The Poison Isn’t the Medicine: Antipsychotics, Mania and Sleep

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What is the appropriate level of antipsychotics necessary to come down from a bipolar mania? This question should be garden-variety to doctors that invest over seven years of their lives into education plus countless hours in practice. What follows is an embarrassment. My insurance was billed over $100,000, six months of my life evaporated and I had to endure the worst abuses of the ruthless psychiatric system all in an effort to find an answer to a very simple question.

After watching the horrific treatment of the United passenger a couple weeks back, I’ve decided to tell my story with full candor in the hopes that others don’t suffer from the same mental lapses that plagued me as a patient. The time has also come for the anti-psychiatry movement to rally around a few key points rather than paint psychiatry dark with broad brush strokes. If we’re honest with ourselves, we haven’t made a dent in stopping the psychiatric bubble that now plagues nearly half of Americans, which is too bad considering that there are a few common sense reforms we should all agree upon.

My doctors have been prescribing mood stabilizers for as long as I’ve been diagnosed bipolar, but the drugs have no obvious effect because at the end of the day I control my moods, not a pill. Lithium was thought to remedy mania since as far back as the Greeks, but it was actually the hot baths where the lithium originated that made the patient’s body tired and finally willing to succumb to sleep, which is the obvious way out of a mania. The other class of mood stabilizers like oxcarbazepine have no active ingredient and no sedative effects; the rumor is that combined with antipsychotics they produce some kind of magical potion to pull a patient out of mania. This theory is complete rubbish. We know antidepressants work just barely better than placebo, meaning they don’t work at all. Something like lithium that is a poison at level 10 cannot be a salvation drug at level 7, otherwise we should all be consuming more lithium. But sadly, doctors are a bit too squeamish to apply such remedies to themselves or their family members.

To test the theory that a lack of sleep would trigger mania and resumption of sleep would restore health, I conducted what I thought would be a straightforward experiment: while still on lithium and a low dose of antipsychotics, I suppressed sleep for a few days. Immediately I could feel the roar of mania within my brain. My mind figuratively stretched and the supposed safety net of the cocktail I was on did nothing to prevent my third mania from occurring. As expected, I felt creative and enjoyed the natural high for a few weeks, but anyone that’s been manic knows that lack of sleep for days on end is analogous to torture. The time finally came to be treated, but sadly, as you’ll soon learn, hospitals have little training for reducing mania if the patient doesn’t exhibit obvious signs like rapid speech and full out psychotic symptoms.

The first hospital I checked into gave me antipsychotics and released me after 48 hours even though I was begging to stay and be treated more thoroughly. The economics of a hospital bed are simple: at $10,000/night, mania/lack of sleep cannot be billed for more than a night or two, and they don’t give two damns what happens to you in the outside world when another sick patient is waiting with insurance willing to pay for longer use of the same hospital bed. After a handful more days, the time came for a second hospitalization. Same initial process, but this time they recognized that I needed more than a 72-hour hold and kept me in the psych ward for a week. However, I had no voice in my treatment and despite obviously needing sleep, the doctor thought it a good idea to wake me up at 5:00 every morning to receive an injection that supposedly dripped antipsychotics into my system, but in reality had no sedative effect and simply robbed me of a couple hours of sleep I badly needed.

Again before I was in total remission (and how could I be in remission having to wake up so early every morning?), they released me only to treat me again a week later. The problem is that the dose they gave me in the hospital worked and made me fall asleep fairly quickly, but in the outside world the recommended dose was lower and didn’t have enough sedation to make me fall asleep consistently. I eventually flew to a different city in the hope that a different staff would finally recommend the magic potion that would CONSISTENTLY work. My outside doctor intervened and gave me a prescription for Risperdal, but again at a dose that was too low to be effective. So I took matters into my own hands in a way that could have ended tragically. Manic, sleep-deprived and very scared of a world where no one cared whether I was healthy or not, I took pill after pill until, almost before I knew it, 4,500 milligrams of Seroquel were in my system and I was walking aimlessly through the airport unsure of what my next steps were.

A cop happened to pull up to the curb and noticed me in obvious distress. “Spit out what’s in your mouth, NOW!” A half dozen pills came tumbling out. Soon, a few more cop cars descended and they took a statement from me while I was handcuffed and sitting on a curb, beads of sweat coming out of every pore in my body. Had I fatally overdosed? Would I survive? Why was the ambulance taking so damn long to get there? The cops were, to their credit, professional, and quickly turned me over to the EMT workers who were mortified that I had taken such a large dose. Sadly, only a fellow mental patient or an accused terrorist in Guantanamo could relate to the delirious and painful effects a prolonged period of little to no sleep has on the psyche. To my chagrin, after a brief stay at a good hospital, they transferred me to a place with metal rods for a mattress and the same ineffective dose, releasing me after a couple days when I was no longer a threat to myself.

At this point, my money was running low and I had to fly back to my native San Francisco. My parents were flabbergasted that I had spent so much money and was going in and out of hospitals; they didn’t know what to do and refused to allow me entry into the house until I got help. But every time I got help, they put me on the same low dose and lithium combinations that didn’t do the necessary job. By this point I was homeless in San Francisco and found myself going to the police station to feign self-harm so I could be admitted to a hospital and hopefully connect with a doctor that understood. But incredibly none of them did. I was placed in a halfway house for a couple weeks, only to be kicked out because they didn’t feel I was improving fast enough. But I couldn’t improve when the Seroquel dose wasn’t sufficient to sedate. I would check myself back into the hospital only to find them offering Benadryl — fucking Benadryl — in the hope that I would simply go away.

But my anger started spilling over at this point. I demanded to see a psychiatrist, and after a three hour wait, a doofus from the psych ward finally emerged. I spoke slowly and explained I needed something between Benadryl and Fentanyl in strength. I did NOT want to be forced back into emergency psych’s locked unit where I had been three times over the last month, all to no avail. But because I was homeless, the expansive definition of GRAVELY DISABLED meant I had no rights and they wheeled me up to psych anyway.

SF General’s Emergency Psych Ward is one of the dirtiest, dingiest dungeons in all of America. Three SF police officers are stationed to make sure no angry patient makes contact with staff, and staff believes it is perfectly reasonable to spend only 10-15 minutes per day interacting with each patient. I began spitting in the vicinity of the police officers, but not at them because that’s assault and they were only doing their jobs, sitting in chairs bored as can be. But this lack of viewing me as a human being was bothering me. To compound my anger, the place was so grizzly that the average American would be shocked — twenty beds fit into such a small, unclean space that supposedly was designed to help people.

The staff ordered me into a seclusion room which I went into, thinking the worst was over. But no. Before I knew it, a half dozen SF sheriffs were pounding on my door. I immediately leaped onto the bed stomach first with my arms to my side. Anyone that’s watched Lockup on MSNBC knows what happened next. They assaulted me, the officer stationed to my head pushing so hard on my neck that I would later need to be treated for neck pain. An officer on each arm, the two sheriffs responsible for my legs bent my knees and pushed up as hard as they could, sending pain searing through my entire body.

They knew I had disrespected their fellow cops and thought it their right to inflict as much pain as possible without leaving bruises, several of them hurling obscenities at me as if I was an actual criminal as opposed to someone paying for the service of trying to get better within a hospital rather than a maximum security unit. After five excruciating minutes, my arms and legs were strapped and a spit mask placed on me as I lay claustrophobic on the bed, shaking at the extreme example of violence that so quickly escalated over something so stupid as spit. And to make matters worse, the doctors knew who I was from my previous visits, so they fake injected me in order to write in their reports that I was so manic and out of control that this display of violence was justified.

A couple hours passed and a friendly nurse untied me and gave me something to eat. The next day they wheeled me up into the psych ward, and this time the doctors treated me seriously. They introduced me to Thorazine, one of the oldest and most sedative of drugs, and combined Seroquel with the moderate dose of Thorazine. Finally, after nearly four months of hospitalizations, a way to permanently come out of the mania. The female doctor patiently explained that the combination of drugs is what worked; any one drug in a moderate dose wasn’t enough to give me the sedation I needed to sleep. Eventually they moved me off Thorazine to 6 mg of Risperdal and 200 mg of Seroquel, which put me out within two hours every single night.

Obviously, this was a horrifying ordeal to go through. But I never again have to question what works and what doesn’t, nor am I scared of big, bad Thorazine. The pharmaceutical drug market knows that Thorazine was and remains a miracle drug in terms of sedation, which is why every attempt from Risperdal to Seroquel to Zyprexa and now Abilify is simply a knock-off of Thorazine. The infamous side effects are as much a response to physical violence as they are to the drugs themselves. I was shivering not from what was happening inside my brain but from what my body had been exposed to as a result of the assault I went through. I witnessed other cases of similar violence, but a doctor’s order is the law and that’s that.

What can we as reformers advocate around for immediate change? Unlike Tom Wootton and his beliefs that drugs are always bad (which simply feeds into his business model being the healthy alternative), we have to recognize that short-term acute can become long-term chronic in the flash of an eye. They threw all sorts of labels at me on top of bipolar, including anti-social personality disorder and schizoaffective disorder — nonsensical terms I quickly brushed off because I knew mania was my one and only problem. To keep things simple, I propose three rallying cries that we can all unite and work towards to improve the system and alleviate short-term suffering:

1)  Newspapers and governments have ombudsmen — why not a hospital? 

