campaigns such as the infamous Lilly campaign much maligned by the likes of David Healy in the UK, but it is also due I think to a genuine desire by psychiatrists and sufferers alike to blow away the stigma and misunderstanding associated with the label of BPD. The recent television documentary on the subject presented by the commedian Stephen Fry, in which he discusses in great detail his own illness, had a great impact on awareness in the UK.
As a researcher into bipolar disorder in the pharmaceutical industry I have listened to many discussions about “early onset” bipolar disorder. I have never heard comments that might justify the charge of disease mongering, but I have myself considered whether there might be a prodromal state of bipolar disorder that might be treated in order to prevent the emergence of the full blown disorder. For example, if a child’s family history suggests that he or she is at risk of BPD, then would it be worthwhile considering lifestyle changes or career counseling to avoid the stressors that can precipitate the illness? Easier said than done!
However, I do agree that medication would probably not be the best approach… yet. The problem is that we know so little about the aetiology and development of BPD, and given the plasticity of a child’s brain we risk alot giving medications that we know can alter brain chemistry and function. We’ve got a very long way to go with BPD; however, I’m hopefull that we are making some progress. There certainly needs to be more informed debate on the subject of childhood mental illness, because if the adult disorder does arise from changes occuring during adolescence or earlier then there may be a much better chance of applying a correctional treatment at that stage.
liz | 1:26 PM | Uncategorized
The medicated child
In my post about childhood diagnosis, I wrote: “I cannot imagine how my growth–both physical and mental–would have been compromised had I been put on OCD meds as a 9-year-old.”
A TTWS, name witheld, has the following answer:
At age 11, I started seeing a psychiatrist four times a week who prescribed Thorazine for my OCD. He continued to increase the dosage without associating the photosensitivity I experienced with the medication he prescribed. Eventually, the photosensitivity became so severe that I largely ceased going outside. My inability to engage in normal childhood outdoor activities caused me to dissipate my energy in my family’s apartment. This led, in part, to my placement in residential treatment where I spent the next three years.
liz | 3:47 PM | Uncategorized
Preventing depression
An article in the Cinncinati Enquirer says new research shows that preventive treatment for depression can be effective in at-risk populations, like those with SAD, or people with diabetes and heart disease. In two studies the preventive treatment was antidepressants. In the third it was psychotherapy.
I’ve used this strategy myself in the past, to grapple with pretty dramatic depression due to PMS. I used to take Zoloft for a week before the PMS, and then stop it when I got my period. It worked for a long time, but the Zoloft ultimately caused side effects I didn’t feel like dealing with, so I don’t take it anymore.
However, this kind of treatment makes me nervous. While it’s true that heart disease sufferers are at higher risk for depression, does it make sense to start the meds before knowing if this particular patient will struggle with those symptoms?
I think I’d only employ this treatment strategy in relation to postpartum depression, which is a major factor in my not wanting to have a baby biologically.
Depression can sometimes be prevented
[Don't the Zoloft round things look just like the characters in the Korean anime Doggy Poo?]
liz | 9:14 AM | Uncategorized
I’m confused
If this is true, why have my depressive symptoms responded so favorably to Effexor? Does this mean I don’t have bipolar disorder? I’m so confused!
Antidepressants don’t help bipolar patients, study finds
liz | 2:02 PM | Uncategorized
The bipolar child: myth or reality?
I’ve been fairly candid about my opinion of the increase in bipolar diagnosis: It’s bunkum. The more something gets into the public consciousness, the more people report it. It’s a zeitgeist contagion, and even I’m not immune. Last night, I was talking to a mental health activist at the University of Pennsylvania. She said she always thought Sylvia Plath (pictured) was schizophrenic, but learned at a Mental Health Awareness Week Quizo (brilliant idea, BTW) that Plath was actually depressed. “Well,” I said, “today she’d probably be diagnosed as bipolar.”
Then I thought about it: Why did I say that? Nothing in Plath’s chronicle of her struggle or her history suggests bipolar disorder; I said it because it has become a reflex. It’s almost as though people are questioning the very existence of clinical depression. I’d hate for people to think, “Have I ever been in a good mood? I guess I’m bipolar!” And the increase in diagnosis among clinicians has more to do with big pharma than observable patterns of behavior (she said cynically).
In the recent past this flurry of bipolar enthusiasm has garnered media attention, due, in part, to the case of Rebecca Riley, the little girl who was diagnosed with BP at age 2, and who died of an overdose of her psych meds. Her story is horrifying. I am completely opposed to using multiple psych meds in small children, and I’m extremely wary of attributing a 2-year-old’s behavior to a complex (and not fully understood) disorder like bipolar. Okay, I’m being cagey in case a p-doc challenges me. The truth is, I simply do not believe it’s possible to diagnose a toddler with mental illness.
