Is Driving a Civil Rights Issue?
Thanks to Joe for sending me this article about a man who wanted a driver’s license despite being diagnosed with schizophrenia. In my experience in community mental health, getting a driver’s license was basically impossible with such a diagnosis; psychiatrists didn’t want to sign the paperwork allowing a person to apply for a license. It was something that distressed me to no end. When I reported the problem to the city authorities, they were appropriately appalled. But nothing changed. A man would go in, ask for a signature that would allow him to simply take a permit test, and be rejected. Yet at the same time he was being told not to define himself by his diagnosis; what a mixed message. He was being told he could recover and lead a “normal” life. But what kind of life is it without being “allowed” to drive?
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.
liz | 9:01 AM | DISABILITY, SCHIZOPHRENIA, bipolar disorder, depression, hospitals / hospitalization, meds, side effects, stigma
Stigma in My Sleep
Last night I dreamt that it was revealed that Al Franken (who won, by the way) had schizophrenia. People were very upset about it. He got on a bus with me and some people I knew, and everyone was nervous around him, as though he might “go off” at any moment. When we all arrived at our destination — some kind of summer camp — Franken disappeared, and everyone got very uncomfortable with his absence. We looked around and finally found a bathroom that was locked. We heard a struggle inside. We pried open the door and there was Franken, stuffing a small girl’s body into a paper bag. He had killed and mutilated her.
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.
liz | 10:03 AM | SCHIZOPHRENIA, stigma
No Shit. Really?
Did you ever see Broadcast News — and the scene where Albert Brooks is giving info to Holly Hunter for the nightly newscast over the phone? He’s bitter because he’s not the anchor; William Hurt is. But he does want the news to make sense, so he calls Hunter, who’s the producer, to give her a tip on how to cover a story. Within seconds, he hears William Hurt say exactly what he said, and he comments ruefully, to himself: “I say it here and it comes out there.”
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.
liz | 2:36 PM | BIG PHARMA, SCHIZOPHRENIA, depression, meds, side effects
The Trouble With Spikol: Print Edition: Bonus Funny or Offensive
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?’”
liz | 3:45 PM | Funny or Offensive?, SCHIZOPHRENIA, media
What If Someone Said: “Yes, We Fucked Up”?
Harris jury awards $3M in death involving excessive force
They’re going to appeal. Unbelieveable.
liz | 5:22 PM | SCHIZOPHRENIA, criminal justice system, hospitals / hospitalization
A Father’s Battle With Schizophrenia
I just took a look at a link sent to me by EdVS about Delaney Ruston, the daughter of a man who suffered with schizophrenia. She’s recently made a documentary about her dad called Unlisted, and I thought the piece might be good blog fodder. What made me start crying — and I’m not much of a crier — is the fact that her father jumped into the water at the Santa Monica Pier and killed himself. That’s the horror of schizophrenia: that it sometimes takes people to a place — whether in their everyday lives or in their minds — that involves so much pain.
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.
liz | 1:52 PM | SCHIZOPHRENIA, suicide
