My New Hero: Glenn Close

Not because she’s a phenomenal actor, which she is, but because she’s just initiated a new project to banish stigma. The project is highly personal, as she explains on Huffington Post:

As I’ve written and spoken about before, my sister suffers from a bipolar disorder and my nephew from schizoaffective disorder. There has, in fact, been a lot of depression and alcoholism in my family and, traditionally, no one ever spoke about it. It just wasn’t done. The stigma is toxic. And, like millions of others who live with mental illness in their families, I’ve seen what they endure: the struggle of just getting through the day, and the hurt caused every time someone casually describes someone as “crazy,” “nuts,” or “psycho”.

What’s remarkable is not her frankness about this personal history, but her motivation to act, which seems almost like a wholesale rethinking of her career and what it’s meant in popular culture. In Fatal Attraction, for example, she played a woman obsessed with Michael Douglas (those were the days, right Michael?). She loses control of the obsession and becomes terrifying. As Close writes, the movie was a great success, and audiences loved to hate her character.

Alex Forrest is considered by most people to be evil incarnate. People still come up to me saying how much she terrified them. Yet in my research into her behavior, I only ended up empathizing with her. She was a human being in great psychological pain who definitely needed meds. I consulted with several psychiatrists to better understand the “whys” of what she did and learned that she was far more dangerous to herself than to others.

The original ending of Fatal Attraction actually had Alex commit suicide. But that didn’t “test” well. Alex had terrified the audiences and they wanted her punished for it. A tortured and self-destructive Alex was too upsetting. She had to be blown away.

So, we went back and shot the now famous bathroom scene. A knife was put into Alex’s hand, making her a dangerous psychopath. When the wife shot her in self-defense, the audience was given catharsis through bloodshed — Alex’s blood. And everyone felt safe again.

The ending worked. It was thrilling and the movie was a big hit. But it sent a misleading message about the reality of mental illness.

This is a bold admission from a woman who derived so much success from this role, but there’s no escaping what she says. It has long bothered me — and, I suspect, other advocates — that the message there is one of terror and fear.

Not only does Close take on her role in that film, she assesses the entertainment industry as a whole:

Whether it is Norman Bates in Psycho, Jack Torrance in The Shining, or Kathy Bates’ portrayal of Annie Wilkes in Misery, scriptwriters invariably tell us that the mentally ill are dangerous threats who must be contained, if not destroyed. It makes for thrilling entertainment.

There are some notable exceptions, of course — Dustin Hoffman in Rainman, or Russell Crowe’s portrayal of John Nash in A Beautiful Mind. But more often than not, the movie or TV version of someone suffering from a mental disorder is a sociopath who must be stopped.

I like to think that her speaking out will change this. As she so eloquently says, silence is the problem. Read more of her elegant prose here. It is well worth it. There you’ll find links to the initiative she’s promoting.

Thank you, Glenn, for speaking out against silence. You rock.

liz | 10:30 AM | SCHIZOPHRENIA, bipolar disorder, celebrities, depression, media, meds

Liveblogging Primetime Outsiders

All the below is about this show.

Madigan: They didn’t flatter you with that lighting.

David Oaks: You’re looking so handsome! I had no idea. Your eyebrows are very sexy. (I’m completely sincere.)

“But critics worry …” That’s journalism-speak for “We don’t have any specific sources who say this, but we’ll generalize it so we have reason to focus on …”

… violence. That’s what they’re focusing on. Why am I not surprised?

So of all the things they could talk about related to Mad Pride — and related to mental health — this is what they’ve come up with: criminals and violent crime. Ugh. TV is so predictable and depressing.

Okay, so now we’re telling the story of a kid with hallucinations and delusions (the CIA, yadda yadda) who KILLS HIS MOTHER? Does the average American viewer understand how fucking rare this kind of thing is? That it’s not the necessary result of deciding not to take meds?

