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.

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.

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.

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]

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

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.

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.]

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.]

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

What made me angry is that I know plenty of incompetent drivers who shouldn’t be on the road, and they don’t suffer from mental illness. I also know drivers who have severe mental illnesses who acquit themselves quite admirably on the roadways (myself included). It’s a violation, in my opinion, of a person’s civil rights to prevent them from applying to get a license.

One woman who did get approval was empowered by it. She failed the permit test again and again, but it never ceased to be a goal, which fit in with the messages given by the community health center: Make sure the clients set goals for themselves; it gives them hope. Perhaps it was an unrealistic goal for her. I don’t think she’ll ever drive. But it was the trying that mattered, and if she ever gets behind the wheel, I hope she drives far away into the sunset with a great song on the radio. Just for fun.

A Guy, a Car: Beyond Schizophrenia by Ronald Pies M.D.

Isn’t that horrible? What’s (possibly) worse is that because I worked in the mental health field, I was expected to be able to handle things. I took the bag out of his hands and pulled the folded body out and lay it down on the floor. I knew I was supposed to be grossed out, so I pretended to swoon. But I wasn’t grossed out. I felt nothing. And I was ashamed to feel nothing.

Prior to that? I dreamt I was watching a TV special about rehabilitating serial killers.

Dark nights, my friends.

For some reason that line comes to me sometimes, in childish I-told-you-so situations. So when I read the AP article titled: “Panel: Seroquel not 1st choice for depression,” I thought of that line. If Philip Dawdy saw the movie, he probably thought of that line too.

Of course Seroquel doesn’t work for depression. It’s an antipsychotic, people. It was created to treat schizophrenia, which — despite Big Pharma’s craven desires — IS NOT THE SAME AS DEPRESSION.

Here are some relevant tidbits, including some deliciousness about Seroquel causing diabetes. I went a little crazy with the bolds:

WASHINGTON (AP) — Federal health experts said overwhelmingly Wednesday that the side effects of AstraZeneca’s schizophrenia drug Seroquel are too worrisome to make it a first choice against depression.

However, the panel of Food and Drug Administration advisers also said the drug could be useful as a supplemental therapy for patients who are not finding relief with other antidepressant drugs.

Seroquel, which posted sales of $4.5 billion last year, is already approved to treat schizophrenia and bipolar disorder. Now the London-based drugmaker wants the FDA to approve it for patients with depression and anxiety disorder, a much larger population that includes more than 20 million U.S. patients.

But FDA regulators expressed concerns about allowing nearly 10 percent of the U.S. population to use a drug with side effects including weight gain, high blood sugar and potential heart problems.

Panelists voted unanimously that the drug was not safe enough for use as a first choice, stand-alone treatment of depression and anxiety disorder, given older, more established drugs.

“I saw no clear advantage demonstrated in efficacy,” said Dr. Wayne Goodman, an NIH researcher who chaired the panel. “There were side effects, and I would expect unintended consequences associated with wide-scale use of the drug.”

FDA is not required to follow the advice of its panels, though it usually does.

Seroquel is part of a new generation of psychiatric medications, called atypical antipsychotics, thought to be safer than older medications. But a paper published in the New England Journal of Medicine earlier this year found that patients taking newer medications have the same likelihood of dying of a sudden heart problem. The study from researchers at the Vanderbilt University found there were about three deaths per year for every 1,000 patients taking older or newer antipsychotics.

“Our study provides evidence that this drug may produce a side effect that is of extreme concern to patients,” said Vanderbilt’s Dr. Wayne Ray, who was invited by the FDA to present his findings.

Many physicians already prescribe Seroquel and other antipsychotic medications to manage depression and anxiety. But FDA approval would allow AstraZeneca to market its powerful antipsychotic for those uses.

The company said there is a significant need for new depression treatments, pointing out that the disease returns in a third of patients treated with existing antidepressants. Many patients stop using the drugs due to side effects like insomnia, sweating and decreased sex drive.

Largely absent from the panel’s discussion was the ongoing debate about Seroquel’s possible role in contributing to diabetes, a controversy that has generated thousands of lawsuits against AstraZeneca in recent years.

However, more than a dozen members of the public — including spouses of patients who died while taking the drug — called on the FDA panel to deny approval of Seroquel for depression, with many citing its metabolic side effects.

“It is your job to keep Seroquel off the market for this expanded use unless the company can conclusively prove that it does not increase the risk of diabetes,” said Dr. Diana Zuckerman of the National Research Center for Women and Families.

Lawyers representing some 15,000 former Seroquel users claim AstraZeneca knew nearly a decade ago that the drug caused diabetes, but kept that information secret.

A brief released by the plaintiffs attorneys Wednesday morning claims that internal AstraZeneca memos and data show Seroquel is both risky and not very effective.

One study showed Seroquel was not effective against depression but a comparator drug was. Several other studies of Seroquel failed to prove that depression symptoms stopped or waned significantly by six weeks, according to the brief.

Spikol the Blog merges with Spikol the Column — OMGWTF!!!!

Schizo-phrenzy’s Sour Humor

I remember when the first arcade videogame touched down in Center City, around 1979. It landed at 18th and Spruce at Day’s Deli, a diner/convenience store. The game was near the cash register so the cashier could chastise us if we shook the machine (which didn’t work the way it did with pinball) or cheat by feeding it Canadian pennies. A year later, its novelty was gone: Videogame parlors crowded Chestnut Street—with everything from Asteroids and Space Invaders to Galaga and Ye Olde Pinballe in the back.