Yes, there are patient advocates that appear on court days and spend a whopping twenty minutes speaking with patients and preparing them for a visit with the judge. But what about the cries for help that are ignored daily on each and every emergency psych ward, from people that doctors dismiss as out of control patients? A poor woman had a hernia and the doctor was too busy surfing the Internet to heed her pleas and simply threw her into an isolation room. It wasn’t until other patients and staff intervened that the doctor applied what limited knowledge he had in attempting to treat this woman.

Nurses are subservient to doctors and too many lack empathy to properly function as a liaison between patient and doctor. And if we’re being honest, virtually every doctor working in an emergency psych ward suffers from antisocial personality disorder themselves. Why is it okay to spend ten minutes a day per patient and bullshit and waste time with colleagues the rest of the time? An ombudsman should have seniority over a doctor and be able to write objective reports linking the connection between a patient’s pain and the doctor’s treatment for the army of hospital administrators that never step foot on the ground floor of this travesty known as involuntary holding rooms.

2) Rally newspapers and magazines to our cause against forced stays and shoddy conditions

Sadly, in America, hear-no-evil see-no-evil is the status quo. Only when One Flew Over the Cuckoo’s Nest was released did the barbaric practice of lobotomies ebb. Since the average American cannot picture a modern dungeon without shows like Lockup to take people into the world of an emergency psych ward, the blame for being there in the first place is placed squarely on the sick patient. If Americans had exposure to SF General’s Emergency Ward, if pictures could be taken and interviews with patients done, every single person responsible for working in that dungeon would be fired within a week. How can we turn cameras and attention to these conditions the same way African Americans used images of police brutality in the 1960s to win civil rights concessions? This question should be on all our minds because that’s how this fight could end overnight. But what the mainstream doesn’t know, they don’t know, and we’re too busy chasing our own tails to educate them on the obvious abuses of power that occur every single day.

3) Draw a deep line of demarcation between short-term acute and long-term chronic

We come across as radicals when we lament things like increases in the number of dopamine receptors when these obviously go away from atrophy after the acute crisis is over. Brain damage was the last thing on my mind as I was looking for a cure, but modern medical research claims there’s no such thing as sleeping drugs. Yes there is: combinations of antipsychotics. I’ll remain on my cocktail for another month or two to make sure I fully come out of any lingering mania, and will always have a bottle nearby in case I have sleep problems again. Simple breathing exercises and counting down from 1,000 help, but nothing works better than 6 mg of Risperdal and 200 mg of Seroquel. Schizophrenics also have acute mania crises and this combination of drugs helps restore order, but as Robert Whitaker has advocated, the evidence is highly suspect that these people need permanent doses far in excess of what’s necessary to return to normal. If we work with psychiatry to acknowledge that modern medicine has its place, we can fight for limitations to these authorities and their incredible range of power over human lives.

I had to go through a deep personal tragedy to find a cure that can be applied to anyone suffering from mania. The lesson is to not fight with doctors but to ask for the highest dose they’re willing to prescribe of a combination of antipsychotics. When order is restored, the choice is entirely ours whether to continue taking medication or not. And levels of sleep, not fear of the unknown, should be our guiding light as to what is an acceptable level of treatment. Having the peace of mind to know that I can slip in and out of mania in the future and have a cure handy makes me highly comfortable moving forward. But sadly, the fight for true reform still remains in the earliest of innings because we foolishly cannot narrow our scope and decide what exactly we’re rallying against.

[Editor’s note: due to personal circumstances, the author has chosen to publish under an abbreviated version of his name.]

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

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97 COMMENTS

    • You’re right, it’s a typo. It was 4500 milligrams of Seroquel, a bottle of nearly 60 pills. That came after a pair of hospitalizations, and I was so sleep deprived that my judgment was heavily impaired. I wanted very badly to fall asleep and knew almost instantly that I had made a bad error.

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  1. “The lesson is to not fight with doctors but to ask for the highest dose they’re willing to prescribe of a combination of antipsychotics. When order is restored, the choice is entirely ours whether to continue taking medication or not.”

    Not really at least not with me, I got the mania as part of alcohol withdrawals. I went to an ER for detox instead of buying more alcohol and got transported to a UHS psychiatric hellhole, UHS is infamous for kidnapping people till insurance runs out > https://www.buzzfeed.com/rosalindadams/intake

    Long story short they tried zombifying me with a massive 3 drug cocktail including Haldol and I refused and then they threatened me with an injection. I got to keep this short but I threatened them back stick a needle in me I may see you outside this hellhole someday and stick a needle in you so they threatened to call police and I said go ahead all did was make the exact same threat of stabbing people with needles that you just did at me. Police were not called but I was just going to make the exact same complaint of people making threats that they were. How is it OK for them to make threats and not me ? Eye for an eye bitch.

    What would have happened if I took the massive dose for a month ? When I got out I would have had the same problem but instead of not being able to sleep without alcohol I would not be able to sleep without lots of pills after being saturated for a month. Of course I put up a fight, I lived Zyprexa withdrawal years before after just taking what they gave, something worse than kicking benzos and 100 times worse then kicking alcohol. Not doing nueroleptic withdrawal again.

    I have a stash of Seroquel in case of run away insomnia to knock it down but screw that take massive amounts of drugs for “prevention” they tried pushing on me again.

    That hospital nightmare will never happen to me again, if some tragedy gets me so upset and ‘manic’ that I start drinking again and get to that point, that horrible point of dysfunction hell, I won’t go within 100 miles of a hospital instead its a high end rehab for Ativan Seroquel to come down. A place with a gym, yoga classes nice food and of course by the beach. Been many years since I had problems but if it happens that’s the plan.

    I was so upset by what happened in that ‘hospital’ , kidnapping and threats at me, the first thing I did was get alcohol when it was over, the nearest store, then when I was thoroughly sick from drinking for about another week I made it to a nice rehab.

    Even for someone that does not have addiction issues like I had the ticket might be to claim them, get drunk and claim alcoholism, and MI if you think it would be helpful, cause it is very difficult to find anything besides a locked hellhole for straight up mental illness but drug and alcohol rehabs are all over the place and they compete for customers by offering nice amenities.

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    • I’m sorry to hear about your forced hospitalization. I’ve been injected many a times and unless there is a sedative effect to the injection, it doesn’t do anything that it should do. Those injections are also $800/each as a supposed “maintenance” treatment.

      One thing that’s been very slow to change is how they treat involuntary hospitalizations. If you have insurance, they want to keep you as long as possible. If you don’t or have bad insurance as I had, you’re not a priority and decisions are made based on dollars and cents as opposed to common sense. I was furious that even though I didn’t exhibit common symptoms of mania, had a place to stay, they still treated me like a zombie and held me against my will. It’s how they make money, bodies to beds. Until we have a single-payer system of insurance, this system won’t change.

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      • I personally believe the psycho/pharmaceutical/medical industrial complex needs to be broken up, and we need to go back to family doctors who believe what their patients say, and who comprehend their pharmaceutical industry funded scientific misinformation is based upon the greed of the pharmaceutical industry, rather than reality, with an understanding that medicine is an art, not a science.

        I will say to you, as one who had the common symptoms of antidepressant discontinuation syndrome misdiagnosed as “bipolar,” that a combination of Risperdal and Seroquel created anticholinergic toxidrome in me.

        https://en.wikipedia.org/wiki/Toxidrome

        So your recommendation of this drug combo as a panacea for all suffering from insomnia is unwise. As it is a drug cocktail that can actually create “psychosis,” via anticholinergic toxidrome in people who don’t actually have sleep problems, but whose doctors have odd delusions their patients have sleep problems, according to their medical records.

        But I do agree with you that there is a problem for those who have good “insurance, they want to keep you as long as possible.” The fraud based “mental health system” will illegally hold you as long as the insurance companies will allow them to do so.

        “Experiment with yourself if you want. Don’t play this shit with the rest” of us, as oldhead states below. But I do appreciate your pointing out the crimes within our current DSM deluded “mental health” industry.

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      • A single payer system seems like it would be a good idea but consider it would be owned/run/managed by the USGov and it’s crony mega contractors (Tricare, Anthem, UHC, ExpressScripts, Sentara, Kaiser). That means the gov’t would keep paying the corrupt insurers, providers & facilities (hospitals0, but we the people could have our health insurance and health care cut off instantly via a ‘continuing resolution’ i.e. government shut down.

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    • OK I’ve taken a deep breath. Perhaps the author is facing involuntary circumstances at the moment and has to speak in code, and this is just sort of a cry for help. But it’s tragic to see someone so thoroughly ensconced in the same fraudulent system that has been responsible for so much torture in his life, and only seeing relief in the form of “reforms” while accepting his “diagnosis” as a fact of life.

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      • Hard to say. If the editor’s blurb at the top of the comments is correct, this throng of shrinks he’s seen induced his misery from the get-go with some bungled antidepressant treatment where the prescriber spent no time searching for dysperceptions in the “prescribee”, and consequently launched the first of this series of episodes of flailing and failing psychiatric endeavors.

