Wednesday, June 28, 2017

Comments by Maria Mangicaro

Showing 97 of 97 comments.

  • Lori,

    Thank you for sharing your family’s very important story.

    By doing so, you are being a voice for others in need of help.

    Underlying conditions, such as Lyme Disease, that go overlooked are a large piece of the “epidemic of mental illness” puzzle.

    We never know who we might help down the road by sharing our experiences with others, so your effort is very important to those involved in advocacy, treatment, journalism or other causes. I am glad that you were able to share your story on MIA.

    I have met many individuals originally diagnosed with a “mental illness” and later found to be suffering from Lyme Disease or other underlying medical conditions.

    A serious flaw in our mental health system exists because psychiatry uses the DSM5 with what they refer to as a “Chinese menu” approach.

    “Mental Disorders” are nothing more than descriptions of moods, thoughts, behaviors, emotions, etc. that are perceived to be “abnormal”.

    While the descriptions of states of anxiety, depression, mania, psychosis, etc. are very accurate, the labels of “mental illness” are worthless. The psychiatric labeling process is unscientific, unethical and has created a medication management monopoly.

    “By consensual agreement within the APA, psychiatric diagnoses are descriptive labels only for phenomenology, not etiological or mechanistic explanation for syndromes. Thus, a psychiatric diagnosis labels a pattern of signs and symptoms, but offers no hypothesis concerning the mechanism(s) of the clinical phenomena.(Davidoff et al., 1991).”

    All individuals who claim to be advocates for others should support a unified advocacy agenda that will advance testing for and treating the many known underlying causes of “mental illnesses”.

    Recently, an acquaintance confided in me that after undergoing routine surgery, she suffered for months with what was diagnosed as severe anxiety/depression.

    She was treated by a number of specialists and her bloodwork/MRI/other tests came out in the normal range.

    She ended up on psych meds, seeing a psychologist once a week for therapy and was completely debilitated by her condition.

    Finally, her primary care suggested checking her ferritin levels.

    Her levels came back extremely low.

    After 3 months of taking an iron supplement, she is back to her normal self, off of all psych meds and no longer in therapy.

    Sharing her story was a blessing to my family.

    For the past eight months two of my family members have been suffering from dementia-like symptoms and labeled with depression/anxiety.

    I suggested they have their ferritin levels checked and labwork just came back for one of them that their ferritin levels are 3 times higher than the normal range.

    Among the possible causes is hemochromatosis, a hereditary conditions considered a “silent killer”.

    It’s heartbreaking to know how much unnecessary suffering is caused by doctors who rely on quick assessments, rubber-stamp psychiatric labels and reach for a prescription pad before considering running even just routine bloodwork on their patients.

    On top of the physical/mental suffering and the stigma of being dx’d with a “mental illness”, there are the mounting financial costs that cause additional burdens to the patient and their family members.

    Ignoring underlying medical conditions and labeling individuals “mentally ill” is not a best practice standard of care. It is cruel and unacceptable. I am outraged every time I find out of a case like this.

    As a long-time mental health advocate, my goal is to advance a uniform advocacy agenda that promotes best practice standards of care.

    To support this goal, I maintain membership and support the mission of the International Society for Ethical Psychology and Psychiatry, engage in community volunteerism, send information to our lawmakers, have shared my own experiences through a narrative that was published in the Journal of Participatory Medicine and given presentations at local NAMI and CCHR events.

    Kind Regards,
    Maria

  • Factor in toxic exposure, bacterial/viral and other underlying medical conditions and you will have a winning strategy to combat the “epidemic” of severe mental illness.

    In Wyatt v. Stickney 325 F.Supp. 781 (M.D.Ala. 1971), a key issue was that patients have a “constitutional right to receive such individual treatment as will give each of them a realistic opportunity to be cured or to improve his or her mental condition.”

    Our broken mental health care system is a result of our mental health professionals using the DSM5 with a flawed “Chinese Menu” approach that rubber-stamps stigmatizing labels on individuals and feeds psychiatry’s Medication Management Monopoly.

    If mental health advocates want to tip the scale quickly, they must consider the fact individuals in a psychotic state can be a danger to others and this results in lawmakers supporting coercive psychiatry. We are in need of a unified advocacy agenda that supports Best Practice assessment of psychosis and treatment that will address the underlying cause.

    https://psychoticdisorders.wordpress.com/bmj-best-practice-assessment-of-psychosis/

  • Hi Duane,

    I rarely visit this site for the same reason. I would much rather be engaged in rewarding community volunteerism than feel like I am typing on my computer to a brick wall.

    The fact are, it’s all about job security and since “mental illness” is a money making opportunity for so many, it is very easy to turn a blind eye to the facts, use smokes and mirrors to create illusions and sell a “new paradigm” to those who don’t mind profiting off of the suffering of others.

    Peace to you my dear friend

  • Fred,

    Thank you for sharing your experiences.

    Isn’t it amazing how with an “epidemic” of “mental illness” no one seems to make the connection to an epidemic of lead/mercury/other toxic poisoning/bacteria/virus and other known causes of psychosis?

    Very sad indeed that turning a blind eye to the known causes boils down to just one thing…..job security.

    The very sad truth is psychiatrist are not the only professionals making a profit from turning a blind eye, main stream mental health advocates are guilty of advancing the Medication Management Monopoly that exists today.

    And it is very sad to see the “new paradigm” that is being advanced by so many also excludes and overlooks the known underlying causes of psychosis/mania.

    We live in a critical time period, all mental health advocates should be supporting a unified advocacy agenda that includes the right of patients suffering from symptoms of “severe mental illness” to be tested for underlying causes.

  • Hi B,

    Very sad indeed.

    Here is just one case of a 15-year-old girl who was misdiagnosed for two years with bipolar disorder.

    She was treated at the same hospital that misdiagnosed me with bipolar disorder.

    Below is a link to a narrative I wrote that was published in the Journal of Participatory Medicine.

    I did receive a worker’s comp settlement and was entitled to sue for malpractice but declined to do so. I was happy to have found recovery solutions through Functional Medicine and complimentary therapies and hoped being a peaceful advocate would help make change for others but I did hold my breath either.

    Neuropsychiatric systemic lupus erythematosus presenting as bipolar I disorder with catatonic features.
    Posted on November 25, 2012 | Leave a comment | Edit
    Psychosomatics. 2009 Sep-Oct;50(5):543-7.
    Alao AO, Chlebowski S, Chung C.
    SOURCE
    Department of Psychiatry, SUNY Upstate, NY 13210, USA. [email protected]

    ABSTRACT
    BACKGROUND:
    The American College of Rheumatology has defined 19 neuropsychiatric syndromes associated with systemic lupus erythematosus (SLE) involving the central, peripheral, and autonomic nervous systems. Neuropsychiatric manifestations of lupus (NPSLE) have been shown to occur in up to 95% of pediatric patients with SLE.

    OBJECTIVE:
    The authors describe a 15-year-old African American young woman with a family history positive for bipolar I disorder and schizophrenia, who presented with symptoms consistent with an affective disorder.

    METHOD:
    The patient was diagnosed with Bipolar I disorder with catatonic features and required multiple hospitalizations for mood disturbance. Two years after her initial presentation, the patient was noted to have a malar rash and subsequently underwent a full rheumatologic work-up, which revealed cerebral vasculitis.

    RESULTS:
    NPSLE was diagnosed and, after treatment with steroids, the patient improved substantially and no longer required further psychiatric medication or therapy.

    CONCLUSION:
    Given the especially high prevalence of NPSLE in pediatric patients with lupus, it is important for clinicians to recognize that neuropsychiatric symptoms in an adolescent patient may indeed be the initial manifestations of SLE, as opposed to a primary affective disorder.

    http://www.jopm.org/perspective/narratives/2011/03/28/psychosis-possibly-linked-to-an-occupational-disease-an-e-patient%E2%80%99s-participatory-approach-to-consideration-of-etiologic-factors/

  • Dear Dr. Berezin,

    Respectfully, I am sure you are aware of the fact medical and mental health professionals most often use the DSM5 with a flawed”Chinese Menu” approach.

    Many individuals suffering from underlying medical conditions that induce psychotic/manic behavior are commonly misdiagnosed with psychiatric conditions.

    While the underlying condition goes untreated, patients are simply rubber-stamped with a psychiatric diagnosis and treated with a one-size-fits-all drug therapy regime that lasts the rest of their life.

    The British Medical Journal has published guidelines for Best Practice Assessment of Psychosis.

    https://psychoticdisorders.wordpress.com/bmj-best-practice-assessment-of-psychosis/

    Psychiatry’s current paradigm of care fails to use best practice standards of care.

    This paradigm prolongs the suffering of patients and subjects them to a life-long and harmful medication management protocol.

    In addition, because individuals suffering from psychosis/mania can have distorted perceptions and beliefs, this psychiatry’s current paradigm of care jeopardizes the health, safety and welfare of the public.

    Recently, here in Florida three young men who were reported to have a history of mental illness committed horrific crimes.

    23-year-old Christian Gomez brutally murdered his mother, cutting her head off with an ax.

    25-year-old John Jonchuk threw his five-year-old daughter off of a bridge.

    23-year-old Jason Rios stabbed to death his mother and young niece.

    Psychiatry’s new paradigm of care must include testing for and treating underlying medical conditions that manifest as psychosis and mania.

    It is very unfortunate this information is being ignored.

    Psychosis Due to a Medical Condition involve a surprisingly large number of different medical conditions, some of which include: brain tumors, cerebrovascular disease, Huntington’s disease, multiple sclerosis, Creitzfeld-Jakob disease, anti-NMDAR Encephalitis, herpes zoster-associated encephalitis, head trauma, infections such as neurosyphilis, epilepsy, auditory or visual nerve injury or impairment, deafness, migraine, endocrine disturbances, metabolic disturbances, vitamin B12 deficiency, a decrease in blood gases such as oxygen or carbon dioxide or imbalances in blood sugar levels, and autoimmune disorders with central nervous system involvement such as systemic lupus erythematosus have also been known to cause psychosis.

    A substance-induced psychotic disorder, by definition, is directly caused by the effects of drugs including alcohol, medications, and toxins. Psychotic symptoms can result from intoxication on alcohol, amphetamines (and related substances), cannabis (marijuana), cocaine, hallucinogens, inhalants, opioids, phencyclidine (PCP) and related substances, sedatives, hypnotics, anxiolytics, and other or unknown substances. Psychotic symptoms can also result from withdrawal from alcohol, sedatives, hypnotics, anxiolytics, and other or unknown substances.

    Some medications that may induce psychotic symptoms include anesthetics and analgesics, anticholinergic agents, anticonvulsants, antihistamines, antihypertensive and cardiovascular medications, antimicrobial medications, antiparkinsonian medications, chemotherapeutic agents, corticosteroids, gastrointestinal medications, muscle relaxants, nonsteroidal anti-inflammatory medications, other over-the-counter medications, antidepressant medications, neurleptic medications, antipsychotics, and disulfiram . Toxins that may induce psychotic symptoms include anticholinesterase, organophosphate insecticides, nerve gases, heavy metals, carbon monoxide, carbon dioxide, and volatile substances (such as fuel or paint).

  • Hi B,

    Yes, same experience here and it it not just psychiatrists who we have to blame.

    Where are our mental health advocates?????

    It is unbelievable how psychiatry has sold underlying medical conditions/substances that can induce altered states of mind as ” severe mental illness”.

    Here is an interesting case:

    John Maxwell Montin experienced a medication-induced psychotic state and spent two decades of his life involuntarily committed and forcibly treated for “mental illness” at the Lincoln Regional Center in Nebraska.

    Last year, a psychiatrist employed by the center recognized that Montin was misdiagnosed as “mentally ill” and he was finally released.

    Montin recently filed a malpractice lawsuit in federal court seeking $23.4 million in damages. The lawsuit claims that he was incorrectly labelled “mentally ill”, unnecessarily held in the psychiatric facility, and given unnecessary psychiatric treatment. The amount includes $808,000 in lost wages and $10.6 million in punitive damages. The lawsuit names 21 former or current staff members from the Lincoln Regional Center.

    http://isepp.wordpress.com/2014/07/14/former-psych-patient-files-malpractice-lawsuit-seeking-23-million-in-damages-for-being-misdiagnosed-mentally-ill/

    Many different medical conditions and substances can induce a psychotic state of mind and be misdiagnosed as “severe mental illness”.

    We need to start questioning why best practice standards are being ignored by our hospitals and by those who claim to be our advocates.

    Advocates have a duty of care and mental health advocates who promote an agenda without acknowledging best practice assessment standards are acting with negligence.

    Sooner or later common sense will kick in and mental health advocates will be forced to set their egos aside and form a unified advocacy agenda that supports the use of Functional Medicine to accurately determine underlying causes of what is being labeled as “severe mental illness”.

    Unfortunately, one man’s loss is another man’s gain, so the debates, the research, the books, the websites, the conferences, the summits and the profits will continue for some, while the medication, ECT, murders, suicides and suffering will continue for others.

    Maybe someday the “mentally ill” will place a class action lawsuit against their advocates for ignoring this information.

    By consensual agreement within the American Psychiatric Association psychiatric diagnoses are descriptive labels only for phenomenology, not etiological or mechanistic explanation for syndromes. Thus, a psychiatric diagnosis labels a pattern of signs and symptoms, but offers no hypothesis concerning the mechanism(s) of the clinical phenomena.(Davidoff et al.,1991).

    The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) classifications of psychotic disorders includes:

    Substance/Medication-induced psychotic disorder
    Psychotic disorder due to another medical condition
    293.81 With delusion as the predominant symptom
    293.82 With hallucinations as the predominant symptom
    Distinguishing medical conditions and substance-induced psychosis from schizophrenia or Bipolar disorder through clinical presentation often is difficult.

    Psychosis Due to a Medical Condition involve a surprisingly large number of different medical conditions, some of which include: brain tumors, cerebrovascular disease, Huntington’s disease, multiple sclerosis, Creitzfeld-Jakob disease, anti-NMDAR Encephalitis, herpes zoster-associated encephalitis, head trauma, infections such as neurosyphilis, epilepsy, auditory or visual nerve injury or impairment, deafness, migraine, endocrine disturbances, metabolic disturbances, vitamin B12 deficiency, a decrease in blood gases such as oxygen or carbon dioxide or imbalances in blood sugar levels, and autoimmune disorders with central nervous system involvement such as systemic lupus erythematosus have also been known to cause psychosis.

    A substance-induced psychotic disorder, by definition, is directly caused by the effects of drugs including alcohol, medications, and toxins. Psychotic symptoms can result from intoxication on alcohol, amphetamines (and related substances), cannabis (marijuana), cocaine, hallucinogens, inhalants, opioids, phencyclidine (PCP) and related substances, sedatives, hypnotics, anxiolytics, and other or unknown substances. Psychotic symptoms can also result from withdrawal from alcohol, sedatives, hypnotics, anxiolytics, and other or unknown substances.

    Some medications that may induce psychotic symptoms include anesthetics and analgesics, anticholinergic agents, anticonvulsants, antihistamines, antihypertensive and cardiovascular medications, antimicrobial medications, antiparkinsonian medications, chemotherapeutic agents, corticosteroids, gastrointestinal medications, muscle relaxants, nonsteroidal anti-inflammatory medications, other over-the-counter medications, antidepressant medications, neurleptic medications, antipsychotics, and disulfiram . Toxins that may induce psychotic symptoms include anticholinesterase, organophosphate insecticides, nerve gases, heavy metals, carbon monoxide, carbon dioxide, and volatile substances (such as fuel or paint).

  • Hi Francesca,

    Consumer protection could be the Achilles’ heel of coercive psychiatry.

    In the U.S., involuntary commitment is governed by state law and procedures vary from state to state.

    Here in Florida, state law maintains that involuntarily committed patients are responsible for the cost of the treatment and services they receive at the facilities they are literally being held captive in. The exception is felony arrests involving violence against another person.

    I questioned PsychRights attorney Jim Gottstein and he stated a long time ago he researched this situation and in every case he found the courts held this “forced to stay and forced to pay’ concept as constitutional.

    In my opinion, mental health consumers who are being billed for forced treatment should challenge coercive psychiatry as illegal forced contracts.

    Here is a copy of an outrageous bill that I received from forced treatment after experiencing psychosis from an untreated abscessed tooth in 2008.

    https://docs.google.com/document/d/1rl25nAtEWCZDC85aATy09i-gP9qQlxrVzzVxDabzSCM/edit?usp=sharing

    I wrote a letter of complaint to the facility claiming this bill was an illegal forced contract. The facility dropped the charges and I did not pay them one penny.

    Another unfair practice occurs when mental health consumers purchase expensive pharmaceutical products and they can not use these products because of unbearable side effects.

    As consumers, they should have the right to return defective pharmaceutical products to the store they purchased them from and get their money back.

    This consumer right does not exist and patients loose money because they are advised by medical professionals to purchase defective products that are not being recalled.

    Consumer protection is greatly needed in mental health care.

  • These two videos provide great insights into problems with the current perspectives on treating “mental disorders”.

    In the first video, Syracuse psychiatrist Mantosh Dewan, former Chair of the Department of Psychiatry at SUNY Upstate Medical University, is promoting what seems like a Cliff Notes version of psychotherapies to help his peers “quickly catch up” in order to provide patients “solution-focused treatment”. He also states that biological psychiatry (treatment with medications) is somewhat “easier” than psychotherapy.

    This would make one think that rather than maintaining a best practice standard of care, psychiatrists routinely choose the “easier” way to treat patients through medication management.

    In the second video, author Dr. Julie Holland talks about her book “Weekends at Bellevue”. She explains that she likes psychopharmacology better than psychotherapy because it is “quicker” and it better suits her personality as an “impatient person”. Dr. Holland admits that just shooting people up with drugs is fast but does not fix the underlying problems. She admits that she deprives her patients best practice standards of care.

    Persons labeled with mental disorders face stigma, discrimination and marginalization. They are in need of strong advocates who will push the envelope to ensure patients receive best practice standards of care.

    The court’s decision in Wyatt v. Stickney 325 F.Supp. 781 (M.D.Ala. 1971), stated patients have a “constitutional right to receive such individual treatment as will give each of them a realistic opportunity to be cured or to improve his or her mental condition.”

    Psychiatry’s quick and easy, rubber-stamp labeling system has not only created a medication management monopoly, it also violates a patient’s right to receive individual treatment that will prevent prolonged suffering and give way to optimum recovery.

    Advocates have a duty of care to ensure best practice standards are being advanced in our mental/behavioral health care system. Failure to do so is unethical.

    http://psychoticdisorders.wordpress.com/2014/02/18/promoting-integrated-treatment-are-psychiatrists-behind-on-solution-focused-therapy/

  • Sunny,

    Thank you for helping to organize a conference that will highlight the different approaches that exist to treat psychotic symptoms.

    I appreciate the fact your MIA bio states that you are “a forceful advocate for goal-based treatment versus illness-based treatment” and that you enjoy “challenging psychiatry residents and medical students to question traditional psychiatric treatment.”

    Even for the most experienced psychopharmacologist, treating a patient in a psychotic state can be extremely challenging.

    Many patients suffering from psychotic symptoms are legally forced into contracting and paying for the service of providers/facilities and purchase/consume potentially harmful pharmaceutical products.

    In any other practice, forced contracts would be considered a violation of consumer rights and illegal. In any other industry, forcing a consumer to purchase products is unheard of.

    From the stance of a social justice advocate, in order to ensure consumers of anti-psychotic products and services are provided with the most ethical, humane and evidence-based recover strategies available, I love pushing the envelope on psychiatric treatment too.

    In March of 1996, I suffered an acute psychotic episode and after seeking trustworthy opinions on where to find expert help, my family members were told to bring me to the emergency room at Upstate University Hospital in Syracuse.

    Although my family members informed the treating physicians that for over a decade I had been exposed to chemical toxins in the work environment and begged them to test for chemical poisoning, a psych referral was made and I was quickly assessed as having manic-depression with psychotic features, medicated and admitted into the psych ward.

    Below is a link to a narrative published in the Journal of Participatory Medicine that explains more about my recovery from psychosis [1]

    Also pasted below is an abstract published by the Department of Psychiatry at SUNY Upstate regarding a 15-year-old girl who was misdiagnosed with Bipolar I disorder with catatonic features. Two years later the correct diagnosis was finally made and she was treated with steroids. After the underlying condition was accurately diagnosed and treated, she no longer needed psychiatric medication or therapy. [2]

    There are dozens of underlying medical conditions/substances that can induce psychotic states and be misdx’d as sz/bp.

    Most industries that strive to avoid mistakes use the risk management process to create process improvements and best practice standards.

    A best practice is a method or technique that has consistently shown results superior to those achieved with other means, and that is used as a benchmark. In addition, a “best” practice can evolve to become better as improvements are discovered.

    The British Medical Journal published a step-by-step guideline for the best practice assessment of psychosis. [3]

    It is very unfortunate that psychiatrists fail to use best practice assessment guidelines and instead use the DSM5 with a”Chinese Menu” approach to assign labels of “mental illness”.

    The end result is misdiagnosis, prolonged suffering of patients and in some cases, public safety is jeopardized.

    I hope you will consider highlighting the value of best practice assessment at this conference.

    [1] Psychosis Possibly Linked to an Occupational Disease: An e-Patient’s Participatory Approach to Consideration of Etiologic Factors http://www.jopm.org/perspective/narratives/2011/03/28/psychosis-possibly-linked-to-an-occupational-disease-an-e-patient%E2%80%99s-participatory-approach-to-consideration-of-etiologic-factors/

    [2] Neuropsychiatric systemic lupus erythematosus presenting as bipolar I disorder with catatonic features.

    Psychosomatics. 2009 Sep-Oct;50(5):543-7.
    Alao AO, Chlebowski S, Chung C.
    SOURCE
    Department of Psychiatry, SUNY Upstate, NY 13210, USA. [email protected]

    ABSTRACT
    BACKGROUND:
    The American College of Rheumatology has defined 19 neuropsychiatric syndromes associated with systemic lupus erythematosus (SLE) involving the central, peripheral, and autonomic nervous systems. Neuropsychiatric manifestations of lupus (NPSLE) have been shown to occur in up to 95% of pediatric patients with SLE.

    OBJECTIVE:
    The authors describe a 15-year-old African American young woman with a family history positive for bipolar I disorder and schizophrenia, who presented with symptoms consistent with an affective disorder.

    METHOD:
    The patient was diagnosed with Bipolar I disorder with catatonic features and required multiple hospitalizations for mood disturbance. Two years after her initial presentation, the patient was noted to have a malar rash and subsequently underwent a full rheumatologic work-up, which revealed cerebral vasculitis.

    RESULTS:
    NPSLE was diagnosed and, after treatment with steroids, the patient improved substantially and no longer required further psychiatric medication or therapy.

    CONCLUSION:
    Given the especially high prevalence of NPSLE in pediatric patients with lupus, it is important for clinicians to recognize that neuropsychiatric symptoms in an adolescent patient may indeed be the initial manifestations of SLE, as opposed to a primary affective disorder.

    [3] BMJ: helping doctors make better decisions
    Step-by-step diagnostic approach
    The evaluation of the acutely psychotic patient includes a thorough history and physical examination, as well as laboratory tests. Based on the initial findings, further diagnostic tests may be warranted.

    http://psychoticdisorders.wordpress.com/bmj-best-practice-assessment-of-psychosis/

  • Hi Dr. Ragins,

    In March of 1996, I experienced my first psychotic episode.

    I was hospitalized and treated by doctors who were apparently taught in medical school and psychiatric residency to:

    1. not talk to people about their voices/delusions
    2. use the DSM with a “Chinese menu” approach to rubber-stamp individuals with bp/sz.
    3. medicate symptoms and ignore underlying medical conditions
    4. disregard the importance of taking an effective occupational history in order to recognize an occupational disease

    The “Chinese menu”/rubber-stamp-em and drug-em approach really did not work well for me, involved a lot of risks, almost killed me several times over and prolonged hazardous work conditions for myself and my coworkers.

    I feel the most ethical protocol to manage the risks involved when a person exhibits psychotic symptoms is for treating physicians to use the following Best Practice Assessment guidelines published by the British Medical Journal:

    Best Practice: Assessment of psychosis
    BMJ: helping doctors make better decisions

    Step-by-step diagnostic approach

    The evaluation of the acutely psychotic patient includes a thorough history and physical examination, as well as laboratory tests. Based on the initial findings, further diagnostic tests may be warranted.

    Organic causes must be considered and excluded before the psychosis is attributed to a primary psychotic disorder.

    The most common cause of acute psychosis is drug toxicity from recreational, prescription, or OTC drugs.

    Patients with structural brain conditions, or toxic or metabolic process presenting with psychosis, usually have other physical manifestations that are readily detectable by history, neurological examination, or routine laboratory tests.

    Brain imaging is reserved for patients with specific indications, such as head trauma or focal neurological signs. The routine use of such imaging is unlikely to reveal an underlying organic cause and is not recommended.

    Read more here: http://psychoticdisorders.wordpress.com/bmj-best-practice-assessment-of-psychosis/

    I have an informal survey question for you and for anyone involved in MIA who is willing to respond, including Bob.

    No one is immune from psychosis, so if you experienced a psychotic symptoms would you:

    a. Seek treatment at a hospital?
    b. Other, please explain.

    I look forward to MIA answers.
    Kind Regards,
    Maria

  • Hi B,

    While the use of coercion in psychiatry stirs a lot of controversy among advocates, no one really seems to care about who gets stuck with the bill.

    Coercive psychiatry means a mental health patient is forced to contract and purchase products, services and accommodations without choices or alternative options.

    The contractual relationship between a psychiatrist ordered to treat a patient, as well as the contract between a facility detaining a forcibly treated patient, should be challenged in court.

    In the U.S., “liberty of contract” is implicit in the Due Process Clause of the Fourteenth Amendment. Under forced treatment laws, mental health patients are deprived liberty to contract.

  • Hi B,

    I would love to talk to you about insanity.

    I wish I could say April Fool’s Day, but yes, in most stated, for psych patients, forced to stay and forced to pay is the law.

    Coercive psychiatry is a unique situation in which our lawmakers have created a system which allows legal forced contracts between mental health patients and providers/facilities.

    And also, unlike any other bad product, there is a no refund policy at the drug store for bad pharmaceutical products that induce side effects that can kill you.

    I’ve thrown away prescriptions that cost me out-of-pocket up to $250 because I could not tolerate the side-effects.

    Many psych patients can’t afford tp purchase food, but they can get plenty of lethal medications paid for by their insurance.

    Adderall has become a very popular medication to obtain and sell, as taking stimulants affects the metabolism of alcohol in the body. As a result we are seeing increases in DUI accidents/related deaths.

    Mental health advocates with opposing views will argue with each other about what type of treatment “psychotic” patients should receive, but they don’t seem to care about getting them food to eat.

    And also, psychiatrists will order lab-work/tests to run up the patients bill and then never even review the results, or give them to the patient.

    I recommend to all psychiatric patients that they obtain their medical records and lab work from all of their doctors.

    It’s no mystery to me why on average our “mentally ill” are living 25 years less than our mentally healthy population. Yet, no one really seems to care about helping them receive proper medical and dental treatment.

    My own situation involves an occupational disease that manifested as an acute manic episode. Long-term chemical exposure in the work environment caused toxic encephalopathy (Multiple Chemical Sensitivities).

    I was misdiagnosed with manic-depression with psychotic features and it took several years before I found help through alternatives/Functional Medicine.

    As Bob correctly points out, psychosis can have flu-like characteristics of coming and going on its own.

    The reason why symptoms of psychosis can sometimes come and go is because there are a multitude of underlying conditions, such as food allergies, or undetected infections, that exacerbate symptoms, even many years after recovery.

    Here is a copy of a +$8000 bill that I received after an abscessed tooth exacerbated symptoms of psychosis and I was forcibly treated for psychotic symptoms.

    I filed a complaint with the facility that this was an illegal forced contract that deprived me of my fundamental right to receive necessary medical treatment for an abscessed tooth.

    They dropped the bill completely.

    The facility I was “treated”, along with NAMI, would run an ad in the Sunday paper showing a baby behind bars, stating children with “untreated” “mental illness” end up in jail.

    Nice advertisement for bad “treatment”.

    Another facility I was “treated” at ran an EKG that showed possible anterior infraction. My doctor never even looked at the results and I was never informed there was a problem.

    Nice of them to administer drug therapy for “mental illness” and ignore physical illness.

    The treatment of psychotic symptoms is boiling down to a battle between Medication Management v. Open Dialogue, while failing to address treatable underlying conditions.

    Albert Einstein defined Insanity as: doing the same thing over and over again and expecting different results.

    Mental Health Care = Insanity in America

    https://docs.google.com/document/d/1HGhDuHaojrVnYGaipMnJ6PAEVSCMdWpZK_5zLd42Xyo/edit?usp=sharing

    Kind Regards,
    Maria

  • Hi larmac,

    My sincere condolences on the loss of your son.

    While I appreciate the efforts of Robert Whitaker and all of those involved in the Mad in America site, I find the failure to understand the value of Functional Medicine/Integrative Psychiatry/Orthomolecular concepts very troublesome.

    Soteria House and Open Dialogue are very nice concepts but unfortunately, they fail to test for and treat underlying causes of psychosis/mania.

    In 2011, 19-year-old Mozelle Nalan was a victim of a fatal shooting at the Soteria House in Alaska.

    In Mozelle’s case, the Soteria model failed. Without applying Best Practice Assessment standards, it will always fail.

    No one on this site seems to understand Best Practice = The Right Way to do something.

    Take care, Maria
    “Better to light a candle than curse the darkness”

    I hope you find comfort in these words:

    Desiderata
    Go placidly amid the noise and haste, and remember what peace there may be in silence.
    As far as possible without surrender be on good terms with all persons.
    Speak your truth quietly and clearly; and listen to others, even the dull and ignorant; they too have their story.
    Avoid loud and aggressive persons, they are vexations to the spirit.
    If you compare yourself with others, you may become vain and bitter;
    for always there will be greater and lesser persons than yourself.

    Enjoy your achievements as well as your plans.
    Keep interested in your career, however humble; it is a real possession in the changing fortunes of time.
    Exercise caution in your business affairs; for the world is full of trickery.
    But let this not blind you to what virtue there is; many persons strive for high ideals;
    and everywhere life is full of heroism.

    Be yourself.
    Especially, do not feign affection.
    Neither be critical about love; for in the face of all aridity and disenchantment it is as perennial as the grass.

    Take kindly the counsel of the years, gracefully surrendering the things of youth.
    Nurture strength of spirit to shield you in sudden misfortune. But do not distress yourself with imaginings.
    Many fears are born of fatigue and loneliness. Beyond a wholesome discipline, be gentle with yourself.