On to the withdrawal story: Clearly, the program wasn’t looking for a success story. This poor woman who decided to do the show so they could feed off her misery — I knew that’s what they wanted. Is she doing the withdrawal in conjunction with a doctor? Who the hell knows? The show doesn’t tell you. It hardly tells you her name. And …

Oh! There it is again: “Critics worry … ” (that she’s going to be “a time bomb” without her meds). Who are these critics worrying about this girl? Frank Rich? David Denby? I’d love to know.

“Violence is unpredictable with or without drugs.” Brilliant script.

Blurry homeless images. Madigan cello-ing. … This show is so bad, it’s like a joke. I guess it all goes back to what producer Ia Robinson told me, when we discussed my being on the show: She doesn’t have any friends or family who have mental problems, so the whole topic was like “walking on the moon.” Yes, that’s the phrase she used. The show should’ve been blasted out to Mars.

Except Joey P. He’s delightful and a voice of reason.

liz | 9:34 PM | SCHIZOPHRENIA, alternative treatments, bipolar disorder, celebrities, criminal justice system, depression, hospitals / hospitalization, meds, philadelphia, side effects, stigma, suicide, violence

Drug Approved for Illness That Responds Better to Older Drugs

One of the apparent contradictions inherent in medicine: Just when you think you’ve discovered something new and helpful, research comes out to suggest that it may be counterproductive.

Invega has now come out with a different formulation: the sustained release. Apparently, this is the first atypical to be approved for the once-monthly injection formulation, though there are other neuroleptics used in this fashion. Personally, I’d love a once-monthly instead of the everyday pill. Bring it, yo evildoers at AstraZeneca! I’m ready for my Seroquel shot!

Or maybe not. A new Lancet study says older antipsychotics, like clozapine, are safer over the long term than Seroquel, Zyprexa and Risperdal. From the L.A. Times health blog:

Researchers in Finland, where clozapine is still widely prescribed for schizophrenia patients, found that users of the drug were less likely to die than those who took any one of three other second-generation (also called “atypical”) antipsychotics — Seroquel, Risperdal and Zyprexa — or those who took the first generation schizophrenia medication pherphenazine (once marketed as Trilafon).

…

Sufferers of schizophrenia have long been known to die earlier than the general population, markedly more often by suicide and by complications of diabetes. They are far more likely to engage in behaviors that lead to earlier death as well, including tobacco use, substance abuse and sedentary lifestyles. The Lancet article found that a schizophrenia patient who took any of the studied medications for seven to 11 years was less likely to die prematurely. And the longer she took it, the less likely she was to die an early death.

American physicians have largely abandoned Clozaril, which has been on the U.S. market since 1989, in favor of Zyprexa, Seroquel, Risperdal and Abilify — all newer drugs that have been aggressively marketed to doctors and patients as safer and more effective than the first-generation of antipsychotic drugs, including pherphenazine and haliperidol (better known by its commercial name, Haldol).

Meanwhile, the numbers of people being prescribed these powerful psychiatric drugs have skyrocketed. In 2008, 50 million prescriptions for antipsychotic drugs — overwhelmingly the newer ones — were filled.

liz | 10:07 AM | BIG PHARMA, SCHIZOPHRENIA

Scott McGann

Thanks to Tony W. for sending a link to a NY Daily News article about Scott McCann, who placed a fake bomb at LaGuardia. He’s now at Bellevue for observation, and his mother is upset, to say the least:

The distraught mother of would-be LaGuardia bomber Scott McGann defended her mentally ill son Sunday night.

“He’s not a kook,” Margie Jones told the Daily News, barely able to speak through her tears.

She said her 32-year-old son suffers from catatonic schizophrenia – a form of the disease that leaves victims in a psychotic state where they’re unable to speak, respond or even move.

“I love my son,” said Jones, a school psychologist who lives three hours north of San Francisco in Willits, a town of 5,000.