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      • Medication Spellbinding… Why do so many individuals persist in taking psychoactive substances, including psychiatric drugs, after adverse mental and behavioral effects have become severe and even disabling?

        But give the guy a break, I have been there, I can’t sleep and those bastards won’t give me the good stuff to get me to sleep ! There is more to my story the that one hospital, the last, that lead me to writing here like every day. That very last psychiatric kidnapping was all different cause medication spellbinding was gone I knew the truth of psychiatry and I had no interest in going back to hell.

        Before that One time inpatient they started taking my mattress after blood pressure wake up bullshit I guess the thought being if early wake up would lead to early sleep if I could not go lie down, sleep deprivation the thing that really got me to the hospital was now going to cure me. I really should not even be thinking about this 15 year old memory but I already hate them. Back then I still thought the answer was good downers. Medication spellbinding, I could not even imagine my problem was the treatment itself. I never said to myself I was 100x better of before I ever went near those quacks and if I just walked away and got off all that crap I would return pretty much to the way I was before.

        Load me up with all the brain dead zombie shit that made me tired but not sleep, tell me to take it I guess forever. Well WTF give me the damn Xanax, what possible difference does it make if it is addictive if I need to pop pills every day anyway ?? Give me a logical answer. At least it made me sleep !

        They gave me Haldol , I was still up all night. The next hospital how much later I can’t remember but the same crap, That time Abilify and the can’t sleep nightmare. WTF I can’t sleep everyone else is sleeping.

        I was at the point of hating psychiatry over the locked abusive part of inpatient, they could go to hell but the medication spellbinding still had me. Maybe the author is still at that point.

        I am not an anti drug warrior and anti psychiatry what does that even mean? Take what ever damn pills you want but force is a human rights violation and I always call forced drugging rape cause they violate your insides as opposed to assault that violates just your outsides.

        Thinking about the mania, heavy drugging is just like ice on a burn, take the ice away pain comes back or like on the drugs your still in the mania but zombie at the same time that makes it more frustrating. I hate to even use the word mania, its insomnia anxiety and anger all mixed up.

        I know what I have to do to stay out of it or not do, the party drink and get high lifestyle can’t do it, I would like too but I end up a mess. The fun to hell ratio sucks. I also know to plan my life to not include the necessity to wake up early, that’s worse then an occasional drinking party. I have said no to good jobs, I know what happens with that early wakeup requirement with me. I can’t sleep till real late then get just a few hours day after day till I get so tired out eventually I bug out.

        “Just get up early so at night you are tired” Oh please STFU my whole life that never worked.

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          • I was initially irritated and also thought the author might be gong through something drastically different then I did till later when I though back to what I went though before I came out of it. Maybe that was the point of publishing it. It was a psych survivor talking to me that initiated my coming out of it.

            Also I see alcohol and drugs in this picture, psych hospitals and homelessness just go with drinking or doing drugs.

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          • The_cat has it correct: you have to go through a case of extreme sleep deprivation to understand that the drugs are not the problem; they are the solution. The problem is everything else that comes around the solution: violence, forced involuntary status, and chronically treating someone with the same tool that is only applicable for a short term problem of restoring order and sleep.

            Half the people in a psych ward legitimately cannot sleep and need drugs while the other half are there for obtuse reasons: one man was caught touching himself and they couldn’t throw him into prison so they put him in a psych ward. This is obviously wrong but allowable because his insurance covers the expense and they hope he learns a lesson. Because the definitions of involuntary status are so expansive, this nonsense is permissible and happens every day.

            No drugs or alcohol were involved. Once the mania is cranked up to a high enough level, there isn’t much of an alternative to drugs. If you favor breathing and meditation ala Tom Wootton, that’s one path but that’s not something you’re going to learn at the height of insomnia.

            I wish Ativan was available over the counter. I know a couple of those tablets make me fall asleep every single time. But releasing Ativan to the masses subverts psychiatrists and they’re not in favor of anything that takes away the power of their pen and pad.

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          • The_cat has it correct: you have to go through a case of extreme sleep deprivation to understand that the drugs are not the problem; they are the solution.

            OK that’s as far as I go with this. Oppression is the problem. Liberation is the solution. I know what not being able to sleep is like. Neither Cat nor I concur with your conclusions however. But you seem too ensnared by the system right now for logic to have much relevance. Good luck.

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      • Oldhead, I don’t think the writer has read any of Whitaker’s books or anything else critical of psychiatry. I used to believe psychiatry was a legitimate branch of medicine.

        We all have to start somewhere.

        I guess MIA has abandoned its stance of anti-psychiatry/psychiatric criticism. If it ever had one.

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        • I have read his books but in my opinion they don’t sufficiently address the short-term, acute need for medication which is psychiatry’s single main-stay as an institution.. This is the bread-and-butter use case for why psychiatry should exist. But there’s so much BS with an 800 page book of useless categorizations that they’ve obfuscated their main reason for existence, which is to treat acute patients like myself.

          The books do an excellent job of addressing long-term use of anti-psychotics. They are very influential in my reason to get off the meds now that the crisis stage is over.

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          • I have read Mad in America and Anatomy of an Epidemic, and have seen several presentations by Whitaker, and he has been very consistent in saying that tranquilizers do seem to be useful *sometimes* in the short term. What else was he supposed to say about that?

            The usefulness of tranquilizers (in the short term, to help people sleep) in no way validates psychiatric theories.

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          • The problem with psychiatry is that it does not–as a system–confine itself using its drugs as a short-term solution (6 weeks or less.) Far from it. The dosages and polypharma cocktails are far from minimalist. The exact opposite of how a homeopath prescribes. Though homeopaths stick to natural remedies–usually stuff they find in the wild or grow themselves. Not synthetic chemicals that smell like bathroom cleaning agents!

            I still take 52 mgs of effexor since I’m in the process of tapering. Amazing now, how that stuff smells like Comet or Bartender’s Friend!

            By the way, I’ve been diagnosed as Bipolar. No longer on neuroleptic or “mood stabilizer” and far from manic–though I keep coughing and my parents think I may have some physical sickness like FM. Effexor has proven very addictive and hard to come off for me. Any doctor who tells me differently doesn’t know what he’s talking about and is not to be trusted. Liar or fool.

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          • “acute need for medication” wrote Vlado C. May 1, 2017 at 6:32 pm

            WTF? You purposely stayed awake to bring on a mania.

            That is not something a responsible adult would do.

            You are not a “patient” but a drug (ab) user and need a legitimate source for drugs. That is not medicine.

            Prove you have some physical defect ( that you did not cause yourself) , then a doctor would be issuing medicine, otherwise it is legal drugs.

            You write of wanting over the counter Ativan in anther post. If you do not know the withdrawal consequences from Ativan, then you are truly inexperienced in the mental health world.

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  2. I went straight up when I stopped lithium – but it wasn’t genuine mania it was more a change in personality from flatness to enthusiasm. I my view I have never in my life been clinically depressed or clinically elated.

    Anxiety was my main problem when I stopped medication. But this has changed now as I have worked my way through it.

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  3. Anyone who has “can’t sleep mania” should read this The myth of the eight-hour sleep http://www.bbc.com/news/magazine-16964783

    Sleeping at the “right time” what a steaming pile of horse crap. If you read it now you know. Also below,

    Delayed sleep phase disorder- Attempting to force oneself onto daytime society’s schedule with DSPD has been compared to constantly living with jet lag; DSPD has, in fact, been referred to as “social jet lag”. It is responsible for many patient complaints of chronic insomnia. However, since many doctors are unfamiliar with the condition, it often goes untreated or is treated inappropriately; DSPD is often misdiagnosed as primary insomnia or as a psychiatric condition. A chief difficulty of treating DSPD is in maintaining an earlier schedule after it has been established, as the patient’s body has a strong tendency to reset the sleeping schedule to its intrinsic late times. People with DSPD WILL improve their quality of life by choosing careers that allow late sleeping times, rather than forcing themselves to follow a conventional 9-to-5 work schedule.

    “Just get up early so at night you are tired” Oh please STFU my whole life that never worked.

    We get lots of views someone who never heard of Delayed sleep phase disorder is going to read this and be like finally that explains it !

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  4. Good God! These clowns conned Vlado out of his time and his money. And, at the end of this fraudulent malpractice, they did no more than he could have done, had he been permitted to LEGALLY “self-medicate”. Folks in the Mad community are often forced to drug themselves to the limit, in order to secure consistent sleep and protect themselves from being court-ordered to “treatment” (i.e. caged, brainwashed, poisoned, and raped with needles and/or electrodes). For instance, Linda Gray Sexton wrote about her experience with “calculated narcoticizing” in her memoir, Half in Love. Compared to a healing bath, this self-care option is pathogenic and barbarous. And over the long-term, what we need to do is criminalize EVERY Mad health care protocol that isn’t 100% safe. But, until then, Vlado has set an excellent example of how to psychiatrize, while assuming the least possible risk of harm. Way to go, Vlado!

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    • J, thanks for the positive comment. You captured the essence of my story, that I was legitimately seeking help for sleep deprivation only to find these most of these people are completely untrained to what should be a straight-forward part of the job. Sleep deprivation is the cornerstone of bipolar/schizophrenic diagnoses and the multiple cocktail approach really basic to understand and implement. But I learned the hard way most of these doctors simply don’t care. We’re numbers; not patients.