    You are a child of the universe, no less than the trees and the stars;
    you have a right to be here.
    And whether or not it is clear to you, no doubt the universe is unfolding as it should.

    Therefore be at peace with God, whatever you conceive Him to be,
    and whatever your labors and aspirations, in the noisy confusion of life keep peace with your soul.
    With all its sham, drudgery and broken dreams, it is still a beautiful world. Be careful. Strive to be happy.

    © Max Ehrmann 1927

  • Thank u WW for your response.

    Somehow, someway, mental health advocates from opposing views must find common ground to stand on.

    Advocates should not be spending valuable time and effort seeking ways to defeat one another.

    In order to serve the best interest of those they claim to be advocating for, advocates must seek issues that everyone can agree upon.

    The common ground issues are the ones that must be brought to the forefront so that our lawmakers can make educated decisions based on a consensual agreement of best-practice, best- interest, presented as a unified advocacy agenda.

    Below is the comment I have submitted to our FL Senators.

    I am writing in regards to a Doc Fix that includes Section 224 of House bill (HR 4302).

    It is my understanding that this action would use federal dollars to pay for forced psychiatric treatment in our communities.

    Our mental health care system is seriously flawed in that most medical and mental health professionals use the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5) with an opinion-based process they refer to as a “Chinese menu” approach.

    This unscientific method leaves individuals suffering from symptoms of psychosis, mania, delusions, paranoia, etc. quickly assessed and labeled with a severe mental illness and treated with a life-long, one-size-fits-all drug therapy regime.

    The “Chinese Menu” approach of using the DSM5 is an unfair and unethical medical practice that seriously jeopardizes the health, safety and welfare of not only the patient, but the public at large.

    In Wyatt v. Stickney 325 F.Supp. 781 (M.D.Ala. 1971), a federal district court concluded patients have a “constitutional right to receive such individual treatment as will give each of them a realistic opportunity to be cured or to improve his or her mental condition.”

    When a psychotic state occurs, an individual can become vulnerable. Very often a person experiencing psychosis can lose their ability to manage and maintain personal relationships, employment, medical care, and in some cases, housing.

    A psychotic experience distorts an individual’s belief system and perceptions. Many individuals experiencing a psychotic state of mind have poor insight regarding the abrupt change in their mental status and refuse to acknowledge that a problem even exists.

    Unlike most other conditions, a psychotic state can cause a person to harm themselves or another.

    Because there is a legitimate interest in public safety, the state maintains a compelling interest in the treatment of psychotic symptoms.

    While forced psychiatric treatment may be deemed necessary, if federal tax dollars are providing the treatment, strict scrutiny must be used. The state must ensure a patient’s fundamental right to receive individual treatment is preserved and best practice assessment standards are available.

    Diagnostic accuracy and individualized treatment of psychosis is cost-effective for both the mental health consumer and society.

    The British Medical Journal has published guidelines for Best Practice Assessment of Psychosis.

    Over 100 medical conditions and a long list of substances can induce a psychotic/manic state, which can lead to a misdiagnosis of severe mental illness.

    From what I have observed, our mental health system is suffering because of conflicting research and divided advocacy agendas.

    Advocates continue to maintain opposing views from different perspectives and refuse to listen to each other.

    When it comes to the treatment of psychosis, mental health advocates need to consider more than just conflicting research, we must consider the facts.

    The facts are psychosis can be caused by a wide variety of underlying medical conditions, or exposure to substances and patients are being rubber-stamped with mental illness labels.

    Typically, psychiatric treatment fails to test for and treat underlying causes of psychosis.

    In many cases, patients are placed at risk and because of the legalization of coercive treatment, the patients are responsible to pay for the treatment they received.

    Patients not only continue to suffer unnecessarily, they received outrageous bills for treatment that failed to consider the underlying cause of their symptoms.

    These bills should be considered illegal forced contracts of goods, services and accommodations.

    If federal dollars are used to pay for forced treatment, patients must be ensured their fundamental right to receive assessment and treatment according to best practice standards is preserved.

  • Hi Bob,

    Of all of your online lectures that I have listened to, I greatly appreciate the observations you made in your C-SPAN Book Discussion on Anatomy of an Epidemic.

    In your talk, you correctly point out that in some cases psychosis can have flu-like characteristics of coming and going on its own.

    Unfortunately, when a psychotic state occurs, an individual can become vulnerable. Very often a person experiencing psychosis can loose their ability to manage and maintain personal relationships, employment, medical care, and in some cases, housing.

    A psychotic experience distorts an individual’s belief system and perceptions. Many individuals experiencing a psychotic state of mind have poor insight regarding the abrupt change in their mental status and refuse to acknowledge that a problem even exists.

    Unlike most other conditions, a psychotic state can cause a person to harm themselves or another.

    As the cases of Ryan Ehlis and David Crespi exemplify, a first-time psychotic episode can lead to devastating tragedies that will permanently impact the entire family.

    Because there is a legitimate interest in public safety, the state maintains a compelling interest in the treatment of psychotic symptoms.

    Yes, the case is closed and the treatment of psychosis deserves strict scrutiny.

    Not only do psychiatrists need to rethink how our mental health patients are being treated, our mental health advocates must rethink their advocacy agenda. Advocates from opposing views must work together and create a unified advocacy agenda.

    “Advocate” is defined as : a person who publicly supports or recommends a particular cause or policy.

    For the past 15 years of my life, I have actively engaged in mental health advocacy.

    From what I have observed, our mental health system is suffering because of conflicting research and divided advocacy agendas.

    Advocates continue to maintain opposing views from different perspectives and refuse to listen to each other.

    When it comes to the treatment of psychosis, mental health advocates should be considering more than just the research, we must consider the facts.

    In your book Mad in America, you correctly point out that psychosis various underlying causes of psychosis, including untreated infections in the body such as dental carries.

    The facts are psychosis can be caused by a number of underlying medical conditions, or exposure to substances.

    If we consider the decision in Wyatt v. Stickney 325 F.Supp. 781 (M.D.Ala. 1971), a key issue was that patients have a “constitutional right to receive such individual treatment as will give each of them a realistic opportunity to be cured or to improve his or her mental condition.”

    Our mental health patients under observation for psychosis have the fundamental right to know their diagnosis based on Best Practice Assessment standards.

    The “Chinese Menu” approach of using the DSM5 is an unfair and unethical medical practice that seriously jeopardizes the health, safety and welfare of the public.

    Psychiatry must move towards adopting Best Practice Assessment Standards and integrative care for their patients as outlined in the British Medical Journal.

    All persons who are speaking publicly about the treatment of psychosis are acting in the capacity of a mental health advocate. Mental health advocates have a duty of care to ensure patients suffering from psychosis are assessed and treated under best practice guidelines.

    It is negligence on the part of those speaking, lecturing and writing on the treatment of psychosis to ignore the importance of testing for and treating underlying causes.

    As a mental health advocate my goals are to advance:

    1. awareness of underlying causes of psychosis/mania and the benefit of treating accordingly

    2. a Participatory Model of Mental Health Care

    3. proactive bullying prevention programs

    Please review the BMJ’s Best Practice Assessment of Psychosis guidelines and if you see fit, include discussion of it in the information you provide the public about the treatment of psychotic symptoms.

    http://psychoticdisorders.wordpress.com/bmj-best-practice-assessment-of-psychosis/

    Kind Regards,
    Maria Mangicaro

  • Dear Larmac,

    It’s very sickening to know the truth.

    Exposing the truth in the tainted MH system is like pealing an onion, there are many layers and it really stinks the facts continue to be shoved under the rug.

    Number one on my list is lead poisoning.

    Good God, why is this being ignored?????

    Past exposure to lead was one of the key factors in my own situation and corrected with Chelation Therapy which has been around for over 60 years.

    Another factor linked to psychosis, and something I have experienced personallly, is revealed in Bob’s book Mad in America. Simply suffering from an abscessed tooth can be an underlying cause of psychosis. Treat the abscessed tooth and the psychosis goes away.

    If we want to improve mental health care, we need to improve dental care.

    Here is a link to a narrative I wrote that was published in the Journal of Participatory Medicine:

    http://www.jopm.org/perspective/narratives/2011/03/28/psychosis-possibly-linked-to-an-occupational-disease-an-e-patient%E2%80%99s-participatory-approach-to-consideration-of-etiologic-factors/

    To be honest with you, at this point I believe the only way to clean up our tainted mental health care system is for mad-as-hell patients to start suing their p-docs.

    A Florida attorney posted a success care for Failure to timely diagnose and treat encephalitis with a $25,000,000 verdict.

    Here is another interesting case

    http://nypost.com/2009/10/04/my-mysterious-lost-month-of-madness/

    Najjar estimates that nearly 90 percent of those suffering from autoimmune encephalitis go undiagnosed.
    “It’s a death sentence when you’re still alive,” Najjar told me. “Many are wasting away in a psych ward or a nursing home.”
    I was the first person in NYU Medical Center’s history to be diagnosed with NMDAR encephalitis.

  • For the past six years I have been a volunteer for the International Society for Ethical Psychology and Psychiatry (ISEPP) and maintain their website, blogs and social network accounts.

    Robert Whitaker presented at the ISEPP 2013 conference and is highly respected among our members.

    You might also find of interest information from some of our other past conferences:

    Psychiatrist, Dr. Grace Jackson and her lecture on Brain Repair

    his presentation has four goals:

    1) to describe the health problems of the mentally ill

    2) to explain problems associated with pharmaceutical use in the USA

    3) to provide a brief overview of brain damage due to psychiatric drugs

    4) to introduce possible methods for brain repair

    http://www.psychintegrity.org/gracejacksonmdlecture.php

    Child psychiatrist, Dr. Scott Shannon on Functional Medicine

    http://isepp.wordpress.com/2011/08/24/the-ecology-of-the-child-a-new-view-of-pediatric-mental-health/

    Gary Kohls MD on the dangers of psychotropic drugs

    http://isepp.wordpress.com/2012/04/27/dr-gary-kohls-on-psychotropic-drugs-the-hidden-dangers/

    Charles Gant, MD is not a member of ISEPP but he is the MD who helped me and many other patients.

    http://www.youtube.com/watch?v=MDQPb6cV8Jw

    In Kindness, Maria

  • Dear Larmac,

    I am glad to know that you find value in the BMJ’s publication of Best Practice assessment of psychosis.

    My employment background includes working in professions that involve adhering to strict deadlines, pleasing a demanding clientele in highly competitive environments, and in some cases, very limited profit margins.

    In many such industries, error mean loss of profit and jeopardizes sustainability.

    The application of the risk management process leads to process improvements, development of benchmark-best practice standards and a profitable, sustainable business operation.

    This is what the BMJ has done for our health care system. They have created a benchmark-best practice standard based on root cause analysis of evidenced-based causation factors that can create a psychotic state of mind.

    Unfortunately, for the masses who may enter into a psychotic state, our health care and criminal justice system’s lack of responsibility allows for error and for misdiagnosis.

    These systems profit from our “Mad in America”.

    The use of “Bad Science, Bad Medicine” and “Magic Bullets” that results in the “Enduring Mistreatment of the Mentally Ill”, is a profitable and sustainable business for many professionals.

    Implementing Best Practice Standards would erode the need for many services.

    Sad but true, one man’s continued suffering is another man’s job security.

    In Kindness, Maria

  • Dear Larmac,

    My condolences on the loss of your son. There is no greater loss than the loss of a child. My heart goes out to you and your family. I appreciate the fact you speaking out about your son’s experience and are striving to prevent others from suffering the same loss.

    I was blessed to be “normal” for 33 years of my life before suffering spontaneous “mental illness” and rubber-stamped with the label of manic-depressive with psychotic features.

    In my lifetime I have known a number of individuals, including people I have cared deeply for, who have taken their own life after suffering from symptoms that are considered “mental illness”.

    I can honestly say that before living through the mental and physical hell of an encephalopic condition, I did not understand how any human could possibly harm themselves or others.

    After experiencing first hand the torment brought on by illnesses that cause delusions, hallucinations and psychotic symptoms, along with disabling side effects of psych meds that included severe parkinsonslike syndrome, tardive dyskinesia, suicidal thinking and weight gain of 85lbs in 6 months while taking Zyprexa, I have made it a priority in my life to advocate for medical and mental health professionals to adhere to best practice standards of care.

    The British Medical Journal published a very comprehensive guideline for doctors to follow when assessing patients who are clearly suffering from a psychotic state. Here is a link:

    http://psychoticdisorders.wordpress.com/bmj-best-practice-assessment-of-psychosis/

    The colossal failure in our medical and mental health care system begins when we fail to ensure our doctors are adhering to this Best Practice standard of care. This lack of accountability reflects poorly on advocates and members of our society who speak out on the treatment of psychotic disorders.

    Our society has allowed main stream psychiatry to develop a medication management monopoly which is supported by a strong advocacy agenda promoted by NAMI and other advocacy organizations.

    Our current health care system allows our doctors to assess patients using the DSM 5 with a flawed “Chinese menu” approach.

    This unethical practice results in patients being rubber-stamped with stigmatizing labels that do in fact accurately describe a person’s pattern of behavior, emotions and moods but completely disregard and fails to test for and treat the broad-range of underlying causation factors.

    These factors include, but are not limited to, undetected viruses, bacteria, toxins, injury, trauma, disease, or combination of such.

    Patients with many different underlying conditions that manifest as similar psychiatric symptoms are simply categorized and treated with a magic bullet pharmacological approach.

    Because medical doctors are among the most respected individuals in our society, the practice of psychiatry has developed into an unregulated power-base of authority in our society. Unlike any other business, our mental health consumers can be legally forced to contract poor quality, ineffective care from providers and facilities.

    In order to ensure patients suffering from symptoms of psychosis and mania are given an optimal chance at recovery without being dependent on the long-term use of dangerous antipsychotic medications, mental health advocates, regardless of affiliations, should strive to ensure our doctors are using Best Practice Assessment standards.

    Mental health patients should not be forced into purchasing sub-standard, unethical care and ineffective, potentially lethal products.

    While I appreciate Dr. Steingard’s support of Robert Whitaker’s work, I do not believe it is in his best interest to breaking down the information presented in Mad in America and Anatomy of an Epidemic as there is a right way and a wrong way, especially considering the death of a young woman at the Soteria House in Alaska.

    http://www.adn.com/2011/07/20/1976804_after-shooting-death-at-assisted.html

    NAMI advocates who fear alternatives and read “Whitaker is probably right” can twist Dr. Steingard’s meaning into respected mental health advocates like author Pete Earley are probably wrong.

    In my opinion, using Best Practice Assessment of psychosis guidelines is the most ethical standard of care to treat a patient in a psychotic state.

    This standard of care should be at the foundation of a unified advocacy agenda as it prevents unnecessary suffering from being misdiagnosed as does the current bad practice of psychiatrists using the DSM with a “Chinese menu” approach.

  • Hi Jim,

    Sorry to be a so late on giving you recognition for this, I wanted to let you know that I was thrilled to hear of your success in the Oral Argument in ex rel Watson v. King-Vassel.

    Great job! Not to say that I do not have faith in you, but I was a bit concerned on this one.

    May you and Toby have continued success in this case, as it deserves a favorable outcome.

    Regarding the constitutionality of “forced to stay and forced to pay”, patients need to be aware of the fact they still the right to complain and there are many different sources to complain to.

    It’s amazing how much flexibility billing departments have when it comes to substantially reducing a patient’s bill, or in my case, completely dropping $8000+ in facility and service charges, only because I presented a strong argument that it was a forced contract. I did pay the bills from the medical doctor, but I refused to pay the facilities portion as it was not a mutual agreement and I was under duress.

    Seriously, do behavioral/mental health facilities just make up over-inflated prices in hopes that some who are forced into contracting their services will just go ahead and pay full price? while others will be forced to file bankruptcy?

    Here’s a copy of the first bill the facility expected me to pay in full.

    https://docs.google.com/document/d/1HGhDuHaojrVnYGaipMnJ6PAEVSCMdWpZK_5zLd42Xyo/edit?usp=sharing

    At the time, the average rent for a very nice 2 bed/2bath apartment in the area was $900/month.

    They actually expect someone to pay $600/day for a cot with dirty blood stained sheet from the last patient and a single shower shared by 10-15 people, that is not cleaned in between usage.

    Are they out of their freaking minds?

    The rate for the Don Cesar in St. Pete’s is only $200/night.

    If only insurance companies would pay for mental health stays at luxury resorts, our rates would go down. Heck, I’d even take the Econolodge over some of these places that had mold and flies all over the shower.

    My advice to all mental health patients who have had hospitalizations is to always obtain all of their medical records.

    They might be surprised to find abnormalities in their lab work that was never reviewed or mentioned to them, and they might consider seeing a specialist for.

    In my case the lab work helped substantiate my worker’s comp claim, in which I was entitled to reimbursement of medical expenses. When I reviewed my records, I was pretty surprised to see abnormalities including an EKG indicating Possible Anterior Infraction that no doctor ever bothered to mentioned to me, or bothered to make a referral to a cardiologist.

    Since my own worker’s comp case, I have been able to help 4 other individuals originally dx’d bp, establish worker’s comp cases for toxic encephalopathy. That may not seem like much, but at least it created a greater awareness among their doctors and employers.

    Patients should always look for answers, consider alternative answers, ask questions, ask more questions and most importantly COMPLAIN about being forced to purchase really Bad Science, Bad Medicine and Enduring Mistreatment.

    The astonishing rise in mental illness in America has more than likely caused an astonishing rise in bankruptcy and divorce because of “Forced Psychiatric Debt”.

    If we factor in the “criminalization of mental illness”, the “Mental Illness Industry” is probably much more profitable for attorneys than it is for psychiatrists.

    Unfortunately for many, considering the economic development created by modernistic views of “mental illness”, along with the pharmacological revolution, “The Industrialization of Mental Illness” is probably the most profitable and successful transformation our society has ever experienced.

    Nevertheless, shifts taking place indicate “The Deindustrialization of Mental Illness” is well underway.

    I was happy to hear in a recent email exchange from pediatrician and ISEPP board member Dr. Bose Ravenel, that he is incorporating a Functional Medicine approach to his practice.

    Dr. Charles Gant, the MD who I turned to for help in 1997 used this approach and the lab testing he ran helped to determine the obvious underlying cause of toxic exposure from working around chemicals leaking out of broken equipment.

    At the 2009 ICSPP conference, Dr. Gary Kohls presented on a Functional/Integrative Medicine approach but unfortunately his lecture only attracted a hand full of patients and no key member of ICSPP. And at the L.A. ISEPP conference, child psychiatrist Dr. Scott Shannon, author of Please Don’t Label My Child, presented on Integrative Psychiatry.

    I will not be able to attend the upcoming ISEPP conference but I hope if you and Nancy are able to attend that you will consider participating in Dr. Ravenel’s lecture.

    Here is the outline of his presentation.

    Take care, Maria

    An Integrative Approach to Common Behavior and Learning Problems in Children: A role for gluten sensitivity and MTHFR polymorphism

    http://iseppinfo.wordpress.com/2013/09/23/isepp-2013-pediatrician-dr-bose-ravenel-on-the-benefits-of-a-functional-medicine-approach/

  • Dear Copy_cat,

    You’ve got that right, it is chemical rape.

    I have a question for you, were you also billed for the rape services?

    Here in the state of Florida, under the Baker Act involuntarily committed individuals are financially responsible to pay whatever the costs are of the forced treatment. The exceptions are cases of felony offense arrests. Bills for forced treatment should be considered forced contracts.

    Unlike any other situation, those labeled “mentally ill” become part of a class of our society who can be forced into contracting the services of facilities and their employees.

    The constitutionality of of coercive psychiatry should be questioned as it creates forced contracts with limited providers.

    Involuntary commitment laws are dangerous because they place consumers in a forced relationship with facilities and their employees while limiting their ability and access to contract medically necessary treatment options.

    Involuntary commitment facilities do not allow access to electronic devices, thereby limiting their consumer’s ability to informed consent and knowledge of medically necessary treatment options.

    In October of 2008 I was Baker Acted by a psychiatrist employed at a non-hospital, not-for-profit facility in FL.

    During the 12 day period of my detainment, this facility provided me with extremely limited, noneffective services in poor quality, non therapeutic conditions, at an undisclosed rate of over $600 per day.

    I received a statement from the facility listing each “transaction” for a total of $8263.01 to be paid in full.

    Transaction is defined as:
    An instance of buying or selling something; a business deal.
    The action of conducting business.

    I filed a complaint with the billing department of this facility disputing the cost of services that were undisclosed to me at the time of the forced “transactions”.

    The complaint included documents from my prior worker’s comp case involving suffering from an occupational disease that was originally misdiagnosed as bipolar disorder with psychotic features and later schizoaffective disorder.

    Although the treating psychiatrist employed by the facility acknowledged that I was suffering from an abscessed tooth, he extended my stay by pursuing a Baker Act. This action against me interfered with my ability to contract necessary dental treatment, prolonged my suffering, restricted my personal freedoms and caused me to incur substantial debt. The medication management provided by the facility made my symptoms worse and quickly induced tardive dyskinesia. His actions and the advice of the attorney who solicited and represented me at the Baker Act hearing were discriminatory in nature and not in my best interest.

    My complaint to the facility included billing statements from my dentist indicating that upon release from the facility I sought medically necessary treatment for the infected tooth.

    Once the infected tooth was treated, symptoms abated and I tapered off of all psychiatric medications.

    The 2008 Baker Act has not been expunged from my records but I did successfully argue that I was misdiagnosed and entered into an invalid forced contract with the facility.

    If a contract isn’t voluntary, it can’t be valid.

    The representative of the facility stated the best way to satisfy my complaint was by dismissing all financial obligations.

    When considering forced psychiatric treatment, mental health advocates must consider the fact individuals with symptoms considered to be severe mental illness have higher rates of chronic general medical illness compared to the general populations and on average their lifespan is 25 years less.

    It is critical for advocates to work together and strive to improve the overall health care of consumers labeled “mentally ill”.

    Symptoms of psychosis and mania should always be assessed using the Best Practice Assessment guidelines published in the British Medical Journal. Failure to do so is negligent and unethical, as it limits a consumer’s treatment options to medication management and jeopardizes their long-term health.

    My own experiences in our mental health care system include numerous situations in which indications of underlying medical conditions have been obviously overlooked and blatantly ignored.

    Psychiatric treatment acts with negligence and commits criminal assault.

    Thank you for expressing your views.

    Kind Regards,
    Maria Mangicaro

  • Dear mah3md,

    Respectfully, I appreciate your honest and open critique.

    Advocating for the health, safety and welfare of others is something that I take very seriously and I believe transparency in advocacy is a must. I would like to address the claims that you are making against me.

    Considering some individuals suffering from symptoms of severe “mental illness” and “psychosis” engage in harmful behavior to themselves and others, and treatment of symptoms can involve limiting a patient’s personal freedoms and treatment options, strict scrutiny should be used in assessing the problems within our current paradigm of care, professional standards and proposed solutions.

    I would like to note that Robert Whitaker correctly points out that psychosis can have “flu-like” characteristics of coming and going on its own.

    While I do not claim to have a scientific background, I have taken courses in Human Anatomy and Physiology, Abnormal Psychology and have some training in complimentary therapies. I’ve also found resources at the medical library open to the public extremely helpful to gain insights into one’s own health problems. Not all information can be found online, therefore those involved in online-mental health advocacy must keep an open mind to the criticism of others.

    Developing a shared perspective is critical to formulate an effective, economical, best-practice advocacy agenda that can be supported with a unified platform.

    Concerns over the use of Lithium were introduced by a prior comment.

    As a person who has taken Lithium, I have an experiential background and concern for others who may be taking it. As you can clearly see, I was cautious to add a “Disclaimer” on my statement as I am a peer and not a medical professional and I know my place.

    The duty of care required of professionals is one of reasonableness.

    Patients considered “mentally ill” are often deprived of the right to make reasonable decisions for themselves.

    I believe that individuals labeled “mentally ill” should not be deprived treatment options. If Lithium is a treatment option, they should be provided with informed choice on the types of Lithium available. The patient is the ultimate consumer and should have the right to information and choice, regardless of their scientific background.

    In 1996 I experienced an acute manic/psychotic episode. After being treated unsuccessfully with several different medications (including haloperidol) and suffering side effects that included severe-Parkinsonslike syndrome and tardive dyskinesia, symptoms were temporarily alleviated by treatment with Lithium Carbonate. It was a temporary solution, not a permanent fix.

    A psychopharmacologist with a stellar reputation prescribed ascorbic acid because there is evidence to support it will help prevent toxic side effects and improve the patient’s quality of life. I was also advised to take Omega 3 supplements, which is reported by NAMI.

    http://www.nami.org/ADVTemplate.cfm?Section=20111&Template=/ContentManagement/ContentDisplay.cfm&ContentID=118508

    After spending two years cycling in and out of manic/psychotic episodes, I made the decision to incorporate complimentary therapies into my recovery strategy.

    The use of Functional Lab testing revealed past exposure to Lead and other chemical toxins were impacting my health. I had been employed for 15 years in the prepress department of a printing company and exposed to numerous chemical toxins. I began a series of EDTA intravenous chelation treatments and noticed remarkable improvements in my mental health. Within 6 months I was able to taper off of all psychiatric medications.

    On my own I explored the connection to chemical exposure and symptoms of psychosis/mania. Eventually I gained supportive depositions in a worker’s comp case to Substance Induced Psychosis/Mania and the dx of toxic encephalopathy. I have assisted 4 other individuals originally dx’d bp/sz and actually suffering from toxic encephalopathy establish worker’s comp cases.

    During the past decade, environmental allergies, the routine use of over-the-counter cold and pain medicine, a bout of ocular shingles and bacterial infection from an abscessed tooth have exacerbated symptoms of psychosis but in each situation quickly came under control once the underlying problem was treated.

    Prior to an acute manic episode, the only noticeable symptoms I had were yellowing of my eyes and memory impairment.

    Just from a general science background, we understand the liver is the most important blood purification organ in the body and is the body’s principal chemical plant. By comparison, if a plant was built to perform all of the chemical functions of one person’s liver, it would have to cover 500 acres, so we understand it is a pretty intricate organ.

    “The blood-brain barrier (BBB) is a dynamic interface that separates the brain from the circulatory system and protects the central nervous system from potentially harmful chemicals while regulating transport of essential molecules and maintaining a stable environment. The blood-brain barrier (BBB) is formed by highly specialized endothelial cells that line brain capillaries and transduce signals from the vascular system and from the brain. The structure and function of the BBB is dependent upon the complex interplay between the different cell types (such as the endothelial cells, astrocytes, and pericytes), and the extracellular matrix of the brain and blood flow in the capillaries”

    “elevated blood lead levels (BLLs) impair the blood-brain barrier function…The blood-brain barrier has a very important function in maintaining the fluid environment of the nervous system. While other organs in the body transport molecules by the simple method of diffusion, the blood-brain barrier is very persnickety in that it selects only certain and essential water-soluble molecules (essential amino acids, glucose, calcium, sodium, and potassium) to be transported by carriers in the plasma membrane. This intricacy in the transportation of molecules through the blood-brain barrier explains the barrier’s susceptibility to trauma due to dangerous toxicants”

    “The ability of lead to pass through the blood-brain barrier is due in large part to its ability to substitute for calcium ions. Within the brain, lead-induced damage in the prefrontal cerebral cortex, hippocampus, and cerebellum can lead to a variety of neurological disorders, such as brain damage, mental retardation, behavioral problems, nerve damage, and possibly Alzheimer’s disease, Parkinson’s disease, and schizophrenia.”

    “Cerebral allergy is an allergy to a substance, which targets vulnerable brain tissue and alters brain function. Masked cerebral allergy can cause symptoms of mental illness (Walker, 1996; Rippere, 1984; Sheinken et al., 1979). Symptoms range from minimal reactions to severe psychotic states, which may include irrational behavior, disruptions in attention, lack of focus and comprehension, mood changes, lack of organizational skills, abrupt shifting of activities, delusions, hallucinations, and paranoia (Sheinken et al., 1979; McManamy et al., 1936).”

    While doctors and many mental health advocates may not be concerned about “Drug-induced Creutzfeldt-Jakob like syndrome”, the patients who have taken the drugs or are being prescribed the drugs, might have a different opinion if they were aware of it.

    “A patient with progressive neurological deterioration characterized by cognitive impairment, myoclonus, Parkinson’s syndrome, an abnormal electroencephalogram and fasciculations was considered for brain biopsy for suspected Creutzfeldt-Jakob disease. Complete clinical recovery followed discontinuation of lithium and nortriptyline. Awareness of this unusual drug-induced Creutzfeldt-Jakob like syndrome can avoid costly, invasive and unnecessary investigative procedures.”

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1188422/

    Those with scientific backgrounds may have an advantage when it comes to understanding the language of the research but it is those with experiential background who have an understanding and compassion for the suffering and consequences of failed research.

    While a tremendous amount of effort seems to focus on what treatment works best for symptoms of “psychosis”, there is a failure to recognize the importance of best practice assessment standards as outlined by the BMJ.

    There is a great harm being done to mental health patients because of the failure of medical professionals to test for and treat underlying causes of psychotic/manic symptoms.

    There is less reliance on medications when the underlying condition is treated. This is based on common sense, as well as scientific research.

    http://psychoticdisorders.wordpress.com/bmj-best-practice-assessment-of-psychosis/

    Kind Regards,
    Maria Mangicaro

  • Many individuals who appear to have psychological disorders have worked in industries that involve being exposed to organic solvents and heavy metals that have the same neurotoxic effects as psych meds. Psychiatrist are treating psychosis caused by a neurotoxin with other neurotoxins.

    http://www.aafp.org/afp/1998/0915/p935.html

    “Occupational exposures contribute to the morbidity and mortality of many diseases. However, occupational diseases continue to be underrecognized even though they are responsible for an estimated 860,000 illnesses and 60,300 deaths each year.”

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1031789/

    Neurotoxic effects of n-hexane on the human central nervous system: evoked potential abnormalities in n-hexane polyneuropathy.
    Y C Chang
    Copyright and License information ►
    This article has been cited by other articles in PMC.
    Abstract

    An outbreak of n-hexane polyneuropathy as a result of industrial exposure occurred in printing factories in Taipei area from December 1983 to February 1985. Multimodality evoked potentials study was performed on 22 of the polyneuropathy cases, five of the subclinical cases, and seven of the unaffected workers. The absolute and interpeak latencies of patterned visual evoked potential (pVEP) in both the polyneuropathy and subclinical groups were longer than in the normal controls. The pVEP interpeak amplitude was also decreased in the polyneuropathy cases. Brainstem auditory evoked potentials (BAEP), showed no difference of wave I latency between factory workers and normal controls, but prolongation of the wave I-V interpeak latencies was noted, corresponding with the severity of the polyneuropathy. In somatosensory evoked potentials (SEPs), both the absolute latencies and central conduction time (CCT) were longer in subclinical and polyneuropathy cases than in the unaffected workers and normal controls. From this evoked potentials study, chronic toxic effects of n-hexane on the central nervous system were shown.