The heartsick mother had planned to see McGann this past weekend after buying him a ticket to fly to California some time before Saturday’s airport scare.

The question of his mental illness and diagnosis is likely to be pursued intently if there’s a criminal trial, and catatonic schizophrenia seems, on the surface, an odd explanation for this particular event. More about McGann from the article:

A computer programmer and artist, McGann was described by friends as a kind and pensive person who peddled his handmade goods in Union Square.

“He was a friendly guy who worked a lot with skateboarders,” said William Saar, 50, who sells used books in Union Square.

“He didn’t seem like the type of guy to do something like this,” Saar said.

…

Christopher Gause, 20, another artist who sells in Union Square, said McGann made sculptures out of scrap metal.

“There was some spirituality he found in his art,” Gause said. “He was very calm, very friendly, and smiled.”

Sounds like such a nice guy. I wish the diagnosis hadn’t been disclosed so early on — or maybe I just wish it weren’t true. While to “normal” citizens, the diagnosis seemingly explains bizarre behavior, to those who deal with mental health issues — especially those with schizophrenia — it merely exacerbates the perception that we’re all dangerous and could “snap” at any moment.

LaGuardia fake bomber Scott McGann’s mom says he’s sick and needs help, not crazy

For a more humorous look at the situation, you must check out New York Magazine’s take on how Scott McGann could be your boyfriend.

[Photo copyright NY Daily News]

liz | 10:21 AM | SCHIZOPHRENIA, violence

Schizophrenia Made Me Do It?: Shoot Two Cops

From the Charlotte-Observer, about Demeatrius Montgomery, who killed two police officers two years ago. (Hmm. Those wheels of justice sure do turn … slowly.)

A relative recounted for a courtroom Monday how Demeatrius Antonio Montgomery looked out the window of her home and said “they’re after me.”

At other times, Gwendolyn Hinton said her nephew would talk to himself, burst into laughter during serious conversations and behaved almost childlike.

The picture of a disturbed and occasionally violent Montgomery emerged during a hearing to determine whether he is mentally competent to stand trial in the 2007 shooting deaths of Charlotte-Mecklenburg police officers Sean Clark and Jeff Shelton.

Clark, 34, and Shelton, 35, were killed at the Timber Ridge apartment complex in east Charlotte. Their deaths prompted a citywide outpouring of grief as thousands attended their funerals.

Authorities arrested and charged Montgomery, 27, with two counts of first-degree murder. Since then, state mental health workers and his lawyers have tried to assess his mental stability.

But for the most part, Montgomery has refused to speak to them, witnesses testified Monday.

Psychiatrist George Corvin said he has tried to examine Montgomery seven times, but most of the time “he is completely mute.”

Montgomery also has refused to speak with his attorneys, Corvin said.

Corvin, testifying as an expert witness for the defense, said he believes Montgomery has paranoid schizophrenia and is not competent to stand trial. But a state psychiatrist who examined Montgomery disagrees..

In fact, prosecutors think they’re being played.

They noted he has never sought mental health treatment and that his father said his behavior is likely linked to drug use.

Prosecutors said he has functioned well enough while incarcerated to ask relatives to send him books on civil rights leaders and religious material, such as the Quran.

Either way, this case has tragedy written all over it, even above the murders of the officers. First of all, Montgomery has two children, so that’s no good. And his life sounds troubled.

At Monday’s hearing, Hinton, his aunt, spoke of a troubled man who has remained mentally unstable since his teen years.

Montgomery lived with his grandmother as a child because his mother drank heavily, Hinton said. His mother died in a 2003 fire.

Montgomery had little contact with his father, she said.

He attended South Mecklenburg High School, but dropped out in 11th grade. At the time of the police shooting, he was one credit shy of earning his GED certificate.

Hinton said Montgomery’s behavior became erratic after an altercation with police in 1999. Montgomery suffered an injury to his head.