      Insanity is defined as doing the same thing over and over again and expecting different results. By this definition, the system is absolutely nuts. That’s why, to me, a reforms-based approach to dealing with the ills makes more sense than talking down the medicine, which is legitimately helpful to those who have a need.

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        • The alternative to accepting anti-psychotics was to accept the label “schizophrenia” and face permanent institutionalization. Anti-psychotics do not get you “high”, rather they bring you down from the natural high that is mania.

          I should have done a better job delineating between psychiatric drugs like benzos that do get people high and anti-psychotics, which no one abuses because they don’t have anything addictive in them. They are designed to bring down mania and I was trying to illustrate they work best in combinations rather than stand-alone.

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          • “they don’t have anything addictive in them”

            Olanzapine Withdrawal: Sally’s Story. … I had a couple of goes coming off too quickly, and suffered horrific withdrawal symptoms; headache, agitation, anxiety, insomnia, nausea and vomiting, and feeling appallingly ill. I am vomit phobic, so the sickness drove me back on to the drug, and the symptoms went away. https://rxisk.org/olanzapine-withdrawal-sallys-story/

            Drugs that have nothing addictive in them don’t make you sick when you quit. Thats what addiction is take the drug or get sick, getting high has nothing to do with it.

            Common symptoms of antipsychotic withdrawal include nausea, anorexia and vomiting. Headaches, insomnia, anxiety and agitation may also occur when a patient no longer takes the antipsychotics.

            No one told me about the sickness they just said take this Zyprexa for six months don’t worry it is “non addictive” so non addictive the withdrawals almost killed me so sick I went to ER then 2 weeks later went back when those pills ran out got locked in psych and those bastards blamed me not the drug.

            Psychiatry needs to tell the F ing truth. Informed consent. They are lying sacks of crap.

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      • “Insanity is doing the same thing over and over and expecting different results.”

        Such as checking into the psych ward for more drugs every time you have trouble? And why did you deliberately stay awake for several days in the first place?

        There are milder treatments you could give yourself without imprisonment. Unless your brain was severely damaged in a certain spot you would have fallen asleep finally. Walk briskly for an hour, soak in a warm epsom salt bath (not hot), eat a turkey or tuna sandwich. Take a few benadril and maybe an advil if your muscles ache. Wash them down with warm milk and honey. Play some soft, soothing music and lie down. Even if you can’t sleep, the rest will help. It may take a few nights to sleep soundly again. But it will work! The psych ward will not give you the help you need.

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        • “Insanity is doing the same thing over and over and expecting different results.”

          PLEASE don’t repeat that — it is NOT the definition of insanity in ANY dictionary (except maybe the “urban dictionary”).

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          • No, it’s not the legal definition–or psychiatrists could all be labeled insane!

            It’s a quote that did not originate with Vardo. Not sure who said it.

            I was merely quoting him. And repeating harmful/ineffective behaviors over and over is stupid any way you cut it.

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  5. Okay, so you needed a major tranquilizer to sleep. I believe you. I don’t see how it follows from that that there is anything worthwhile about psychiatry. In fact, you made the case that you would have done better without it if you would have had the short-term access to major tranquilizers that psychiatric gate-keeping initially prevented.

    The time has also come for the anti-psychiatry movement to rally around a few key points rather than paint psychiatry dark with broad brush strokes.

    By definition, that would not be anti-psychiatry. Psychiatry deserves only to be abolished, because it is an illegitimate medical specialty and as such will always harm people. Your own story attests to that fact.

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    • This is where we have to agree to disagree. Mania is a real phenomena. Failing to acknowledge it is what sets back the antipsychiatry movement and portrays us as extremists rather than reformers.

      There IS a place for anti-psychotic drugs even if we agree that anti-depressants and benzos are sham. If psychiatry was all-bad, why would it still be around in 2017? I needed professional advice on how best to sleep/reduce the mania and that dialogue was missing until the very end. I never need the conversation again because I now know what works. But too many people who are new to psychiatry don’t know that a mix of anti-psychotics will alleviate symptoms in the short-term. Instead, they’re led to believe a single drug or a mix with lithium is the solution when that’s not the case.

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      • “If psychiatry was all-bad, why would it still be around in 2017?”

        Because it is the perfect tool for social control???

        I don’t believe in ‘mania’ or ‘depression’ or any other adjective in the DSM…there is only a range of human experience. And just because one is ‘stuck’ in a particular place of discomfort or distress does not disprove the law of flux–*everything* changes.

        There’s so many other ways to address insomnia–but you had to have the quick fix, just like most populations with ‘advanced’ economies. Pharma loves that…

        Good luck to you. I wonder what your attitude will be in years to come?

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        • Capitalism is a more effective tool of social control than psychiatry. All the labels with bad outcomes like Borderline Personality Disorder, Narcissism, etc don’t have methods of treatment besides maybe therapy.

          I can’t make you believe in mania but it’s real, otherwise there would be no such thing as bipolar. Lack of sleep is the cause and it’s tantamount to torture when it escalates. It feels like your brain is on fire; wouldn’t you want a fire hose to put it out? That’s the purpose of the anti-psychotics. The reason I shared my story is to offer a family a blueprint for what works to get out of mania.

          As for my attitude in years to come, now that I have the answer for what works, I have no fear of mania. I simply resume the short-term use of medications. I wrote a post a few years back on resistance but now realize it’s futile when all the violence is concentrated to one side. Treat yourself as quickly as possible, get out of the system and into the safety of your own home, and spend time reminiscing on causes and triggers so you can be better prepared for another bout. I doubt my thinking will change from there. Thanks for the post.

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      • I don’t think you understand where I am coming from. I believe you about your experience of mania, and I believe that taking tranquilizers helped you sleep.

        The question about psychiatry being good because it still exists in 2017 is just silly. Plenty of things exist in 2017 that are shit. What you did is called an “is/ought” fallacy of logic.

        You continue to say how psychiatrists (“experts”) are so badly needed even as you say how shit they are and how you got fucked over by their cluelessness. That argument doesn’t make any sense.

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        • Reminds me of some friends of mine caught in abusive relationships. They’re miserable. They keep getting black eyes, broken noses and arms in slings. But just try to suggest that she leave the creep!

          Oh, Harry’s really not such a bad guy. He just needs to get his drinking under control….

          Yeah, he’s beaten me pretty bad while we’ve been living together. But now that we’re getting married….

          All Harry needs is counseling. He promises to get anger management therapy if I’ll come back.

          Denial of an abusive codependency. Sorry, but this article and the writer’s follow up comments make me think of abusive boyfriends. (There are abusive girlfriends too. As a woman I see more battered girlfriends though.)

          Oh, the psychiatry establishment is good and necessary. It saved my life! Dr. Quackenbush just needs to listen to my symptoms more/prescribe more or less “medicine”/realize my life is rough/treat me like a human being….

          Sometimes you just have to flee the abuser. I had to do that.

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        • The point of MadInAmerica, and where you and I have common ground, is how far psychiatry has strayed from it’s mission statement. I’m glad you agree that short-term cases need to be professionally addressed. But with so many labels and other factors for psychiatrists to consider, they now fail to treat the very patients who were their only customers a few generations back.

          Money is at the root of this system. My old doctor charged $175/30 min.. If I could get Ativan over the counter, there would be no doctor. But there’s always new patients and families entering the field without a clue of what works and what doesn’t. They were my main audience and inspiration for writing this article.

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          • Just to be clear, I don’t agree that anything needs to be addressed by a psychiatrist. I see your argument as similar to one I’ve seen from reformist psychiatrists who say that psychiatry needs to go back to the “good old days” when they were able to focus on the “real mentally ill” as opposed to dealing with the “worried well.” The problem with that is that psychiatry has never had a golden age in which it had anything helpful to offer.

            There are no “anti-psychotics,” only major tranquilizers. Thorazine tranquilizes people, so psychiatry got a hold of it and created a story about why it “worked” to treat “the seriously mentally ill.” It’s not medicine in the sense that insulin is medicine, and we don’t need a fake medical specialty to make up stories about why a tranquilizer tranquilizes people.

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          • The BKL21 is a round kitchen sink featuring a full sized classic D-Bowl. It’s large size make it the king of the kitchen in terms of functionality. Crafted of 18 gauge 304 Stainless Steel. Brushed satin finish will withstand the test of time and endure for years to come. Get all your needs fulfilled in one sink

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  6. I don’t believe that antipsych medication is the only effective way to sedate yourself.

    During my experiments with raw diets in the early 2000s, I experienced hypomanic or perhaps manic episodes (without disability) and would go without sleep for 3 days (that is my record). I was still attending grad school and functioning during the day. Hypersexuality was a problem though. I was never diagnosed and never reached a point where I needed help.

    It later occurred to me how to best deal with such episodes and I came up with a set of sedative methods. They work against insomnia, and they work against hypomania and severe agitation. I occasionally experiment with hypomania to this day, just for fun, but I now know how to control it.