  • Yes, Lithium Carbonate can cause horrific conditions like CJ Disease, also known as Turn Your Brain Into a Sponge Disease.

    http://psychoticdisorders.wordpress.com/category/lithium-induced-creutzfeldt-jakob-syndrome/

    Psychiatrist Grace Jackson is a really wonderful person and her book Drug Induced Dementia is excellent.

    http://isepp.wordpress.com/2013/07/28/drug-induced-dementia-a-perfect-crime-by-isepp-member-dr-grace-jackson/

    Vitamin C is known to help reduce the toxic side effects of Lithium but seldom do psychiatrists are even aware of this.

    Lithium Orotate, said to pass through the liver brain barrier easier and is less toxic, is now sold in health food stores.

    http://www.youtube.com/watch?v=ijMbycw2boM

    Take care, Maria Mangicaro

    DISCLAIMER: This comment is not intended to replace medical information and does not give out medical advice. Withdrawing from psychiatric medications can be dangerous; consult your treating physician regarding all such treatment decisions.

  • Donna,

    Thank you for passing along Dr. Sinaikin’s information. I am a volunteer for the International Society of Ethical Psychology and Psychiatry (ISEPP) and met Phil through the organization.

    Phil presented twice at the ISEPP conferences, unfortunately, there were so many sessions going on only 30 people came to the first one and last year only 1 person had interest in his presentation, so he didn’t bother even presenting. He left the conference very discouraged.

    Dr. Gary Kohls presented at the 2009 conference and felt the same way. His presentation (on Orthomolecular/nutrition) was the main reason why I made an effort to attend. Sadly, even among the minority agenda, important voices get lost.

    Phil’s book PSYCHIATRYLAND is a labor of love and a gift to anyone looking for empowerment concepts. Literally a gift because he wants people to have it and would give it away to anyone who asks.

    Phil works at a very busy VA hospital that is overwhelmed with an influx of veterans being admitted with mental health issues. A very serious and sad situation to deal with. The stories are horrific. My sister-in-law works at the other local VA psych ward. Patients are overmedicated and given ECT.

    Phil’s book is self-published and got little exposure. As a courtesy to ISEPP members who need help on the internet, I offer to help them with their websites or set up blogs. I’m glad Phil took me up on the offer because it is always an honor to help someone who is willing to stick their professional neck out on the line.

    That is why I chose to volunteer for ISEPP, rather than CCHR. If I didn’t feel an obligation to somehow help protect the professionals who are in the position to help others who suffer from underlying medical conditions and are misdiagnosed with “mental illness”, I’d be doing more hands on work to help others.

    My own doctor stuck his neck on the line for his patients and he ended up having his license suspended. Over 1000 people came to a rally in support of him and another local doctor who also had her license suspended and used Functional/Orthomolecular/Complimentary Medicine. The testimonies were incredible and they were buried in legal fees getting their licenses back.

    Phil’s presentation exposes Big Pharma information that he obtained “back in the day”. It’s unfortunate that no key member of ISEPP attended it. It is really very shocking.

    Personally, I like Phil’s book and love the analogies in PSYCHIATRYLAND. He hits the nail on the head of a Disneyland-train-of-thought why people turn to psychiatry in the first place. We were taught to play follow-the-leader as kids and we still do it today.

    The content comes from his insights as a seasoned professional whose education as a psychiatrist was immersed in many disciplines and not just how to drug your patients.

    Back in the day, where he was educated, Orthomolecular Psychiatry and all of the various branches of psychology and philosophy were part of the core curriculum.

    His book is written from his personal perspective, so of course others are going to think he is wrong.

    Phil lives about an hour away and a few years ago we met up for lunch.

    I asked him the same question CCHR videos ask, are there any test to determine someone has a mental disorder?

    He gave the same response as all of the CCHR interviews, no.

    I pulled out a copy of his book and pointed out to him what he wrote about Bipolar Disorder in his book:

    “I don’t think and neither would you have any problem identifying Bipolar I Disorder in someone currently suffering from a manic episode. They truly act crazy. A number of my Bipolar I patients had a tendency to take all their cloths off in public when manic. Some love to ‘spread the word’. I pointed out in his book where he states: A true Type I manic can rarely escape public notice….”

    My next question was, so if you have a patient who is clearly in a manic state, there are no tests that you would run?

    He immediately knew what I was getting at and started with, well, umm, of course we would run a thyroid test, and it would be nice if everyone had an MRI, but we don’t do that….

    I rephrased his answers and said

    So, there are no tests to diagnose a mental disorder, but there are tests to determine a person does not have a mental disorder, but we just don’t do them, correct?

    “Well, yes, that’s true” was his answer.

    “Psychosis Due to General Medical Conditions”,
    and “Substance Induced Psychosis”

    They aren’t new to the DSM, they just don’t get used much and no one seems to care about them.

    Despite its really good efficacy for psychosis, using best practice assessment standards to test for and treat the underlying medical condition seems like a waste of time to most medical doctors.

    All-in-all, Phil really is a great guy, with a big heart and a very talented musician.

    He is one of our unsung heroes and a diamond in the rough. Phil is a close friend of an Executive Producer at 60 Minutes. Phil contacted him about the Rebecca Riley case and that is how Rebecca’s death captured the attention of our main stream media. Unfortunately, the national alliance claiming to be mental health advocates are oblivious to these tragic incidents.

    Although I was not on it very long, my memories of the scathing effect of Haloperidol-induced Parkinsonslike Syndrome are still quite vivid in my mind. Sure would have been nice to have a bit of Cogentin with that crap.

    Here’s a video that points out our prominent psychiatric researchers and mental health advocates suck.

    http://www.youtube.com/watch?v=EKe8YhIkMtg

    Another aspect of medicating symptoms is that fact many individuals work in industries that involve long-term exposure to organic solvents like hexane, or heavy metals like lead that also have neurotoxic effects.

    In those “more drug reactive” patients, doctors should consider taking an occupational history, or suggesting a hair analysis.

    It doesn’t matter how nice the Brave New World Funny Farms are, ya can’t cure “mad” or “crazy” without getting the lead out.

    While some are making money writing books about the treatment of “mental illness”, others got “mental illness” from printing them.

    We really do live in a backwards dlrow.

    Take care,
    Maria

    Neurotoxic effects of n-hexane on the human central nervous system: evoked potential abnormalities in n-hexane polyneuropathy.
    Abstract

    An outbreak of n-hexane polyneuropathy as a result of industrial exposure occurred in printing factories in Taipei area from December 1983 to February 1985. Multimodality evoked potentials study was performed on 22 of the polyneuropathy cases, five of the subclinical cases, and seven of the unaffected workers. The absolute and interpeak latencies of patterned visual evoked potential (pVEP) in both the polyneuropathy and subclinical groups were longer than in the normal controls. The pVEP interpeak amplitude was also decreased in the polyneuropathy cases. Brainstem auditory evoked potentials (BAEP), showed no difference of wave I latency between factory workers and normal controls, but prolongation of the wave I-V interpeak latencies was noted, corresponding with the severity of the polyneuropathy. In somatosensory evoked potentials (SEPs), both the absolute latencies and central conduction time (CCT) were longer in subclinical and polyneuropathy cases than in the unaffected workers and normal controls. From this evoked potentials study, chronic toxic effects of n-hexane on the central nervous system were shown.

    Am J Ind Med. 1986;10(2):111-8.
    An outbreak of N-hexane induced polyneuropathy among press proofing workers in Taipei.

    Wang JD, Chang YC, Kao KP, Huang CC, Lin CC, Yeh WY.
    Abstract
    The objective of this study was to determine the prevalence and the etiology of polyneuropathy observed among press proofing workers in Taipei. Neurological examinations of 59 workers, from 16 press proofing factories, were conducted. Fifty-four of those workers subsequently underwent studies of nerve conduction velocities. Samples of bulk solvent from the involved factories were analyzed for their contents using gas chromatography. Fifteen (25%) of the study group were found to have polyneuropathy. All 15 patients with polyneuropathy were from factories in which solvents containing n-hexane were regularly used, and there was a significant association between n-hexane concentration in the bulk samples and prevalence of polyneuropathy. The air concentration of n-hexane in one factory in which all six employees developed polyneuropathy was 190 ppm. Workers who were exposed to n-hexane at air levels of less than 100 ppm but who frequently worked overtime showed a significant slowing of motor nerve conduction velocities on median, ulnar, and peroneal nerves. Of 13 workers who regularly slept in the factory, 12 (92%) had polyneuropathy compared to three (7%) of 46 workers who did not sleep in the factory. The outbreak of polyneuropathy was attributed to a combination of the use of solvents with high contents of n-hexane, poor ventilation, and the practice of sleeping in the factories between shifts.

  • Julie,

    The only challenge I made was to keep the faith.

    Build it and they will come. Duane already put together the floor plans, you’ve done your part in learning how to fit right in, now we just need the materials to start building.

    My comment is actually about how simple legal challenges can have the power to make broad-sweeping changes, very quickly.

    Sometimes, its not about working harder, its about working smarter through implementing the risk management process.

    NAMI has worked very hard, but they have failed to assess the risks and find less harmful options of care.

    The minority advocacy agendas have also worked very hard, but they have failed to organize an effective agenda and communicate through an alliance. It sends out a convoluted message and gives the upper hand to the majority mental health advocacy agenda.

    This case demonstrates NAMI members are not only advocating for universally accepted drug-dependent treatment plans, they are advertising them as the gold standard of care.

    That is not how Ke’onte Cook felt. He earned the right to advocate on behalf of his peers, frustrated and angry NAMI members do not.

    Jeff commented, what gives someone the “right” to call themselves a mental health advocate?

    He hit the nail on the head.

    Considering many individuals labeled “mentally ill” are among a marginalized population, and because of incarceration, hospitalization, low income, poor health, or homelessness, do not have access to the internet, they are not even aware of this case, or who is claiming to be speaking on their behalf.

    Is mental health advocacy a “right”? a privilege?
    a fiduciary relationship to everyone considered “mentally ill”?

    Should mental health advocates be held to the same ethical standards as other professionals?

    Sometimes when you are in a David and Goliath situation, it is very easy to level the playing field when you have a few giants on your side.

    Anyone claiming to be a mental health advocate and using the internet to promote their agenda, should probably start making sure they have all of their ducks in order as there are some heavy hitting watchdogs waiting in the shadows.

    For NAMI members, this is a case of wearing blinders to the problems many journalists have written about, including Pete Earley himself.

    http://www.peteearley.com/2012/05/09/abbott-board-should-be-forced-to-publicly-apologize-write-ethics-essay/

    http://www.peteearley.com/2010/01/26/pill-pushers-and-dedicated-doctors/

    •May 7, 2012, The Wall Street Journal: Abbott To Pay $1.6B To Settle Depakote Marketing Probes

    •April 10, 2012, FOX News: Shocking footage of Judge Rotenberg Center torturing a teen with symptoms of autism

    •January 19, 2012, The New York Times: J & J to pay $158 million to settle improperly marketing its Risperdal antipsychotic drug to Medicaid patients, including children.

    •Nov. 30, 2011, ABC News: Study Shows U.S. Gov. Fails to Oversee Treatment of Foster Children With Mind-Altering Drugs

    •January 25, 2011, The Boston Globe: Tufts settles malpractice suit against Rebecca Riley’s psychiatrist for $2.5m

    •The Boston Globe, March 26, 2010, The Boston Globe: Father convicted of 1st-degree murder in death of Rebecca Riley

    •March 17, 2010, CBS News: After 7-Year-Old Gabriel Myers’ Suicide, Fla. Bill Looks to Tighten Access to Psychiatric Drugs

    • January 21, 2010, The Boston Globe: Social worker warned that Rebecca Riley, 4, was overmedicated

    • January 19, 2009, MSNBC: Eli Lilly settles Zyprexa lawsuit for $1.42 billion

    • February 11, 2009, 48 Hours: Out Of Control: Enough Warning? Adderall causing a psychotic reaction

    • May 13, 2004, Dept. of Justice : WARNER-LAMBERT TO PAY $430 MILLION TO RESOLVE CRIMINAL & CIVIL HEALTH CARE LIABILITY RELATING TO OFF-LABEL PROMOTION OF NEURONTIN

    DISCLAIMER: This comment is not intended to replace medical information and its author does not give out medical advice. Withdrawing from psychiatric medications can be dangerous; consult your treating physician regarding all such treatment decisions.

  • Julie,

    At only twelve-years-old, Ke’onte Cook was able to find the advocate within.

    http://isepp.wordpress.com/2013/07/26/12-year-old-testifies-at-2011-us-senate-hearing-about-labeling-children-in-our-foster-care-system-mentally-ill/

    Do you think any NAMI member could argue with a child advocate who is advocating on behalf of his own peers?

    In the business world, mistakes/poor quality are costly. Improvements are made by implementing the 5 step Risk Management process.

    Step 1 Identify the hazards
    Step 2 Decide who might be harmed and how
    Step 3 Evaluate the risks and decide on precautions
    Step 4 Record your findings and implement them
    Step 5 Review your assessment and update if necessary

    This process can be applied to any situation/model or even routine activities that needs improvements and proactive solutions.

    This is a critical time period and all mental health advocates should be closely scrutinizing the situation at hand.

    Our mental health care system has been controlled by a powerful advocacy agenda primarily promoted by a single organization. NAMI makes false and misleading claims to be a national alliance.

    Solutions for our broken mental health care system must come from the bottom, real life situations up and not the research data information down.

    Once the playing field is finally level, we’ll all be meeting in the middle.

  • Dear AA,

    You have every right to be cynical.

    We are in a critical time period.

    Our U.S. mental health-care system is a multibillion-dollar industry

    Transparency and close scrutiny of those who have the most influence on advocacy agendas, fundraising and government spending is needed.

    One way to help those who are currently in the system would be to divert money that goes into researching the problems, and invest it into the existing hands-on nonprofit organizations that have been providing solutions.

    Researchers easily skew data, information can be misinterpreted resulting in convoluted and conflicting opinions.

    Investing in more and more research is not a proactive solution to the problems we know are taking place in the here and now.

    The Delancey Street Foundation is one of my favorite nonprofits.

    “In 1971 Delancey Street began with 4 residents, a thousand dollar loan, and a dream to develop a new model to turn around the lives of people in poverty, substance abusers, former felons, and others who have hit bottom, by empowering the people with the problems to become the solution.”

    http://www.delanceystreetfoundation.org/

    Started with $1000 and is the country’s leading residential self-help organization for former substance abusers, ex-convicts, homeless and others who have hit bottom. No mention of “mental illness”.

    CooperRiis donated $2 million dollars as seed money to start the Foundation in Excellence in Mental Health Care. It is my understanding the cost of CooperRiis is $17,000/month, although they do offer scholarships, this model does not consider those from our lower-socioeconomic class and are at rock bottom right now.

    The Salvation Army, the Rescue Mission, the Homeless Emergency Project, our Food Banks/Churches and hundreds of nonprofits in the US help individuals suffering from symptoms of “mental illness” on the most basic level, like food and shelter.

    The problems in our mental health care system stem from the age old problem of “too many chiefs and not enough Indians”.

    Journalism is a very competitive profession and thrives off of societal problems and controversial issues.

    In reality, psychiatrists and “Big Pharma” are not the only professionals who profit from having a broken mental health care system.

    Attorneys defending the “mad” and “crazy” people who commit crimes make money, attorneys suing drug companies make money, the private prison systems make money, treatment facilities make money, researchers make money and many, many others are making their living off of our broken and seriously flawed system.

    Trust comes from faith.

    Keep the faith in yourself, you’re on the right path.

  • @ Duane,

    O ye, of little faith.

    Please read this brilliantly written piece written by a dear cyberfriend and look in the mirror to see the remarkable person who wrote it.

    http://isepp.wordpress.com/2011/07/25/mental-health-freedom-and-recovery-act/

    “Imagination is more important than knowledge. For knowledge is limited to all we now know and understand, while imagination embraces the entire world, and all there ever will be to know and understand.” ― Albert Einstein

    All of the King’s researchers, and all of the King’s journalists, could never have crafted that brilliant masterpiece.

    It is a gift to us all.

    Someday the children of NAMI will thank you.

  • Dear Duane and Julie,

    I’m always the odd ball out, I’m in it to unite, stand together, share knowledge and experiences, and work together for the highest good of all involved.

    “one thing I know–that I was once blind and that now I can see.”

    I am blessed that in my darkest hour a kindhearted stranger came into my life and spent the time to show me there were alternatives, and that I was able to educate myself on what my alternative options were, options were available to me, I had the resources and the senses to make informed choices and that no one stood in my way to try them.

    “Great truths pass through 3 stages: First, ridiculed; second, violently opposed; third, accepted as self evident.” — Arthur Schopenhauer

    “Any smart fool can make things more complex or violent. A little genius and a lot of courage move in the opposite direction.” A. Einstein

    Wisdom from the Peaceful Warrior.

    http://www.peacefulwarrior.com/

    Namaste,
    Maria

  • Hi,

    If you recall, Pete’s book offers the only choice of stay on your meds and have an abortion to women who are on meds and get pregnant.

    He discouraged his son when he caught him searching on the internet for alternatives.

    When I read his book I thought, why would any parent want to take advice from a man who admits, as a father he didn’t have the skills to help his own son in a mental health crisis, so he used his professional skills to write a book to help others?

    With so many different perspectives, what gives anyone the right to call themselves a mental health advocate in the first place?

  • Hi Seth,

    The real testimony comes from Pete’s son himself.

    These videos are very sad.

    Kevin has to remind himself everyday that he is “crazy”.

    He is brainwashing himself that he is “mentally ill”…and now he is a peer-to-peer counselor to help others become “recovered”.

    His parents gave him dirty looks when he would not take his meds, his brother told him he could no longer be part of the family, if he did not take his meds, because he and his wife were having a new baby and they did not want him around if he was “crazy” and off meds.

    http://www.youtube.com/watch?v=r1j4ejK71v8&list=TL6hQ2Pxq2vxQ

    http://www.youtube.com/watch?v=hS-8O39kvG0&list=TL6hQ2Pxq2vxQ

  • Bob,

    When I first read Pete’s book “Crazy” in 2008, I immediately contacted him about concerns I had with his book.

    Because I noticed “Crazy” developing a strong influence on both our mental health care and criminal justice systems, I felt Pete’s efforts should be closely scrutinized and I have followed his blog since its creation.

    Among the concerns I brought to Pete’s attention was his investigation into the life and death of Deidra Sanbourne.

    Deidra’s symptoms were diagnosed as schizoaffective disorder and she spent over 20 years being “treated” in psychiatric wards.

    Twenty years is a very long time to be “treated” and not get any better.

    In 1988, Deidra was named as plantiff in the landmark civil rights case, Sanbourne v. Chiles. The case challenged the conditions of Florida’s mental health institutions.

    Diedra’s 2003 death, as reported by Pete, occurred from a bowel obstruction while being “treated” in a psychiatric unit at Westchester General Hospital.

    Many reviews of “Crazy” falsely state Diedra died after being neglected in a boarding house.

    The medication Clozapine is used to treat severe
    cases of schizophrenia.

    Clinical research suggests Clozapine has caused bowel obstructions leading to death in individuals being “treated” for symptoms considered to be schizophrenia.

    Deidra’s “treatment” could have caused her death.

    It is important for those who take antipsychotics to be aware of the wide range of possible side effects, so that they can recognize them, alert their prescribing physician and seek immediate help.

    It is irresponsible of Pete to ignore the possible cause of Deidra’s death and for his readers to be mislead. Pete has repeatedly shown a blatant disregard for the psychiatric drug-induced death of others.

    Pete takes a position of advocating for forced medication management, yet continually fails to warn his readers of the possible harmful/deadly side effects.

    Forced medication management, should be considered as forcing consumers to contract the services of select providers/facilities, and forcing them to purchase certain, potentially lethal, products.

    In the State of Florida, the patient is primarily responsible for the payment of “treatment” as an involuntary Baker Act commitment.

    Forced to stay, and forced to pay, just does not seem right, but that is the way it is for our mental health care patients.

    Those who advocate for forced “treatment”, that only includes medication management, should consider the fact they are forcing other consumers to purchase products that may result in their own death, at their own expense.

    They have contributed to a medication management monopoly.

    If a contract is not mutual, it should not be viewed as legal.

    Forced consumers deserve treatment options and an alternatives to being forcibly “treated”.

    While I admire Pete for his fierce stance and dedication, I do not believe he has the patience to tediously sort through and digest vast amount of research comparable to your efforts as a medical journalist and author of very well-researched books.

    Pete accurately describes himself as a “storyteller” and I do not believe any of his books site any research.

    “Storytellers” are not required to be fact checkers. They fabricate from whatever information they gather and seems to fit their opinions and supports their own beliefs, in order to create a believable story, from their own perspective, while ignoring, or belittling the perspectives of others.

    In this blog title, Pete had no right to change your presentation title from “The Case for Selected Use of Anti-Psychotics”
    to “Robert Whitaker’s Case Against Anti-Psychotics”.

    He changed a pro-best practice stance that many agree to, to a negative-based claim that you alone are making. Was he trying to create discussion, or a lynch mob?

    Pete recently wrote about medication management that, “While it may not be effective for everyone and may, as Mr. Whitaker claims, harm some, it has helped keep my son…”

    It is not YOUR claim that medications “harm some”, it is a fact.

    Where does he think the FDA warnings came from?

    http://isepp.wordpress.com/2012/06/02/1991-fda-hearings-on-prozac/

    Does he not understand, “possible side effects” means someone else actually did experience them and the drug company is now obligated to warn others?

    Does he not listen to the commercials?

    http://www.peteearley.com/2012/05/09/abbott-board-should-be-forced-to-publicly-apologize-write-ethics-essay/

    For the NAMI – “National Alliance of Mandatory-medicating-mental Illness” members like Pete, it is not a matter of opening Pandora’s Box, or pointing to bloody hands, it is a matter of taking the blinders off, putting down the boxing gloves and opening their hearts and minds to the suffering others have gone through and what they may go through as well.

    Despite the very sad “psycho-feud” going on among advocates, “it’s better to light a candle, than curse the darkness”

    Thank you for being committed and supporting individuals like the professional members of the International Society of Ethical Psychology and Psychiatry (ISEPP).

    Without the providers, patients would have no choice.

    Kind Regards,
    Maria Mangicaro
    ISEPP Volunteer

  • Seth,

    Honestly, I agree with you wholeheartedly.

    We are saying the same thing, just speaking a different language through different experiences.

    I agree with Bob and after listening to all of his online talks, I’m pretty darn sure Bob would agree with me.

    You say, every “psychiatric diagnosis” is a misdiagnosis.

    I say, all “mental disorders” are nothing more than labels that describe a behavior that the norm considers abnormal.

    These labels are used not just by psychiatrists and unfortunately, in order to get help to those who need it, we need to use labels to communicate.

    Bob uses the terms schizophrenic/bipolar all of the time in his talks.

    How else can he communicate his message without calling individuals schizophrenic/bipolar?

    Psychosis is nothing more than a word used to describe what appears to be, or may actually be, an altered state of mind/consciousness.

    Mania is nothing more than a word used to describe a very energetic brain.

    Schizophrenia is just a label placed in individuals acting differently, but perhaps dangerously.

    These are the type of “schizophrenic” stories that make our society scared of those acting differently than the norm.

    These are the type of stories that our lawmakers consider and continue to empower psychiatrists as the experts, despite the fact the medications/withdrawal effects may have been a contributing factor to the danger to public safety.

    http://www.dailymail.co.uk/news/article-1386762/British-woman-beheaded-Tenerife-machete.html

    In third world countries, Shamans/Gurus use hallucinogenic substances, or deep meditation to achieve an altered state of mind/consciousness/energetic brains and their society accepts them.

    I am not a Shaman but I did have similar experiences. I did not use hallucinogenic substances, I was exposed to a number of different toxic substances that eventually had a synergistic effect that produced the same as hallucinogenic substances. I suffered an organic psychosis, toxic encephalopathy. It was a closed head injury, the toxins I worked around can cause neuropsychiatric disorders and that is what caused my initial symptoms.

    The most simple way that it was described to me was my brain was swelling and I suffered organic brain damage that was successfully treated. I I had a very broken brain, literally and I was labeled bipolar, schizoaffective and schizophrenic. I relate well to individuals with TBIs because I also suffered a closed head injury causing cognitive deficits, and to this day still have residual effects of memory/neurological/cognitive problems/multiple chemical sensitivities/autoimmune disorder.

    In the United States some of the most horrific tragedies have involved individuals in altered states of mind/consciousness.

    Having a very energetic brain can lead to erratic behavior/spending, etc. and have permanently damaging effects on one’s life.

    No one is immune from suffering an altered state of mind/consciousness that can have damaging effects and lead to being labeled with a “mental disorder”.

    Those concerned with how they/their loved one would be treated should have a Psychiatric Advance Directives in place.

    Altered states of mind/consciousness due to a Medical Condition involve a surprisingly large number of different medical conditions, including but not limited to: brain tumors, cerebrovascular disease, Huntington’s disease, multiple sclerosis, Creitzfeld-Jakob disease, anti-NMDAR Encephalitis, herpes zoster-associated encephalitis, head trauma, infections such as neurosyphilis, epilepsy, auditory or visual nerve injury or impairment, deafness, migraine, endocrine disturbances, metabolic disturbances, vitamin B12 deficiency, a decrease in blood gases such as oxygen or carbon dioxide or imbalances in blood sugar levels, and autoimmune disorders with central nervous system involvement such as systemic lupus erythematosus have also been known to cause altered states of minds leading to the dx of sz/bp.

    A substance-induced altered state, by definition, is directly caused by the effects of drugs including alcohol, medications, and toxins. Psychotic symptoms can result from intoxication on alcohol, amphetamines (and related substances), cannabis (marijuana), cocaine, hallucinogens, inhalants, opioids, phencyclidine (PCP) and related substances, sedatives, hypnotics, anxiolytics, and other or unknown substances. Altered states can also result from withdrawal from alcohol, sedatives, hypnotics, anxiolytics, and other or unknown substances.

    Some medications that may induce altered states include anesthetics and analgesics, anticholinergic agents, anticonvulsants, antihistamines, antihypertensive and cardiovascular medications, antimicrobial medications, antiparkinsonian medications, chemotherapeutic agents, corticosteroids, gastrointestinal medications, muscle relaxants, nonsteroidal anti-inflammatory medications, other over-the-counter medications, antidepressant medications, neurleptic medications, antipsychotics, and disulfiram . Toxins that may induce altered states include anticholinesterase, organophosphate insecticides, nerve gases, heavy metals, carbon monoxide, carbon dioxide, and volatile substances (such as fuel or paint).

    The ENERGY & COMMERCE COMMITTEE’s Examination of SAMHSA’s Role in Delivering Services to the Severely Mentally Ill, indicates that those of us concerned with alternatives to medication management are in critical time period and we need to figure out how to communicate our messages effectively to those in control of our mental health care system.

    Our lawmakers are the ones who empower the Medication Management Monopoly.

    This hearing should be sending off an alarm to all advocates concerned with advancing the availability of alternative therapies.

    http://energycommerce.house.gov/hearing/examining-samhsas-role-delivering-services-severely-mentally-ill

    Seth, I am enjoying this exchange, thank you for your comments. It’s the best way to flesh out ideas on how to communicate effectively to the main stream.

  • Hi Seth,

    I know u will find this hard to believe, but we’re on the same side, we just come from different backgrounds, have had very different experiences and have very different perspectives.

    I come from a working class family.

    I spent 15 years in the graphic arts industry, which involved fast-paced production while adhering to strict deadlines. Maintaining profits meant perfecting one’s craft and a zero tolerance for error.

    As a consumer, I make wise choices.

    During my recovery I spent time volunteering as an arts and craft instructor for individuals who suffered TBIs, all of whom were on antiseizure/psychotic meds and also labeled with “mental illness”.

    In a flash of an instant, these individuals lost so much of their life from car/motorcycle accidents, brain aneurysm, strokes, etc. For one man, that is all it took was a mosquito bit to suffer Equine Encephalitis and end up labeled “mentally ill”.

    Spending time with these individuals was priceless. Together we produced beautiful artwork and crafts and at the end of the season we had an art exhibit at a local cafe. Sharing the joy they experienced as their finished pieces were framed and hanging was shear joy. To be part of their life was truly a gift in itself.

    As a patient, I would often use artwork to cheer up other patients. Many who had birthdays really appreciated getting a handmade card signed by all of the other patients. It would be the only form of celebration they had. I would also make calendars for patients because we would lose track of what day it was, when our family members had birthdays, when the holidays were and when our bills were due.

    Sometimes I wonder if mental health advocates are even aware of the small items lacking in these overpriced psych wards. Decks of cards, calendars, magazines, books, art supplies, paper, pens, board games, DVDs/CDs, extra clothing, these are all things in need at many psych wards.

    From a patient’s perspective and from the perspective of a friend to individuals with TBIs, Dr. Foster’s description of a patient as “a bottomless pit of needs” were very upsetting.

    And for him to decide that “In her case, keeping her semi-sedated makes some sense–to spare herself and society the legal and criminal consequences of her mind unleashed.” demonstrates the control medical professionals believe they have over their patients. They decide who is worth helping and who should be kept drugged.

    From a common sense perspective, it is wrong for a doctor to discuss his patient’s history in such detail in public. This patient is entitled to her privacy. If this woman did have blonde hair, then he is identifying a specific trait and violating her privacy rights.

    The case below exemplifies the problem of our medical and mental health professionals using the DSM 5 with a “Chinese Menu” approach.

    This case happened at the same hospital I was misdx’d at and the same hospital Dr. Szasz was Professor of Psychiatry Emeritus at.

    This is the result that we should be striving for “no longer required further psychiatric medication or therapy.”

    And for this “mentally ill” patient, steroids were the answer.

    Working within the existing parameters of Psychiatryland, in order to have zero tolerance for cases like this, can we agree that this “Chinese Menu” approach needs to go?

    Neuropsychiatric systemic lupus erythematosus presenting as bipolar I disorder with catatonic features.
    Posted on November 25, 2012 | Leave a comment
    Psychosomatics. 2009 Sep-Oct;50(5):543-7.
    Alao AO, Chlebowski S, Chung C.
    SOURCE
    Department of Psychiatry, SUNY Upstate, NY 13210, USA. [email protected]

    ABSTRACT
    BACKGROUND:
    The American College of Rheumatology has defined 19 neuropsychiatric syndromes associated with systemic lupus erythematosus (SLE) involving the central, peripheral, and autonomic nervous systems. Neuropsychiatric manifestations of lupus (NPSLE) have been shown to occur in up to 95% of pediatric patients with SLE.