Records show Montgomery was arrested in 1998, charged with larceny and resisting a public officer. He was 16. Montgomery has been found guilty of assaulting a government official or resisting a public officer at least four times, N.C. court records show

In 2004, Montgomery was arrested for hitting the mother of his two children. The police report said he punched the woman on the side of the face several times at their northeast Charlotte apartment, leaving red marks and a bloodshot eye. He was sentenced to 18 months of probation, which records show he violated in 2005.

Hinton said relatives encouraged Montgomery to seek mental health treatment, but never forced him. She said she was worried about his behavior because even as a grown-up he played with children’s toys and watched cartoons.

Montgomery’s competency hearing resumes today.

So sad.

Mental health of suspect in cop killings argued

liz | 1:59 PM | SCHIZOPHRENIA

R.I.P. Scott Kurtis (1970-2009)

From the Chicago Tribune:

The son of former Chicago newsman Bill Kurtis (pictured) was found dead early Monday, July 20, on the Kansas cattle ranch owned by his father, family members said.

Scott Kurtis, 38, suffered from paranoid schizophrenia since his mid-teens, said his stepmother, Donna LaPietra.

Mr. Kurtis was last seen during the day Sunday and may have died late Sunday or early Monday. At the time of his death, Mr. Kurtis was alone in his home on the ranch, LaPietra said.

He was found by his sister, Mary Kristin Kurtis, who lives near the ranch.

Mr. Kurtis’ family is expected to get the results of an autopsy by Thursday, LaPietra said. Mr. Kurtis also suffered heart and thyroid ailments as a result of the schizophrenia, she said.

“It’s a lonely life — it’s a very sad illness,” LaPietra said.

“Quite frankly, there’s not very much anyone can do, so he struggled with that illness and various complications that arise from it,” LaPietra said. “Tragically, Bill and I have known for a while that often … schizophrenics do not live past the age of 40. It was something we always had in the back of our minds, and Scott really struggled.”

For the last 10 years, Scott Kurtis had worked at the ranch in Sedan, LaPietra said.

…

Her stepson often said his dream was to be a truck driver so he could travel and see the country, LaPietra said.

“He loved the road. It was always a battle for us to persuade him that it was better to be on the land than on the road,” LaPietra said. “It was his obsession.”

Full story here.

liz | 9:48 AM | SCHIZOPHRENIA

Schizophrenia in Children: January Schofield

There’s a great post over at Furious Seasons by Philip about Shari Roan’s LA Times story about a 6-year-old girl, January (pictured), who has been diagnosed with schizophrenia. As Philip points out, many of us are skeptical of such an early onset and skeptical of childhood diagnoses in general. The article has caused many reactions–good and bad–which Philip generously breaks down, and questions the strange lapse (from a journalistic standpoint) of omitting facts.

What disturbs me about the whole thing is that if you read her father’s blog (the content of which isn’t mentioned in the piece), which Philip links to, you get an uncomfortable sense that Jani/Janni’s father Michael is really stubborn about his daughter’s “lifetime illness,” as he calls it. Here’s an excerpt that shows some of this recalcitrance; I’m also uncomfortable with the bolded part.

We saw Janni today and she was at her most psychotic in several weeks. I have a nice welt on my arm where she hit me when I refused to call her toy rat “99.” Of course, I was goading her, but I wanted to see if she could deal with it. Of course, she couldn’t. She’d been talking about the rats for awhile (she is back to insisting they are real-these are the rats in her head) but now the violence is back. 400 the cat has reappeared after a long absence, and 400 cat is a bad cat that tells her to hit and scream (which she is also back to doing). She is on 300 mg a day of Seroquel is doing nothing. They need to up her Thorazine from 100 mg a day as that is the only thing that works. However, we are frustrated because the staff and doctors seem to thinking that it is just her “imagination” again, and considering autism and Asperger’s (even though this has already been ruled out time and time again). Yes, she “self-stems” as they call it, rubbing her hands together real fast….but that and the “autistic” behaviors went away at 300 mg of Thorazine. I don’t know why in the hell they are so resistant to labeling her “schizophrenic” but yet so eager to label her “Asperger’s.” Is schizophrenia really so much worse? But she fucking talks to animals and people who aren’t there! And she is violent! That isn’t autism! That’s psychosis! I feel like we are just going around and around in fucking circles here.