Those were days, I’ve been told, that videogame aficionados think of as a golden age, and it was the last time I could call myself an experienced gamer. Recently, though, I tried Adult Swim’s newest online game, Schizo-phrenzy, on the suggestion of Aaron Fisher, a reader of my blog. He thought the game was perfect for Funny or Offensive?, in which I ask readers if something is comical or just plain rude.

Let’s get you in the mood:

Example A: A few years ago, The Onion published an article headlined “GOD DIAGNOSED WITH BIPOLAR DISORDER.” It began: “In a diagnosis that helps explain the confusing and contradictory aspects of the cosmos, … God, creator of the universe and longtime deity to billions of followers, was found Monday to suffer from bipolar disorder.”

Funny, right?

Example B: In 2002, there was a fire at New Jersey’s Trenton Psychiatric Hospital and The Trentonian ran a headline that read: “ROASTED NUTS.”

Oh, boy. Offensive.

You could debate either one, and the same can be said for Schizo-phrenzy.

The premise of the game is that the protagonist, a private eye with schizophrenia, has paranoid fantasies about the mayor of the town, who’s pictured as a looming clownlike face. The P.I. fights multicolored gremlin-y hallucinations that come from all sides. The score is kept in terms of his “sanity,” which is measured, in part, by how many blue pills he takes. The less sanity, the more frequent the hallucinations, which also affect the players—only instead of cartoon gremlins, their hallucinations are gruesome photographs that flash, strobe-like, on the screen. Players also hear auditory hallucinations while they navigate Schizo-phrenzy’s landscape.

The game’s platform isn’t especially sophisticated; I’d put it at the level of Donkey Kong, circa 1982. But is it offensive?

I asked Kristin Bell, a popular blogger with more than 1,000 YouTube subscribers, to play the game. Having suffered with schizophrenia since she was 15, the 35-year-old talks frankly about her experience in her videos, and she does so with a great sense of humor.

“Part of how I’ve dealt with my mental illness is to joke about how ‘crazy’ I am and to try to laugh about something that is seriously devastating,” she says. “I’m well medicated, so sometimes I even forget that I’m so weird. And I try to accept that probably 98 percent of the world knows little to nothing about what it’s like to have schizophrenia.”

At first, Bell enjoyed the game. “I thought, ‘Well, at least it’s showing how irritating and ever-present the hallucinations can be,” she says. But the more she played, the less she liked it. “This game is operating within the context of a culture that doesn’t understand mental illness,” she says. “Do we really need another way to make fun of ‘the crazies?’”

Joel Gurin, board member and acting president of NARSAD, formerly known as the National Alliance for Research on Schizophrenia and Depression, says no.

“I think when you’re talking about humor about serious subjects,” he says, “you always have to ask whether it’s a subject that’s well understood so people can step back and laugh a little—so it’s harmless— or whether it’s something that’s so poorly understood that humor can actually be misleading and destructive.”

In the case of Schizo-phrenzy, Gurin thinks it’s the latter. “[Schizophrenia] is a very serious challenge,” he says. “And it’s not on the level of seeing some strange bug that you can jump on and make disappear.”

Gurin and Bell both wonder how the game would be received it if lampooned sufferers of other kinds of serious illness.

“Maybe when I see more cancer-sure-is-hilarious videogames, I’ll change my outlook,” Bell says.

Cartoon Network/Adult Swim Digital’s public relations department was happy to answer questions about the game, though they preferred to attribute the comments to an unnamed “Adult Swim Games spokesperson.”

“Based on game developer pitches,” Mystery Spokesperson said via email, “we choose those games that will appeal to our audience and are well-made. We always closely monitor games feedback on our message boards, and it has been positive to date.”

That may be an understatement. Players give the game a huge thumbs up.

Lord Kai writes: “Such a lovely little bout of insanity! There’s nothing better than flying from building to building with gravity on your side … Rainbow world is fun, too.”

Hungryfreak writes: “This is the best game this site’s produced yet. Old-school platforming with gravitational twists and a side of insanity that makes for amazing style.”

Others rave about the higher levels of play.

But dissenting gamer LaceFX writes: “I have a close friend with paranoid schizophrenia … and I can’t help but think, Why in the hell would anyone make a game out of a mental illness? It’s a nightmare for those who actually have it.”

Bell knows that firsthand. And she gets frustrated by alienating portrayals of people with her illness.

“When people are given the opportunity to consider mental illnesses within a believable context, the gap between ‘the crazies’ and ‘the normals’ suddenly becomes shorter,” she says.

But others with the illness see the game as harmless fun. On Schizophrenia.com’s support forums, Peter5 wrote: “I like it. I see that game as a good game to play for people with our disease. I didn’t see it offensive during the game but just a bit during the introduction, but for a very small part.”

So which is it? A fun game with a great user interface and thrilling play? Or another stigmatizing portrayal of people with severe mental illness?

I make it a policy not to comment on Funny or Offensive, but I’m going to end with Bell’s final thoughts on the matter: “I know we need clowns,” she says, “but maybe not so much when the tigers are in the cage.”

They’re going to appeal. Unbelieveable.

To those who don’t have the illness, it’s almost inconceivable to imagine what it’s like: hallucinations, delusions, disordered thoughts — symptoms that make the sufferer seem almost invisible. They’re so removed from the world the cogent person knows and lives in, it’s hard to imagine there’s some emotion in there, some experience, that could connect with everyone else. But we all understand pain. And for whatever reason a tiny minority of those who suffer from the disease will deliberately end their lives.

Delaney Ruston’s father was one of those people. Maybe it’s because his illness forced him to live in such compromised circumstances. Maybe it’s because he was tired of fighting against the symptoms. It’s just heartbreaking. Maybe later I’ll understand better why this upset me so much.

Documenting a troubled mind

Below is a clip of Richard Ruston.