mental illness issues

Share Your Tips on Talking to Doctors / Psychiatrists

→ July 8, 2011 - 22 Comments

Communication with Psychiatrists

I’m working on my first ebook. It’s going to be about building a relationship with your doctor. Essentially, it’s about getting what you, the patient, need from the person behind the prescription pad.

Why Write About Doctor-Patient Communication?

I’m writing this book because of the plethora of mental health questions I get on the subject. I believe people with bipolar disorder, depression and other mental illnesses don’t get optimal care due to dysfunctional medical relationships. This is not necessarily the fault of the doctor / psychiatrist or the patient. It just means the relationship isn’t as good as it could be. Think of it like couples counseling between doctor and patient.

So, I have some questions for you; please weigh in. (Oh, you don’t have to answer all the questions. Any that interest you would be great though.)

What Do You Wish You Had Asked Your Doctor When You Were Diagnosed?

Pre-diagnosis, before you understood your mental illness, what do you wish you had known? What do you wish you had asked your doctor about your diagnosis? What do you wish you had said to your family doctor or psychiatrist specifically?

Communication with Psychiatrists

What Do You Wish You Had Asked About Your First Treatment?

What do you wish you had known about treatment? What do you wish your doctor had told you? What do you think new patients should know? Who do you think should handle treatment?

What Do You Think Patients Should Ask About Treatments / Side Effects?

When you get a new treatment or change your treatment, what do you ask your doctor? What should people ask? What do you want to ask but always forget? What do you want to ask but are too afraid too? What do you wish your doctor would tell you?

What Should You Tell Your Doctor / Psychiatrist?

What is most important for a doctor / psychiatrist to know? What do you always tell your doctor? What are you too scared to tell your doctor? Is there something you think you shouldn’t tell a doctor/psychiatrist?

What Makes a Relationship with a Doctor / Psychiatrist Work?

After dealing with doctors for over a decade, I have my own ways of making the psychiatrist-patient relationship work. What are your tips for patients? What works with a doctor and what doesn’t?

What Other Questions Would You Like to See Addressed?

What else do you think I should put in the book?

Why Am I Asking?

I’m asking because I would like to represent the real voice of the real patient as much as possible. I know what I want to write and why, but I’d like to hear varying opinions. Every one of you is different and every one of you has a different insight to share. Whether you love or hate doctors, this book is designed to make your relationship with them work better for you, and maybe for them as well.

I look forward to hearing your thoughts.

Note

By responding here you agree to be quoted in the book should I choose to do so. I’ll only use aliases to identify people so you don’t have to worry about people identifying you. If you don’t want to be quoted, that’s no problem, just say so.

If you have something to add but wish to do so privately, contact me here.

Are Psych Meds Addictive? – Antipsychotics (Part 2)

→ June 28, 2011 - 14 Comments

Are Psych Meds Addictive? – Antipsychotics (Part 2)

In the first of this series I discussed antidepressants and addiction. Some people contend antidepressants are addictive; however, not only is the term “addiction” not defined medically, the use of antidepressants does not generally match the symptoms of any defined substance use disorder either. (More information on substance abuse and substance dependence.)

This time antipsychotics are up to bat. Are antipsychotics addictive? Are people dependent on antipsychotics? Do antipsychotics cause withdrawal?

Read more

Antidepressants and Addiction, Dependence – Talkback

→ June 12, 2011 - 43 Comments

The Bipolar Burble recently received a couple of comments on the antidepressants and dependence / addiction post from Tabby. My response to her second comment ended up being so long I decided to put it in it’s own post.

Here is an excerpt from Tabby’s comments (edited for length). If you would like to read them in their entirety, please see here and here. (Symbol […] indicates removed text. Other ellipses are from the original text.)

Antidepressants and Addiction and DependenceComment on Are Antidepressants Addictive?

I know of people who cannot go not 1 day without their medication and the medication not be a life saving med like a blood thinner but be a Anti-depressant. They become all anxiety ridden and panic filled because they just know that if they miss that 1 dose or those 2 doses for that 1 day […]

They can’t sleep and they get agitated and they get quite vile until they get that dose or doses. They resort to sobbing, they resort to melodrama of threatening suicide…

[…] I’m talking a cymbalta, or a lexapro. I work in a MH agency and we have patients call cause they’ve gone 1 day without their prescription. […]

I am also one with Bipolar and when your entire day, or entire life, is solely dependent on whether you took your pill or pills that 1 day… I dare to say, you have a dependence.

Now… you have blood clots and you miss 1 day of your blood thinner.. then we may have a major issue. You miss 1 day of your Seroquel, or your Cymbalta, or your Depakote… seriously, it will be okay… if not, use your psychotherapy techniques. Oh, that’s right… not too many actually do psychotherapy… it’s all the meds baby.