    OBJECTIVE:
    The authors describe a 15-year-old African American young woman with a family history positive for bipolar I disorder and schizophrenia, who presented with symptoms consistent with an affective disorder.

    METHOD:
    The patient was diagnosed with Bipolar I disorder with catatonic features and required multiple hospitalizations for mood disturbance. Two years after her initial presentation, the patient was noted to have a malar rash and subsequently underwent a full rheumatologic work-up, which revealed cerebral vasculitis.

    RESULTS:
    NPSLE was diagnosed and, after treatment with steroids, the patient improved substantially and no longer required further psychiatric medication or therapy.

    CONCLUSION:
    Given the especially high prevalence of NPSLE in pediatric patients with lupus, it is important for clinicians to recognize that neuropsychiatric symptoms in an adolescent patient may indeed be the initial manifestations of SLE, as opposed to a primary affective disorder.

  • Dear AA,

    Thank you for replying to my comment.

    Your two cents are worth a lot in common sense.

    When it comes to mental health care, we are really in a Seven Blind Men and an Elephant situation.

    Because so many lives are at stake, including those who may be harmed by someone who are accurately described as being in a psychotic state, we really need to work hard at being patient and understanding every perspective.

    Everyone has insights in to the problem but many have their blinders on to the problems others face.

    I have witnessed first hand how primary care physicians have mishandled individuals suffering from insomnia and led to the destruction of their life because of treatment with psych meds.

    I’ve dealt with insomnia myself and it can be unbearable.

    Six years ago I had the opportunity to have dinner with a very well renown advocate who traveled 3000 miles to attend a conference in my area. They are known for their strong stance against psychiatry and were dx’d sz themselves. They had to cut our evening short because they needed to take an Ambien early on so they would not be groggy in the am.

    The following year, while volunteering at a conference for a nonprofit mental health advocacy organization I noticed the Executive Director did not look well. I asked them if they were ok and they said yes. It was easy to recognize they were in some serious pain, so I asked once again if they were ok. They said they had a bad migraine and would be ok soon because they just took a vicodin.

    If intelligent individuals who know the risks and are capable of looking into the alternative still want to rely on medications, that is their choice.

    Who am I to judge?

    Robert Whitaker has stated in his lectures that Anatomy of an Epidemic does not take an anti-medication/psychiatry position and that medications will always have their place.

    Considering many individuals who take psych meds are happy taking them, that seems like the most rational, commonsense perspective to take.

    We need to continue to question, we need to continue to rationalize, we need to continue to share our opinions without overly criticizing.

    Personally, Dr. Kayoko Kifuji, the psychiatrist who treated Rebecca Riley and her siblings, makes me sick to my stomach.

    I would gladly pay out of my pocket whatever the costs are to have her deported back to the apparently Godless country she came from.

    http://isepp.wordpress.com/2011/04/27/2-5-million-settlement-in-wrongful-death-of-rebecca-riley-against-psychiatrist/

    http://www.patriotledger.com/news/x905416295/Rebecca-Riley-s-doctor-on-the-defense

    In the US we “celebritize” and care about the problems of some, and turn a blind eye to the suffering of those who do not get their story sensationalized by the media. Those who are labeled “schizophrenic”, “mentally ill”, “psychotic” are especially among a marginalized population that our society has historically not given a crap about, taken advantage of and profited from.

    How can we send Michael Jackson’s doctor to jail and still let the doctors who treated children like Rebecca Riley and Gabriel Myers remain in practice?

    http://isepp.wordpress.com/2011/11/07/drug-styles-of-the-rich-and-famous-a-guilty-verdict-in-the-murder-trial-of-michael-jackson-what-the-jurys-decision-could-mean-for-the-rest-of-us/

    How can we place recalls on tricycles and bean bag chairs, yet allow harmful psych meds to be passed out like candy?

    How do we allow a pharmaceutical company to openly state, “despite the slaying” a medication is still a fine and dandy solution for ADHD?

    http://uniteforlife.wordpress.com/2012/04/04/if-pharma-made-trikes-buyer-beware/

    My perspective may seem “inconsistent” but that is only because the nature of mental health advocacy itself is schizophrenic.

    As much as there are horrific problems in our mental health care system, lumping all psychiatrists in the category of bad professionals is not something I can do.

    I have been under the care of and have met many psychiatrists who use medications with a best practice, judicious approach and are very compassionate individuals who offered talk therapy when I was off meds.

    I have met 3 psychiatrists from my hometown of Syracuse, NY who were trained in acupuncture and offered it to their patients. One would do it for free to his patients who could not afford it. I have met psychiatrists who are knowledgeable in vitamins and made recommendations to me. They were open to the use of complimentary therapies and happy to hear of my success.

    I believe in the benefit of the Participatory Medicine movement and collect information on participatory concepts in mental health care.

    http://participatoryconcepts.wordpress.com/

    To me it is not about fighting psychiatry or Big Pharma.

    It’s not about fighting the opinion of a chemical imbalance or what method works best or what the latest research shows.

    It’s about getting the labels off of people and the options they would like to choose available to them.

    It’s about waking up to the needs of others and meeting those needs.

    I like Robert Whitaker a lot.

    He has a very likable personality and everyone seems to take to him very easily.

    He is very intelligent and speaks in a very calm tone that is easy to listen to.

    Although he does not consider himself a mental health advocate, if you look at the definition of “advocate”, he is certainly acting in the capacity of one.

    I appreciate his effort as a journalist who has focused his efforts on change in our mental health care system and the tremendous amount of time and energy putting together this forum for discussion.

    I can only imagine how exhausted he must be after his lecture and travels around the globe.

    He has sacrificed his personal time with his family for the cause of mental health advocacy, and that is admirable.

    In the US, our society suffers from Infectious Cronkitis.

    We expect our journalists to digest large amounts of information for us and then regurgitate it back and spoon feed us the key points.

    We consider our journalists as our middleman to the best of the so-called experts. Because of their profession, they have access to resources that the average person does not. They have a limited perspective but their view are highly regarded.

    Personally, from the perspective of an individual who was considered a “psychotic” patient, I greatly appreciate the efforts of CCHR.

    Actor Tom Cruise is the only well-known celebrity that has spoken out for our rights.

    It doesn’t matter to me if Tom was a Scientologist, a Wiccan, a devotee or Sai Baba, or a Catholic priest, he spoke the truth and revealed it with a feverish passion.

    This is the type of individual I want in my corner as an advocate.

    Personally, I found Bob’s comment in this interview very disturbing and I hope he would consider the many individuals who credit CCHR with saving their life.

    http://motherboard.vice.com/blog/why-psychiatry-embraced-drugs-an-interview-with-author-robert-whitaker

    “You mentioned Eli Lily and their response to data showing Prozac being associated with suicidal ideation, and how scientology and its views on psychiatry entered the picture.”

    “I made a little joke in the book about psychiatry secretly funding scientology, but really, it couldn’t have worked out better for the pharmaceutical companies and biological psychiatry. The reason is that, of course, it delegitimizes criticism. The fact that scientology is so visibly attacking biological psychiatry and attacking psychiatric drugs delegitimizes all criticism. Scientologists clearly do have a cult-like status and they clearly do have an agenda. The fact that they’re so visible makes it very easy for psychiatry and pharmaceutical companies to say, “This is just criticism coming from that crazy group.”

    Some of the stuff, they’ve gone into the data and they’ve brought out some information. Because it was scientology and CCHR that was out front with the criticism and raising questions and raising accusations that these drugs were causing suicide and violence, just made it really easy for pharmaceutical industry and Eli Lily to have it dismissed. If we didn’t have Scientology. Imagine it doesn’t exist and there’s no such group raising criticism. The questions around whether Prozac can stir violence or could cause someone to become suicidal or homicidal would have had a lot more traction.”

    I advocate from an open, honest, commonsense perspective that is willing to listen to others.

    Areas of my interest involve

    1. preventing the misdiagnosis of individuals suffering from symptom accurately described as mania/psychosis

    2. advancing participatory concept of mental health care

    Thank you for being open-minded and listening to what I have to say.

    Kind Regards,
    Maria

  • Hi Marian,

    Thank you for your reply.

    Your question to me is:

    “What would you do if somebody told you they were hearing the voices of a bunch of bullies that they’ve actually been stalked by in the past?”

    I would just listen to the person.

    I’m a very good listener and would have plenty of bullying experiences to share with them.

    If this individual wanted the voices to stop, and for some strange reason preferred the advice of Cashier Maria, over that of an experienced mental health professional, I would suggest they learn more about Bioenergetic Therapy, as I found this type of mind-body work extremely powerful and effective for emotional trauma.

    If they told me they were having visual hallucinations along with hearing voices, I would strongly suggest to them to have Functional Lab testing done because there is probably an organic contributing factor to this problem that when addressed would improve their overall health. If they had insurance, an MRI is always nice to rule out a brain tumor.

    If they seemed like Jason Russell, I would suggest they drink a lot of water.

    https://www.youtube.com/watch?v=TjdH2LDH5LM

    If they had a Marty Feldman look, I would suggest they have their thyroid checked.

    If they drank a lot of caffeine, used illegal drugs, alcohol, or smoked cigarettes, I would suggest they cut down as those could be contributing factors.

    If they told me they had not slept in 7 days, I would highly suggest they look at all of their options and figure out the best way to get some sleep, because after 8 days without sleep you could die.

    If they told me they had recently ignored a bad tooth ache, I would strongly advise they no longer ignore it and get it treated as soon as possible. And also make sure their dentist prescribes the antibiotic flagyl because it is an anaerobic bacteria that could have festered, spread to their brain and is now affecting their ability to think clearly.

    If they could not afford the dentist, I would suggest Oil Pulling, Mrythe, garlic and try to get a prescription of flagyl from their PC.

    http://www.amazon.com/books/dp/0941599671

    Dental care is very important to our overall health and definitely can have negative impact on our mental state. Although I am not a medical professional, I have been in psych wards enough to recognize many of our “psychotic” patients have personal hygiene issues and have been lacking adequate dental care.

    I think it is important to consider psychosis, mania, schizophrenia, bipolar disorder, etc. are nothing more than labels that describe behavior.

    They can be very accurate descriptions, so therefore they seem very real and we need some form of communication other than referring to people as “crazy”.

    http://www.youtube.com/watch?v=J6GrxUjePuY

    http://www.youtube.com/watch?v=OAy8IVvS_wA

    I have a lot of friends who are psychics/mediums who hear voices/have visions/see spirit-beings. I don’t judge anyone as psychotic for hearing voices/seeing things that I don’t.

    I also have had friends who heard voices that told them to do very harmful things to others/themselves and became labeled schizophrenic.

    Sometimes I wonder if I was the only person on the planet who read a small article published in the USA Today back in 1999 that stated:

    “despite the slaying, Adderall remains a safe and effective drug for controlling AD/HD.”

    http://isepp.wordpress.com/2011/04/20/23/

    Ryan Ehlis suffered a Substance Induced Psychosis.

    Many other “psychotic” patients have also suffered psychosis from a substance, or a medical condition.

    Open Dialogue fails to acknowledge these cases and would leave many at a loss.

    Many of our “psychotic” patients are limited to their choices of treatment because they can not afford anything other than what their insurance/prison/jail will give them.

    My goal as a mental health advocate is to get patients choices in the help they receive.

    Kind Regards,
    Maria

  • Duane,

    What we need in mental health advocacy is teamwork.

    Is there any issue that all mental health advocates can set aside their differences and all agree on?

    As an experience “psychotic”, I can tell you psychosis has many tricky aspects.

    The first tricky aspect is the fact many spiritual/creative connections can be made and there are some individuals who are able to handle this kind of extreme energy/state.

    I admit, getting “messages from God” is pretty amazing but psychosis can get very hairy and as we see sensationalized in the news all of the time, can be very dangerous, or have deadly consequences.

    As Joseph Campbell said, “the schizophrenic drowns in the same waters in which the mystic swims with delight.”

    Unfortunately, if a first time “psychotic” patients acts like Adam Lanza, Jared Loughner, or James Holmes, the primary concern is for public safety, and further supports the position of those in favor coercive psychiatry.

    Bob addresses the nature of psychosis correctly in several of his lectures when he states psychosis CAN have “flu-like” characteristics of coming and going on its own.

    This makes sense when you consider a psychotic state CAN be caused by a bacteria/virus, or environmental allergens.

    Unfortunately, if a psychotic state results in a massacre of US children, what is being done in Finland becomes irrelevant.

    Success rate for “psychotic” patients can be improved by developing an awareness of what can exacerbate symptoms.

    While for some individuals conditions manifest as neurological problems, for others, psychotic symptoms are our weakest link.

    Recovery rates are tricky because there are many other conditions can exacerbate symptoms even decades later in life.

    For some of us, the routine use of over-the-counter cold medicine, pain killers, or an untreated abscessed tooth can cause psychotic symptoms.

    By having an awareness of this, we are able to be proactive in preventing symptoms from exacerbating.

    Open Dialogue and Soteria are reactive solutions, they ignore the possible underlying causes and do not give rise to proactive, preventative solutions.

    Just like patients have the right to know about the potential harmful side effects, our “psychotic” patients have the right to know about possible underlying causes.

    Just because us “psychotic” patients may seem crazy, does not mean that we are stupid.

    From an economic standpoint, treating the underlying condition save $$$$$ for the patient and the taxpayer.

    Unfortunately, many professionals loose out.

    The blame always seems to go on psychiatry/Big Pharma. The fact is there are many who profit from our “psychotic” patients.

    I have an NAMI – MIA Charitable Donation Challenge.

    I am seeking to raise $3 million dollars to build a retreat at a nonprofit organization I am a volunteer at.

    I challenge every NAMI member, along with every MIA blogger and commenter to answer this question;

    If you, or a loved one, experienced an acute psychotic episode would you want:

    a.) to go to a psych ward and trust main stream psychiatry

    b.) no treatment at all because you want to live through the experience

    c.) go live at the Soteria House in Alaska

    d.) go to Finland for treatment

    e.) take the advice of Cashier Maria and make sure your doctor abides by Best Practice Assessment guidelines, and uses Functional Lab work to test for and treat possible underlying causes

    f.) other, please explain your answer

    If you selected answer e.

    would you please consider chipping in a dollar or two for a NAMI – MIA Charitable donation to my favorite nonprofit organization, Quantum Leap Farm?

    http://quantumleapfarm.org/

    Seriously, we don’t need to go to Finland, and we don’t need any more research.

    Enough research and case studies already exist in a massive overload of information in our medical libraries.

    We just need to ensure best practice standards are met and support the many wonderful organizations here in the US like Quantum Leap Farm, the Delancey Street Foundation, the Homeless Emergency Project, the Salvation Army, etc., etc.

    http://www.delanceystreetfoundation.org/

    If you are a mental health advocate, please consider supporting the organizations that are providing hands-on help for those suffering from symptoms of severe mental illness.

  • Hi Seth,

    Thank you for your critic of my comment.

    Although I do like the sound of “Dr. Mangicaro”, I go by the title of “Cashier Maria” at a local retail store.

    While I understand your harsh criticism of a perspective different than yours, I hope that you would take the time to get to know me better so that you would be able to understand my perspective and I will feel welcome on this site.

    I usually don’t bother commenting anymore because of the hostile nature of those who do not accept my perspective and it is time consuming to try and explain.

    I would like you to know that I am a very honest, hardworking individual who is very passionate about everything I do.

    Arrogant, no, tenacious, you bet.

    I am also very thorough.

    Although I am only a cashier, as a mental health advocate and volunteer for several nonprofit organizations, I strive to listen to and understand the perspectives of others, while maintaining a high level of ethical standards.

    To give myself some credibility as an honest, trustworthy individual, here are two recent letters sent out by my store manager about the bullying prevention volunteer project I have initiated at our local schools. The project supports the use of team building skills as a bullying prevention tool:

    “Thank you so much for all you do for our community and especially for the
    children. I admire you and respect you so much for what you do. You are so
    generous and compassionate. It seems that there is no limit to what you are
    willing to do to help those that need it most. You are an inspiration. I am so
    proud to have you on our team and thankful that you’ve chosen to be our
    ambassador in the community.”

    “Our Cashier Maria Mangicaro has single-handedly led our anti bullying campaign
    this school year. She involved many team members in a number of local schools.
    One of the school we partnered with on a number of events awarded
    us their Business Partner of the Year award. We will continue to spread the anti
    bullying message next school year.”

    I became a mental health advocate after experiencing the problems in our mental health system first hand as a “psychotic” patient, as well as understanding the problems of others as an acquaintance, a roommate, a friend and a caretaker to many other “psychotic” patients.

    Because it took the life of my father and nearly killed me, I would never underestimated the harm done by psychiatry.

    However, I respect the opinion of others who claim psych meds, ECT, and psychiatry have saved their life/the life of their loved one.

    I experienced psychosis as a result of lead and chemical poisoning from long-term exposure while working in the pre-press department of a printing company.

    While the spiritual aspects, the extreme creativity and the “messages from God” were really very cool, the key word here is

    “POISONING”,

    not cool at all and treatable through a mutlimodal approach of Orthomolecular treatments/detoxing therapies.

    Honestly, I didn’t need Bob or Dr. Breggin to show me neuroleptics are so dis–abling.

    I was able to experience first hand severe-Parkinsonslike syndrome, tardive dyskinesia, excessive weight gain and a host of other dis-abling side effects from a wide variety of psych meds.

    I also found out on my own that an abscessed tooth can sure as hell exacerbate symptoms of psychosis.

    Not cool either. The experience was torture and nearly killed me.

    Not all psychoses are created equal and some can lead to fatal consequences.

    A friend who I shared my experiences with told me about his 21-yr-old niece from Rochester, NY who also experienced similar symptoms and became labeled with bp. As the symptoms progress, her doctors thought she had MS but later they found she was suffering from CJ Disease and she died a horrible death.

    Albeit rare, our “psychotic” patients have the right to know they may be suffering from a fatal condition.

    I’m happy others were/are being helped through Open Dialogue and Soteria, but for many of us “psychotic” patients, in order to become “un-psychotic” we need treatment for the underlying medical condition.

    I was extremely fortunate that when I was at my wits end of dealing with repeat bouts of manic/psychotic episodes, I was introduced to complimentary therapies that I had access to and was able to afford.

    Our “psychotic” patients get passed off to psychiatry, or our prison systems, because on a large-scale basis, no one else wants to deal with us.

    Most primary care physicians do not have training to deal with patients in psychotic states.

    We should consider what a primary care physician wrote on his MIA blog about one of his patients:

    “She is a difficult patient, a bottomless pit of needs with no coping mechanisms, and I don’t have a clue how to help her. She is truly a “broken brain”–literally–and will always be disabled. In her case, keeping her semi-sedated makes some sense–to spare herself and society the legal and criminal consequences of her mind unleashed. It seems to be what she wants.”

    Because psychosis involves people who are a “threat to society”, the law entrusts psychiatry with our care.

    The “it’s better for society” mentality stems back to the 1927 US Supreme Ct decision of Buck v. Bell.

    If we really want to fight coercive psychiatry, we need to create an awareness of the reasons why a psychotic episode can suddenly and without warning occur.

    Past exposure to lead is a darn good reason why.

    Even dehydration, excessive caffeine intake, the flu shot, or the routine use of over-the-counter cold medicine can cause psychosis.

    These are basic facts and it makes sense for all advocates to work together and create public awareness.

    In order for Soteria to be accepted, we need to listened to the concerns of others. The neighbors of Soteria in Alaska described it as a “ticking time bomb”. The para-professionals at Soteria were not able to prevent the death of Mozelle Nalan.

    http://www.ktva.com/home/top-stories/Assisted-Living-Home-Where-Shooting-Took-Place-Responds-124903434.html

    Individuals who are labeled with “mental illness” deserve a chance.

    Unless we can explain why psychosis can occur, our “psychotic” patients will always be at the mercy of psychiatry.

    My goal as a mental health advocate is to call attention to the many underlying causes of psychosis, so that individuals who are “psychotic” patients will have access and the ability to make choices for the care that is most effective for their individual circumstances.

    If our society wants to force our “psychotic” patients into treatment, that treatment must include testing for and treating the underlying cause.

    Open Dialogue and Soteria are reactive solutions.

    When it comes to psychosis, advocates need to support proactive, preventative solutions.

    Understanding what causes psychosis can help prevent it.

    While I am certainly no doctor, I did have a medical-reviewed narrative published in the Journal of Participatory Medicine.

    It took me six months working with the editors (six medical doctors) to get this narrative approved for publishing.

    Mine is the only narrative the journal published in which the editors requested research to support.

    Several of the doctors objected to publishing it because they felt it might encourage other “psychotic” patients to go off medications. They also changed my title to “possibly linked to”, instead of “linked to”

    http://www.jopm.org/perspective/narratives/2011/03/28/psychosis-possibly-linked-to-an-occupational-disease-an-e-patient%E2%80%99s-participatory-approach-to-consideration-of-etiologic-factors/

    Please do not take offense, but the best minds in the field on Mad in America blog have completely left out any mention of Orthomolucular concepts, Functional Medicine, Integrative Psychiatry.

    I don’t understand why these concepts are being left out on this site.

    It sure seems as if our “psychotic” patients are being caught in the middle of an internet-based egotistical battle between psychiatrists v. psychologists.

    Many of our “psychotic” patients are among a marginalized population and who because of incarceration, hospitalization, low income or homelessness, do not have access to the internet.

    Those who want treatment for underlying medical conditions and are being denied, deserve a voice and those are the individuals that I continually advocate on behalf of.

    I have been a “psychotic” patient and I advocate for others the same as I would for myself or a loved one.

  • Duane,

    The good Lord does work in mysterious ways but this sure seems more like Texas hold ’em, with the expected gain being on Open Dialogue.

    In cases of psychosis;

    Medication Management – Best Practice Assessment = a medical story of continuing harm done

    Psycho-social alternatives – Best Practice Assessment = a medical story of continuing harm done

    Our “psychotic” patients have the right to know what caused their symptoms.

    I fought for my rights to know by going to the medical library myself and pulling out numerous studies to support a worker’s comp case.

    When I could not find an attorney to represent my case, I represented myself.

    When I finally did find an attorney, in order to get opinions in my favor, I needed to write him questions during the depositions with my doctors because he didn’t know anything about my case.

    When a psychiatrist treated me badly and billed my insurance company over $4000, I wrote a letter to the insurance company and he accepted payment of $4.56.

    When another ER psychiatrist denied me access to medical treatment and assumed I was manic, I filed a complaint with the Division of Human Rights for denying public accommodations and received a settlement.

    When a treatment facility billed me for over $8000 for forced treatment, while ignoring the fact I had an abscessed tooth and was in need of treatment, I filed a complaint that it was an illegal, forced contract that interfered with my right to contract medically necessary treatment. They dropped the entire bill.

    My tenacious self will continue to fight tooth and nail to ensure our “psychotic” patients receive treatment options that incorporate best practice standards.

  • In wake of the Sandy Hook massacre, the Aurora shooting, the Tucson shooting, the deaths of Kendra Webdale/Mozelle Nalan, and the extremely long list of U.S. tragedies involving “psychotic” individuals, it is time for mental health advocates to develop a strong, unified advocacy agenda that incorporates best practice standards of assessment and care for our “psychotic” patients.

    Medical and mental health professionals, not just psychiatrists, must to do the right thing and acknowledge that, if we want individuals who seek, or are force into treatment, to have the best care, our treatment and criminal justice facilities must be proactive and test for the many underlying causes of psychotic symptoms.

    For the most part, psychiatrists, psychologists, other medical/mental health professionals use the DSM 5 with a “Chinese menu” approach.

    The DSM 5 includes “Substance/Medication-induced psychotic disorder” and “Psychotic disorder due to another medical condition”

    unfortunately, no one ever seems to consider them.

    Patients who suffer psychotic/manic symptoms are rubber-stamped with the label of schizophrenia/bipolar

    While there are no biological tests to determine a patient has sz/bp, there are many tests to prove “psychotic” patients do not have sz/bp and are SUFFERING from underlying medical condition.

    The concepts of Open Dialogue and Soteria means “psychotic” patients will continue to SUFFER while the underlying cause goes undetected and untreated. This is cruel and potentially harmful.

    In his book “Mad in America”, author Robert Whitaker points out historically cases of “insanity” were cured by treating infected teeth.

    This still holds true today.

    Proper psychosocial support

    or, a root canal for an abscessed tooth?

    If you were a “psychotic” patient and in need of both, which one would you want first?

    From my personal experience, take the root canal.

    Many individuals labeled with sz simply need dental care, while others are suffering from lead poisoning, Lyme disease or a host of other underlying conditions caused by toxins, bacteria, viruses, or other medical conditions.

    On average, people with severe mental illness die 25 years earlier than the general population. Advocates can no longer ignore the fact underlying conditions of psychosis are being ignored and untreated. We need to work together to ensure best practice standards of assessment are met.

    While Open Dialogue and Soteria are nice concepts, I would think any reasonable person would conclude that the care of “psychotic” patients should be entrusted to those who implement best practice assessment standards.

    The British Medical Journal put together a very nice guideline. It would be nice if advocates supported the use of it.

    http://psychoticdisorders.wordpress.com/bmj-best-practice-assessment-of-psychosis/

    MIA blogger, psychiatrist Vivek Datta, recently made this comment evidencing the fact mental/behavioral health facilities fail to provide patients with the same standard of care others patients are given:

    “I do my best to do a thorough neurological examination and assessment of the cognitive state in my evaluations that would point towards a toxic-metabolic encephalopathy or secondary cause of the person’s mental state, and where indicated various laboratory and radiological investigations. Unfortunately today, many psychiatrists have very little postgraduate medical and neurological training, and are only expected to know when another medical condition may be contributing to a patient’s mental state rather than to look for the cause. This is in my view a tragedy, as the value of a good psychiatrist, is the medical training and the ability to be able to recognize the wide range of conditions (endocrine, metabolic, nutritional, neoplastic, autoimmune, systemic etc) that can cause neuropsychiatric disturbances and present as “depression”, “mania”, “psychosis”, “confusion” and so on. It begs the question of what use is a psychiatrist if she cannot use this supposed medical expertise.
    Unfortunately, this situation is compounded as there is no real mental health parity in the US. As a result, unlike in almost any other hospital service, psychiatry is unable to bill for blood tests, brains scans, lumbar punctures etc, in the inpatient setting. The result is there is a financial disincentive to NOT look for other causes contributing to the mental state. In fact, management often breathes down our necks if we DO investigate and treat medical conditions that are either comorbid or contributory! Until this changes, I do not see the culture shifting.”

    When it comes to psychosis, psychiatry has created a medication management treatment monopoly.

    I don’t understand how Open Dialogue and Soteria are taking a precedent over Best Practice Assessment standards.

    My optimistic self hopes advocates involved in MIA will do their best to advance best practice assessment standards, while my realistic self knows it’s like talking to a door freaking knob.
    (Beside you Duane)

  • Hi Kathy,

    I am a mental health advocate and a volunteer for several nonprofit organizations, including the International Society for Ethical Psychology and Psychiatry (ISEPP).

    Robert Whitaker has been a past conference presenter for ISEPP and will be presenting at ISEPP’s upcoming conference in November.

    I attended my first, and last NAMI convention in 1999.

    While it was one of the most impressive events I have ever been to in my life and I appreciated the chance to meet William Styron, I did not like the fact one of the psychiatrists who presented falsified the information and admitted to it. The audience thought nothing of it and he even made a joke about it. I walked out of the conference extremely disappointed as there is such a need for a strong, unified alliance to help those in our mental health system.

    As a parent, I can certainly understand your fears.

    I have been in the position of a caretaker for loved ones suffering from symptoms of mental illness. I can also relate to your son’s experiences, as I have also been a person who suffered from symptoms of severe mental illness and needed to be cared for. I also know what it is like to suffer severe side effects from medications and the costs involved in being in our mental health care system.

    I know what it is like to feel that you have put your trust in the wrong hands and I know what it is like to find information and professionals you can trust implicitly.

    After suffering an acute manic episode in 1996, I put my trust and faith in the main stream medical model.

    I was labeled with bipolar disorder and lead to believe it was a hereditary condition.

    I was 33 years-old at the time and had no prior symptoms of either mania/depression.

    After a second manic episode in less than one year, I started became more proactive in searching for information. I put my trust in higher powers and put my faith into my ability to seek out and find answers to my many questions.

    The first step I took was signing up for night courses in Abnormal Psychology and Anatomy and Physiology, as well as attending support groups to learn from others.

    I approached the situation with an open-mind and a blank slate.

    While it might seem like a Pandora’s Box situation, in reality it is a matter of taking off our blinders.

    Mental health advocates are in a “Seven Blind Men and an Elephant” situation.

    Many of Bob’s lectures are available online. The one on C-SPAN is very good and Bob makes his concluding statements very clear.

    My interpretation (summarized) of Bob’s beliefs regarding the treatment of psychosis are:

    – the research supports short-term efficacy of antipsychotics and long-term chronicity

    – the comparison research from 1945-55 involved treating psychotic episodes with hospitalizations that lasted between 12 months and five years.

    – his book is not a medical advice book and does not encourage patients to go off of medications (although some psychiatric patients have gone off medications after reading Anatomy)

    – he believes psychiatric medications have a place in mental health care

    – Anatomy of an Epidemic does not take an anti-medication position and is in fact a “pro-med”, best use practice

    – when considering psychotic patients, some will do better off meds, while others do better on meds

    – he believes the psychophramacology paradigm is a failed revolution

    – psychotic episodes have flu-like characteristics of coming and going on their own, treatment with medication is the best approach to quickly stabilize

    – his appeal is to create a national discussion that incorporates the long-term data

    What I found the most surprising about Bob’s invitation from NAMI was the fact Pete Earley offered bloggers money to write about his presentation.

    In his blog, Pete changed the title of Bob’s lecture from the “selective use of antipsychotics” to “against” antipsychotics. This simply is not true and in my opinion is an attempt at a “shoot the messenger”.

    As an investigative reporter himself, why doesn’t Pete read Mad in America and Anatomy of an Epidemic himself, listen to Bob’s lectures online and write his own opinions.

    I’ve written extensively to Pete and have gotten no response. He has blocked my ability to comment on both his site and his Facebook Fan page. He is an individual who I do not trust.

    His perspective is extremely limited. He rushed to write a book without first taking the time to find the best approach to help his own son.

    He strongly promotes the use of antipsychotic medications, and downplays the serious, harmful side effects. He fails to warn his readers and presents a very misleading dialogue on his blog.

    In his book he researched and wrote about the life of Deidra Sanbourne, yet failed to recognize it may have been a medication that caused her death.

    http://isepp.wordpress.com/2011/09/16/florida-plaintiff-deidra-sanbourne-was-her-death-caused-by-clozipine-induced-bowel-obstruction-readers-of-the-book-crazy-deserve-to-know-about-the-harm-psychiatric-drugs-can-cause/

    When it comes to symptoms of psychosis or mania, all individuals have the right to be tested and treated for underlying medical conditions/substances that are known to cause these symptoms.