Autism and Asperger’s aren’t so cut and dry, but as Michael writes:

It is scary to think you know more than the doctors, but the fact is we do.

Do they? I’m reading and reading his blog and the article and I’m just not sure. I understand that feeling myself, of course. I often think that. And just as often, I’m surprised to discover that I still have so much to learn. Michael Schofield’s voice on his blog makes him come across as a very angry person with serious anger management issues–a person who’s self-aggrandizing and resistant to learning new things (and who can’t seem to spell his daughter’s name the same way consistently, which is just weird).

He comes across as a person who likes the sound of his own voice and a good, punchy, writerly ending to a post more than being open-minded about what’s going on. I understand this, actually, because once we find the Answer (not Allen Iverson, but the initial diagnosis), we cling to that diagnosis, as it’s the first time anyone has taken us seriously. But after clinging to a diagnosis that may or may not be correct, it’s time to let go so that treatment is dictated not by egos and desires (whether doctors or patients or parents) but by eliminating symptoms in a safe, healthy way.

Go to Philip’s page and read the whole argument, including the comments. It’s an important discussion.

Father Of Girl With Schizophrenia Admits Hitting, Starving Girl [Furious Seasons]

[Image by Lawrence K. Ho copyright LA Times. Please don't kill me, LA Times.]

liz | 2:02 PM | SCHIZOPHRENIA, autism, children

People First Language

One of the biggest challenges I’ve had in the 10 years I’ve been writing on the subject of mental illness is the evolving use of language around disabilities. Sometimes I’ve been relieved by change; other times I’ve been frustrated. I recently had the opportunity to start thinking about this again because I accidentally let a writer use the phrase “wheelchair-bound” in an article I edited. Afterward, the subject of the article objected, and I felt terrible. I wasn’t hip to that particular change, but in the future I won’t use it again.

Often, the lack of a consensus stymies writers and members of the media. In my case, I’m sort of okay if you call me “bipolar,” but there are many other people who think that’s terrible — and that you should only say “person with bipolar disorder” or “person who has been diagnosed with bipolar disorder.” As a writer concerned with rhythm and clarity, I have to object to the latter for myself. Yes, I’ve been diagnosed that way, but given that I concur with the diagnosis, I’m comfortable saying “I have bipolar disorder.” A lot of people object to “a person who suffers from bipolar disorder,” but I remember just a couple years ago when that was absolutely the most appropriate language.

One thing I feel we’ve mostly agreed upon: To call a person schizophrenic is really out of date. As in: “I think he’s schizophrenic.” In clinical contexts that emphasize recovery, people definitely say, “I think he has schizophrenia,” if not something more progressive, like the examples above. There’s something historically uncomfortable about the word “schizophrenic” that hasn’t yet accrued to “bipolar,” if only because the illness (oops) only recently shifted from “manic-depression.”

And now to that oops — some people no longer like to say “mental illness.” Some prefer “brain disorders” but others like to go in the opposite direction and say, well, I’m not even sure anymore. Because I subscribe to some of the horrors that many people rail against (like that my symptoms are part of an illness; that medication can work; that not all of the DSM-IV isn’t balderdash), my language may, at times, be less People First-ian than that of others.

For example, I wear two hearing aids and have been, for some years … hearing-impaired? Suffering from hearing loss … ? Partially deaf .. ? (I am not, however, Deaf. That I know for sure.) My friend and I talk about this sometimes because she is partially deaf (with much more impairment than I have) and has been so since childhood. But even she doesn’t know what the hell to call it. If she meets someone who’s like a bit more deaf than she is (but not Deaf), she doesn’t know what to say to contextualize herself. It’s so weird.