When I was 9, I started exhibiting bizarre compulsive behaviors, which I won’t get into now, but which may arise in a future column. My mother was concerned, and had me talk to a friend of hers who was a psychiatrist, who believed the problem was not with my brain, but with my mind. She linked the behaviors to anxiety, and worked with me to identify the source of the anxiety. The behaviors disappeared.
Many years later, in my 20s, I began to exhibit similar behavior. I was diagnosed with OCD and put on Klonopin, a drug I became addicted to and stayed on until just a couple years ago, when I went through the hell of withdrawal. I cannot imagine how my growth–both physical and mental–would have been compromised had I been put on OCD meds as a 9-year-old. And yet, if the same episode took place today, I would most certainly be given drugs as the first line of defense. I’m so grateful that didn’t happen.
There will be a backlash to all this overdiagnosing and overmedicating, and I hope it begins with a serious reassessment of what we’re doing to generations of children when we put them on harsh psych drugs as small children. I know of kids who started meds at 5 and have never been off them, even through college. How do these people have any idea what’s truly wrong? How is it possible that their family practitioners keep calling the prescription in to the pharmacy without requiring a consultation with a psychiatrist–someone new to the case?
Ugh. I could go on and on, but you should head over to Furious Seasons, where there’s some heated debate on this subject. This is an issue that cannot be ignored.
McManamy Talks Bipolar Child Paradigm Again
A Bipolar Child Murdered: Prosecutors Allege Parents Made Up Symptoms
liz | 11:01 AM | Uncategorized
Bipolar Made Me Do It: Burn My Husband’s Clothes and Destroy a Hotel Room
Thanks to TTWS reader Steve for alerting me to Mary Weiland’s self-justification. Mary is the wife of Velvet Revolver’s lead singer, Scott Weiland. Scott has been busted for possession, DUI and other criminal offenses, and like any good rock star, has been in rehab several times. (In Pennsylvania, he would’ve been given life without parole the first time around.)
Rolling Stone’s Rock & Roll Daily blog seems to be skeptical of the Bipolar Made Me Do It rationale. They write: “’It’s okay, I’m just crazy’” seems to be the gist of Mary Weiland’s excuse for destroying a Burbank hotel room and lighting her husband’s clothes on fire.”
As for that hotel brawl, Scott writes on VR’s website: “My wife locked herself in the adjoining room when that damage was done. I want to make it clear that I called security when I heard the glass being broken from next door. Security was unable to enter until she let them in. I sent my children off to a safe place with my assistant (who witnessed all of the events of the evening, until my wife locked herself in the room), and I left the hotel in order to avoid conflict with my wife.”
Those poor kids.
Weiland’s Wife: Faulty Meds Led to Meltdown
[This image came from an MSNBC sotry about the troubled couple.]
liz | 9:50 AM | Uncategorized
Mental Illness Made Me Do It: Pretend to Sell Iraqi Money on eBay
This is a weird one. Jennifer Noble, who claims that unspecified mental problems cloud her thinking, put Iraqi money up for sale on eBay. People from the U.S. and Australia and other big places paid her, but never received their moolah. (I say “moolah” because it sounds especially un-American.)
She’s ordered to pay restitution of $9,700. Let’s hope that’s in American dollars.
liz | 12:03 PM | Uncategorized
New column: By the Book
The Trouble With Spikol: By the Book
I came home and my books were spine-down on the floor, as though the bookshelves had heaved a great sigh and the books had slid off. Vince came in from the next room with more books in his arms.
What was he doing? Looting? While wearing a striped hoodie bathrobe?
He’d gotten tired of waiting for me to organize my books, he explained, and thought if they were all over the floor, I’d be forced to contend with them—a dire strategy, but warranted. I don’t contend with anything at home.
When Vince sees a spindly half-square of Life cereal on the bedspread, his head practically explodes. When I see it … well, I don’t see it. That’s the problem.
In Vince-o-Vision, a wet towel draped on a kitchen chair trips a blinding strobe light. Only returning the towel to the bathroom will shut the light off.
In Liz-o-Vision, the towel miraculously disappears, as does the chair. The room turns into a giant box of Life cereal, and I have to climb inside and crunch until I die.
Poor Vince was like a migraine sufferer. He had the flickering lights of my disorganized books in his eyes for two years.
But unlike anything else in my environment, I care about my books. And I’m vain—I think my collection is interesting and distinctive, and reveals the true essence of an eclectic, sloppy self. That’s why I’ve trucked crumbling, water-dodged volumes from one shithole to the next. The movers always said, “You have a lot of books.” I loved that.
And I loved the surprises. I’d be on my way to the bathroom and I’d catch sight of Delmore Schwartz’s letters, and I’d be reminded of my epistolary period, which started with Schwartz and ended years later with Laclos. “Screw Laclos,” I’d think. “He soured me on Schwartz.”
