Thursday, September 19, 2019

Comments by uomosenzanome

Showing 12 of 12 comments.

  • I agree that benzo dependence and withdrawal can be hell: I’ve seen it in others and determined I would never become addicted to them like that, and I haven’t. I agree even more strongly that the fraudulent and damaging marketing of Zyprexa has been one of the darkest episodes in modern psychiatry (and the competition for that “honor” is stiff); I regard the iatrogenic diabetes, obesity, and other metabolic disturbances, not to mention the creation or exacerbation of psychiatric symptoms rather than relief of preexisting ones (not unrelated to the metabolic effects, if you ask me), as a form of genocide against nonconformists, dissidents, etc., of the sort you read about in the bad old USSR and aren’t supposed to expect to find in the US.
    That said, I think that judicious, *occasional* use of short-acting benzos, under the PRN self-control of a non-addictive personality who is leery of taking psych meds at all, can be a helpful thing to someone in the worst throes of PTSD, if they are seen as an *adjunct* to mindfulness meditation, breathing techniques, yoga, music, exercise, etc. I found them to be so, anyway; I never could have had a lot of dental work without them, because I gave severe dental phobia and it shot my blood pressure through the roof so the dentist was afraid to work on me; but I didn’t want to take BP meds because, frankly, I hate the side effects of them worse, and they did nothing to quell the anxiety I felt over opening my mouth and letting so done stick their hands in. But I refused to take them on any kind of a regular schedule to avoid becoming physically dependent, and I would ordinarily try mightily to calm myself without them. I think they are infinitely preferable to the neuroleptic variety of antipsychotic. The biggest problem with most psych medicines is the attitude, fostered by insurers who didn’t want to pay for talk therapy, that they can be a *substitute* for psychological therapies, that all you need is a 5-minute medication management appointment now and then with the doc who writes them. If instead they are regarded as emergency measures to be resorted to only briefly, intermittently, when all psychodynamic efforts to maintain are unsuccessful, AND ARE self-administered only as needed by someone who would prefer not to take them at all, they can be as useful as a nip of scotch or a hit off a joint. Some of us are unable to tolerate marijuana; I have paradoxical reactions to pot of anxiety, panic, nausea and confusion. It really annoys me to constantly read nowadays about pot as a panacaea; not for everyone, it’s not.
    If you can find a shrink who will write scrips for the lightweight benzos without any pressure on you to actually take them regularly, who trusts your judgment in that matter, it’s a wonderful thing. Sometimes just knowing I have it in reserve if things get really hairy, helps me manage the anxiety on my own. I have had a bottle of 30 1mg Ativan last for a year or two, even more. Used like that, it’s not a problem.

  • This just demonstrates the need to more carefully discern which patients will benefit from stimulants and which ones they will be unhelpful for. “David said the voices told him to.” Anyone who hears voices should probably not be taking stimulants, whether they predated the stimulants or were caused by them. Competent medication management would have detected the existence of voices and terminated the Adderal. And school districts have to be forbidden to require children to be medicated in order to be enrolled. If parents wish to utilize non-medication techniques, they should be free to do so. Schools need to concern themselves more with behavioral *outcomes* than in how those are achieved, and should consider alternative accommodations for “difficult” children rather than forced drugging.

  • SnowyRhodes, I agree with you that blaming the stimulants is an evasion of personal responsibility in this case. Psychotics do not *always* know right from wrong in the legal sense however. They may have a developed moral sense, but sometimes their distorted perception of reality brings them to a belief that a particular action is good and right which most people would regard as wrong. And the delusion or hallucination that induces them to commit one wrong act may not affect their ability to know right from wrong in other contexts.
    I agree with MJK that smiling when he pulled the trigger may be an indication of sociopathy. It is not so much that sociopaths don’t “know” right from wrong; they may be fully aware of what *other* people regard as right or wrong and consequently are aware of what might *get them in trouble* and take steps to avoid it (such as fleeing to avoid arrest after killing someone, or blaming Adderal in an attempt to shift blame). sociopathy is characterized by lack of empathy and a sense that they are not *morally* bound by the same rules as everyone else, that they are *entitled* to break laws or treat people as objects for their satisfaction.