    Without further ado:

    1) The simplest calming diet consists of whole-grain bread and water, but I recommend the following “depressant diet” instead because it is more balanced and effective: whole-grain bread, boiled meat (normal-fat or fatty), and nuts (preferably pulverized in a blender; note that peanuts are not nuts). The depressant diet (not the bread-and-water diet) is likely to cause constipation; therefore, you can add raw fruits and vegetables. That’s it. Dairy is not allowed, and neither are junk food and various seasonings and food additives. If you have problems with anger, then my advice is to exclude any pungent vegetables such as horseradish, garlic, onions, hot peppers, and spices. This diet can make you apathetic and depressed within a few days or weeks. Nowadays, in my normal state, this diet makes me feel like a zombie in a few days. Nuts are an especially heavy food that makes you feel awful in large doses.

    2) A hot environment, several days or longer. Increase the temperature in your room or home using a heater and a fan or central heating, if you can, and put on extra clothes: thermals, a warm sweater, etc. Oppressive heat causes fatigue and will bring you back down to earth. It is a scientific fact that patients with schizophrenia have better outcomes in third-world countries (most of which are in the tropical zone).

    3) A hot bath or a hot shower (excluding the head). These have a relaxing effect but only a temporary one. Can be combined with a hot environment.

    4) Excessive amounts of physical exercise: they will keep you fatigued and sedated. (Small or moderate amounts of exercise will have the opposite effect.) A stationary bicycle in your home is the easiest form of exercise. You can do a 30- to 60-minute workout 6 days a week as follows: Turn on a TV or a radio or put on some music. Do 10 minutes of normal-intensity cycling followed by 30 seconds of maximal-speed cycling. Next, do 20–30 situps. Then do 10 minutes of normal-intensity cycling and another 20–30 situps. Add another one or two repetitions if necessary. Take a shower. All done.

    5) Breath-holding exercise. Three to four breath-holds (30–60 seconds) with an interval of about 5 minutes. These sessions can be repeated once a day when sedation is needed. This is an exercise for the brain and is known to have strong effects on the brain, for example, this method can cause a panic attack in some patients with a diagnosis of anxiety. But usually, this treatment has a sedative effect and if I do it everyday, then I start feeling depressed.

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    • Wallenfan, thanks for the tips. I too see benefits to hypomania which is why I conducted my experiment in the first place. I’m better able to write and express myself in those moments, and the insights you gain stay with you when you’re out of that temperament. My sleep deprivation was more extreme, lasting weeks with less than five hours a night, which is why my judgment was so impaired.

      I’ll try your tips, particularly the exercise. Exercise has helped me stay away from depression, and it makes sense that the sedation from heavy exercise helps sleep.

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        • No, I’m a patient struggling to figure out what works and what doesn’t. I’m certainly not trying to advocate for psychiatry, but I was surprised in my series of events how little they understand about coming out of a disequilibrium state. It’s a major problem in how far they’ve strayed from the basics of their profession.

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          • You have the right to stay in a relationship with your local branch of psychiatry. But, having made the choice to stay in a coercive, abusive relationship for the drugs they offer you have no just reason to complain about the use of force or abuse they continue to inflict and that the drugs aren’t what you wanted.

            News flash! It’s not about what you, the Consumer want or think you need. It’s what your psychiatrist wants for you–what he thinks you need. That’s how the pharmapsychiatric system works.

            I hope some day you will realize how pointless this dance de macabre is and leave the MI System and their dangerous, addictive drugs behind. Then you can have a life!

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          • FeelingDiscouraged,

            Let’s not blame the victim, though. The guy is prone to manic episodes and he needs a way to get to sleep at those times. He has every right to complain about psychiatric abuse.

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          • They don’t want to treat the episodes when they happen, what the system wants is people in a constant state of zombie to prevent them. Then when the victim gets sick of life as a zombie and attempts to quit the drugs the withdrawal reactions are used as proof you need them. I lived this shit.

            Sounds like you are looking to treat just the episodes wile the system is focused on prevention, you are going to run into conflict.

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  7. I finally realized the MI System would never help me. They were determined not to let me recover and the brain drugs they fed me completed my helplessness. Finally, I chose to relocate. Going off my drugs, through with therapy, wellness groups, and all that other nonsense. I hope when my withdrawals are over I can write again. Maybe even go off the SSI my emotionally abusive shrink told me I would always need, like her pills! Wrong about one–probably wrong about both. 😛

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  8. “Vlado C.” is younger than 35, I’ll bet…..
    I’ve just read through all the comments above, and I found it quite painful.
    Before I insult anybody, I’ll let it go, for now….
    “mainia” = “mental illness”?
    Bullshit.
    The *result* of lack of sleep is NOT “mental ilness”….
    Wanting OTC Ativan is called “drug seeking” behavior….
    It’s a form of so-called “substance use disorder”….
    I call Bullshit, Vlado….
    ~Bill

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  9. I was diagnosed with bipolar II disorder by a family physician with little experience in psychiatry. I told her that no antidepressant helped me and she said if the antidepressants weren’t working, I must be bipolar. She put me on lithium which made me absolutely sick. Then I went to see an actual psychiatrist, but I couldn’t shed the bipolar label and they kept giving me horrible mood stabilizers and antipsychotics that made me ill. I’m on a small dose of abilify now, 10 mg. That’s a low enough dose that I don’t feel sick.
    I never had hypomanic episodes until I went off lithium and then after I went off of each successive mood stabilizer and antipsychotic. After a few rounds of that, I started having hypomanic episodes for no apparent reason.
    But I have discovered a cure for my hypomania. Nine milligrams of melatonin at bedtime gets rid of it every time. It seems to me that because lack of sleep brings on mania, the melatonin system must be involved in bipolar disorder some how. It could simply be that the melatonin puts me to sleep, and the sleep itself cures the hypomania.
    Anyway, I hope someone else can benefit from my discovery that melatonin will eliminate a hypomanic episode. It should be noted that my hypomania has never been severe and this may not help someone who has full-blown mania or more severe hypomania than I have.

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    • Going without sleep can certainly make you whacky!

      If you go a whole night (24 hours) with no sleep or three days (72 hours) with only 3 or 4 hours of sleep, take a mild tranquilizer for a few nights. Melatonin is better, if it works. No shrink necessary!

      There are plenty of over-the-counter drugs to knock yourself out. Be careful though. Be sure to stop taking them as soon as the crisis is over and you are sleeping again.

      When I was going to an MI Center I had slept badly for a night or two. A friend told me to get my psychiatrist to prescribe me Lunesta. Not for a week or two. Like all psych drugs–forever and a day!

      I decided against such a stupid course of action. My friend continues to get worse and worse. She “deteriorates” as she takes more and more drugs and gets hospitalized 3 or 4 times a year for “maintenance.” And they call that a “full and productive life!”

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      • There are also folks like me, whose melatonin system is outta whack somehow. I do not say this because of anything a Dr put together. I recognized a seasonal pattern to my life- winters were way hard emotionally, I had low energy, craved sleep and carbs. I was a journal-er, so it was easy to go back and read and confirm. And I happened to read an article about this very phenomenon happening in northern latitude regions. The theory was that sunlight taken in through the eyes triggers a waking response in the brain, signaling us to slack off the melatonin production because dawn is breaking and it’s time to get up. If there’s not enough sun to trigger this response, the melatonin production doesn’t slack off enough. The solution is very bright full-spectrum light, which you can switch on and read your morning paper by, or a dawn simulator that wakes you up with light, soft at first and gradually full intensity. Light therapy worked for me! This is the one and only brain chemical imbalance that I claim, but I do claim it because it rings true in my center, that place of wisdom that knows what’s what. And it makes total sense because my eyes have always been very photo-sensitive; ever since I was a kid I squinted.

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        • I’m pretty weird in that I tend to have prolonged bouts of sadness–sometimes for no big reason–in the spring when there’s more daylight. Like the reverse of SADDS. My dad has this problem. Our ancestors came from the extreme north of the world, which may account for this odd problem. This sadness lasts 2 or 3 weeks. Never more. Generally it’s accompanied by insomnia. In the autumn I feel perky!

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    • See how you go from recognizing that you had simply been given a label by a know-nothing physician to eventually IDENTIFYING with that (invalid) label? It’s insidious. As for melatonin, everyone’s different.

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      • It is insidious. I think I began to believe in the label. I believed I was bipolar, so I became bipolar. But I haven’t had a hypomanic episode in a few years, so maybe I’m over it. And I’m afraid to stop taking the Abilify because it helps with my depression like no antidepressant ever did.

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  10. What the hell did I just read?
    Short term medications for acute mental breaks is where the hell begins!! Your brain chemist, your spirit, and your physical body cannot handle the saturation of medications that fast, that hard, and that much! Never!
    Vlado C, YOU NEED TO heal….you are not going to heal from using synthetic meds, which are nothing more than products of an oppressive patriarchy, used to make us docile, compliant robots.
    OMG! What did I read on MIA? I am so disturbed by this.

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  11. Hi Vlado, I thought I’d highlight some of your comments on MIA so far and as you really have me confused and your comments also have started alarm bells ringing for me. So here are some of your comments:

    Critical of medical/psychiatric model (mainly from your first post):
    ‘What’s scary is that a fallible doctor, relying on a manual that pathologizes any and every behavior or emotion, determines whether we’re acute or chronic. It’s unclear to me how they sleep at night.’