Or I’d run into a play by Brian Friel, and think, “Wait, didn’t he write something with Philadelphia in it?” and I’d comb through the wreckage and finally pull out Philadelphia, Here I Come from a cloud of cat hair and dust. It would be like running into a grade-school friend you thought moved out of town. You again!
But Vince wanted categories. His own books are beautifully shelved, and in sensible ways. When he wants to reference something, he knows just where it is. He knows to avoid certain shelves in certain moods; he knows where to go if he’s lonely for a particular voice. And there’s never any cat hair or dust.
His life is folded. Mine is wrinkled.
When Vince and I first started dating, I called my mother from his apartment: “Mom, I’m in over my head. His apartment is really nicely decorated with framed things on the walls. It’s neat and clean. There are scrubby things under the sink in the bathroom.”
“They’re called sponges,” she quipped.
I couldn’t imagine such a professional person would ever love me. I kept my messiness hidden for a long time. And by the time he knew I ate cereal in bed and cried for my dead cat, he’d moved from Chicago to Philadelphia. Too late to go home—but not too late to organize.
Vince suggested book categories I might want to use: 20th-century literary history, for instance, or cultural studies.
My categories, when I had any, were: books Bessie, my half-Beagle/half-Dachshund, ate when she was lonely, or super-old books I got for less than $10 but will be worth millions when I’m dead.
I did have all books about Chihuahuas in the same spot, but it just wasn’t enough. Hence the books on the floor.
As Vince and I worked together, I kind of got into it.
“Hey,” I’d marvel. “I forgot I had this.”
And then Vince would pick something else up and say, “I didn’t know you had this,” in a way that made me feel like the new girlfriend instead of the old muddled battle-ax.
But I did put my foot down about categories. Fiction. Nonfiction. Books with mostly pictures. Books with mostly words. That’s as far as I was willing to go.
After a few hours of toting books from one room to another, tempers flared. I hedged at alphabetization. I asked Vince if he insisted, half hoping he would just so I could stomp my foot and be mad. But he threw his hands up in the same way he does when I leave one sock in one room and another on the bed: “It’s hopeless.”
It seemed like a victory. “Hah!” I thought. “Miller before Melville. No one can infringe on my rights.” But later that week, when someone asked me about a book, I went over to the shelf and found myself annoyed.
“I thought the whole point of the organization was that we could find things,” I said irritably to Vince. Then I realized it was me who’d hindered perfection. Bah humbug, as they say on Fiction Shelf No. 3.
So tonight I’m putting Melville before Miller, and I’m ashamed to say I think I’m doing the right thing. I haven’t thought about what I’ll do if a new book enters this world order. But clearly it’ll have to behave. This ain’t no roadside flophouse. Not anymore.
liz | 11:45 AM | Uncategorized
Wristcutters marketing
From Mental Health America:
Dear friends,
We need your help. AfterDark Films plans to release a Lionsgate Entertainment movie this summer called Wristcutters: A Love Story. The film premiered at the Sundance Film Festival last year to some acclaim. Mental Health America and its national partners have not yet been able to view the film and cannot yet share any detail on the content.
This month, however, AfterDark will launch an alarming “shock and awe” advertising campaign featuring cutouts of the movie characters in the states in which they kill themselves (e.g., jumping off bridges and electrocuting and hanging themselves). These signs will hang from telephone poles and trees in communities nationwide.
Interestingly enough, recent outrage around the advertising campaign of another one of the companies’ films, Captivity, forced AfterDark to remove billboards that showed graphic images of women, being kidnapped, confined, tortured and killed.
liz | 5:29 PM | Uncategorized
Cute fix: Knut
I don’t know what’s wrong with me. I cannot get past my obsession with this little bear. I’ve been watching him since he was incubator-tiny, and I’ve reveled in his progress and in his close relationship with Thomas, his caregiver. Every time I watch a video of him, I get really emotional. At first I thought it might be PMS, but even post-M I feel this way. I feel like … like I love him. I know that sounds dumb, but it’s true.
One time I was waxing poetic to my boyfriend about his brother. I was saying how great he was, and how much I liked his wife, and how great it was to visit with them. My boyfriend said, “I’m glad you like my brother so much.” And I said, “I love him!” And then I realized how silly I sounded and I crawled under the table to hide.
Since that chagrin-filled moment, I’ve resisted pledging my platonic love. People are funny about non-romantic declarations of love–somehow that word feels too emotional in our cynical age. So to keep my cool, I no longer love anyone who’s not in my immediate family. I like them and respect them.
But Knut. He’s not only not in my immediate family, he’s a polar bear. Yet I’m deeply moved by him. And I feel love, perhaps even more love than for my boyfriend’s brother and his family.
I will continue to chronicle Knut’s growth, given my personal stake in his future. So this is not just your typical cute fix. This is a love fix.
“Knut Day” in Berlin as polar bear cub goes public
[photo copyright Reuters/Hannibal Hanschke]
liz | 10:01 AM | Uncategorized