[…] I am well aware of the benefits of medication compared to no medication for those with Mental Illness. My point was – too many people seek out the comfort of the medication to handle their daily life’s issues […] than to try and work on figuring why they are having the problem in the first place.

Folks do not wake up, naturally, anxious. Something has to have occurred to trigger that emotion and anxiety is an emotion that triggers a physical response. Yet, too many run to the cabinet and down pills to “calm” the anxiety rather than try to do something else non-medicated that […] The first reaction is to kill the emotion/feeling… not to try and figure why it’s happening.

No therapy doesn’t work in all settings or all situations but if you never try, then it will certainly never work. In that your blogs are predominately med supporting… I could say that you mock those who try to use more psychotherapy than meds.

Seroquel and Depakote are not equivalent to Warfarin or some of the other medications needed for literal body functioning. Yet, if you have been on a med for a long period of time, for example Seroquel to put you to sleep every night.. and then suddenly you miss a dose or 2… YOU WILL HAVE SYMPTOMS. That’s med dependence and you’ll have a psychological dependence because you’ll become frantic wanting your med.

[…] Many folks suffer with their Bipolar symptoms, or any MI symptom, long before they ever take the 1st pill. So, the life-saving aspect is only a “feeling”.

I  know the meds help but have they literally saved me? No. They take away the uncomfortable and the frightening… but they don’t keep me from dying. If they were the sole and only reason, then I’m a walking med cabinet.

Even folks that take a plethora of meds, every single day and swear on a stack of their most revered book… still kill themselves […]

Thanks Tabby for your response. I think your thoughts on the issue represent a perspective of many.

Psych Meds for Bipolar and DepressionAntidepressants (and Mood Stabilizers) Are Not Life-Saving

Naturally, I would beg to differ. While yes, people  live with a mental illness before  treatment, and obviously, they don’t successfully kill themselves, that is not proof psych meds do not save lives.

There are two types of people (at least) for whom psychiatric medications are life-saving:

  1. Those who would have killed themselves if not been treated. (Often those who previously attempted suicide and failed.)
  2. Those for whom the medication keeps them from falling into a tremendously dangerous mood such as severe depression or mania which is unpredictable and can easily kill a person (or even those around them.)

In neither case can you “prove” whose lives were saved, but many of us on this side of the illness believe we wouldn’t be here but for the medication.

(Quick FYI on suicide. When autopsies are done of suicide victims it is almost always the case that they do not have a full concentration of psych meds in their system. They either didn’t take the drug or hadn’t taken it regularly.)

Mental Illness Isn’t a Physical Problem

You suggest a blood-thinner is a necessary medication because it fixes a physical problem. Well, so do psych meds. I’ve talked here many times about the biology of mental illnesses like depression. But on top of that, mental illnesses have many physical symptoms like:

  • Headaches
  • Join and muscle pain
  • Hypersomnia / insomnia
  • Eating far too much or far too little
  • Cognitive and memory problems
  • An inability to make reasonable decisions
  • Delusions, hallucinations, psychosis

Those effects alone can lead to death, particularly the psychotic symptoms which can be present in mania, depression schizophrenia and other illnesses. These effects lead people to do things like jump off a roof. All of that sounds pretty physical and much of it life-threatening.

Mental Illness is “Just” a Feeling

I can’t comment on how you experience mental illness, but it certainly isn’t “just a feeling” for me. On top of whatever physical symptoms I may have the feelings themselves are completely out of control. Being driven to slice your wrist with a razor blade is not simply a “feeling.” Driving with your eyes closed isn’t just about a “feeling.” Spending $10,000 that you can’t afford on clothes you don’t need isn’t just a “feeling.”

And on, and on, and on.

While spending what you earn in four months on clothes may not kill you, it sure may kill your life.

You Do Not Just Wake Up with Anxiety

Certainly, you can feel that way, but a person with an anxiety disorder would likely beg to differ. Anxiety may be the sign of a troubled marriage, a bad dream or Starbucks running out of scones, but it may also be a real, organic mental illness, like any other.

I Mock People Who Do Therapy

[push]I’ve done more therapy than anyone I know.[/push]

Um, no, I really don’t. I don’t mock people for it in the slightest. I think it’s a good idea. Some people have problems that can be solved through quality therapy. You’ll get no argument from me on that.

As for non-medication treatments, I have talked about many. Light therapy, triple-chronotherapy, the importance of strict schedule, the importance of sleep and so on and so forth. This week, in fact, on Breaking Bipolar I talked about six areas to increase mental wellness that are not pharmacological.

Dependence on Antidepressants Makes You a Walking PillI Need Psych Meds to Function so I’m a Walking Medicine Cabinet

If you say so.

As you’ve mentioned, you draw a line between psych meds and other meds which you deem “acceptable” to be necessary. That’s your call. But a mental illness is just an illness and medication for it is just as critical as it is for any other illness.