    ‘Not knowing anything about psychiatry and trusting these people were real doctors’

    ‘I’ve come a long way in the years since and have rejected the bipolar/mentally ill label.’

    ‘What I am is someone capable of experiencing mania. And for that reason alone, psychiatry wishes to hold onto me forever.’

    Vlado, was this a way of gaining a platform on MadInAmerica, then gradually you begin to throw in the comments below:

    Support for Ativan:

    ‘At long last they gave me the sedative, Ativan, which if available in stores would have saved me all this trouble.’

    ‘If I could get Ativan over the counter, there would be no doctor.’

    ‘I wish Ativan was available over the counter. I know a couple of those tablets make me fall asleep every single time. But releasing Ativan to the masses subverts psychiatrists and they’re not in favor of anything that takes away the power of their pen and pad.’

    I have just read about how there is $7 billion on average to be made when a drug goes from prescription to over-the-counter. Funny how Ativan’s patent has expired and is not as profitable anymore? Is this your agenda or are you so blind to the lack of effectiveness Ativan has outside of your own experiences and the incredible amount of damage it causes. Maybe you should check out: https://rxisk.org/mood-stabilizers/ or https://rxisk.org/top_100_reactions/Lorazepam/ You are either incredibly self-centred to wish these were available over the counter or are pushing Ativan as part of your agenda?

    Support for meds:

    ‘Either an anti-psych or benzo enables me to sleep, lessening the effects of mania’

    ‘The lesson is not to fight with doctors but to ask for the highest dose they’re willing to prescribe of a combination of antipsychotics.’
    Vlado, following this advice can and does kill people!!!!

    ‘nothing works better than 6 mg of Risperdal and 200 mg of Seroquel’
    For you, maybe. For others, it’s been a disaster

    ‘you have to go through a case of extreme sleep deprivation to understand that the drugs are not the problem; they are the solution’
    No, you don’t. You can just read and study the likes of the works of Peter Gotzsche, Robert Whitaker, etc. You don’t have to have been a ‘peer’ or have had a ‘lived experience’ to realise the drugs ARE the problem

    ‘Half the people in a psych ward legitimately cannot sleep and need drugs’
    Seriously?!? In my current role I regularly visit a psych ward. I wouldn’t sleep either if I knew at any second I could be forcibly held down and drugged, could have my human rights taken away or could be given ECT involuntarily but no, your solution is not to address why people aren’t sleeping just drug them or yourself up so you can sleep…

    ‘in my opinion they don’t sufficiently address the short-term, acute need for medication which is psychiatry’s single main-stay as an institution.. This is the bread-and-butter use case for why psychiatry should exist.’
    A lot of people’s journey on the destructive psychiatric merry go round starts when they have acute needs for help/support and given drugs for this and you are saying that this starting point is legitimate…really???!!!!

    ‘By this definition, the system is absolutely nuts. That’s why, to me, a reforms-based approach to dealing with the ills makes more sense than talking down the medicine, which is legitimately helpful to those who have a need.’
    Have you read anything on MIA about the science for the ‘medicine’, i.e. dangerous and destructive drugs?

    Confusion or lack of consistency over how you label or diagnose yourself and your experiences after saying that ‘you have rejected the bipolar/mentally ill label:
    ‘I’m a patient struggling to figure out what works and what doesn’t.’
    A ‘patient’: so you haven’t left the ‘bipolar/mentally ill’ label behind? or you forgot that this was part of your narrative/script?

    ‘What is the appropriate level of antipsychotics necessary to come down from a bipolar mania?’
    Again – ‘bipolar/mentally ill’ label left behind?

    Support for more insurance/more access to services/more money for psychiatry/Big Pharma:
    ‘If you have insurance, they want to keep you as long as possible. If you don’t or have bad insurance as I had, you’re not a priority and decisions are made based on dollars and cents as opposed to common sense. I was furious that even though I didn’t exhibit common symptoms of mania, had a place to stay, they still treated me like a zombie and held me against my will. It’s how they make money, bodies to beds. Until we have a single-payer system of insurance, this system won’t change.’
    Big Pharma and psychiatry would love this $$$$$$$$$

    ‘Money is at the root of this system. My old doctor charged $175/30 min..’
    More insurance, more $$$$$ for psychiatry/Big Pharma

    Support for psychiatry:
    ‘The point of MadInAmerica, and where you and I have common ground, is how far psychiatry has strayed from its mission statement.’

    ‘As for psych being a “junk science”, most consider mania, depression, psychosis, to be real medical conditions when diagnosed correctly.’
    Consensus doesn’t equal fact/’science’

    ‘I have yet to see an article on M.I.A. about how to come back to “baseline” without meds. I’m sure it’s possible as our ancestors didn’t have these drugs available; I just don’t know how at this point. And in relieving these short-term conditions, I don’t believe psych is a junk science.’
    Vlado, this is an insult to many contributors to MIA who have produced many articles highlighting alternatives to meds to help with distress. And how about just time? Or finding some good, trustworthy, authentic and supportive people in your life to be with you during times of distress to help bring you back down? Or how about getting out into the bush/forest/green spaces? Or finding a safe, warm comfortable places where you can breathe/switch off? Or how about talking about the meaning and depth of your distress? All ways of coming back to ‘baseline’ and who decides this ‘baseline’ anyway? Again, have you read anything on MIA? Have you searched for anything in relation to distress?

    ‘There IS a place for anti-psychotic drugs even if we agree that anti-depressants and benzos are sham. If psychiatry was all-bad, why would it still be around in 2017? I needed professional advice on how best to sleep/reduce the mania and that dialogue was missing until the very end.’

    ‘It’s a major problem in how far they’ve strayed from the basics of their profession.’ – subtle support here where you are saying it’s a good profession really, it’s just lost its way a bit, poor psychiatry like the paedophile priest that was sent to the next diocese and not punished because ya know, he’ll be ok in the next one, he just needs time to reform…

    Psychiatry’s tactics of ‘we will find the underlying biological cause soon, just give us more time’:
    ‘Until neuroscience identifies what causes psychosis or depression, little of psychiatry has any scientific merit. Instead it’s an art form where all too many of the practitioners are poor in practice, in large part because they haven’t seen enough genuine patients that can function drug-free at a high level.’
    Who the hell are ‘genuine patients’ and who gets to decide this? The experienced psychiatrists/doctors? You?

    Attempt to de-legitimise anti-psychiatry movement:
    The anti-psych movement will NOT gain ground until those numbers grow or until someone goes deeper into explaining why these drugs are harmful.’
    Vlado: seriously?!?? have you read anything by the likes of Robert Whitaker, Peter Gotzsche, David Healy, Peter Breggin, Joanna Moncrieff – are their analyses not deep enough for you?

    Vlado, from what I have read I don’t trust what you are trying to sell. You are either very confused or using extremely solipsistic or self-centred ways of seeing and responding to distress or you have another agenda that involves defending psychiatry, pushing more medical insurance coverage and supporting some really harmful and destructive drugs. Big Pharma is very skilled at trying to infiltrate organisations and plant seeds of doubt here and there. It uses social media to its advantages and identifies and responds to threats. MIA is definitely a threat – I wonder if this is what is happening here? Just a thought…

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    • MartinMc, I don’t mean to defend psychiatry with my article, only the short-term administration of medicine necessary to come down from a mania. As I mentioned earlier, I could have done a better job of delineating between antipsychotics and benzos and anti-depressants, some of which are harmful and addictive while the latter have no therapeutic effect because they only work slightly better than placebo.

      The facts are incredibly simple and I’ve been consistent in my two articles about what they are: lack of sleep causes mania, and wishing it away or being with peers doesn’t bring one back to an equilibrium state. The challenge for patients (and we’re patients if we’ve experienced mania) is to differentiate between good and bad drugs. Depakote, Oxcarbezapine, Lithium have had nothing but bad effects on me. Abilify is more for depression than a sedation drug for mania. But the class of atypical anti-psychotics which include Risperdal, Seroquel, and Zyprexa (which admittedly has a ton of side effects) does the job it’s intended: to bring one down from a mania. They don’t work as well stand-alone as they do in a combination.

      I have no interest in taking these drugs, including Ativan, in a long-term way as it’s harmful and not necessary if I can get a decent nights rest without them. There was a time before my first mania that I could sleep well without medication and I know tapering off is the right thing to do again. My alluding to wishing Ativan was over the counter is that it would be more effective, and cheaper to treat, if we could go to a store and buy something for sleep as opposed to dealing with an entire industrial complex hell bent on squeezing every last dollar out of treatment. Put all the warnings on the box, I don’t care, but being caught in a pinch without medication and reality spinning out of control is a terrible ordeal for anyone to go through.

      All that being said, the treatment of the mentally ill within these facilities is despicable and is the real culprit behind how permanent labels are placed.. The perseverance of mania outside the range of a few weeks or months is called schizophrenia, and permanent institutionalization is still a real threat. That’s what you don’t understand not having gone through a serious case of mania; the alternative to treatment is more horrible than the short-term application of treatment if done right. And that’s the challenge, separating good from bad methods of treatment and being consistent across all patients.