Maybe because I was a translation scholar, I love this kind of discussion. I’d be interested to hear (but talk loud! Heh.) what you all think of People First language, in all its permutations.

[Button (that I should really get for public situations) available here.]

liz | 2:55 PM | DISABILITY, SCHIZOPHRENIA, bipolar disorder, stigma

Mentally Ill Man Pummeled by Cops: WARNING GRAPHIC CONTENT

Officer seen striking mentally disabled man on video is placed on desk duty

liz | 11:50 AM | SCHIZOPHRENIA, criminal justice system

Codey Will Transform System?

The headline at NJPoliticker.com reads: “CODEY BILLS WOULD TRANSFORM PATIENT CARE AT STATE PSYCHIATRIC HOSPITALS”

Explanation:

A package of bills sponsored by Senate President Richard J. Codey that are designed to protect patient safety and improve employee training and oversight at state psychiatric hospitals was approved yesterday by the Senate Health, Human Services and Senior Citizens Committee. … Sen. Codey worked closely with the Public Advocate’s office in drafting these bills, in part, to address a number of injuries and deaths that had arisen recently at state facilities such as Ancora Psychiatric Hospital.
Bill S2492, would require the Department of Human Services (DHS) to establish a training program for staff members who work directly with patients at state psychiatric hospitals in order to ensure the delivery of safe, secure, and therapeutic care.  Utilizing best practices in patient treatment, the curriculum would include topics such as state and federal reporting requirements, patient safety, disease prevention, health wellness activities, anger management, skilled decision-making and how to deal effectively with life-threatening emergencies. … The bill would require DHS to establish an on-site educational assessment and remedial instruction program at each state psychiatric hospital in order to evaluate the proficiency of all staff members who work directly with patients.

The bill would also require the commissioner of DHS to establish minimum educational standards for staff members at a hospital who work or will work directly with patients. … Employees already working directly with patients at the time of the bill’s enactment would be required to undergo an evaluation to determine if they meet the educational standards or require remedial instruction through the on-site education program.Any employee that refuses to participate in the training program or fails to meet the educational standards and refuses to participate in remedial instruction, would be terminated from employment at the hospital. …

The second bill, S2493, would require current and future employees of state psychiatric hospitals, developmental centers and veterans’ memorial homes to undergo drug testing for controlled dangerous substances as a condition of employment.

The last bill in the package, S2494, would require DHS to report the number of physical assaults and deaths that occur at state psychiatric hospitals. The report would be a public record, posted on the official DHS website, and updated quarterly, but would not contain any identifying information about patients or staff members.

As a longtime fan of Sen. Codey’s commitment to mental health matters, I do think it’s a good move. But is it transformative? As an astute TTWS reader notes:

It’s hard to see how these three bills alone will transform patient care at New Jersey’s state psychiatric hospitals which includes Ancora, let alone insure the care long required by law, New Jersey Statutes Annotated 30:4-27.1(c), It is the policy of this State that persons in the public mental health system receive inpatient treatment and rehabilitation services in accordance with the highest professional standards and which will enable those hospitalized persons to return to their community as soon as it is clinically appropriate.

Too often words and deeds fail to intersect at our nation’s psychiatric hospitals. Transform and its variants are now used so frequently that any change is considered transformative. More recently at another New Jersey state psychiatric hospital where a new building was going to lead to transformation (click here, paragraph 5), the reality belied the representations, ex. Developing therapeutic alliances between patients and staff remains a challenge, with differences in race, ethnicity, social class and education creating a ‘them versus us’ scenario.

“When I use a word it means just what I choose it to mean — neither more nor less.” Humpty Dumpty

liz | 1:05 PM | DISABILITY, SCHIZOPHRENIA, bipolar disorder, depression, hospitals / hospitalization, media, meds, politics