    Medical and mental health professionals commonly do very little testing and literally use a “Chinese Menu” approach in diagnosing patients with symptoms of severe mental illness

    We become rubber stamped with either bipolar disorder or schizophrenia and are told we need medication the rest of our lives.

    Whether you are a member of NAMI or CCHR, all mental health advocates should form an alliance to ensure patients in our mental health care system are assess using the Best Practice Assessment guidelines as published in the British Medical Journal.

    http://psychoticdisorders.wordpress.com/bmj-best-practice-assessment-of-psychosis/

    Mental health advocates need to find common grounds to build upon. Advocates spend more time fighting amongst each other than fighting for the needs of those in our mental health care system.

    Many individuals in our mental health care system are among a marginalized population. Because of incarceration, hospitalization, low-income or homelessness, they may not have access to the internet.

    The internet is now a powerful tool for mental health advocates, but it excludes the voice of those being advocated for.

    All individuals who consider themselves “mental health advocates” should consider, if they were suffering from mania/psychosis, would they want to be tested for underlying causes?

    If so, then this is what we should all be fighting for together under a unified advocacy agenda.

    Kind Regards,
    Maria Mangicaro

  • Dear Dr. Brogan,

    As a mental health advocate who supports the benefits of Functional Medicine/Integrative/Orthomolecular approaches, I greatly appreciate your efforts.

    I am very concerned with the lack of awareness regarding the underlying causes of psychotic/manic symptoms and the benefits of Functional/Integrative Medicine.

    Considering symptoms of psychosis/mania can have a dismantling effect on a person’s life, as well as result in harm to others, there is a critical need for advocates to form a strong alliance and advance best practice standards.

    Patients suffering from severe mental illness are among a marginalized population and because of incarceration, hospitalization, low income, or homelessness, many do not have equal access to the internet as their so-called advocates.

    The ongoing battle among advocates who are pro-antipsychotics vs. those who are anti-antipsychotics moves us away from supporting a unified advocacy agenda in favor of implementing best practice standards of care.

    Anyone who is speaking on the future of psychiatry and the treatment of psychotic symptoms, should first consider the British Medical Journal’s published guidelines for Best Practice Assessment of Psychosis and consider what standard of care they would want for themselves, or their loved one.

    http://psychoticdisorders.wordpress.com/bmj-best-practice-assessment-of-psychosis/

    Whether an advocate belongs to NAMI, or CCHR, they should be supporting the right of our mental health patients to have access to accurate assessment and treatment of the underlying cause.

    It’s very disappointing to realize the internet is being used to create arguments based on picking apart opinions, rather than solutions based on critical facts.

    http://www.peteearley.com/2013/07/01/nami-convention-coverage-robert-whitakers-case-against-anti-psychotics/

    Kind Regards,
    Maria Mangicaro

  • Dr. Datta,

    Your testimony on what psychiatrists don’t learn, and what they did learn but don’t use, is very insightful and one that I hope Robert Whitaker takes note of.

    As an individual who studied medicine in London and a psychiatrist in training, you bring a new set of eyes to the obvious problems in our flawed mental health care system.

    Mental health advocates must consider the failure of psychiatry to investigate and treat possible underlying medical conditions as a contributing factor to the epidemic of “mental illness” and the rising costs of care.

    On Saturday Mr. Whitaker will be presenting at NAMI’s national convention and his talk will be on: “The Case for Selective Use of Antipsychotics”

    Many NAMI members support coercive psychiatry and long-term use of antipsychotic meds. They often misinterpret and are fearful of “Anatomy” as supporting an anti-psychiatry agenda.

    Your comments further support Mr. Whitaker’s case for the selective use of antipsychotics, as well as the need for a unified advocacy agenda in support of best practice standards of care for our psychiatric patients.

    The landmark Supreme Court decision of the FCC v. Pacifica Foundation involving comedian George Carlin taught our citizens a valuable lesson about having a voice. Sometimes it just takes the valid complaint of a single person to make change happen quickly.

    We have to keep the faith and believe that it is better to light a candle, than curse the darkness.

    I look forward to your next post.

  • Dear Dr. Datta,

    I enjoyed reading your post.

    In March of 1996 I was dx’d bp after suffering an acute manic episode from toxic encephalopathy. Although the hospital was made aware of long-term chemical exposure in my work environment by my family members, I was not referred to the Dept. of Occupational Medicine and only give a psych dx.

    Below is a link to a narrative I wrote that was published in the Journal of Participatory Medicine describing my experiences.

    I consider myself very fortunate that my case was assigned to a very knowledgeable and experienced psychopharmacologist who respected my choices and worked with me in partnership rather than tried to control my treatment options.

    In my hometown of Syracuse, NY I know of 3 psychiatrists who are also licensed acupuncturist and I have been under the care of psychiatrists who prescribed essential fatty acids. vitamin C with Lithium to reduce the toxic side effects and were more than willing to provide just talk therapy to monitor possible exacerbation of symptoms. I have met many psychiatrists who are very skilled at their profession and do not over prescribe.

    In my case, tapering off of psych meds was only possible once the underlying cause was determined and treated.

    The BMJ published Best Practice Assessment of Psychosis guidelines. Below is a link to them.

    As a mental health advocate my goal is to create an awareness of the critical need to recognize underlying causes of psychosis/mania and the benefits of Functional Medicine/Integrative Psychiatry/Orthomolecular and Participatory Medicine concepts.

    Kind Regards, Maria

    http://psychoticdisorders.wordpress.com/bmj-best-practice-assessment-of-psychosis/

    http://www.jopm.org/perspective/narratives/2011/03/28/psychosis-possibly-linked-to-an-occupational-disease-an-e-patient%E2%80%99s-participatory-approach-to-consideration-of-etiologic-factors/

    Psychosis Possibly Linked to an Occupational Disease: An e-Patient’s Participatory Approach to Consideration of Etiologic Factors

    Summary: The purpose of this narrative-analysis is to: Consider medical conditions and substances that may induce psychotic symptoms; identify some unique challenges that providers and patients dealing with psychotic disorders must overcome in order to establish effective recovery strategies; and to illustrate the benefits of participatory concepts in mental health care. This article describes one patient’s experience with discovering that her psychosis might have been caused by toxic encephalopathy from occupational exposure, and the benefit she gained from becoming an active participant in her own care.

  • Duane,

    Honestly, it’s to the point where I can not help but believe that the psychotic symptoms some individuals suffer from are nothing more than job opportunities for a multitude of professionals, including authors.

    When it comes to symptoms of psychosis,

    we don’t need to reinvent the wheel,

    we don’t need any more research that involves just talking to “schizophrenic people”,

    https://www.madinamerica.com/2012/10/new-research-project-funded-by-the-foundation-for-excellence-in-mental-health-care-is-in-process/

    we don’t need any more books,

    we don’t need any more lectures,

    there are enough case studies and research out there already,

    we do need caring medical and mental health professionals who want to help others and will follow best practice standards of assessment,

    psychosis shouldn’t be a such a mystery when there is such a long list of underlying causes,

    http://psychoticdisorders.wordpress.com/bmj-best-practice-assessment-of-psychosis/

    we do need funding to help people suffering from the symptoms get the testing and treatment they need for the underlying condition (which as Bob has already stated, in many cases is probably substance abuse)

    we do need creative individuals like the founders of the Delancey Street Foundation to help those in recovery obtain job skills

    http://www.delanceystreetfoundation.org/

    we can no longer blame the pharmaceutical companies for hindering the paradigm shift,

    at this point, those who claim to be mental health advocates, need to evaluate how they are impacting the health, safety and welfare of others if they are not supporting best practice standards.

  • In response to “Can Psychosis be Treated With Nutrition?”

    That would depend on what is causing the psychosis.

    If the psychotic state is being caused by something like an Ovarian Teratoma, then the answer is no.

    The woman featured in the story below spent two months suffering from psychosis and labeled with schizophrenia, the second woman in the story spent two years suffering psychotic symptoms and labeled schizophrenic before two Teratomas were discovered. Her psychotic symptoms abated one day after the tumors were removed.

    There are many underlying causes of psychosis and mania. There is no one-size-fits-all treatment. Nutrition is the answer for some, but not all.

    Functional Medicine, Integrative Psychiatry and Orthomolecular Psychiatry certainly are the best options if a patient is interesting in detecting and treating the underlying cause, as well as hopefully preventing future episodes.

    http://psychoticdisorders.wordpress.com/2013/05/29/ovarian-teratoma-causing-psychosis-monster-inside-me/

  • Hi Joanne,

    In one of his Youtube videos, Robert Whitaker described psychosis as having flu-like characteristics of coming and going on its own.

    This makes sense when you consider psychosis caused by encephalopathy can be caused by a virus/bacteria/toxin or a combination of such and stressful/emotional situations can weaken our immune system.

    I suffered psychotic and manic symptoms from toxic causes but symptoms also exacerbated from an abscessed tooth that I delayed treatment for and after a bout of ocular shingles.

    Below is a link to a narrative I wrote that was published in the Journal of Participatory Medicine explaining my experiences.

    Bob is correct that psychosis can have flu-like characteristics but it is important to test for and treat the underlying cause. Although the symptoms are alike, the treatments may vary considerably.

    http://www.jopm.org/perspective/narratives/2011/03/28/psychosis-possibly-linked-to-an-occupational-disease-an-e-patient%E2%80%99s-participatory-approach-to-consideration-of-etiologic-factors/

  • Dear Bob,

    If you think the Open Dialogue approach is one worthy of knowing about, then would you

    PLEASE, Please, please,

    consider learning more about the value of an Orthomolecular approach, Functional Medicine and Integrative Psychiatry as well as the successful outcome of cases treated according to best practice assessment standards.

    Two-time Nobel Prize winner, and molecular biologist, Linus Pauling Ph.D.,coined the term “Orthomolecular” in his 1968 article “Orthomolecular Psychiatry” in the journal”Science

    You will find Orthomolucular approaches are based in solid, scientific data.

    http://profiles.nlm.nih.gov/MM/B/B/J/Q/

    As a mental health advocate, I am BEGGING you to PLEASE incorporate the importance of accurate assessment of psychotic symptoms in your presentations.

    In each presentation that you fail to acknowledge organic causes of psychotic symptoms

    – something mainstream psychiatry readily accepts but also fails to acknowledge in order to promote the concepts and treatment of schizophrenia/bipolar disorder –

    you are leaving out a huge piece of the puzzle.

    We are in a critical time period and mental health care patients are in need of critical thinkers who will use due dillegence to consistently focus on best practice standards of care, especially when engineering a new paradigm of care that focuses on psychotic symptoms.

    The best reported outcomes in the Western world will not bring Mozelle Nalan, Kendra Webdale and 20 Sandy Hook Elementary School students back to life.

    When public safety is at risk, advocates and lawmakers in the US will not simply agree on a paradigm of care based on a greater percentage of people get back to work and school. The fear factor of the Sandy Hook massacre is contributing to a zero tolerance mentality.

    Advocates in favor of the Selective Use of Antipsychotics and alternative treatment options need to step up their game plan.

    The obstacle mental health advocates are up against includes the fact we are fighting each other’s agendas without finding common grounds to form a united advocacy agenda.

    The BMJ’s Best Practice Assessment of Psychosis is something all ethical advocacy agendas should consider supporting.

    Many individuals suffering from symptoms of severe mental illness are among a marginalized population, in jails/prison/psych wards/homeless and do not have access to the internet, or a voice in their proposed treatment agenda (something which they may be forced into and forced to pay for without treatment options)

    Anyone who is speaking out on the treatment of psychosis must act to ensure they are promoting treatment standards with both patient best-interest and public safety considerations.

    In some of your talks you describe psychosis as having flu-like characteristics of coming and going on its own.

    From my personal experiences and the fact a psychotic state can be caused by a virus/bacteria (including dental caries, one of the most prevalent chronic diseases of people worldwide and mentioned in Mad in America) you are correct in making this assessment.

    This assessment is true in some cases of psychosis, but not all.

    The diverse array of underlying causes of psychosis contributes to the problem of trying to create a uniform treatment plan that works best for the majority.

    As you have also stated quite factually, antipsychotics do appear to help stabelize a person seeking treatment, or forced into treatment for psychotic symptoms.

    The length of time one suffers from a psychotic state can be reduced when the underlying cause is targeted and treated.

    The length of time antipsychotic medications are used, and the risk of adverse side effects will also be reduced.

    Being aware of what triggers can exacerbate symptoms is the best way of preventing reoccurance.

    Targeting underlying causes of psychosis/mania needs to be recognized for a best-practice standard of care to be established.

    Mainstream psychiatry and the use of anti-psychotic medications will always have the upper hand in a society that does not want people suffering from a temporary bout of psycho-flu purchasing guns.

    The appearance of stabilizing on medications, makes a convincing argument for main stream advocates and law/policy makers to support long-term use and even early intervention.

    Many NAMI advocates are parents who do not want their child to suffer another bout of psycho-flu ever again.

    The mass shootings promote discussion of the “treatment” of psychosis and gun control but the media agenda does not consider the critical aspect of what can cause a psychotic state in the first place.

    The anti-psychiatry/alternatives agendas eagerly to point to the use of psychiatric medications but fail to consider the possibility of a combination of factors such as the interaction of cold medicine/a flu shot/abscessed tooth, etc and the exacerbation of psychotic symptoms.

    What your book Mad in America indicates is that taking a case history for individuals in a psychotic state has never been a standard of care, that is why we ended up locked away, institutionalized, criminalized, ostracized, demonized and contributes to the fact currently our life expectancy is 25 years less than others.

    Before promoting a universal, one-size-fits-all treatment approach for symptoms of psychosis, law/policy makers need to recognize the fact there are many underlying medical conditions and substances that can induce a psychotic state and be misdiagnosed as schizophrenia/bipolar disorder.

    In this presentation you mention that antidepressant medications can cause a “bad reaction” and induce mania, resulting in a person who was originally dx’d with depression being labeled with bipolar disorder.

    The “bad reaction” is a toxic encephalopic response and should be diagnosed as a Drug Induced Mood Disorder (292.84), not bipolar disorder.

    You might be interested in listening to “Expert”, Dr. Ankur Saraiya, explain the same scenario in what psychiatrists “informally” refer to as Bipolar 3

    http://www.howcast.com/videos/498598-Bipolar-Disorder-1-2-and-3-vs-Cyclothymic-Disorder-Mood-Disorders

    In a separate video Dr. Saraiya explains the “Chinese Menu” approach of using the DSM.

    Chinese Menu?????

    Need I say more about a defect in that approach?

    Patients in our mental health care system suffer from the fact medical/mental health professionals and advocates use a rubber-stamp approach of labeling all manic/psychotic behavior as Bipolar/Schizophrenia without understanding the DSM recognizes the variations in causes of psychosis/mania.

    I would urge that you consider breaking away from referring to symptoms of psychosis and schizophrenic behavior as one in the same.

    Clear distinctions are made in the DSM, they should be referred to as such.

    Advocating for a paradigm of care that does not ignore taking a patient’s case history is the main focus of my personal mental health advocacy agenda.

    Thank you for your support.

    292.11 Amphetamine-Induced Psychotic Disorder, With Delusions

    292.11 Cannabis-Induced Psychotic Disorder, With Delusions

    291.3 Alcohol-Induced Psychotic Disorder, With Hallucinations

    293.83 Mood Disorder due to (indicate general medical condition)

    333.90 Medication-Induced Movement Disorder NOS

    310.1 Mental disorder due to medical condition

    296.46 Manic, most recent episode, full remission

    292.12 Drug Induced Psychotic Disorder, With Hallucinations

    292.11 Drug Induced Psychotic Disorder, With Delusions

    292.84 Drug Induced Mood Disorder

    292.89 Drug-Induced Sleep Disorder

    Posted on Mad in America, January 17, 2013

  • “Another Case for Selective Use of Antipsychotics”

    Dear Bob,

    The mass shootings in the US have brought the topics of “mental illness”, the treatment of psychosis and our flawed mental health care system to the forefront of concerns in our country.

    Mental health care involves a large-scale, complex system.

    The interaction between our mental health care and criminal justice systems contributes to the unregulated power-base of psychiatric authority in our country.

    Unlike physical illness, individuals who are precieved and labeled “mentally ill” are of a class of people who can be deprived liberty and legally forced to contract treatment services/consume potentially lethal products without treatment/product options.

    Individuals labeled “mentally ill” are in critical need of a strong, ethical and uniform advocacy agenda founded in evidence-based, best-practice standards of care.

    I realize that you do not want to consider yourself a mental health advocate, but if you consider the definition of the word “advocate” is:

    “A person who publicly supports or recommends a particular cause or policy.”

    – listening to this video, you are acting in the capacity of an advocate for the Soteria Model and Open Dialogue.

    Your journalistic perspective has taken on an authoritative position challenging the main stream paradigm of care for the treatment of psychotic symptoms.

    If anything, you should at least consider yourself a public advisor for the treatment of psychotic symptoms.

    The paradigm of care that you are promoting is one that fails to consider testing for and treating underlying medical conditions and substances that are known to induce psychotic/manic behavior.

    This is an unethical standard of care.

    It might come to a surprise to you, but many individuals who experience acute psychosis are individuals who are socially well-adjusted, educated, employed, home owners who have loving family and friends and do not need a Soteria Home, a Healing Farm House or Open Dialogue approach.

    They need medical assessment and medical treatment for medical conditions that manifest as abnormal behavior.

    As an individual who has been in our mental health care system and treated for psychosis on numerous occasions, what I benefited from the most is Functional Medicine/Integrative Psychiatry/Orthomolecular approach, Chelation therapy, vitamins, minerals, nutrients and detoxing treatments.

    I recognize psychosis as being caused by a virus, bacteria, toxin (including medications and not just psych meds) physical injury/disease.

    I acknowledge the selective use of psychiatric medications can help stabelize psychotic/manic symptoms while the body heals itself or an effective treatment is found.

    As a mental health advocate, I believe there is a need for mental health patients to have access to affordable integrated/dental care, alternative therapies/products and concepts that support patient empowerment through the Participatory Medicine movement.

    As an advisor to those considering the treatment of psychosis, could you please give me your opinion of the Best Practice Assessment of Psychosis guidelines published in the British Medical Journal?

    Personally, I think it is pretty comprehensive and I do not understand why it is not the number one consideration for medical and mental health professionals treating psychotic symptoms, as well as mental health advocates concerned with the treatment of psychotic symptoms.

    http://psychoticdisorders.wordpress.com/bmj-best-practice-assessment-of-psychosis/

    I look forward to your opinion.
    Kind Regards,

    Maria Mangicaro

    Posted on Mad in America dot com 01/17/2013

  • AA,

    Yes, I had been a patient at that hospital before and they had access to my medical records.

    I had initiated a worker’s compensation claim for the diagnosis of toxic encephalopathy but was still under the care of a psychiatrist.

    The psychiatrist had recently resigned as head of the department of psychiatry but he still had admitting rights.

    I remained under the care of a psychiatrist because the insomnia was very difficult to control.

    He knew I was having cognitive problems and was the one who made the referral to the head of neurology at the same hospital.

    I made it clear to the ER doctor that I was a patient of both doctors as I had nothing to hide and I brought along the MSDS sheets from the chemicals I worked around to aid in the evaluation process.

    For my worker’s comp case I obtained all of my medical records.

    I would recommend to all psychiatric patients to obtain their records.

    Lab work indicated abnormalities from day one that were never disclosed to me.

    Below is a case from the same hospital I was treated at of a young girl who was misdiagnosed for two years with bipolar disorder.

    As a mental health advocate I support a movement that promotes accurate assessment of symptoms of psychosis/mania to rule out underlying medical/substance-induced conditions before labeling individuals with bipolar/schizophrenia.

    The Soteria Model and Open Dialogue fail to consider this critical aspect.

    http://psychoticdisorders.wordpress.com/2012/11/25/neuropsychiatric-systemic-lupus-erythematosus-presenting-as-bipolar-i-disorder-with-catatonic-features/

    Neuropsychiatric systemic lupus erythematosus presenting as bipolar I disorder with catatonic features.

    OBJECTIVE:

    The authors describe a 15-year-old African American young woman with a family history positive for bipolar I disorder and schizophrenia, who presented with symptoms consistent with an affective disorder.

    METHOD:

    The patient was diagnosed with Bipolar I disorder with catatonic features and required multiple hospitalizations for mood disturbance. Two years after her initial presentation, the patient was noted to have a malar rash and subsequently underwent a full rheumatologic work-up, which revealed cerebral vasculitis.

    RESULTS:

    NPSLE was diagnosed and, after treatment with steroids, the patient improved substantially and no longer required further psychiatric medication or therapy.

    CONCLUSION:

    Given the especially high prevalence of NPSLE in pediatric patients with lupus, it is important for clinicians to recognize that neuropsychiatric symptoms in an adolescent patient may indeed be the initial manifestations of SLE, as opposed to a primary affective disorder.

  • Dear Mark,

    I have had similar experiences. On one occassion I drove myself to the hospital requesting to consult the neurologist I was under the care of. For several nights I woke up with sudden severe headaches. It progressed to numbness going down my left arm, loss of cognitive functioning (I could not understand what people were saying to me) loss of peripheral vision and feeling like I was going into a coma.

    Because I had a history of “bipolar disorder” the ER doctor ordered a psych consult. A young psychiatrist told me that I could only be admitted to the psych ward for mania.

    I refused “treatment” and told him I was leaving.

    He told me to wait a few minutes because his shift was over and he would walk me to my car because it was late at night and he was worried about me.

    Assuming I was “manic” he acted inappropriately, which he later regretted as I filed a complaint with the Division of Human Rights for failure to provide public accomodations and was awarded a settlement (without an attorney)

    My prior EKGs were normal. After that episode they indicate a myocardial infarction.

    Is it any wonder the life expectancy of our mental health patients is 25 years less than the rest of society?

    Esmin Green’s death is an example of how the label of “mental illness” negatively impacts medical treatment.

    http://articles.cnn.com/2008-07-01/us/waiting.room.death_1_hospital-staff-hospital-employee-kings-county-hospital-center?_s=PM:US

  • Ok,

    I admit,

    I have a lot bottled up and got pretty long winded.

    To Keep it Short and Simple.

    When it comes to symptoms of psychosis/mania

    First

    Foremost

    and Critically Important

    “Organic causes must be considered and excluded before the psychosis is attributed to a primary psychotic disorder.”

    That is a fact

    There is no arguing this point

    ALL MENTAL HEALTH ADVOCATES SHOULD AGREE THAT OUR MENTAL HEALTH CARE SYSTEM SHOULD NOT ONLY MEET, BUT EXCEED BEST PRACTICE STANDARDS

    WE NEED TO GET ON THE SAME PAGE WITH THIS

    Bob’s conclusions regarding psychosis make a lot of sense

    but they would make more sense if he incorporated the value and importance of testing for and treating underlying causes of psychosis/mania

    Following the BMJ’s guideline is the most ethical, most economical and most humane stragegy available

    It’s not rocket science, it is human anatomy and physiology

    http://psychoticdisorders.wordpress.com/bmj-best-practice-assessment-of-psychosis/

  • I had some additional comments to the information below

    – the research supports short term efficacy of antipsychotics and long-term chronicity: PERHAPS, MAYBE, JUST MAYBE THAT IS BECAUSE IN SOME CASES OF PSYCHOSIS THE EFFECT OF SEDATION GIVES THE BODY AND BRAIN A CHANCE TO HEAL FROM AN UNDERLYING MEDICAL CONDITION SUCH AS A VIRUS, BACTERIA OR TOXIN

    – the comparison research from 1945-55 involved treating psychotic episodes with hospitalizations that lasted between 12 months and five years. HELLO???? THAT WOULD BE VERY EXPENSIVE THESE DAYS….LOOK INTO THE COST OF COOPERRIIS I THINK IT IS AROUND $17,000 PER MONTH, A MUCH BETTER APPROACH EXISTS IF MEDICAL PROFESSIONALS UTILIZED BEST PRACTICE ASSESSMENT STANDARDS AS OUTLINED IN THE BRITISH MEDICAL JOURNAL…THAT IS A RELIABLE SOURCE OF INFORMATION FOR MEDICAL PROFESSIONALS, RIGHT?

    – his book is not a medical advice book and does not encourage patients to go off of medications (although some psychiatric patients have gone off medications after reading Anatomy) AND ONE PERSON THAT I KNOW OF ENDED UP HAVING A PSYCHOTIC EPISODE RESUTLING IN A PSYCH HOSPITALIZATION

    – he believes psychiatric medications have a place in mental health care: NICE OF BOB TO GIVE SOME HOPE TO THOSE WHO DEPEND ON THEM FOR PROBLEMS LIKE CHRONIC INSOMNIA….IF A PERSON GOES MORE THAN 8 DAYS WITHOUT SLEEP THEY COULD HAVE A FATAL REACTION, SO YES, PSYCH MEDS WILL ALWAYS HAVE A PLACE

    – when considering psychotic patients, some will do better off meds, while others do better on meds: TREAT THE UNDERLYING PROBLEM AND THEIR CHANCES OF GOING OFF OF PSYCH MEDS WILL INCREASE

    – psychotic episodes have flu-like characteristics of coming and going on their own, treatment with medication is the best approach to quickly stabilize (PERHAPS, MAYBE, ONE COULD CONCLUDE THAT THE FLU-LIKE CHARACTERISTICS OF PSYCHOSIS ARE BECAUSE IN SOME CASES IT IS CAUSED BY A VIRUS, BACTERIA OR TOXIN, and IN SOME CASES THAT TOXIN IS A PSYCHIATRIC MEDICATION)

    I THINK BOB IS A PERSON WITH COMMON SENSE

    NO PERSON IS IMMUNE FROM A PSYCHOTIC/MANIC EPISODE

    IF BOB, OR ONE OF HIS LOVED ONES, EXPERIENCED A PSYCHOTIC EPISODE WHAT TREATMENT, IF ANY DO YOU THINK HE WOULD SEEK?

    OPEN DIALOGUE?

    MEDICATION MANAGEMENT?

    INTEGRATIVE PSYCHIATRY?

  • Dear David,

    Thank you for opening this dialogue with me in the Mad in America community.

    This turned out a lot longer than I expected and I hope it makes sense as I put it together in a bit of a hurry.

    The information in “Why Psychiatry Embraced Drugs: An Interview with Author Robert Whitaker” is one example of Bob’s inconsistency and apparent cluelessness.

    Here is the link.

    http://motherboard.vice.com/blog/why-psychiatry-embraced-drugs-an-interview-with-author-robert-whitaker

    In this interview Bob states:

    I made a little joke in the book about psychiatry secretly funding scientology, but really, it couldn’t have worked out better for the pharmaceutical companies and biological psychiatry. The reason is that, of course, it delegitimizes criticism. The fact that scientology is so visibly attacking biological psychiatry and attacking psychiatric drugs delegitimizes all criticism. Scientologists clearly do have a cult-like status and they clearly do have an agenda. The fact that they’re so visible makes it very easy for psychiatry and pharmaceutical companies to say, “This is just criticism coming from that crazy group.”

    Some of the stuff, they’ve gone into the data and they’ve brought out some information. Because it was scientology and CCHR that was out front with the criticism and raising questions and raising accusations that these drugs were causing suicide and violence, just made it really easy for pharmaceutical industry and Eli Lily to have it dismissed. If we didn’t have Scientology. Imagine it doesn’t exist and there’s no such group raising criticism. The questions around whether Prozac can stir violence or could cause someone to become suicidal or homicidal would have had a lot more traction.

    The Citizens Commission on Human Rights is a nonprofit organization that was founded in 1969 by the Chruch of Scientology and Dr. Thomas Szasz to “investigate and expose psychiatric violations of human rights and to clean up the field of mental healing.”

    While CCHR was founded in part by the Church of Scientology, membership is open to all individuals, regardless of religious beliefs.

    Apparently during this interview Bob’s arrogance took over and he apparently forgot about the efforts of MindFreedom, PsychRights, ISEPP (formerly ICSPP) and many other nonprofit organizations and groups who have been speaking out for decades.

    He is apparently clueless to the fact many mental health and medical professionals have risked their reputations and license to practice for the sake of providing safe and effective alternatives to mental health patients.

    Nice of Bob to formally lump us all together as the “crazy group”.

    By the way, that “crazy group” CCHR has helped inform and support a countless number of individuals including Maria Bradshaw and Amy Philo. CCHR gives a voice to those who no one else seems to listen to.

    CCHR’s accomplishments include documenting thousands of individual cases that demonstrate psychiatric drugs and often-brutal psychiatric practices create insanity and cause violence.

    Bob should learn more about CCHR first hand before he criticizes this organization or places blame on the Church of Scientology for the ignorance that delegitimizes all criticism of psychiatry.

    Tom Cruise is the ONLY well-known celebrity that has ever spoken out against the harm of psychiatric medications.

    Personally, I don’t care what church Tom Cruise Mapother belongs to, or how many times he gets married/divorced, or what kind of crappy movies he makes, the day he spoke up on the behalf of people being harmed by the overuse of psychiatric medications and the benefit of safer alternatives, is the day I became his number one fan.

    If anyone wants to criticize members of CCHR as mental health advocates, they better have a list of accomplishments that outshines what CCHR has done.

    Here are several points that I would like to make:

    1. Please know that I am very understanding towards Bob’s position as a journalist doing his job which involves a “shades of gray” balancing act.

    It is important to realize that Bob does not have the same perceptions as an individual who is an advocate seeking change for unjust policies, procedures and practices in our flawed, broken and failed mental health care system.

    Bob has no experience being part of our mental health care system and at this point I doubt he has ever even taken a basic course in abnormal psychology, so I would not expect him to have the same perspectives as those of us who have. His work reflects the fact that he has no knowledge or comprehension of Orthomolecular concepts/Integrative Psychiatry/Disciplines of Psychology and he focuses his criticism on main stream psychiatry.

    In correspondence with Bob, I have always used thoughtful comments as personally I do not think he handles criticism very well and there are many factors involved in the strong critic that I hold towards his efforts in the mental health arena. I explained some of them to him during a phone conversation in October of 2010.

    2. The mass shootings in our country have pushed the topics of “mental illness”, psychosis and violent criminal behavior to the forefront of our national concerns.

    Blame for the problems in our flawed mental health care system lies in the schizophrenic nature of mental health advocacy. Advocates need to find ways of getting on the same page with each other. A divided advocacy agenda is futile and will not succeed.

    It is time for mental health advocates to clean house, straighten out their messages and create a clear, concise, uniform advocacy agenda to present to policy and law makers.