  • Ted Chabasinski, the story also indicates that, without his doctor’s knowledge, Hamilton additionally was using marijuana and alcohol, and “Before the homicide, Hamilton praised Adderall,” Indicating his claim of “involuntary” intoxication may be specious. In my view, he is probably a poly-drug abuser, and *that* — NOT simply Adderal, taken as directed in therapeutic doses — may have greatly contributed to his irrational and violent behavior. Alcohol abuse is frequently blamed for violence, why blame only the medication here? Furthermore, in people who may be susceptible to psychosis, marijuana alone can and does push them over into unreality.

    “Only Michael Hamilton was at the house. He came to the back door wearing no shirt. It appeared he had been sleeping, Richard Marcyan said.” He may have been awakened by them in the middle of sleeping off a “speed run” in which taking *abusive* quantities of Adderal (as opposed to therapeutic doses) led to sleep deprivation, both of which (excessive dosing and sleep disturbance) can independently cause psychosis, plus he may have used alcohol and/or pot to “take the edge off” and they may have had some contributing effect to his state of mind. And in the *several days* it can take to feel rested after even a short (1-2-3-night) speed run, irritability, paranoia, etc., are common, and any interference with getting the sleep that now feels absolutely imperative can be greeted with extreme hostility.

    “Amphetamines” don’t make people do weird things. Excessive amounts of amphetamines make people do weird things. What is excessive depends in part on the biochemistry of the individual. Please don’t tar with a broad brush as inherently dangerous and weirdness-producing a medication that, used properly for properly diagnosed problems, without complicating the picture by adding in pot and booze (and who knows what other drugs), can be a real boon to people with certain difficulties.

  • I tried straterra. It created bizarre disruptions in my sleep patterns: I was wide awake and agitated in the middle of the night, and falling asleep in my oatmeal in the morning. It did NOTHING y help my ADHD symptoms. This insane prejudice against stimulants because SOME people abuse them, driving the pharmaceutical companies and doctors to cone up with ANYTHING BUT STIMULANTS to give people with ADHD is reminiscent of the ANYTHING BUT OPIOIDS approach to pain control, and it is robbing patients of access to the MOST effective (and for some people, the ONLY effective) treatment. If America dealt better with its drug abuse problem — looking seriously at WHY people abuse drugs (hint: it’s not merely availability) — it wouldn’t have an excuse to blame the problem on people whose lives are GREATLY IMPROVED by access to those drugs on a prescription basis.

  • As an adult who firmly believes in the existence of ADHD IN ME, who was NOT medicated as a child because my “behavior” was not the problem, my ability to work up to the potential indicated by my intelligence was — no one suffered from my (primarily inattentive) ADHD but ME, so the medical establishment didn’t give a rats ass at the time — I am pissed off by people like this who, by make it harder for me to get medication that HELPS ME subjectively: helps me not feel overwhelmed, indecisive, unable to stay on task and not be distracted, unable to prioritize when I lack appropriate mental or neurological filters that would make some things recede into background. It pisses me off when people who DONT have ADHD deny the reality of those who do. I’m not saying the medications aren’t inappropriately prescribed sometimes, and I tend to dislike ANY psych medications being given to children under 6 (but if you ask me, the REAL crisis we should be paying attention to is this insane push to put preschoolers on HEAVYDUTY ANTIPSYCHOTICS AND SO-CALLED MOOD-STABILIZERS for alleged “bipolar disorder” when these drugs have far worse permanent damaging effects on the brain and metabolism).
    This kind of anti-ADHD propaganda just perpetuates discrimination against people who need stimulant medication to be able to cope with a society that is set up for people who think quite unlike the ways I think; society is not going to change, and I don’t WANT to change myself PERMANENTLY, I just want to be facilitated in *dealing with society the way you jerks have set it up to suit people like YOU.*
    There are some ways in which my ADHD contributes to my creativity, which is why I would not want to be “cured” of it. But as long as I am forced to live in a society set up along lines that favor a very different kind of brain, you’re damn straight I want access to stimulant medication so I can do things “your way” when necessary.

  • Anonymous,

    Thank you for saying this so eloquently (would that it did not need to be said at all). I managed through some miracle to avoid much forced drugging although I spent time in jail after being railroaded (there were other charges concocted but my main crime was being homeless and insisting that *I* knew better than the system what was wrong with me and what would help, and pursuing it from alternative practitioners) under severe pressure to accept it and only was let out on probation by a fascist judge who acted like she was an expert in brain science (she was not) and was obsessed with the idea that I should be on heavy antipsychotics, when I agreed to “take whatever was prescribed for me” and then made it my business to secure the assistance of a therapist and a psychiatrist who did not believe it would be helpful on balance to involuntarily medicate me nor that I was in fact severely symptomatic enough to justify that. Thankfully they gave me a chance to prove she was full of shit in her obsession about me. i have had extensive deprivations of liberty nonetheless and most of the symptoms she attributed to something else were actually PTSD *from the treatment I had been forced to endure*..