      We have a long way to go to properly understand why my brain responds to lack of sleep different than a quote unquote normal person but I’m prone to manias and that’s a fact of life. It’s actually really easy to treat now that I’ve gone through the whole gamut of treatment options but in the beginning there’s so much fear and frustration that it’s hard to identify what works and what it all means. And I see beauty in the condition as it allows my thinking to expand in a creative, abstract way that is so different from how I normally experience reality.

      MIA has done a great job of exposing abuses within the system particularly with the unhelpful and harmful class of drugs. A lot of people without symptoms become enmeshed with the system in detrimental ways. But we have to shed a light too on the treatments that work for those where it’s needed. That’s a reality that a subset of us that experience manias have to live with.

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      • Hi Vlado,
        You don’t portray the facts as ‘incredibly simple’. I find this remark arrogant and it applies that I have somehow been confused by what you have said rather than what you have said being confusing. I can handle inconsistency here and there but you have been very inconsistent in how you have described yourself and your story. One minute you are saying that you have left the ‘bipolar/mentally ill’ label behind then the next you are saying that you are a ‘patient’ and not a ‘normal’ person and aligning yourself with the ‘mentally ill’. You also mention ‘a lot of people without symptoms’ indicating that you still believe in the medical/disease model. To me this indicates that you have not left the ‘bipolar/mentally ill’ label behind. You see yourself as part of a ‘subset’ of people that experience ‘mania’. Every human being can potentially experience mania given certain circumstances. This is a fact of life. You are not special in this but it seems like you want or need to be seen as so. The things you have been consistent with is your support, not ‘alluding to’, for having Ativan available over the counter. You mentioned it three times in two posts or replies to comments after your posts.

        Secondly benzos, SSRIs and neuroleptics (I’m refusing to use ‘anti-depressants’ and ‘anti-psychotics’ and use the language that we have been conditioned to) are all potentially harmful and addictive drugs and there is no evidence that SSRIs are anymore clinically effective than a placebo. Who said ‘wishing it away’ is the way to treat experiences of mania? I listed giving it time as a thing that could work along with other things that involve action not just sitting there. The drugs you have listed bring YOU down from your experiences of mania and they work well for YOU in combination. It seems like you are still pushing drugs as the cure/remedy for your supposed ‘illness’. Have you ever sat and reflecting what it would be like for other people and society if Ativan was seen as a safe enough drug to be sold over the counter? Again I don’t like what you are selling and you are reaffirming some of my initial suspicions.

        And how do you know what I have and haven’t been through? I said that people don’t need to go through what you have been through to know that the drugs ARE the problem not that I’ve never been through my own extreme states. And anyway going through your own extreme experiences doesn’t make you an expert to guide everyone else in theirs. I know plenty of peers who still push ‘the drugs worked for me so it’s best to do what your doctor says’ agenda and have been co-opted by the mainstream medical model. Thankfully we have some dedicated researchers like Robert Whitaker and Peter Gotzsche who can help people make truly informed decisions about the options they take which is grounded in much better evidence and reasoning that your advice.

        There are a couple of areas that still ring alarms bells for me and strike me as tactics similar to what I have seen by the pharma industry. Firstly, there is a bit of scaremongering and calls for the need for early pharmacological intervention. You say: ‘The perseverance of mania outside the range of a few weeks or months is called schizophrenia, and permanent institutionalization is still a real threat.’ So you are saying that if you don’t treat the mania with drugs this could happen. While in reality and in most people’s cases if you do treat extreme experiences with drugs it actually leads to long term prescriptions of these drugs and rising disabilities as documented by Robert Whitaker and other researchers. You then seem to emphasise how terrible the experiences of mania are and try to pull on heart strings to get the treatments you want available. Again this is another tactic of the pharmaceutical and psychiatric industries. Yes life experiences are bloody tough but boo bloody hoo that you can’t get want you want, OK, as there are other people apart from yourself who will be incredibly damaged if they followed the ‘consistent’ treatments you advocate for. I believe in freedom of choice so you can do whatever the hell you want with your mind, body and spirit and you can live with the consequences, not other people.

        Vlado, your reply still has alarm bells ringing for me and I really don’t know what your agenda is. If you are for real then I’d recommend taking some time out, do some more reflection and study, try to really think about what would be the consequences of your advice and try to figure out how you see yourself, i.e. do you see yourself as ‘ill’/’patient’/in a certain ‘subset’, and are you truly ready to leave the ‘bipolar/mentally ill’ label behind?

        Frankly, from what I have read I don’t trust your reasoning or what you are selling and I don’t think other people should either but they can make up their own minds on that.

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        • It’s a fair question whether anyone could have a mania or not, something I’ve spent a lot of time thinking about. But consider that someone today has been diagnosed and their family is going through the gamut of treatment options for what best to bring this person out of mania. And I stand by my words; a combination of these drugs brings the desired effect. We can try putting them on a fancy diet or throw them on an exercise machine but a combo of antipsychotics does work best and I would know because I’ve tried everything over my six years of being in the system.

          You also have to consider how many people self-medicate out of these moods with alcohol and street drugs. I witnessed this first hand when I was on the streets. I’m sorry but using Ativan for the first few days until antipsychotics kick in isn’t nearly as dangerous as being hooked on street substances.

          Our failure to give pharma ANY credit sets us back as a movement. I’m very surprised at how adamant you are against a technique that does work and has helped pull me out of the depths. The goal is to never be hospitalized again, and so long as I have a bottle of the necessary meds handy, it doesn’t need to happen. That’s the moral of my story.

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          • Speak for yourself, Vlado, when you say, “Our failure to give pharma any credit”…. I will always maintain, that sometimes, some people do seem to do better, for some short length of time, on some synthetic chemical drug/s. But, even MORE strongly will I state that wide-scale, long-term use of polypharmacy, – the sadly current “standard of care”, – ALWAYS does more harm than good in the long-term. You have a right to drug yourself out of mania, and into sleep. But I’d say your approach is best described as “band-aids on bullet wounds”. Until and unless you look at *WHY* you seem to seek regular episodes of sleep-deprivation and resulting mania, the episodes will continue to recur. Maybe you just like an occasional “drug holiday”. Nothing wrong with that, IMHO. But I’m all about HONESTY, rigorous honesty. And the pseudoscience LIES of the drug racket known as psychiatry are hardly honest….

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          • https://allpoetry.com/column/7525245-Drugs-Are-Inanimate-Objects—A-Guide-to-Their-Culture-and-Effect-by-King-Bongmaster

            ” There is no such thing as a “good” drug. There is no such thing as a “bad” drug. Until an animate object comes along and does something with a drug, the drug will just sit there.

            Inanimate objects have no agenda. If your child is killed by a moron in a car, you can join a campaign to ban all cars, or you can join a campaign to stop morons from driving cars.

            If your spouse dies of alcoholism, you can send bombers to destroy the wine fields at Chateau Mouton Rothschild, or you can teach people to drink responsibly.”

            I will not give pharma any credit and its not about their drugs it is about their actions.

            Over the course of 20 years, Johnson & Johnson created a powerful drug, promoted it illegally to children and the elderly, covered up the side effects and made billions of dollars. This is the inside story. http://highline.huffingtonpost.com/miracleindustry/americas-most-admired-lawbreaker/

            The Zyprexa Papers Scandal – PsychRights http://psychrights.org/States/Alaska/CaseXX.htm

            The pharmaceutical companies are run by complete psychopaths with the inability to care if we live or die, check out the links I provided before even attempting to defend them. Only sub humans would hide horrific side effects of drugs and fraudulently market them to children.

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          • Vlado, man, I really think that you keep digging your own grave and making me even more suspicious of your agenda. It seems like you are trying the pulling at the heartstrings tactic again with the reference to the family difficulties and scaremongering with your reference to the dangers of street drugs. Now wait, where have I heard these sort of tactics before?…Oh that’s right, the pharmaceutical and psychiatric industries.

            Maybe you should think about all the families who lost their loved ones 20 to 25 years too soon because of some of the neuroleptic drugs you advocate for or maybe you should think about all the 1477 families whose family member took their own lives while on this drug (see: https://rxisk.org/top_100_reactions/Lorazepam/).

            As for ‘street substances’. Well, I worked with people using heroin for years. When they heard a bad patch was going around that was causing serious problems and it was coming from a particular dealer people would avoid this dealer and he’d either have to sort his batch out or lose business. Big Pharma and psychiatrists do not seem to care if people die or have serious complications from the drugs they deal out as there’s always people coming back due to misinformation or forced back due to our current system. I would say that these drugs are more dangerous once you start on them as it is not just dependency that will make them hard to quit but the weight of the law behind psychiatry as well. People following your advice could very well end up on this deadly conveyer belt as well.

            You are ‘very surprised at how adamant [I am] against a technique that does work’. Vlado, you can do whatever you want with your body but when you become a blogger on MIA you are in a position of influence where you have now used it to give advice based on your experience to people. I don’t see how you are surprised by my reply if you know anything about this site or have read reliable research on these drugs. I am not at all surprised that people are anti-psychiatry and anti-psychiatric meds having spent a bit of time on MIA and read works by researchers I have already mentioned. Again this suggests to me that you are either very naïve or confused but mostly I think that you have another more sinister agenda in pushing these drugs.