    3. Our contemporary society suffers from “Walter Cronkitis”, we expect journalists to take the lead to sort through and spoon feed us the conclusions of large amounts of important information that we do not take the time to learn about, analyze and evaluate for ourselves.

    Journalists and the media have the ability to easily persuade their audience through their storytelling abilities. Bob is very knowledgeable and has a lot of charm.

    The reason why Dr. Torrey and Bob agree on the following statements is because they are UNDISPUTABLE FACTS that all mental health advocates should agree on:

    “Whitaker got many things right, including criticism of the broad DSM diagnostic criteria for mental illnesses; the reckless prescribing of psychiatric drugs for children; and the prostitution of many psychiatric leaders for the pharmaceutical industry”

    We should not nit-pick any other details, we need to focus on the FACTS and confirmed problems.

    The focus should be on working together to fix these problems.

    THE RECKLESS PRESCRIBING OF PSYCHIATRIC DRUGS FOR CHILDREN.

    LET’S MAKE THIS A PRIORITY!!!!

    There is only one mention of Ke’onte Cook on this site, there is no mention of Rebecca Riley and no mention of Gabriel Myers. This is a shame!

    4. Bob put a lot of time and effort into learning about the problems in our mental health care system and about the treatment of psychosis.

    So, what are his conclusions for the treatment of psychosis?

    Individuals suffering from psychosis and mania are among our society’s most vulnerable and marginalized population.

    Many are in psych wards, the criminal justice system or homeless.

    They do not have access to the internet and they do not have a voice for advocacy agendas being formulated within internet communities.

    The Mad in America website is a place of public accommodation to discuss the treatment and advocacy agenda for those suffering from symptoms of psychosis, but excludes individuals suffering from those symptoms.

    Bob may not consider himself and a mental health advocate, but if we consider the definition of advocate: “A person who publicly supports or recommends a particular cause or policy.” he is acting in the capacity of an advocate.

    He also was one of the founders of the FEMHC.

    In his C-SPAN lecture Bob makes his concluding statements very clear.

    My interpretation (summarized) of his his beliefs regarding the treatment of psychosis are:

    – the research supports short term efficacy of antipsychotics and long-term chronicity

    – the comparison research from 1945-55 involved treating psychotic episodes with hospitalizations that lasted between 12 months and five years.

    – his book is not a medical advice book and does not encourage patients to go off of medications (although some psychiatric patients have gone off medications after reading Anatomy)

    – he believes psychiatric medications have a place in mental health care

    – Anatomy of an Epidemic does not take an anti-medication position and is in fact a “pro-med”, best use practice

    – when considering psychotic patients, some will do better off meds, while others do better on meds

    – he believes the psychophramacology paradigm is a failed revolution

    – psychotic episodes have flu-like characteristics of coming and going on their own, treatment with medication is the best approach to quickly stabilize (PERHAPS, MAYBE, ONE COULD CONCLUDE THAT THE FLU-LIKE CHARACTERISTICS OF PSYCHOSIS ARE BECAUSE IN SOME CASES IT IS CAUSED BY A VIRUS, BACTERIA OR TOXIN, and IN SOME CASES THAT TOXIN IS A PSYCHIATRIC MEDICATION)

    – his appeal is to create a national discussion that incorporates the long-term data

    Bob has a much different perspective in this video and he states quite clearly that youth doing marijuana are at increased risk of ending up with bipolar labels when they show up with what looks like psychiatric symptoms.

    http://wellnesswordworks.com/maria-mangicaro-check-for-physical-causes-of-psychiatric-symptoms-first/

    He also states he believes more than 50% of those labeled with mental illness entered the system starting from the use of illegal drugs. He states he did not realize this when he wrote Anatomy of an Epidemic.

    Best Practice assessment of psychotic symptoms is the most ethical standpoint an advocate could take. Why would we want to overlook a medical condition or a substance causing psychosis, especially when that substance could be a psychiatric medication that induced a psychotic episode resulting in a parent killing their own child, like Ryan Ehlis, Dena Schlosser, Otty Sanchez, Julie Schenecker and David Crespi.

    5. Because Mad in America, Inc. is a business that supports a plethora of writers and diverse opinions, journalists seeking information on the topic of “mental illness” will use the Mad in America website as a resource.

    In my opinion, Bob should have a clear-cut statement of what his conclusions are on the Mad in America website from his journalistic perspective.

    As is, the Mad in America website is sending out convoluted messages to the media.

    Without a clearcut commitment to an advocacy agenda, this website and has the potential to contribute to poor outcomes in advocating for the rights of some of our society’s most vulnerable population.

    Mad in America, Inc. needs to remedy a situation that currently has the potential to cause harm to patients in our mental health care system.

    6. Bob did a great job starting up the FEMHC. The Foundation received a $2 million dollar donation right off the bat from a single donor.

    It would be nice if Bob spent some effort trying to raise money for nonprofit organizations that have existed for many years and have successfully helped individuals suffering from mental/behavioral/emotional conditions.

    Some examples that I am particularly fond of are:

    The Delancey Street Foundation

    Quantum Leap Farm

    The Rescue Mission

  • Dear David,

    Before proclaiming myself a “mental health advocate” I obtained a paralegal certificate, a bachelor’s degree in legal studies and a mediation certificate. I carefully selected the courses to supplement my goal of becoming an advocate.

    I take advocating on the behalf of others very seriously.

    I have experienced and witnessed first hand how our broken and flawed mental health care and criminal justice systems contain a tremendous amount of unnecessary suffering for many, and an enourmous amount of profit for others.

    I scrutinize information that has the potential to affect changes in our mental health care system very carefully, to the point of reading between the lines of the fine print.

    In his review of Anatomy of an Epidemic, Dr. Torrey wrote this:

    “In its 396 pages Whitaker got many things right, including criticism of the broad DSM diagnostic criteria for mental illnesses; the reckless prescribing of psychiatric drugs for children; and the prostitution of many psychiatric leaders for the pharmaceutical industry. Indeed, regarding the last, Whitaker may have understated the problem, based on recently released court documents detailing how the pharmaceutical industry secretly controlled the Texas Medication Algorithm Project.”

    Does anyone else on this site see reason to celebrate Dr. Torrey’s review?

    I am not insinuating Bob is not consistent or sincere in what he’s been saying and that everyone should all watch/listen to him closely for heretical behaviors, I am stating he is inconsistent and that yes, please pay close attention to his lectures/presentations available on youtube.

    If you have any doubts, I can provide many examples.

  • Dear Dr. Steingard,

    I am glad that Bob’s work has influenced your perception of mental health care.

    I hope that you will continue to listen closely and evaluate carefuly comments and information Bob shares throughout his work, lectures and online interviews.

    During one interview Bob states that it is an “inside joke” among those who have been diagnosed “mentally ill” that on average our life expectancy is 25 years less than individuals who are not in the mental health care system.

    Personally, I thought this comment was in bad taste as I have been on psychiatric medications in the past and suffered horrific and life-threatening side effects. I have been under the care of psychiatrists who failed to consider underlying medical conditions, failed to review results of tests they ran and ignored physical signs of illness in lieu of labeling symptoms as “mental illness”.

    At one point I was told by 3 different psychiatrist during a 5 month period that I was depressed. My only complaint was that I was so tired I could not get out of bed and I felt like I was dying.

    Finally after telling my mother about my symptoms she immediately assumed that it was probably my thyroid. I looked into the thyroid connection and knew she was right. When I went to my primary care physician and requested a test, she acted like I was a hypochondriac. My TSH level came back at 147. It took two years of adjusting thyroid medications before the primary care physician finally referred me to an endocrinologist for further testing.

    If you get a chance please re-read page 80 of Mad in America which states “scattered reports in the scientific literature, dating back to 1876, of insanity being cured by the removal of infected molars or cuspids. From this initial site of infection, he reasoned, bacteria could spread through the lymph or circulatory systme to the brain, where it ‘finally causes the deeath of the patient or, if not, a condition worse than death – a life of mental darkness”

    Doctors at the National Integrated Health Associates, NIHA, in Washington, DC are having success treating symptoms considered “mental illness” with Integrative Medicine and biological dentistry.

    I posted a video to the ISEPP blog yesterday that demonstrates a mother’s frustration dealing with mental health professionals who failed to recognize adverse reactions to Haldol given to her son who suffers from symptoms considered autism.

    It is very sad to know that our mental health system is so failed because people fail to listen to eachother.

    Thank you for taking the time to listen

    Kind Regards,
    Maria Mangicaro

    http://isepp.wordpress.com/2013/01/04/in-light-of-the-sandy-hook-massacre-support-is-warrented-for-isepps-call-for-a-federal-investigation-into-the-link-between-psychotropic-drugs-and-mass-murder/

    Posted on Mad in America dot com 1/5/2013

  • The connection between creativity and mania are very intriguing.

    At a 1999 NAMI convention I had the opportunity to meet Pulitzer Prize-Winning Author William Styron. He spoke about suffering from depression and his book Darkness Visible. In front of an audience of over 500 people I asked if he could relate to manic symptoms during extended periods of intense writing and if he thought a more accurate description of his condition was manic-depression. He thought on that for a few moments before answering. His answer seemed to shock everyone, including himself. He said “Yes, yes, I can relate to manic highs and I do think a more accurate description is manic-depression.”

    It is important to consider many aspects to intense mental states, including stress from relationships. Kirk Douglas gave a brilliant performance playing Vincent Van Gogh in “Lust for Life”. It is a must see for anyone labeled “mentally ill”. Van Gogh’s art an writing indicate the torment he suffered. Although, another contributing factor we must consider is lead poisoning.

    Many artists continue to work around chemical solvents such as toluene and n-hexane that can cause neuropsychiatric disorders.

    “Because Van Gogh used lead based paints there are some who believe he suffered from lead poisoning from nibbling at paint chips. It was also noted by Dr. Peyron that during his attacks Van Gogh tried to poison himself by swallowing paint or drinking kerosene. One of the symptoms of lead poisoning is swelling of the retinas which can cause one to see light in circles like halos around objects. This can be seen in paintings like The Starry Night.”

    posted on Mad in America 12/6/2012

  • Hello,

    I agree with every point that Dr. Fulli has made above.

    Individuals labeled “mentally ill” are among the most vulnerable in our society and in need of hardworking advocates.

    Advocates need to find common grounds to create a strong and uniform advocacy agenda.

    Those we advocate for are at a disadvantage when advocates pursue arguments amongst each other rather than ensuring their agenda includes protecting the health, safety and welfare of mental health patients.

    What I appreciate about the Citizens Commission on Human Rights (CCHR)of Florida is the fact they expose crimes in our mental health care system, not just psychiatry.

    Here is a website created by a member of CCHR. There are more psychologists, social workers and counselors listed than psychiatrists.

    http://www.psychsearch.net/mug_shots.html

    As Bob has pointed out, many primary care physicians in our society are at fault for the proliferation of prescriptions for psychiatric meds, not just psychiatrists.

    Primary care physicians tend to believe the stigmatizing aspects of “mental illness”.

    I seem to be the only person who was very bothered by Dr Mark Foster’s Sept. 10, 2010 post on Mad in America describing one of his patients as:

    “A 31 year old blond woman with a history of traumatic brain injury and partial hemiplegia. She also has Hep C and a history of severe polysubstance abuse. She states “I don’t want any more drugs” and then promptly asks to be switched from Effexor to something else because it doesn’t help anymore, and by the way could I give her something for pain and for anxiety and for sleep? She tells me she’s taking 6-8 tylenol PMs twice a day to help her sleep. She says she’s “addicted to sleep” because that’s the only way she can avoid the impulse to go back to illicit drugs. And by the way, she’s trying to get pregnant. (Gulp)

    I switched her from Effexor to Trazodone. She is a difficult patient, a bottomless pit of needs with no coping mechanisms, and I don’t have a clue how to help her. She is truly a “broken brain”–literally–and will always be disabled. In her case, keeping her semi-sedated makes some sense–to spare herself and society the legal and criminal consequences of her mind unleashed. It seems to be what she wants. In her case, I made a med change that may address one aspect of her problems (sleep) and hopefully spare her the liver damage from the Tylenol, and then we live to fight another day.”

    The stigma of being labeled “mentally ill” prevents many individuals from receiving adequate medical care.

    At one point I had 3 different psychiatrists tell me that I was depressed, all three offered a prescription of prozac. My complaints were that I was so tired I could not get out of bed and I felt like I was dying. I did not complain or indicate that I was sad or depressed. Finally a relative suggested I have my thyroid levels checked. Hypothyroidism made complete sense once I looked up all of the other symptoms I was having. My primary care physician was reluctant to run the test and almost accused me of being a hypochondriac. My TSH came back at a dangerous level of 147. I have witnessed other mental health patients deprived adequate medical treatment and dental care while being treated in psych wards at a cost of over $800/day.

    Much human suffering could be prevented if better medical and dental care was afforded to those labeled “mentally ill”.

    Bob pointed out in Mad in America that cases of “insanity” were cured by treating infected teeth. He went on to include the mistreatment of patients who became victims of “bad medicine” but he missed the main point that treating infected teeth can abate symptoms of psychosis. Today, holistic dentists take into consideration tooth decay and abscessed teeth can be contributing factors to schizophrenic-like behavior.

    Preventing and ending unnecessary suffering should be a concern for all mental health advocates, regardless of what type they are considered to be.

    Posted on Mad in America 12/5/2012

  • Corinna,

    I’m not sure how this statement fits into anything that I am referencing.

    “Marijuana is not a food group like some people may be thinking.”

    Marijuana as a food group? I’m not really sure how this applies.

    The issues that I am concerned with involve the “Chinese menu” approach or using the DSM:

    1. Are certain individuals in our mental health care system suffering from underlying medical conditions misdiagnosed as sz/bp being forced to contract ineffective and potentially lethal treatments?

    Yes, there are many medical conditions and substances that can induce encephalopic conditions and manifest as psychotic symptoms.

    Medical professionals should follow Best Practice assessment guidelines to rule out underlying medical condition and ensure medications are not used on a long-term basis.

    2. Are there any diagnositic tests for mental disorders?

    Yes, these are mental disorder as described by the DSM:

    293.82 Psychotic Disorder Due to Medical Condition, with Hallucinations

    293.83 Mood Disorder Due to Medical Condition

    293.89 Anxiety Disorder Due to Medical Condition

    There is a long list of medical conditions that can manifest as psychosis, including brain tumors and Hashimoto’s encephalopathy. An MRI and blood tests are diagnostic tests that can diagnose these mental disorders.

    Please listen to this interview,

    http://www.youtube.com/watch?v=pm77RQdtpSY

    Bob states quite clearly youth doing marijuana are are increased risk of ending up with a dx of bp.

    He also states he believes more than 50% of those labeled with mental illness entered into the system from the use of illegal drugs. He states he did not realize this when he wrote Anatomy of an Epidemic.

    These are emails responses I have had from Bob regarding underlying causes of psychosis.

    Best Practice assessment of psychotic symptoms is the most ethical standpoint an advocate could take.

    Why would we want to overlook a medical condition or a substance causing psychosis?

    Especially when that substance could be a psychiatric medication that induced a psychotic episode resulting in a parent killing their own child. eg. Ryan Ehlis, Dena Schlosser, Otty Sanchez, Julie Schenecker and David Crespi.

    Advocates need to get on the same page with this problem.

    1. APA seems to embrace psychotherapy/cognitive therapy Thu, May 10, 2012 4:01 am

    Hi Maria,

    I was speaking to a group of primary care physicians yesterday, and this very point came up. And that is, in the past, the first thing doctors did when presented with someone with psychiatric symptoms was think of possible physical causes (thyroid, vitamin and mineral deficiencies,), and of course environmental toxins.

    And your letter does highlight part of the problem, which is that those against the drug model usually have their own horse they want to ride, which is talk therapy, or some other form of therapy.

    But you are right–I think nutrition, environmental toxins, lack of sleep, other medications, etc., should be seen as possible culprits for psychosis (whenever someone presents with such.)

    All the best,

    Bob

    2. Integrative Psychiatry/Medicine Thu, Oct 6, 2011 8:49 am

    HI Maria,

    Thank you for this.

    I am very much looking forward to Dr. Shannon’s presentation. I also think that your story illustrates that when someone experiences a manic or psychotic episode, the first thing doctors should look for are agents (such as chemical exposure, psychoactive drugs–illicit or licit) that could have triggered such episodes.

    I hope that integrative psychiatry becomes the future.

    Bob

    3. Article: After Soteria House Shooting Victim Dies, Questions Remain July 24 2011

    Hi Maria,

    What happened at Soteria is such a tragedy. What the article didn’t state is that the woman who was killed was one of the home’s real success stories. She had gotten off medications and was doing so well. Her death is so heartbreaking.

    Regarding your other point here, well, I think all of psychiatry needs to think about this point, which is that many things can induce psychosis, including other medications, and thus they avoid seeing psychosis as necessarily a sign of mental illness. Physicians a century ago regularly thought that psychosis could result from poisoning, other diseases, etc.

    I recently was at an event where one of the psychiatrists said that he believed that 80% of those diagnosed with schizophrenia in recent years had been doing illicit drugs before they had their psychotic break.

    all the best,

    Bob

    4. Talk by e-Patient Dave from the Society of Participatory Medicine Wed, Jul 6, 2011 10:52 am

    Hi Maria,

    It was nice to meet Dr. Sinaikin there, and all in all, the conference was decent, and actually not too radical.

    I’m sorry to hear that ICSPP didn’t show much interest in Dr. Kohl’s presentation.

    And I agree with you on this–many, many things can induce psychosis (illicit drugs, lack of sleep, physical illnesses, etc.), and it’s a mistake to lump psychosis into one large cagtegory.

    I think the old adage of doctors needing to take a detailed case history (which is a form of participatory medicine) needs to be recalled and reintegrated into practice.

    Psychosis is just a symptom of something amiss, and often, not a disease unto itself.

    Thanks for this link. I’ll check it out.

    Bob

    posted on Mad in America dot com 12/2/12

  • Dear Fulli MD,

    I am not quoting a church.

    The Citizens Commission on Human Rights (CCHR)of Florida is a not-for-profit organization.

    Members of CCHR are from many different religions. The organization was founded in part by the Church of Scientology but many of the members are Christian.

    CCHR has a long list of accomplishments that have helped to protect individuals in our mental health care system and they are credited for educating many individuals who did not know of the great harm psych meds can cause.

  • Corinna,

    I’m not sure how this statement fits into anything that I am referencing.

    “Marijuana is not a food group like some people may be thinking.”

    Marijuana as a food group? I’m not really sure how this applies.

    The issues that I am concerned with involve the “Chinese menu” approach or using the DSM:

    1. Are certain individuals in our mental health care system suffering from underlying medical conditions misdiagnosed as sz/bp being forced to contract ineffective and potentially lethal treatments?

    Yes, there are many medical conditions and substances that can induce encephalopic conditions and manifest as psychotic symptoms.

    Medical professionals should follow Best Practice assessment guidelines to rule out underlying medical condition and ensure medications are not used on a long-term basis.

    2. Are there any diagnositic tests for mental disorders?

    Yes, these are mental disorder as described by the DSM:

    293.82 Psychotic Disorder Due to Medical Condition, with Hallucinations

    293.83 Mood Disorder Due to Medical Condition

    293.89 Anxiety Disorder Due to Medical Condition

    There is a long list of medical conditions that can manifest as psychosis, including brain tumors and Hashimoto’s encephalopathy. An MRI and blood tests are diagnostic tests that can diagnose these mental disorders.

    Please listen to this interview,

    http://www.youtube.com/watch?v=pm77RQdtpSY

    Bob states quite clearly youth doing marijuana are are increased risk of ending up with a dx of bp.

    He also states he believes more than 50% of those labeled with mental illness entered into the system from the use of illegal drugs. He states he did not realize this when he wrote Anatomy of an Epidemic.

    These are emails responses I have had from Bob regarding underlying causes of psychosis.

    Best Practice assessment of psychotic symptoms is the most ethical standpoint an advocate could take.

    Why would we want to overlook a medical condition or a substance causing psychosis?

    Especially when that substance could be a psychiatric medication that induced a psychotic episode resulting in a parent killing their own child. eg. Ryan Ehlis, Dena Schlosser, Otty Sanchez, Julie Schenecker and David Crespi.

    Advocates need to get on the same page with this problem.

    1. APA seems to embrace psychotherapy/cognitive therapy Thu, May 10, 2012 4:01 am

    Hi Maria,

    I was speaking to a group of primary care physicians yesterday, and this very point came up. And that is, in the past, the first thing doctors did when presented with someone with psychiatric symptoms was think of possible physical causes (thyroid, vitamin and mineral deficiencies,), and of course environmental toxins.

    And your letter does highlight part of the problem, which is that those against the drug model usually have their own horse they want to ride, which is talk therapy, or some other form of therapy.

    But you are right–I think nutrition, environmental toxins, lack of sleep, other medications, etc., should be seen as possible culprits for psychosis (whenever someone presents with such.)

    All the best,

    Bob

    2. Integrative Psychiatry/Medicine Thu, Oct 6, 2011 8:49 am

    HI Maria,

    Thank you for this.

    I am very much looking forward to Dr. Shannon’s presentation. I also think that your story illustrates that when someone experiences a manic or psychotic episode, the first thing doctors should look for are agents (such as chemical exposure, psychoactive drugs–illicit or licit) that could have triggered such episodes.

    I hope that integrative psychiatry becomes the future.

    Bob

    3. Article: After Soteria House Shooting Victim Dies, Questions Remain July 24 2011

    Hi Maria,

    What happened at Soteria is such a tragedy. What the article didn’t state is that the woman who was killed was one of the home’s real success stories. She had gotten off medications and was doing so well. Her death is so heartbreaking.

    Regarding your other point here, well, I think all of psychiatry needs to think about this point, which is that many things can induce psychosis, including other medications, and thus they avoid seeing psychosis as necessarily a sign of mental illness. Physicians a century ago regularly thought that psychosis could result from poisoning, other diseases, etc.

    I recently was at an event where one of the psychiatrists said that he believed that 80% of those diagnosed with schizophrenia in recent years had been doing illicit drugs before they had their psychotic break.

    all the best,

    Bob

    4. Talk by e-Patient Dave from the Society of Participatory Medicine Wed, Jul 6, 2011 10:52 am

    Hi Maria,

    It was nice to meet Dr. Sinaikin there, and all in all, the conference was decent, and actually not too radical.

    I’m sorry to hear that ICSPP didn’t show much interest in Dr. Kohl’s presentation.

    And I agree with you on this–many, many things can induce psychosis (illicit drugs, lack of sleep, physical illnesses, etc.), and it’s a mistake to lump psychosis into one large cagtegory.

    I think the old adage of doctors needing to take a detailed case history (which is a form of participatory medicine) needs to be recalled and reintegrated into practice.

    Psychosis is just a symptom of something amiss, and often, not a disease unto itself.

    Thanks for this link. I’ll check it out.

    Bob

    posted on Mad in America dot com 12/2/12

  • Corinna,

    Here is one of Bob’s recent lectures.

    His lectures support the disease model, don’t they?

    At this point I am at a loss why he does not incorporate the fact the most common cause of acute psychosis is drug toxicity from recreational, prescription, or OTC drugs and organic causes of psychosis are being overlooked.

    I am quite sure if he or one of his loved ones experienced a first time pyschotic episode he would want a physician who would test for and treat underlying medical conditions.

    Robert Whitaker – Global Psychiatric Epidemic – October 23, 2012 – CPH

    http://www.youtube.com/watch?v=VgS79hz1saI

    posted on Mad in America dot com 11/28/2012

  • Thank you for your reply.

    In his book Mad in America, Bob mentions “insanity” cures included pulling infected teeth.

    Some individuals suffering from a psychotic epidsode might actually benefit from a visit to their dentist and a prescription of the antibiotic flagyl.

    In my opinion, in cases of acute psychotic/manic episodes seeking/forced into treatment, our mental health care system would benefit greatly if medical doctors moved away from the “Chinese menu” approach of using the DSM and moved towards Best-practice assessment, integrated care and informed consent.

    Just because someone is in a psychotic state, does not mean they are ignorant enough to refuse an MRI to rule out a possible brain tumor, or other underlying medical condition that can induce psychosis/mania.

    Dr. Fulli do you think this is good advice for someone who experiences a first time psychotic/manic episode?

    “a complete physical examination by a competent medical practitioner who does not prescribe psychiatric drugs. Very often when a person is experiencing emotional or behavioral problems, there is an underlying, undiagnosed medical condition causing the symptoms diagnosed as a psychiatric disorder. These conditions include, but are not limited to, allergies, infections, sleep disorders, toxins, nutritional deficiencies and hormone imbalances.”

  • Gina,

    I would like to conduct an informal survey among mental health professionals and others who write about the treatment of psychosis and mania.

    If we consider symptoms of psychosis/mania could be caused by a number of medical conditions including but not limited to: brain tumors, cerebrovascular disease, Huntington’s disease, multiple sclerosis, Creitzfeld-Jakob disease, anti-NMDAR Encephalitis, herpes zoster-associated encephalitis, head trauma, infections such as neurosyphilis, epilepsy, auditory or visual nerve injury or impairment, deafness, migraine, endocrine disturbances, metabolic disturbances, vitamin B12 deficiency, a decrease in blood gases such as oxygen or carbon dioxide or imbalances in blood sugar levels, and autoimmune disorders

    then, we should all keep in mind that no person is immune from a manic/psychotic episode.

    This is the question I have for Dr. Harrow, Robert Whitaker, yourself and all others who blog on Mad in America: If you experienced an acute psychotic/manic episode, what treatment, if any, would you seek? and why?

    Kind Regards,
    Maria Mangicaro

    Posted on Mad in America dot com on 11/27/2012

  • Dr. Fulli,

    You are welcome.

    Consider symptoms of psychosis/mania could be caused by a number of medical conditions including but not limited to: brain tumors, cerebrovascular disease, Huntington’s disease, multiple sclerosis, Creitzfeld-Jakob disease, anti-NMDAR Encephalitis, herpes zoster-associated encephalitis, head trauma, infections such as neurosyphilis, epilepsy, auditory or visual nerve injury or impairment, deafness, migraine, endocrine disturbances, metabolic disturbances, vitamin B12 deficiency, a decrease in blood gases such as oxygen or carbon dioxide or imbalances in blood sugar levels, and autoimmune disorders

    I think any reasonable person would value medical care during an acute psychotic/manic episodes.

    We should all keep in mind that no person is immune from a manic/psychotic episode.

    If I could ask Robert Whitaker one question in an interview it would be: If you experienced an acute psychotic/manic episode, what treatment, if any, would you seek? and why?

    If you wouldn’t mind me asking, what would be your answer to this question?

    Kind Regards,
    Maria Mangicaro

    posted on Mad in America dot com 11/27/12

  • Corinna,

    If we consider the broad spectrum of issues that concern many regarding mental/behavioral/emotional health care, we start to realize there are more than 50 shades of grey in the antomy of the “mental illness” epidemic.

    But what if we could distinguish certain issues as purely black and white? right or wrong? we could start to really create transparency among advocates.

    For example, I am sure you are familiar with the war of the words between Bob and Dr. Torrey.

    But how did this very important admission by Dr. Torrey get so overlooked:

    “In its 396 pages Whitaker got many things right, including criticism of the broad DSM diagnostic criteria for mental illnesses; the reckless prescribing of psychiatric drugs for children; and the prostitution of many psychiatric leaders for the pharmaceutical industry.”

    If these are issues that both Dr. Torrey and Bob feel are problems, shouldn’t advocates who support both Dr. Torrey and Bob be working together to highlight these issues and find solutions?

    These are the same issues highlighted by CCHR, so shouldn’t they be included as well?

    When we realize just how much information is being thrown around on the internet, are we overlooking prime opportunities to make real change?

    I just did a search on Mad in America and there is not one single mention of Gabriel Myers and only one mention of Rebecca Riley and Ke’onte Cook. This site has grown so much, but how are these very important cases being overlooked by so many Mad bloggers?

    These are cases that all mental health advocates should create an awareness of.

    What if it were possible to sort through all of the major issues in mental health care and create a uniform advocacy agenda based on a reasonable person standard?

    What would a reasonable person agree to advocate on behalf of?

    From what you are aware of, do you think it would be possible to create a single focused platform that all members of NAMI, all members of CCHR and all members of all other mental health advocacy organizations in between would unanimously agree to add to their agenda?

    As well, this platform would be one that Robert Whitaker, Pete Earley, Dr. Breggin, Dr. Torrey and all other individuals who write about mental health topics and maintain websites regarding the treatment of severe mental illness would agree to support through internet advocacy?

    What would it mean to our troubled health care system and stressed economy if we could find priority issues to push to the forefront in order to promote a set of benchmarking initiatives in specific areas of mental health care?

    Here is just one example:

    If we consider some individuals who experience symptoms that could be considered manic/psychotic are able to adapt to a certain lifestyle, we must also consider individuals who can not cope with mania/psychosis and either seek treatment or are forced into psychiatric care.

    Cases of acute psychosis/mania need to be considered by medical professionals as they could be symptoms of a lifethreatening medical conditions.

    We know that most mental health and medical professionals use the DSM with a “Chinese menu” approach of labeling symptoms of psychosis/mania as schizophrenia/bipolar and a silver bullet psychopharmacological treatment approach.

    Why would advocates not want to support Best Practice assessment of psychosis to ensure patients who are seeking help during a crisis mental/behavioral/emotional condition are not simply labeled “mentally ill”, treated with toxic medications, and leaving encephalopic condition caused by a virus, bacteria, toxin, or other medical condition overlooked and untreated?

    Patients being treated are entitled to accurate assessment, informed consent and integrated care.

    It is an ethical position for advocates to support psychiatry moving away from the “Chinese menu” approach and towards Best-practice assessment standards.

    CCHR Florida has the statement pasted below on their website.

    I think it would be wise of Mad in America dot com and the Foundation for Excellence in Mental Health Care to have similar statements.

    This is sound advice and CCHR Florida has helped prevent many individuals who were labeled bipolar/schizophrenic get help through medical doctors who use Functional Medicine. The Executive Director of CCHR Florida maintains the 24 hour hotline most of the time herself. In one month alone she helped 3 parents figure out their teenagers had a psychotic reaction to the routine use of over-the-counter cold medicine. Another case recently was psychosis from dehydration.

    Advocates need to stop taking sides and figure out ways to work side-by-side. We are all in this together. Regardless of being members of an organization or a religion, we are advocating for others, many of whom are among a marginalized population and do not have access to the internet and discussions on what they think would help them recovery.

    Advocates need to take responsibility and I think this statement on CCHR Florida’s website shows they are being responsible advocates.

    CCHR recommends getting a complete physical examination by a competent medical practitioner who does not prescribe psychiatric drugs. Very often when a person is experiencing emotional or behavioral problems, there is an underlying, undiagnosed medical condition causing the symptoms diagnosed as a psychiatric disorder. These conditions include, but are not limited to, allergies, infections, sleep disorders, toxins, nutritional deficiencies and hormone imbalances.