  • I find it highly ironic that many of the same people who resist tooth and nail every sort of restriction on abortion and claim that pro-lifers only care bout fetuses but once you’re born you’re on your own, often support gross impositions on the freedom of born and grown persons to *think differently* without being forcibly drugged and imprisoned (a psych ward is just a prison where the guards wear white).

  • The only “crime” being “out of the system” is likely to lead to, in my opinion, is homelessness, which should not *be* a crime, and is often the only remaining alternative for people who have fled corrupt, abusive “supportive housing” that is anything but supportive; more like exploitative, demeaning, and permanently enmeshing, but when your record of independent, private-sector (non-crazy) housing and employment has been so trashed by their involvement with the system (in my opinion, purposely so to prevent reassertion of independence that the system finds terribly dangerous to itself but which concern it masks in a patronizing, smothering “concern” for their welfare) it’s near-impossible to *convince* anyone in the non-crazy world to let you back in. It greatly resembles an abusive relationship where the abuser “for your own good, because without me you’d be nothing” purposely cripples you to keep you from running away and lies to every one about you to keep them from helping you escape them.

  • Great post, Bruce. There’s so much here that is right on and needs to be heard beyond the “mental health community.” But what I want to address is the revision which, to my knowledge, has never been proposed to the DSM but which should be, if they don’t throw it out altogether. There is a provision in the diagnostic criteria for schizophrenia that the episode of psychoses must not be due to “organic brain disorder” or, I believe, induced solely by the use of drugs of abuse such as LSD or amphetamines; i believe there is something similar regarding bipolar diagnoses, that the qualifying manic episode must not be actually caused by amphetamine use. (I don’t have the DSM in front of me, so i can’t quote it). There should be a similar criterion added, to whit, any otherwise qualifying manic episode must not be due to a prior course of antidepressants, and if there *was* an immediately prior course of antidepressants, not only should those be discontinued, but confirmation of a bipolar diagnosis should be withheld until a *further* qualifying manic episode occurs *after effective withdrawal* from antidepressants. In other words, no hanging a lifetime label suggesting lifetime medication on someone on the basis of what may be only a side-effect of a drug they perhaps should have never taken or should have discontinued sooner.

  • Kathy, thank you very much for this: for being open to hearing Whitaker’s message, for recognizing that it is the lazy way to rely on the word of doctors and pharmaceutical companies who don’t really know as much as they like to think they know about mental illness and the effects of their vaunted treatments. I know it is not easy dealing with someone with mental illness and I can tell you love your son very much and want the best for him, and it is tempting to accept what you are told by people who seem reasonable, intelligent, educated and in control of their relationship with reality more so than Max has seemed to be sometimes. So to realize and accept that, as confused and confusing as what patient-loved ones say about the effects of medication and why they may not want to stay on it is difficult and frightening. Please be reassured that even though the madness, I am convinced that patients know things about their illness that no doctor, no one outside of their skin, can know, and that knowledge must be listened to with more respect than has been common. (*through* the madness, that should say). I believe that some apparently bipolar symptoms can be and have been caused or exacerbated by some of the medication that has been popularly prescribed due to the iatrogenic metabolic dis regulation they can cause, which has been ignored as an unfortunate side effect by many professionals (some of the “mood stabilizing” drugs end up causing wild and rapid-cycling mood swings, in my observation and experience, as well as the brain changes caused by antipsychotics). In addition, bipolar disorder has been the trendy diagnosis for a wastebasket of various troubles, as schizophrenia was in prior generations. If Max (or anyone else) thinks they might want to taper off meds, I urge them to contactoneof the professionals who are open to working with that. Doing it suddenly and without professional support can be an extremely bumpy ride likely to lead to rehopitalizations and/or run-ins with the law. But if he is a good candidate for it and has proper support, it may be the best thing that ever happened to him, mentally.
    Again, thnk you for your caring, your involvement, your advocacy, nd your openness. The mental health community needs friends like you, and your involvement bodes well for your son’s future.