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        • MartinMc “Have you ever sat and reflecting what it would be like for other people and society if Ativan was seen as a safe enough drug to be sold over the counter?”

          Lots of countries in the world that don’t require prescriptions and nothing bad happens, we have more addicts in the US as it is. The multi billion dollar drug war industry just wants the public to think all hell would break loose without them. It won’t.

          The rarity of addiction to drugs should come as no surprise to the vast majority of Americans who have taken benzos and painkillers Maybe they enjoyed the buzz, but they did not continue taking the drugs every day after getting a script at the dentist. Medicine cabinets everywhere with forgotten drugs inside proves it.

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          • That’s horseshit, cat.

            There’s folks from *all over the world* who bought benzos over -the-counter who have difficulties getting off ’em.

            It’s DEPENDENCE. They change your brain. Addiction is a whole other story.

            What Vlad doesn’t seem to get it that his/most other Americans run to a pharmaceutical when having difficulty rather than just go thru it. The nature of the world is change. Nothing lasts forever.

            Mania? Isn’t that just another word describing a piece of the range of human experience? I refuse to pathologize any response to our inner/outer ‘chemistries’ with our environments. It’s a slippery slope (as far too many of us already know) to give some ‘professional’ power over anyone with mere words.

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          • The cat,

            This was referring to the idea of Ativan being available over-the-counter in society as it currently is, i.e with all the misinformation about Ativan and the current respect and authority that phamacists are given. If all the accurate and reliable scientific evidence or information was provided for Ativan, i.e. its high rate of ineffectiveness, the list of all the effects it has, and if there was no marketing allowed for this dangerous drug and most people saw pharmacists and pharmacies as dangerous as illegal drug dealers so had a great deal of skepticism about what they were selling in their drug stores then I think Ativan may be safe for over-the-counter. Until those things change (which is incredibly unlikely) I believe Ativan being available over-the-counter would be disastrous for people and society.

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      • I was diagnosed with paranoid schizophrenia, not due to mania, but due to auditory hallucinations and persecutory delusional thoughts. They hospitalized me and started me on anti-psychotics. I was a very physically healthy young person at that point, but after that I never felt so horrible in my entire life up to that point,it was about to get even worse. The side effects of the meds increased as they kept increasing my dosage. Akathisia began but I had no idea what it was. At that point I was already released from the hospital and was attending a s.m.i. clinic, as I had turned 18, and was legally an adult. The psychiatric nurse was still treating me like a child at that point and talking about me to my parents. They sent out what they called a case manager who was supposed to get me all sorts of “services” which is how they suckered me into the system. What a joke! Their “services” were mainly about making sure I continued to take my meds, and don’t worry about the obvious side effects because they said those weren’t really side effects from the meds, those were just new worsening symptoms of schizophrenia getting worse, so that meant I needed a higher dosage of the same damned meds, and some more meds too. I felt worse and worse, and yet I still heard voices that the meds were supposed to stop. Eventually new symptoms appeared that would strip away what little was left of my social dignity. Involuntary movements that at first I didn’t even notice. My parents noticed them first. It was the early stages of Tardive Dyskinesia. My f*ing case manager told my parents again, it was just another symptom of the disease schizophrenia. He said most of the clients with schizophrenia he deals with eventually develop these symptoms. (of course he didn’t mention that all of his clients were taking these meds). The symptoms got worse and I ended up in the emergency room where for the first time I was told by a regular nurse that I was experiencing both akathisia, tardive dyskinesia, and elevated blood sugar, and that all of these were side effects from the meds. (poof! mind blown!)

        I got way off track. The main problem I have is with forced treatment of any kind. If I break the law, fine take me to court, convict me with a jury trial, and then sentence me to a prison term. But don’t punish me for my thoughts, and take away my freedom just in case I might do somehting illegal in the future. That’s not fair. And I value my freedom too much to ever do anything violent. And I have never been violent and probably never will be. Most schizophrenics are not violent.

        I’m still off track here… what I wanted to say is that you were drawing a distinction between short term need for drugs for things like bipolar mania and long term institutionalization for schizophrenia. If I had continued taking those horrible meds I would have needed to be institutionalized forever. The anti-psychotic meds eventually lead to the typical behaviors seen in institutionalized schizophrenics. The meds do more damage to their brains than schizophrenia ever could. Just compare an untreated schizophrenic homeless person to one who has been medicated in a hospital setting for many years. The one out on the streets still has his wits about him. He gets money from begging, he buys food, and finds a place to sleep for the night, etc. Huge difference. Being homeless is not ideal, but I would choose it over spending the rest of my life in a hospital.

        Fortunately, I still have my family to help me, and I’ve learned how to cope with my problems, and I learned a very powerful lesson: NEVER TELL ANYONE IN A POSITION OF AUTHORITY THAT I HEAR VOICES AND HAVE DELUSIONAL THOUGHTS. There should be a Miranda warning rquirement for the psychiatric community because just like cops, only with fewer constitutional protections, they can take away our freedoms.

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        • I have often thought that a Miranda warning would be very appropriate for psych hold evaluations. Maybe that’s a fight we can win?

          Sorry for your HORRIBLE experience! It is hard to believe that such a thing could be considered “treatment” by anybody but a Nazi death camp commandant.

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          • I agree. I think the Miranda warning for psych holds is something we might be able to win. They would have to explain why the mentally ill– who have not yet broken any law– were not at least entitled to the same constitutional right against self-incrimination as someone who had just been caught breaking a law.

            We could piggyback onto the ACLU’s campaign to tell people to keep their mouths shut when anyone is questioning you and trying to take your freedom away.

            And OMG every f*ing thing I said about hearing voices and everything I said about delusions about people following me, etc., they wrote it all down and quoted in right back to use against me in the kangaroo hearing for Assisted Outpatient Treatment. If we could only get the word out about keeping you mouth shut and not telling them the very words they need to diagnose us and take away our freedoms, maybe it would save someone from what I went through.

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          • Forcing MI commandants to mirandize us would also draw attention to the fact that the MI system treats many law-abiding citizens like criminals for acting “weird.” This would demonstrate that the “treatment” is not the kind you get for cancer or heart trouble but actually a form of punishment.

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          • FeelingD, that is a very good reason why I would like to see this. Being arrested is being arrested, and it’s often not pretty. Once it’s clear that people are being taken into custody and their words are being used against them, the general public might start to get an inkling that “involuntary treatment” isn’t some benign act by caring individuals – it’s often an act of the severest brutality!

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        • Miranda warnings as they currently stand are laughable. If you are arrested for any reason, the police are only required to Mirandize you if they plan to interrogate you. However, they can still use any information you volunteer against you in a criminal case even if you have not been Mirandized. I too agree that Miranda warnings should be given. However the entire process of judicial commitment is already a farce and a sham. I wonder what percentage of people make it through those hearings without being committed.

          The other problem associated with mental commitment is the absolute uselessness of public defenders. If you think they are bad during criminal trials, consider that they are basically worthless during a civil commitment hearing. If you don’t have money and a good lawyer, you will most likely lose. They don’t even try. On the flip side, if you have money and a lawyer, you’re far more likely to simply be released without a hearing as the hospital doesn’t want to deal with the litigation.

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  12. “What is the appropriate level of antipsychotics necessary to come down from a bipolar mania?”<—FIRST line in article, above….
    I'm a proponent of the "K.I.S.S." philosophy. KISS = Keep It Simple, Silly! (Yes, sometimes "keep it simple, stupid!" really does work better!)
    So I'm gonna answer Vlado's question. *NO* "antipsychotics" are *necessary* to come down from *ANY* mania. Some drug-induced manias can be counteracted with other drugs. All manias resolve with sleep, time, and appropriate self-care, and appropriate medical care. Saying "bipolar mania" is basically bullshit, because so-called "bipolar" is an imaginary disease that was invented as an excuse to sell drugs. Many, if not most, persons who have been fraudulently "diagnosed" as having, or being "bipolar", are better served without such a flagrantly fraudulent diagnostic label, and the inevitable stigma which such a label carries. So far, I'd say the commenters here at Mad In America have fairly well deconstructed Vlado's *PROPAGANDA*. We're still waiting for a coherent and comprehensive response from Vlado….
    ~Bill./

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    • The whole article is a piece of fiction anyhow, Ewa. Vlado is really a big pharma marketer writing a commercial for Adival. His writing leaves a lot to be desired too.

      Commercial writing is a very lucrative career–ideal for writers with no talent at all!

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      • I don’t think so. I think Vlado is trying honestly to provide his perspective, and I think it’s important that we respect his experience, even though I think most of us would not adopt his suggestions as a good general policy on how to engage with someone in distress. He’s found a way that works for him – good for him! And I think his argument holds elements of empowerment – that psychiatrists should enable their customers to utilize the offered drugs in ways that work best from the customers’ point of view. This would, of course, involve psychiatrists admitting that their entire approach is not scientific, but is basically the offering of substances to make people temporarily feel better subjectively while making no effort whatsoever to figure out what is really wrong, which they would never allow, but still, there is a legitimate point in there that deserves recognition.

        — Steve

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