    The list below is of Recommended Medical Websites that many people have found helpful in finding a competent, non-psychiatric, medical doctor. CCHR provides these websites as a public service on a ‘buyer-beware’ basis, you must use your own judgment in deciding which site will best serve your specific needs, and you do so at your own risk.

    WARNING: No one should stop taking any psychiatric drug without the advice and assistance of a competent, non-psychiatric, medical doctor!

    Posted on Mad in America dot com 11/27/2012

  • Gina,

    By the term “research” I mean the time and effort Bob spent pulling information out of the medical library and selecting individuals to interview in order to support the premise of Anatomy of an Epidemic.

    Bob’s background of course is that of a former Boston Globe reporter and not that of a clinical researcher.

    Do you know if Bob has ever taken a course in abnormal psychology?

    In my opinion, when it comes to symptoms of psychosis/mania, mental health care advocates could start speeding up the process of providing excellence in mental health care (as well as saving the money of tax payers and of course saving the lives of those they claim to advocate for) by working together for common goals.

    We need to consider that most mental health and medical professionals lean towards using the “Chinese menu” approach of applying the DSM labels of schizophrenia/bipolar, and fail to use Best Practice standards that test for and treat:

    1. underlying medical conditions
    2. substance-induced disorders
    3. medication-induced disorder

    Below is just one case of thousands of examples of an individual who suffered for 2 years because of the failure to recognize the underlying cause of her symptoms.

    I find it very sad that mental health care advocates spend so much time and energy disputing opinions and data and can not find ways of communicating more effectively on how to make improvements on issues they are in agreement on.

    Advocates need to start finding common grounds to support one another.

    For example, Dr. Torrey may criticize aspects of Bob’s books, but we need to consider what they both agree on and build from that.

    “In its 396 pages Whitaker got many things right, including criticism of the broad DSM diagnostic criteria for mental illnesses; the reckless prescribing of psychiatric drugs for children; and the prostitution of many psychiatric leaders for the pharmaceutical industry.”

    These are very important problems that should invite joint ventures in resolving.

    If all mental health advocates stood together and supported best practice assessment standards for psychosis that would help prevent patients from being misdiagnosed. What better way to start achieving excellence in mental health care than preventing needless suffering?

    Neuropsychiatric systemic lupus erythematosus presenting as bipolar I disorder with catatonic features.

    Psychosomatics. 2009 Sep-Oct;50(5):543-7.

    Alao AO, Chlebowski S, Chung C.

    Source

    Department of Psychiatry, SUNY Upstate, NY 13210, USA. [email protected]

    Abstract

    BACKGROUND:

    The American College of Rheumatology has defined 19 neuropsychiatric syndromes associated with systemic lupus erythematosus (SLE) involving the central, peripheral, and autonomic nervous systems. Neuropsychiatric manifestations of lupus (NPSLE) have been shown to occur in up to 95% of pediatric patients with SLE.

    OBJECTIVE:

    The authors describe a 15-year-old African American young woman with a family history positive for bipolar I disorder and schizophrenia, who presented with symptoms consistent with an affective disorder.

    METHOD:

    The patient was diagnosed with Bipolar I disorder with catatonic features and required multiple hospitalizations for mood disturbance. Two years after her initial presentation, the patient was noted to have a malar rash and subsequently underwent a full rheumatologic work-up, which revealed cerebral vasculitis.

    RESULTS:

    NPSLE was diagnosed and, after treatment with steroids, the patient improved substantially and no longer required further psychiatric medication or therapy.

    CONCLUSION:

    Given the especially high prevalence of NPSLE in pediatric patients with lupus, it is important for clinicians to recognize that neuropsychiatric symptoms in an adolescent patient may indeed be the initial manifestations of SLE, as opposed to a primary affective disorder.

  • Corinna,

    As a volunteer for International Society for Ethical Psychology and Psychiatry (ISEPP)it is my way of giving back as I feel I have been very blessed.

    Membership in ISEPP is attractive to many as it welcomes both professionals and non-professionals alike.

    From my own experiences, it was very difficult to find providers who offered alternatives to main stream psychiatry and it was even more difficult to find a psychiatrist who would work with me if I used complimentary treatments to try and taper off of psych meds.

    Medical professionals risk their reputation and their credentials by offering evidence-based alternatives like Integrative Psychiatry/Functional Medicine.

    Volunteering for ISEPP gives me an opportunity to help provide support to mental health professionals who are open-minded enough to explore, expand and create awareness of evidence-based alternatives.

    Unlike any other health condition, mental/behavioral/emotional health conditions overlap into our criminal justice system, leaving those in need of help incarcerated and at the mercy of limited services and treatment options.

    Historically, mental health laws are unique because they have been designed to employ and empower medical opinion who select specific treatment options. Coercive mental health treatment contributed to the proliferation of the psychopharmacological revolution.

    Sanctioned by the Supreme Court in Buck v. Bell(1927), many individuals labeled with a mental disorder become part of a class of people who can be deprived equal protection, civil liberties and the liberty to contract. They are in need of a strong, ethical and united advocacy agenda that promotes best-practice standards of treatment and care.

    Individuals in the mental health system can be forced to contract the services of specific providers and forced to become consumers of potentially lethal products.

    Because individuals labeled with mental disorders can be perceived as a threat to themselves or others, psychiatry and the use of medication management as the primary choice of “treatment” has become an unregulated power-base of authority in the U.S.

    The topic of “mental illness” involves a broad-spectrum of concerns. My main advocacy agenda involves symptoms of psyhosis and mania.

    Advocates who support forced “treatment” of psychotic symptoms should consider the possibility the treatment they are advocating for could kill a person they claim to be advocating on behalf of, or cause that person to kill/harm others.

    Likewise, advocates who oppose forced treatment of psychotic symptoms should consider the accurate diagnosis and treatment of the symptoms could save the lives.

    As a mental health advocate, my agenda is very specific and based on the fact many medical conditions and substance-induced conditions can manifest as symptoms of psychosis/mania and be misdiagnosed as schizophrenia/bipolar disorder.

    My goal as an advocate is to raise the bar on forced “treatment” to include accurate assessment, informed consent and treatment options that include the right treatment.

    In 1996 I suffered an acute manic episode from toxic encephalopathy. I was misdiagnosed as having bipolar disorder with psychotic features at the same hospital that according to the published study pasted below, misdiagnosed a 15-year-old girl suffering from lupus. After treatment with steroids, she no longer required psych meds.

    In my opinion, trying to prevent prolonged suffering from being misdiagnosed is well worth putting time, effort and energy into.

    I’m not sure where I would fit in on your graphic.

    Kind Regards,
    Maria Mangicaro

    Neuropsychiatric systemic lupus erythematosus presenting as bipolar I disorder with catatonic features.

    Psychosomatics. 2009 Sep-Oct;50(5):543-7.

    Alao AO, Chlebowski S, Chung C.

    Source

    Department of Psychiatry, SUNY Upstate, NY 13210, USA. [email protected]

    Abstract

    BACKGROUND:

    The American College of Rheumatology has defined 19 neuropsychiatric syndromes associated with systemic lupus erythematosus (SLE) involving the central, peripheral, and autonomic nervous systems. Neuropsychiatric manifestations of lupus (NPSLE) have been shown to occur in up to 95% of pediatric patients with SLE.

    OBJECTIVE:

    The authors describe a 15-year-old African American young woman with a family history positive for bipolar I disorder and schizophrenia, who presented with symptoms consistent with an affective disorder.

    METHOD:

    The patient was diagnosed with Bipolar I disorder with catatonic features and required multiple hospitalizations for mood disturbance. Two years after her initial presentation, the patient was noted to have a malar rash and subsequently underwent a full rheumatologic work-up, which revealed cerebral vasculitis.

    RESULTS:

    NPSLE was diagnosed and, after treatment with steroids, the patient improved substantially and no longer required further psychiatric medication or therapy.

    CONCLUSION:

    Given the especially high prevalence of NPSLE in pediatric patients with lupus, it is important for clinicians to recognize that neuropsychiatric symptoms in an adolescent patient may indeed be the initial manifestations of SLE, as opposed to a primary affective disorder.

    http://psychoticdisorders.wordpress.com/2012/11/25/neuropsychiatric-systemic-lupus-erythematosus-presenting-as-bipolar-i-disorder-with-catatonic-features/

    Posted on Mad in America 11/25/2012

  • The concept of “schizophrenia” as a disease itself is a myth.

    Schizophrenia is nothing more than an unscientific and stigmatizing descriptive label placed on a person through the “Chinese Menu” approach of the DSM. (Which the APA and psychiatrists admit is the case.)

    A person with a head injury could end up labeled schizophrenic or bipolar just as easily as a person with an encephalopic condition could.

    The labels of schizophrenia and bipolar disorder do not address the root causes of psychotic or manic symptoms.

    Recovery from symptoms classified as “schizophrenia” and “bipolar disorder” would be a hell of a lot easier if those using the Diagnostic Manual learned how to use it to rule out:

    1) Medical Conditions
    2) Substance-Induced
    3) Medication-Induced psychosis/mania

    This is not rocket science, and it does not require any research. The codes are right in the DSM.

    293.81 Psychotic Disorder Due to Medical Condition, with Delusions

    293.82 Psychotic Disorder Due to Medical Condition, with Hallucinations

    293.83 Mood Disorder Due to Medical Condition

    293.89 Anxiety Disorder Due to Medical Condition

    298.8 Brief psychotic disorder

    289 Anxiety Disorder Due to Medical Condition

    298.8 Brief psychotic disorder

    291.3 Alcohol-Induced Psychotic Disorder With Hallucinations

    There are many cases medical conditions that have been misdiagnosed as mental illness. It is cruel to allow the suffering to continue.

    Hashimoto encephalopathy presenting as schizophrenia-like disorder.

    Cogn Behav Neurol. 2009 Sep;22(3):197-201.

    Lin YT, Liao SC.

    Source

    Department of Psychiatry, National Taiwan University Hospital and Medical College, Taiwan.

    Abstract

    OBJECTIVE:

    Hashimoto encephalopathy (HE) is associated with numerous neuropsychiatric symptoms and responds well to steroid therapy. In the past, only a few cases were reported to present with pure psychiatric syndromes. We describe a case of HE with presenting symptoms like that of schizophrenic patients.

    METHODS:

    We describe a 73-year-old woman with a history of autoimmune thyroiditis. She had psychotic symptoms for 3 years that responded poorly to antipsychotic agents, and she was thus admitted in 2007.

    RESULTS:

    The diagnosis of HE was made, although the patient presented neurologic symptoms and signs including abnormal electroencephalography, recent memory impairment, and executive function declination. The psychotic symptoms subsided completely in a few days after high-dose intravenous steroid therapy.

    CONCLUSIONS:

    The neuropsychiatric manifestation of HE can be similar to typical schizophrenia. Considering the effectiveness of steroid therapy for HE, we suggested HE as an important differential diagnosis for psychotic disorders, particularly for those patients of late onset, with abnormal electroencephalography, history of autoimmune thyroiditis, or poor response to conventional psychiatric treatment, so as to provide prompt and effective treatment for these patients.

    Psychosomatics. 2009 Sep-Oct;50(5):543-7.

    Neuropsychiatric systemic lupus erythematosus presenting as bipolar I disorder with catatonic features.

    Alao AO, Chlebowski S, Chung C.

    Source

    Department of Psychiatry, SUNY Upstate, NY 13210, USA. [email protected]

    Abstract

    BACKGROUND:

    The American College of Rheumatology has defined 19 neuropsychiatric syndromes associated with systemic lupus erythematosus (SLE) involving the central, peripheral, and autonomic nervous systems. Neuropsychiatric manifestations of lupus (NPSLE) have been shown to occur in up to 95% of pediatric patients with SLE.

    OBJECTIVE:

    The authors describe a 15-year-old African American young woman with a family history positive for bipolar I disorder and schizophrenia, who presented with symptoms consistent with an affective disorder.

    METHOD:

    The patient was diagnosed with Bipolar I disorder with catatonic features and required multiple hospitalizations for mood disturbance. Two years after her initial presentation, the patient was noted to have a malar rash and subsequently underwent a full rheumatologic work-up, which revealed cerebral vasculitis.

    RESULTS:

    NPSLE was diagnosed and, after treatment with steroids, the patient improved substantially and no longer required further psychiatric medication or therapy.

    CONCLUSION:

    Given the especially high prevalence of NPSLE in pediatric patients with lupus, it is important for clinicians to recognize that neuropsychiatric symptoms in an adolescent patient may indeed be the initial manifestations of SLE, as opposed to a primary affective disorder.

  • Belinda,

    I’m not sure why you think that I am a proponent of the use of psychiatric medications.

    I am a very honest person, I have suffered harm from psych meds and I have also experienced benefits from them, I volunteer my time to organizations devoted to mental health advocacy and God is all I want on my side.

    My father’s death was a result of the overuse of psych meds and ECT. I certainly DO NOT promote their use.

    I am a proponent of Integrative Psychiatry/Functional Medicine, alternative therapies and informed consent.

    I feel advocacy is needed to support the benefits of these evidence-based modalities so that they will become readily available and paid for by insurance.

    To me transparency is important in mental health advocacy and I make every attempt to reply to comments in respectful and clear manner.

    I do own a copy of Mad in America: Bad Science, Bad Medicine and the Enduring Mistreatment of the Mentally Ill that I paid $17.50 +tax for.

    I am disappointed that this book outlines the history of psychiatry without acknowledging Dr. Abram Hoffer, Dr. Linus Pauling or Orthomolecular psychiatry.

    The book contains a lot of information but is written with many shades of gray. There are no black and white well-defined conclusions.

    The book skips over the historical significance of Buck v. Bell, a case that directly contributed to the massive unregulated power-base of authority psychiatry has in our society today.

    Bob would have much more knowledge of good science, good medicine and fair treatment of the “mentally ill” if he spent some time learning from doctors who practice Integrative Medicine.

    Bob is not a mental health advocate and he does not take sides between “pro-psychiatry” and “anti-psychiatry”.

    Bob has many anti-psychiatry supporters on his side but keep in mind in order to keep his journalistic perspective and integrity he must remain neutral an he is not on their side.

    The doctor who helped me the most was Dr. Charles Gant. I have encouraged Bob and Dr. Mark Foster to learn more about Integrative Medicine. This past week Dr. Foster posted on his Facebook page that he was attending a conference on Integrative Medicine. I was very happy to hear that as even Bob stated “I hope that integrative psychiatry becomes the future.”

    Belinda, because you are taking the time to respond to my posts, I hope that you will take the time to learn more about my perspective that is inline with that of Dr. Charles Gant. Here is one of his videos.

    http://www.youtube.com/watch?v=MDQPb6cV8Jw

    Kind Regards,

    Maria Mangicaro

    Posted on Mad in America dot com on 10/30/2012

  • Belinda,

    I do not mean to upset you and I welcome discussion.

    From personal experience, side effects of medications can come about quickly. They can build up in your system and suddenly cause a homeostatic imbalance.

    Delusions can also start up for days and either subside or completely take over the thought process. A person in a delusional state can be perceived as normal by others.

    Ryan Ehlis was found not guilty of murder because the drug company and his treating psychiatrist admitted Adderall induced his psychotic state. He was on the medication for 10 days. The symptoms began shortly after he starting taking it but the crime took place on day 10.

    Stephan Antonsson, the Senior Vice-President of Shire Richwood, a British-owned corporation that makes Adderall stated Ryan’s case was “the most severe case that’s ever occurred.”

    I am very familar with David Crespi’s case as I am friends with Kim and have had very long conversations with her.

    David Crespi’s 911 call used to be posted online but I can no longer locate it. During the call it was clearly evident to the 911 operator that David was overmedicated. David was suicidal and about to kill himself. It took years for David to wean off of medications and be back to a normal state of mind.

    The police removed over 560 psych meds from the home of Julie Schenecker. It was clearly visible upon her arrest and friends also testified that Jule suffered from tardive dyskinesia resulting from the long-term use or high dosages of anti-psychotic drugs.

    In August Chevonne Thomas killed her young son by cutting his head off and putting it in the freezer before killer herself. She was on Prozac. You can listen to her 911 call for yourself.

    Fat tissue does store 33% more toxins than lean body mass. Weight loss, or sweating can cause a release of substances such as medications into the blood stream that we have taken in the past.

    Dr. Charles Gant is an MD that would be able to answer your questions, also other doctors involved in Integrative Psychiatrists/Functional Medicine would be able to explain more.

    http://www.youtube.com/watch?v=MDQPb6cV8Jw

    http://isepp.wordpress.com/2012/08/24/cases-of-filicide-do-911-operators-easily-recognize-medication-induced-psychosis/

    Posted on Mad in America dot com on 10/30/2012

  • Ted,

    Considering in a complaint of libel, Bob bears the burden of proof, do you think the moderator of Mad in America dot com should remove any comments that may be viewed as attacking Dr. Torrey’s character or professional abilities?

    Don’t you think Dr. Torrey could have a counter claim if they were not removed by the moderator?

    It may be viewed that Dr. Torrey has misinterpreted a large volume of information that Bob has written about and he has a professional difference of opinion than other psychiatrists who write on Mad in America dot com.

    For the purpose of clarity, it would be helpful if Bob had a summary of conclusions listed on Mad in America dot com.

    There are many shades of gray in the anatomy of the “mental illlness” epidemic and Bob’s work is unique in that he is able to be adapted to fit in at main stream psychiatric events as easily as he can at anti-psychiatry sponsored functions.

    Without clearly defining conclusions and lack of transparency, misinterpretations seem likely.

    I think mental health advocates should take advantage of the fact Dr. Torrey agrees with Bob on major issues that we are up against.

    “Whitaker is correct in criticizing the pharmaceutical industry, the overuse of psychiatric medications by physicians and the psychiatric profession for being financially in the pocket of the pharmaceutical industry.”

    In another review, Dr. Torrey writes:

    “In its 396 pages Whitaker got many things right, including criticism of the broad DSM diagnostic criteria for mental illnesses; the reckless prescribing of psychiatric drugs for children; and the prostitution of many psychiatric leaders for the pharmaceutical industry. Indeed, regarding the last, Whitaker may have understated the problem, based on recently released court documents detailing how the pharmaceutical industry secretly controlled the Texas Medication Algorithm Project.”

    These admissions are a huge win for Bob.

    Anyhow, what’s wrong with creating a new-anti-psychiatry? Bob should be proud of that and based on his own admissions, welcome Dr. Torrey to be part of it.

    Let’s not worry so much about what one pdoc thinks about Anosognosia and let’s start working together to fix problems like the “reckless prescribing of psychiatric drugs for children”, “the overuse of psychiatric medications by physicians and the psychiatric profession for being financially in the pocket of the pharmaceutical industry”

    My question to Dr. Torrey, How do you purpose we fix these problems?

    Posted on Mad in America dot com on 10/30/2012

  • You bring up a great point as there are many substances and medical conditions that are known to induce psychosis/mania that can be misdx’d as sz/bp.

    The DSM lists them, the fault lies on medical professionals for not using the DSM to make accurate assessments.

    On page 80 of Mad in America Bob refers to scientific literature dating back to 1876 of insanity being cured by the removal of infected molars and cuspids. Today holistic dentists are relating many conditions to dental problems, including psychosis. Many individuals in the mental health care system lack adequate dental care, have substance abuse issues or are heavy smokers. We also know that long-term studies indicate childhood exposure to lead increases the chances of violent criminal behavior later in life, leaving individuals at risk of being labeled “mentally ill”.

    Even the routine use of over-the-counter cold medicine can induce psychosis that is clinically indistinguishable from paranoid sz.

    http://psychoticdisorders.wordpress.com/category/cold-medicine-induced-psychosis/

    Many mental health patients labeled with bp/sz are entitled to malpractice suits, as well as other types of law suits.

    The real lies and the real crime is the fact our mental health care system uses a rubber-stamp approach of labeling individuals in a psychotic/manic state schizophrenic or bipolar without testing for and treating the underlying cause.

    Rather than nitpicking over he said/she said opinions and criticizing each other, I think mental health advocates should jump on the fact that Dr. Torrey in his post agrees to major allegations made against psychiatry. He is agreeing to the allegations made by those involved in the anti-psychiatry movement.

    “Whitaker is correct in criticizing the pharmaceutical industry, the overuse of psychiatric medications by physicians and the psychiatric profession for being financially in the pocket of the pharmaceutical industry.”

    Torrey accuses Bob of being part of the anti-psychiatry movement, well he sure seems like he is onboard too.

    I think it is a misnomer to state Scientology as being “anti-psychiatry”, as they don’t like the profession of psychology either and many medical professionals prescribe psychiatric medications, not just psychiatrist.

    In reality Scientology has created an anti-medication management, anti-abnormal psychology movement.

    Posted on Mad in America dot com on 10/30/2012

  • Dear Bob,

    I am understanding to the fact that you are extremely upset over Dr. Torrey’s review of your book and I do not challenge your allegations that Dr. Torrey is liar and that you feel you are entitled to a libel suit against him.

    Have you written any reviews of his book “Invisible Plague: The Rise of Mental Illness from 1750 to the Present”? I would be curious to read them and I think the readers on Mad in America dot com might enjoy your perspectives on his work.

    As a mental health advocate, I appreciate the fact your efforts have made it easier for some individuals to have their opinions recognized and heard.

    Your work is especially important as you have managed to carefully crafts and maintain a position that demonstrates the many shades of gray in the “anatomy’ of the “mental illness” epidemic.

    It is with a delicate balance that you are able to craft your lectures to fit in at events that are managed by main stream psychiatry as comfortably as you would be at those strategically planed as an anti-mainstream-abnormal psychology protest.

    Your concerns that certain individuals who hold prestigious titles and positions make it exceedingly difficult for our society to have an honest discussion about the merits of psychiatric medications, and their place in our society are the same as mine.

    For the benefit of mental health advocates I think it is important to take a careful look at Dr. Torrey’s complete allegations.

    Dr. Torrey states: “Whitaker is correct in criticizing the pharmaceutical industry, the overuse of psychiatric medications by physicians and the psychiatric profession for being financially in the pocket of the pharmaceutical industry.”

    Bob, this is a win for you on a major point. Having his statement in black and white is a huge achievement on the part of those of us who are in line with an agenda that recognizes the great harm caused by the overuse of psych. Advocate for the use of integrated care and alternative modalities is essential in order for them to be paid for by insurance companies. It is the lack of availablity to alternatives that makes the drug industry strong.

    In the U.S. main stream psychiatry is an unregulated power-base of authority. No other industry has government backing to force individuals to contract professional services and consume potentially lethal products at the expense of taxpayers.

    Establishing legitamate alternatives to main stream psychiatry will have a dismantling effect on our current costly mental health care system.

    On another review of Anatomy of an Epidemic Dr. Torrey writes:

    “In its 396 pages Whitaker got many things right, including criticism of the broad DSM diagnostic criteria for mental illnesses; the reckless prescribing of psychiatric drugs for children; and the prostitution of many psychiatric leaders for the pharmaceutical industry. Indeed, regarding the last, Whitaker may have understated the problem, based on recently released court documents detailing how the pharmaceutical industry secretly controlled the Texas Medication Algorithm Project”

    With so many shades of gray in the “anatomy” of this epidemic, it is a great accomplishment to define in black and white the core problems within main stream psychiatry.

    A mediator to the dispute you have with Dr. Torrey would regard his statements as a starting point for conflict resolution.

    Many mental health professionals have conflicting opinions due in part to conflicting interests and lack of awareness/training in alternative modalities.

    The journalistic perspective has a strong impact on advocacy and you have taken on a leading role (even though you are not an advocate).

    Many mental health advocates base their agenda on their own personal experiences which vary greatly.

    Dr. Torrey admits a lot in those statements, we need to recognize the value in that.

    Where Dr. Torrey states that you are “dead wrong in alleging that schizophrenia is caused by the antipsychotic drugs used to treat it”, I have heard you state that you relate long-term chronicity to antipsychotic medications and it is a fact that psychiatric medications (as well as many other meds) can cause psychosis that can be misdx’d as schizophrenia. Heck, even the routine use of over-the-counter cold medicine can induce psychosis that is clinically indistinguishable from paranoid sz.

    Dr. Torrey seems to misinterpret your conclusions. Perhaps if you created a clear summary of your conclusions from Anatomy it would be helpful for those who are critics and seem to twist your words around (from my experience both psychiatrists and psychologists are pretty good at that)

    For a successful libel suit, you need to prove that Dr. Torrey published false statements of fact about you that have harmed your reputation.

    Bob, you are well aware of the fact that an honest discussion means that your efforts will face criticism.

    At this point in time, do you feel you have received any criticism that actually is justified? or in your opinion has all of the criticism on Anatomy been based on lies?

    Bob, I have a great amount of respect for you. Transparency is very important and I think you can tell that I am a very honest individual who is devoted to mental health advocacy.

    Advocates, whether they are members of NAMI, CCHR or any other organization need to find topics they can all agree on. A divided advocacy means that some patients will not have equal representation.

    I am not a Scientologist but I am very grateful to the nonprofit organization CCHR and the members who are also devoted mental health advocates. I am not prejudice of those who choose to belong to the Church of Scientology and I respect them as strong advocates.

    I hope that you will consider learning more about the background of CCHR as a nonprofit organization and be respectful of individuals like Maria Bradshaw, Walter Kowalczyk and Amy Philo who credit CCHR for helping them.

    The following statements you made in your interview “Why Psychiatry Embraced Drugs” seem to discredit the value of almost 5 decades of advocacy by CCHR members:

    “I made a little joke in the book about psychiatry secretly funding scientology, but really, it couldn’t have worked out better for the pharmaceutical companies and biological psychiatry. The reason is that, of course, it delegitimizes criticism. The fact that scientology is so visibly attacking biological psychiatry and attacking psychiatric drugs delegitimizes all criticism. Scientologists clearly do have a cult-like status and they clearly do have an agenda. The fact that they’re so visible makes it very easy for psychiatry and pharmaceutical companies to say, “This is just criticism coming from that crazy group.”

    Some of the stuff, they’ve gone into the data and they’ve brought out some information. Because it was scientology and CCHR that was out front with the criticism and raising questions and raising accusations that these drugs were causing suicide and violence, just made it really easy for pharmaceutical industry and Eli Lily to have it dismissed. If we didn’t have Scientology. Imagine it doesn’t exist and there’s no such group raising criticism. The questions around whether Prozac can stir violence or could cause someone to become suicidal or homicidal would have had a lot more traction.”

    Kind Regards,
    Maria Mangicaro

    Posted on Mad in America dot com on 10/29/2012

  • Dear Phil,

    Are you familiar with Dr. Torrey’s book “Invisible Plague: The Rise of Mental Illness from 1750 to the Present” and his research on acute infection with T. gondii that can produce psychotic symptoms similar to those displayed by persons with schizophrenia?

    Here are some links:

    Toxoplasma gondii and Schizophrenia
    http://wwwnc.cdc.gov/eid/article/9/11/03-0143_article.htm

    Beware of the cat: Britain’s hidden toxoplasma problem

    New research shows 350,000 Britons a year are being infected with pet-borne parasite linked with schizophrenia and increased suicide risk

    http://www.independent.co.uk/news/uk/home-news/beware-of-the-cat-britains-hidden-toxoplasma-problem-8102860.html

    As a mental health advocate, I appreciate the fact that Dr. Torrey states:

    “Whitaker is correct in criticizing the pharmaceutical industry, the overuse of psychiatric medications by physicians and the psychiatric profession for being financially in the pocket of the pharmaceutical industry.”

    On another review of Anatomy of an Epidemic Dr. Torrey writes:

    “In its 396 pages Whitaker got many things right, including criticism of the broad DSM diagnostic criteria for mental illnesses; the reckless prescribing of psychiatric drugs for children; and the prostitution of many psychiatric leaders for the pharmaceutical industry. Indeed, regarding the last, Whitaker may have understated the problem, based on recently released court documents detailing how the pharmaceutical industry secretly controlled the Texas Medication Algorithm Project”

    With so many shades of grey in the “anatomy” of this epidemic, it is a great accomplishment to define in black and white the core problems within main stream psychiatry.

    Many mental health professionals have conflicting opinions due in part to conflicting interests and lack of awareness/training in alternative modalities.

    The journalistic perspective has a strong impact on advocacy and Bob now has a leading role (although he is not an advocate himself).

    Many mental health advocates base their agenda on their own personal experiences which vary greatly.

    Dr. Torrey admits a lot in those statements, I think Bob should recognize the value Dr. Torrey’s admittance have for mental health advocates concerned with the problems he has put forth in his work.

    I can understand why Bob would be upset by Dr. Torrey’s post and I do not challenge his allegations that Dr. Torrey is committing libel and that Bob feels that he is entitled to a libel suit.

    For a successful libel suit, Bob has to prove that Dr. Torrey published false statements of fact about him that harmed his reputation.

    This is an important aspect as it is Bob’s intent to create a national discussion. This discussion needs to include all sides and Bob must accept criticism. Would it be fair to only include those who agree with Bob’s perspectives and opinions?

    What would it mean to mental health advocates if Bob was successful at proving a psychiatrist’s words caused him such great harm that he is entitled to legal recourse?

    Mental health advocates should consider how sad it is that a professional journalist and a medical professional have such a strong standing in our legal system and issue that involves the words of a psychiatrist alone can cause a journalist harm.

    In the United States, psychiatry is an unregulated power-base of authority. It is a unique professions by which state authority can force consumers to contract services and purchase potentially lethal consumer goods at the taxpayers expense.

    I find it disheartening to think of the great harm caused by main stream psychiatry that leaves the families of individuals like Ryan Ehlis and David Crespi with no legal recourse.

    The United States needs strong mental health advocates who accurately present the facts and can create a uniform advocacy agenda. A divided advocacy means unequal and unfair representation.

    The only organization that fights on the behalf of individuals who have been harmed by psych meds is CCHR and even Bob considers CCHR very ineffective. He wrote this an interview on his opinions of “Why Psychiatry Embraced Drugs”:

    “I made a little joke in the book about psychiatry secretly funding scientology, but really, it couldn’t have worked out better for the pharmaceutical companies and biological psychiatry. The reason is that, of course, it delegitimizes criticism. The fact that scientology is so visibly attacking biological psychiatry and attacking psychiatric drugs delegitimizes all criticism. Scientologists clearly do have a cult-like status and they clearly do have an agenda. The fact that they’re so visible makes it very easy for psychiatry and pharmaceutical companies to say, “This is just criticism coming from that crazy group.”

    Some of the stuff, they’ve gone into the data and they’ve brought out some information. Because it was scientology and CCHR that was out front with the criticism and raising questions and raising accusations that these drugs were causing suicide and violence, just made it really easy for pharmaceutical industry and Eli Lily to have it dismissed. If we didn’t have Scientology. Imagine it doesn’t exist and there’s no such group raising criticism. The questions around whether Prozac can stir violence or could cause someone to become suicidal or homicidal would have had a lot more traction.”

    Kind Regards,
    Maria Mangicaro

    Posted on Mad in America on 10/29/2012

  • Dear Anonymous,

    I can completely understand your perspective as 16 years ago I probably would have shared your views.

    I would ask that you please consider the case of Ryan Ehlis.

    In 1999, ten days after Ryan began taking Adderall to control his Attention Deficit Disorder, he slipped into a psychotic fog, shot and killed his infant daughter, then shot himself in the stomach. He said God told him to do it.

    Ehlis was found innocent after testimony by a psychiatrist and by Shire US, Inc., that the “psychotic state” was a very rare side effect of Adderall use.

    Various doctors testified Ehlis suffered from an “Anphetamine-Induced Psychotic Disorder”. (DSM-IV Code 292.11)

    Medical experts and Shire US, Inc., the manufacturer of Adderall, commented that “despite the slaying, Adderall remains a safe and effective drug for controlling AD/HD.”

    You can read more at this link:

    http://isepp.wordpress.com/2011/04/20/23/

    For many reasons, an individual can experience a manic or psychotic state. No human being is immune from the possibility of experiencing mania/psychosis. Under the right circumstances, it can happen to anyone.

    While in a psychotic/manic state, the possibility exists that an individual will act in a way that can inflict harm.

    The Diagnostic and Statistical Manual of Mental Disorders (DSM) lists codes for substances that are known to induce psychosis/mania.

    292.11 Substance [Amphetamine, Cannabis, Cocaine, Hallucinogen, Inhalant, Opioid, Phencyclidine, Sedative*, Other (or Unknown)]-Induced Psychotic Disorder, With Delusions Substance

    292.12 Substance [Amphetamine, Cannabis, Cocaine, Hallucinogen, Inhalant, Opioid, Phencyclidine, Sedative*, Other (or Unknown)]-Induced Psychotic Disorder, With Hallucinations

    A substance-induced psychotic disorder, by definition, is directly caused by the effects of drugs including alcohol, medications, and toxins. Psychotic symptoms can result from intoxication on alcohol, amphetamines (and related substances), cannabis (marijuana), cocaine, hallucinogens, inhalants, opioids, phencyclidine (PCP) and related substances, sedatives, hypnotics, anxiolytics, and other or unknown substances. Psychotic symptoms can also result from withdrawal from alcohol, sedatives, hypnotics, anxiolytics, and other or unknown substances.

    Some medications that may induce psychotic symptoms include anesthetics and analgesics, anticholinergic agents, anticonvulsants, antihistamines, antihypertensive and cardiovascular medications, antimicrobial medications, antiparkinsonian medications, chemotherapeutic agents, corticosteroids, gastrointestinal medications, muscle relaxants, nonsteroidal anti-inflammatory medications, other over-the-counter medications, antidepressant medications, neurleptic medications, antipsychotics and disulfiram . Toxins that may induce psychotic symptoms include anticholinesterase, organophosphate insecticides, nerve gases, carbon monoxide, carbon dioxide, and volatile substances (such as fuel or paint).

    The speed of onset of psychotic symptoms varies depending on the type of substance. For example, using a lot of cocaine can produce psychotic symptoms within minutes. On the other hand, psychotic symptoms may result from alcohol use only after days or weeks of intensive use.

    Kim Crespi is a friend of mine and we have had many long conversations about the tragic loss of her twin 5-year-old daughters.

    Her husband David was so obviously over-medicated that the 911 operators picked up on it immediately and repeatedly asked if he was on any psych meds.

    In my opinion, psychiatric medications could have also played a role in the filicide cases of Dena Schlosser, Otty Sanchez, Julie Schenecker and Chevonne Thomas.

    Kind Regards,
    Maria Mangicaro

    posted on Mad in America dot com on 10/28/12

  • Dear Dr. Steingard,

    I appreciate that you will consider theories of possible underlying causes of psychosis.

    On page 166 of “Mad in America” Bob discusses encephalitis lethargica caused by a virus, and on Page 80 of “Mad in America” he mentions scientific literature dating back to 1876 relating insanity being cured by the removal of infected teeth.

    During the past 16 years I have met/heard of numerous individuals dx’d with bp/sz that were suffering from various forms of encephalitis such as equine encephalitis, lead encephalopathy and encephalitis from Lyme Disease. The worst case was that of a young woman from Rochester, NY who was dx’d with bp and actually suffering from Creutzfeldt Jakob Disease.

    I think that you might also find of interest the narrative written by NY Post reporter Susannah Cahalan, “My mysterious lost month of madness” on anti-NMDAR encephalitis.

    http://www.nypost.com/p/news/local/item_OseCEXxo6axZ8Uyig17QKL/4

    Her neurologist, Dr. Najjar, “estimates that nearly 90 percent of those suffering from autoimmune encephalitis go undiagnosed.

    ‘It’s a death sentence when you’re still alive,’ Najjar told me. ‘Many are wasting away in a psych ward or a nursing home.’

    Susannah was the first person in NYU Medical Center’s history to be diagnosed with NMDAR encephalitis.

    Similarly, in 1998 I was the first person at Syracuse’s Upstate University Hospital ever to be diagnosed with toxic encephalopathy.

    After detoxing through Chelation and other treatments I was asymptomatic for over 7 years. On one occasion, an abscessed tooth caused symptoms of psychosis to temporarily exacerbate. Originally, I was helped through Integrative Medicine. My former doctor is with NIHADC and I contacted him. He said doctors at NIHADC work closely with holistic dentists and recognize bacterial infections from dental problems causing symptoms that can be labeled as schizophrenia. That episode was the first time I had ever experienced audio hallucinations. Prior to that I had only experienced visual.

    He recommended the antibiotic flagyl for anaerobic bacteria and once I had the root canal done the symptoms quickly abated.

    In regard to Dr. Torrey, considering the pelethra of information that is out there, it is nice to see that your post was read by him and that it inspired him to create a dialogue on the topic. Mental health care advocacy is in need of opposing opinions connecting and finding common grounds to create a uniform advocacy agenda.

    We need to push buttons to make real change.

    For Dr. Torrey to state: “Dr. Steingard made some important points”, that’s a great accomplishment.

    For Dr. Torrey to also state: “Whitaker is correct in criticizing the pharmaceutical industry, the overuse of psychiatric medications by physicians and the psychiatric profession for being financially in the pocket of the pharmaceutical industry.” well, kudo’s to Bob and Mad in America dot com for getting Dr. Torrey to admit that!

    If it’s any consolation, I have been called far worse than ignorant by many psychiatrists.

    On Sept. 10, 2012, Dr. Mark Foster wrote this statement about one of his patients:

    “She is a difficult patient, a bottomless pit of needs with no coping mechanisms, and I don’t have a clue how to help her. She is truly a “broken brain”–literally–and will always be disabled. In her case, keeping her semi-sedated makes some sense–to spare herself and society the legal and criminal consequences of her mind unleashed”

    I wrote to both Bob and Mark about this statement. Apparently, since I am the only person who seems to see something wrong with it, I must be much more sensitive than most people about how Mark portrayed this women and how gaurded Bob is of Mark.

    I think because I obtained all of my medical records for my worker’s comp case and this description is close to how several psychiatrists described me.

    Kind Regards,
    Maria Mangicaro

    Posted on Mad in America dot com on 10/28/2012

  • Dear Dr. Steingard,

    What is your opinion of Dr. Torrey’s book “Invisible Plague: The Rise of Mental Illness from 1750 to the Present” and his research studying whether a parasite found in cat droppings called Toxoplasma gondii can trigger an onset of schizophrenia later in life?

    Kind Regards,
    Maria Mangicaro

    http://abcnews.go.com/GMA/OnCall/story?id=1299317

    http://wwwnc.cdc.gov/eid/article/9/11/03-0143_article.htm

    Posted on Mad in America dot com on 10/27/2012

  • Dave,

    Have you ever had your blood lead levels checked? Lead is a toxic substance.

    Although children are primarily at risk, lead poisoning is also dangerous for adults. Signs and symptoms in adults may include:

    High blood pressure
    Declines in mental functioning
    Pain, numbness or tingling of the extremities
    Muscular weakness
    Headache
    Abdominal pain
    Memory loss
    Mood disorders

  • Dear Dr. Healy,

    Writing in plain English, thank you for pointing out the fact that exposure to lead can make SOME people (not ALL people) seem and act like “crazy people”.

    Research on the link between manic/psychotic symptoms and past exposure to lead is something that I have been very interested in since 1997.

    SIDE NOTE: for anyone who reads this and does not appreciate the fact that I use the term “crazy people”, that is the same term Robert Whitaker uses repeatedly in the following video. If you have a complaint about the plain English use of “crazy people” to describe manic/psychotic symptoms, kindly take it up with Bob and not me:

    http://isepp.wordpress.com/2012/01/09/robert-whitaker-at-the-isepp-2011-conference-in-l-a-part-ii/

    From my personal experiences, most psychiatrists, psychologists and other professionals who treat “mental illness” use a “Rubber-Stamp” diagnostic approach that fails to acknowledge, detect or treat underlying causes of psychosis and mania. I feel the failure on the part of mental health professionals in the US to assess psychosis according to the Best Practice guidelines published in the British Medical Journal leads to unethical, ineffective and costly treatment.

    I am curious to know if Robert Whitaker would agree to those statement, as if we consider the “Economy of an Epidemic” money is made by failing to recognize and treat the underlying problems.

    Past exposure to lead and other heavy metals is clearly one of the underlying problems that need to be considered and sought after for liability.

    You might find the book “Toxic Truth: A Scientist, a Doctor, and the Battle over Lead” by Lydia Denworth an enlightening read.

    When considering sources of occupational exposure, the advent of computer aided equipment in the early 80’s welcomed more women into industries that were traditionally male dominated and involve exposure to chemical solvents and heavy metals that even at low-levels of exposure, are recognized as causing neuropsychiatric conditions and birth defects. Gender differences in lead metabolism are also reported.

    I began employment in the printing industry in 1983. At the time it was the third largest industry in the world and was a male dominated profession. During the course of my 15 year employment in the prepress department of a high volume printing company, 5 women had miscarriages and I am aware of 5 of my former co-workers who have children with learning disabilities labeled as autism. Two of whom are men who worked around toluene, n-hexane and leaded inks.

    As you are aware of, screening for blood lead levels only detects current exposure and when lead gets into the blood stream, the body confuses it with calcium/other essential nutrients and stores it in soft tissue or it is used to make bones, muscle, and brain connections.

    We know that lead was among the earliest recognized neurotoxins. The Greek physician, Dioscorides (A.D. 40-90), wrote: “Lead makes the mind give way.” And Benjamin Franklin, a printer at a time when type was made of lead, described classic symptoms of lead poisoning among typesetters.

    In a long-term childhood lead study from Cincinnati, Ohio, Kim Dietrich, PhD, and his team determined that elevated prenatal and postnatal blood-lead concentrations are associated with higher rates of criminal arrest in adulthood.

    “Previous studies either relied on indirect measures of exposure or failed to follow subjects into adulthood to examine the relationship between lead exposure and criminal activity in young adults,” explains Dietrich, principal investigator of the study and professor of environmental health at UC.

    “We have monitored this specific sub-segment of children who were exposed to lead both in the womb and as young children for nearly 30 years,” he adds. “We have a complete record of the neurological, behavioral and developmental patterns to draw a clear association between early-life exposure to lead and adult criminal activity.”

    In my opinion, three decades is a hell of a long time to research a problem without trying to fix it.

    Despite the laws on lead based paint, thousands of toys with lead paint have been imported from China. Old books also were printed with leaded inks and as you point out there are many sources of exposure to lead/mercury/other heavy metals.

    In 1998 I pulled out all of the books and research I could find at the medical library on lead toxicity. At the time I was undergoing chelation therapy after high levels of lead were found in hair analysis. My blood lead levels were normal.

    The onset of manic/psychotic symptoms included visual hallucinations but prior to that I had experienced seeing halos around objects, poor night vision, slight memory problems, glaucoma readings were high and the whites of my eyes were noticeably yellow.

    One of the symptoms of lead poisoning is swelling of the retinas which can cause one to see light in circles like halos around objects as a higher percentage of lead is stored in the visual cortex. Van Gogh is thought to have experienced this.

    Chelation treatments not only eliminated the visual hallucinations, but improved my night vision, glucoma reading and cognitive abilities. Within 6 months of starting Chelation therapy I was able to taper off of all medications. I would not have been able to successfully taper off of psychiatric medications without eliminating some of the toxic overload first.

    One of the studies that I pulled out of the medical library to support my worker’s comp case was this pilot study: Lead Levels in the Hair of Bipolar Patients and Normal Controls, Medical Hypotheses 20: 151-155, 1986 which concludes: preliminary results suggest that in some susceptible individuals-people predisposed to bipolar illness-a relatively high lead burden can tip their balance towards illness. If these results are substantiated, future workups of bipolar patients should routinely include evaluations for extent of lead burden.

    Also, “Several pertinent case histories were given by Machle in 1935. He mentioned the recurrence of a “schizophrenic” condition in two male workers following excessive exposure to lead. These recurrences strikingly resemble what now would be called an episode of mania in one case and a mixed bipolar disorder in the second case.

    The American Journal of Psychiatry published the article, Organic Affective Illness Associated with Lead Intoxication, 141:11, Nov. 1984 which states: We suspect that ignorance about the psychiatric and medical manifestations of lead intoxication and about the sources of occupational exposure to lead contribute to the failure to recognize, report and properly treat psychiatric disturbances associated with lead intoxication….Since psychiatrists receive little information about toxic behavioral syndromes during training, toxic etiologies of psychiatric syndromes and, in particular the less spectacular manifestations of intoxication are often not recognized.

    I hope that you will continue to consider lead and other organic causes of psychosis.

    Kind Regards,
    Maria Mangicaro

    Posted on Mad in America 10/26/2012

  • David,

    Jason Russell’s wife said a contributing factor to the brief reactive psychosis was dehydration. Dehydration can cause psychosis.

    This “as if” assumption in comparing psychosis to a viral infection came from Robert Whitaker, not me.

    Does anyone know if Robert Whitaker has ever taken a course in Abnormal Psychology?

    Or what degrees he holds? and from where?

    David,

    In your opinion, what can society do to prevent tragedies like that of Chevonne Thomas?

    Police found the body of 2-year-old Zahree Thomas after his mother, Chevonne, placed a rambling, sometimes incoherent call to 911. Thomas openly admitted to the dispatchers that she had stabbed her son and in a gruesome discovery the toddler’s head was found in the freezer.

    She admitted to the 911 operator that she was on Prozac before killing herself.

    http://isepp.wordpress.com/2012/08/24/cases-of-filicide-do-911-operators-easily-recognize-medication-induced-psychosis/

  • Sinead,

    I am really enjoying this exchange and I am very glad when I can have a welcoming conversation on this site. Thank you for your courtesy.

    I have not read Anatomy because it it not in my local library system yet. I’m on a low budget and don’t spend a lot of money on books.

    I have seen Robert Whitaker lecture in the past and have watched all of his lectures that are available online.

    I think his C-Span discussion on Anatomy of an Epidemic is excellent.

    If you have not seen this presentation, it is a bit long but well worth watching.

    http://www.c-spanvideo.org/program/293935-1

    Mr. Whitaker provides a concise outline of the research used in his book regarding the treatment of psychosis and shares the conclusions he has come to along his “intellectual path” of discovery.

    Ironically, the conclusions he has come to regarding the treatment of psychosis along his “intellectual path”, relate closely to those I have formed from my not-so intellectual, sometimes psychotic, very grateful for restored sanity path.

    My desire to help others and become an advocate did lead me to coursework that I thought would be helpful including, sociology, public justice, medical ethics, abnormal psychology, Constitutional law and some training in complimentary therapies.

    Mr. Whitaker makes his C-Span concluding statements very clear.

    My interpretation (summarized) of his his beliefs regarding the treatment of psychosis are:

    – the research supports short term efficacy of antipsychotics and long-term chronicity

    – the comparison research from 1945-55 involved treating psychotic episodes with hospitalizations that lasted between 12 months and five years.

    – his book is not a medical advice book and does not encourage patients to go off of medications (although some psychiatric patients have gone off medications after reading Anatomy)

    – he believes psychiatric medications have a place in mental health care

    – Anatomy of an Epidemic does not take an anti-medication position and is in fact a “pro-med”, best use practice

    – when considering psychotic patients, some will do better off meds, while others do better on meds

    – he believes the psychophramacology paradigm is a failed revolution

    – psychotic episodes have flu-like characteristics of coming and going on their own, treatment with medication is the best approach to quickly stabilize

    – his appeal is to create a national discussion that incorporates the long-term data

    Earlier this year, Jason Russell, the creator of “Kony 2012” suffered from “reactive psychosis” resulting in a bizarre incident in San Diego that ended with police transporting him to a mental-health facility.

    TMZ posted the video and described him as “not your average crazy person”. This video demonstrates an important aspect of psychosis, that it can come on quickly and change how others perceive you permanently.

    If this is what having a bout of the flu was like, I would sure want a flu shot.

    http://www.youtube.com/watch?v=yGiR2TmeNYc

    If I has the opportunity to ask Robert Whitaker two questions in an interview it would be:

    If you experienced a first time psychotic episode, what treatment, if any, would you choose? and why?

    What do you think of the BMJ’s guidelines for Best Practice Assessment of Psychosis?

    I would love to know his answers.

  • Dear Dr. Steingard,

    Thank you for your response.

    Functional Medicine/Integrative Psychiatry/Orthomolecular concepts involve testing for and treating underlying medical conditions/detoxing. It basically supports the BMJ’s Best Practice guidelines.

    I have read Mad in America, but I have not read Anatomy of an Epidemic. In Robert Whitaker’s C-Span discussion, linked below he clearly states:

    – his findings support short term efficacy of antipsychotic medications and long-term chronicity

    – he believes psychiatric medications have a place

    – Anatomy of an Epidemic does not take an anti-medication position and is in fact a “pro-med”, best use practice

    – when considering psychotic patients, some will do better off medications

    http://www.c-spanvideo.org/program/293935-1

    Do you disagree with the conclusions Robert Whitaker sets forth?

  • Sinead,

    I appologize if my post has offended you.

    I am employed as a cashier at a retail store, so no I am not involved in signing involuntary commitments.

    In the past I have been perscribed Haldol and I know what it feels like to suffer severe parkinsonslike-syndrome from not being perscribed Cogentin along with it.

    I do not have anything to sell to those suffering from symptoms of mental illness.

    I volunteer my time to several nonprofits concerned with mental health issues.

    The reason why I support the use of Best Practice Assessment of Psychosis is because I was misdiagnosed in 1996 as having bipolar disorder. Below is a link to a narrative that was published in the JoPM that explains my past experience.

    One of my goals as a mental health advocate is to call awareness of underlying medical conditions and substances that can induce psychosis and be misdiagnosed as bipolar disorder/schizophrenia, this is why I support the benefits of Functional Medicine/Integrative Psychiatry and Orthomolecular concepts.

    I have met a number of other individuals who have been misdiagnosed. It is especially sad when an antidepressant or anothe medication induces psychosis and a person commits a horrific crime.

    New Jersey officials reported a tragic filicide-suicide involving a 33-year-old mother who admitted to a 911 operator that she was currently being prescribed the anti-depressant Prozac.

    On August 23, 2012 Police found the body of 2-year-old Zahree Thomas after his mother, Chevonne Thomas, placed a rambling, sometimes incoherent call to 911. Thomas openly admitted to the dispatchers that she had stabbed her son and in a gruesome discovery the toddler’s head was found in the freezer.

    During the 911 call the dispatcher apparently recognized Chevonne’s apathetic tone and bizarre behavior may have been a result of taking a prescription medication and the operator asked if she was taking any. Chevonne acknowledged that she was on the anti-depressant Prozac but didn’t take it that day.

    She could have been suffering a substance-induced psychosis from Prozac. I urge mental health advocates to start working towards a best practice standard of assessing psychotic states to rule out underlying cuases, including medication-induced psychosis.

    Kind Regards,
    Maria Mangicaro

    http://www.jopm.org/perspective/narratives/2011/03/28/psychosis-possibly-linked-to-an-occupational-disease-an-e-patient%E2%80%99s-participatory-approach-to-consideration-of-etiologic-factors/

  • Dear Dr. Steingard,

    The 17th International Conference on the Treatment of Psychosis was hosted by ISPS, “an international organization promoting psychotherapy and psychological treatments for persons with schizophrenia and other psychotic conditions.”

    http://www.isps.org/index.php

    I noticed the 18th ISPS conference is listed as:

    ‘Best practice in the psychological therapies for psychosis: A contemporary and global perspective.’ A conference for all mental health practitioners

    As a mental health advocate, it seems like a lot of time and effort is spent on what appaears to be a constant battle between only two main perspectives of mental health care: psychiatrists and the advancement of medication management v. psychologists and the promotion of talk therapy.

    The many other alternatives and evidence-based treatment options seem to be ignored.

    I appreciate reading Duane’s comment:

    “I only hope that we don’t miss out on using as many tools as possible that lead to self-empowerment – neurofeedback, mindfulness, nutrition (orthomolecular approach), to name but a few.”

    What are your thoughts about the benefits of Functional Medicine for the treatment of psychosis?

    Here is a link to The Institute of Functional Medicine:

    http://www.functionalmedicine.org/themovement/international-movement/

    “The Institute for Functional Medicine is the global leader in functional medicine education. We are a nonprofit organization dedicated to serving the highest expression of individual health through widespread adoption of functional medicine as the standard of care.

    Together, we can change the way we do medicine, and the medicine we do. You can join the movement in several ways and help us move toward a higher standard of health care.”

    In general, do you feel Best Practice Assessment is being used in most cases of psychosis?

    Here is a link to the British Medical Journal’s published guidelines for Best Practice Assessment of psychosis:

    http://psychoticdisorders.wordpress.com/bmj-best-practice-assessment-of-psychosis/

    BMJ: helping doctors make better decisions

    Step-by-step diagnostic approach

    The evaluation of the acutely psychotic patient includes a thorough history and physical examination, as well as laboratory tests. Based on the initial findings, further diagnostic tests may be warranted.

    Organic causes must be considered and excluded before the psychosis is attributed to a primary psychotic disorder.

    The most common cause of acute psychosis is drug toxicity from recreational, prescription, or OTC drugs.

    Patients with structural brain conditions, or toxic or metabolic process presenting with psychosis, usually have other physical manifestations that are readily detectable by history, neurological examination, or routine laboratory tests.

    Brain imaging is reserved for patients with specific indications, such as head trauma or focal neurological signs. The routine use of such imaging is unlikely to reveal an underlying organic cause and is not recommended.

    Kind Regards,
    Maria Mangicaro

  • Maria,

    Thank you for your advocacy.

    It really is very disheartening to know that when it comes to potentially lethal pharmaceutical products consumers are not informed or protected, as they are with other less harmful products.

    The inherent profit motive in mass production and sales of pharmacuetical products has created an opportunity for the mental health care system to exploit consumers.

    Although the US government prides itself as a global leader in the consumer protection movement, when it comes to pharmacuetical products, we are forced to deal with the buyer beware concept.

    In the US after only 10 injuries were reported, a 2010 recall of over 7 million tricycles manufactured by Fisher Price took place.

    In 1999 a recall involved 30,000 bean bag chairs after 3 reported incidents of young children opening the zipper and handling the foam beads. One child needed medical attention after inhaling some of the beads.

    In the same year, the most severe case of Adderall Induced Psychosis occurred, resulting in a father killing his infant daughter.

    The manufacturer of Adderall announced: “Despite the slaying, Adderall remains a safe and effective drug for controlling ADHD.”

    Despite a parent killing their child as a result of taking Adderall over a decade ago, this drug has gained popularity and today is known as “Mother’s little helper”

    While I do not take interest in the Church of Scientology, I thank God for CCHR.

    In my opinion, no other organization has contributed to protecting mental health consumers as much as CCHR has.

    I give a great amount of credit to the many volunteers of this nonprofit organization who are able to get information to individuals like yourself and help support advocacy.

    Since 1969, CCHR has been on the front lines of mental health reform. CCHR continues to document the thousands of individual cases that demonstrate psychiatric drugs can cause violence and suicide.

    Your dedication and commitment is greatly appreciated, God Bless.

    http://uniteforlife.wordpress.com/2012/04/04/if-pharma-made-trikes-buyer-beware/

  • Dear Anonymous,

    Thank you for pointing out that you find my comments long-winded and that you do not feel they are specific to your comment conversation. I rarely post comments on this site so I am a bit surprised that you seem to have taken such offense to posting this information.

    Please accept my appologies as I will try to clarify my position for you and why I would feel it is important to distribute this information on a post regarding schizophrenia/psychosis and brain disease.

    My goal as a mental health advocate is to create awareness of underlying medical conditions and substances that can create what appears to be a manic/psychotic state and can lead to an individual being MISDIAGNOSED as having bipolar disorder/schizophrenia. As an advocate, I also support the Participatory Medicine movement in mental health care.

    “The mental confusion this list of drugs might contribute to, is by no means the same thing just because the BMJ, or you, decided to label it all ‘psychosis’.”

    I am not a mental health professional and I am not responsible for labeling psychotic disorders. The BMJ is just a journal and is not responsible for labeling psychosis either. Information regarding medical conditions and substances that can induce psychosis/mania is listed in the DSM, unfortunately it is ignored by most mental health professionals.

    The mental confusion caused by this list of drugs might be MISDIAGNOSED as bipolar disorder/schizophrenia by a medical professional, this is why I feel it is important to try and create an awareness whereever and whenever possible.

    Advocacy is needed to prevent individuals with mental confusion because of these underlying conditions from being misdiagnosed “mentally ill” and mistreated with psych meds.

    “A best practice is a method or technique that has consistently shown results superior to those achieved with other means, and that is used as a benchmark. In addition, a ‘best’ practice can evolve to become better as improvements are discovered”

    The British Medical Journal is a trusted source of information and the best practice guidelines they have established to assess the mental confusion that presents as psychosis support integrative psychiatry, functional medicine and an Orthomolecular approach.

    If an individual is suffering from mental confusion and what presents as psychotic/manic state and seeks treatment, often they are labeled as schizophrenic/bipolar and very little testing is done to rule out underlying causes.

    I copy and paste the entire list of underlying causes where I think it is appropriate so that key words and phrases are available for those searching for information online.

    My main goal is to get the key words and phrases out there to help individuals who might be helped by this information, as I was.

    I did not realize it would annoy individuals like yourself who do not care about this information. A simple copy and paste is quick and easy as it is rather time consuming to elaborate with a comment and usually leads to long-winded point-counterpoint discussions.

    Certain individuals may be misdiagnosed and entitled to malpractice, or worker’s compensation, as well as alternative therapies paid for by their insurance company.

    For example, if an individual is suffering from symptoms that appear to be mania/psychosis because of past exposure to lead, they should be entitled to chelation therapy paid for by their insurance.

    In my opinion, mental health advocates should be fighting for the rights of patients to be provided alternatives paid for by their insurance companies. I feel the gateway for this is through integrated care, which the APA appears to be embracing.

    I created the blog linked above as a way to collect peer-review articles and case studies that recognize underlying causes of what presents as psychosis/mania because this helps support cases of malpractice and worker’s comp. I started collecting articles during my own worker’s comp case and putting them on a blog just seemed easier to share them with others who were pursuing worker’s comp cases from toxic exposure.

    With so many bloggers adding content, the Mad in America site generates a lot of hits. I don’t think many of the writers support integrative psychiatry, functional medicine, an Orthomolecular approach, or even mention the work of Dr. Abram Hoffer.

    Considering the diverse perspectives and conflicting opinions in mental health care, acknowledging a best-practice approach is fundamental.

    Once again, my appologies. For my own worker’s comp case I dug through the medical library the old fashion way. Since then I have helped 5 other individuals who were originally labeled with bipolar disorder establish worker’s comp cases because of long-term chemical exposure. That may not seem like much but it’s better to light a candle than to curse the darkness.

    Below is a link to a narrative I wrote that outlines my position further.

    Kind Regards,
    Maria Mangicaro

    http://www.jopm.org/perspective/narratives/2011/03/28/psychosis-possibly-linked-to-an-occupational-disease-an-e-patient%E2%80%99s-participatory-approach-to-consideration-of-etiologic-factors/

  • Regarding psychosis, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) classifies psychotic illnesses as “Psychosis Due to General Medical Conditions”, and “Substance Induced Psychosis”. (DSM-IV Codes 293.81 & 292.11).

    Psychosis Due to a Medical Condition involve a surprisingly large number of different medical conditions, some of which include: brain tumors, cerebrovascular disease, Huntington’s disease, multiple sclerosis, Creitzfeld-Jakob disease, anti-NMDAR Encephalitis, herpes zoster-associated encephalitis, head trauma, infections such as neurosyphilis, epilepsy, auditory or visual nerve injury or impairment, deafness, migraine, endocrine disturbances, metabolic disturbances, vitamin B12 deficiency, a decrease in blood gases such as oxygen or carbon dioxide or imbalances in blood sugar levels, and autoimmune disorders with central nervous system involvement such as systemic lupus erythematosus have also been known to cause psychosis.

    A substance-induced psychotic disorder, by definition, is directly caused by the effects of drugs including alcohol, medications, and toxins. Psychotic symptoms can result from intoxication on alcohol, amphetamines (and related substances), cannabis (marijuana), cocaine, hallucinogens, inhalants, opioids, phencyclidine (PCP) and related substances, sedatives, hypnotics, anxiolytics, and other or unknown substances. Psychotic symptoms can also result from withdrawal from alcohol, sedatives, hypnotics, anxiolytics, and other or unknown substances.

    Some medications that may induce psychotic symptoms include anesthetics and analgesics, anticholinergic agents, anticonvulsants, antihistamines, antihypertensive and cardiovascular medications, antimicrobial medications, antiparkinsonian medications, chemotherapeutic agents, corticosteroids, gastrointestinal medications, muscle relaxants, nonsteroidal anti-inflammatory medications, other over-the-counter medications, antidepressant medications, neuroleptic medications, antipsychotics, and disulfiram . Toxins that may induce psychotic symptoms include anticholinesterase, organophosphate insecticides, nerve gases, heavy metals, carbon monoxide, carbon dioxide, and volatile substances (such as fuel or paint).

    The BMJ published guidelines for Best Practice Assessment of psychosis, accordingly, even the routine use of over-the-counter cold medicine can induce a psychotic episode clinically indistinguishable from paranoid schizophrenia.

    http://psychoticdisorders.wordpress.com/bmj-best-practice-assessment-of-psychosis/