I’d say the distinction there is not fair, accurate or supported by data.

People on Antidepressants Are Dependent

In the non-disordered sense of the word, yes, people are physically dependent on antidepressants. Like all people on all long-term medications.

As for psychological dependence, well it’s a grey area. For psychological dependence the drug must produce pleasure for the user. Antidepressants do not produce pleasure; they treat an illness and reduce pain. This makes them very different from a drug like cocaine, which does produce pleasure.

 

Are Psych Meds Addictive? – Antidepressants (Part 1)

→ June 6, 2011 - 16 Comments

Are Psych Meds Addictive? – Antidepressants (Part 1)

Before I started taking psych meds, one of the major concerns I had was addiction.

I didn’t want to be an addict of any sort as I’m quite familiar with the horrors of addiction, having addicts in the family. I’ve also read my fair share of substance abuse information. Will I get addicted to antidepressants?

And I knew people often took antidepressants for long periods of time, sometimes forever.

So weren’t these people addicted to antidepressants?

Read more

What you should be Reading in Mental Health

→ June 3, 2011 - Comments off

Articles to Read on Bipolar and SchizophreniaBusy. Crazy. Crazy busy. New antipsychotic. You know how it is.

Mental Illness Articles You Should Read

As per the usual, however, I plow through my own research materials like a crazy person possessed. So I do know of many excellent articles you should be reading.

Check out these articles from Breaking Bipolar and other great sources:

Hope you enjoy, I’ll be back with fresh content next week.

Psych Meds Prevent Artistic and Creative Thought

→ May 27, 2011 - 54 Comments

Not infrequently, at the Bipolar Burble I get comments about how if famous artists with mental illnesses had of been medicated, we would have no art today. For some odd reason their go-to example is always Vincent Van Gogh. Without his untreated mental illness, they argue, Van Gogh wouldn’t have been the great artist we know him to be today.

Right then. Let’s all go off our meds and paint. And chop off our ears.

Creativity and Mental Illness

There is no doubt that being crazy makes you see things in a new way. I know I can see things in ways that others can’t. It’s both a benefit and a dramatic hindrance. I’m constantly dealing with people looking at me in odd ways as they try to wrap their head around whatever-the-heck logic my thoughts are trying to make. It’s no mean feat.

But that’s not necessarily all the bipolar. That’s creativity. I was creative before I was crazy, before I was medicated. And I’m creative now, on psych medication.

Creativity and Hypomania

I have had hypomanic times where I have written and written and written and written. Thousands and thousands of words pour out of my skull. And they are brilliant.

Or at least, so I think at the time.

Hypomanic (and manic) people think they are brilliant. Think they are unbelievably talented and creative. Think they are genius. It doesn’t mean they actually are.

Creativity and Psychiatric Medication

Since being on psych meds I have written thousands of pages. Thousands. Some professionally, some not, but many fairly laudable and creative. Believe it or not folks, I do have talent and that talent hasn’t magically been removed because of the medication.

Of course, if I’m too depressed because of the bipolar to get off the couch, that has a rather adverse effect on producing anything, talented or not.*

Van Gogh Committed Suicide

Van Gogh, Self-portrait with Straw Hat, 1887–8 (via Wikipedia)

Artists, Psychiatric Medication and Death

But so you don’t agree with me. You have personally found you’re brilliant off meds and not on. OK. Fine. And maybe you think you’d be willing to part with your ear to be Van Gogh. OK. Fine.

But you might want to keep in mind some truly brilliant people who killed themselves due to mental illness, including Van Gogh whose depression worsened over the course of his lifetime, making him unable to paint, leading to his suicide at the age of 37.

And then there are other famous artists dead from suicide:

  • Sylvia Plath, suicide at 30
  • Kurt Cobain, suicide at 27
  • Ernest Hemingway, suicide at 62 (and just in case you’re doubting genetics, his father, brother and sister also committed suicide)
  • Diane Arbus, suicide at 48 (both a drug overdose and slashed wrists)
  • Arshile Gorky, suicide at 44
  • Alexander McQueen, diagnosed anxiety and depressive disorders, suicide at 41
  • Virginia Woolf, suicide at 59, part of her suicide note to her husband:

I feel certain that I am going mad again. I feel we can’t go through another of those terrible times. And I shan’t recover this time. I begin to hear voices, and I can’t concentrate. So I am doing what seems the best thing to do. . . I don’t think two people could have been happier ’til this terrible disease came. I can’t fight any longer. . . I can’t read.

And a whole bunch of other talented people both known and unknown who had their lives cut short by suicide.

And my guess is the loved ones of every single one of those people wish treatment had of been available for /used by their loved ones.

Psych Medication Destroys Creativity and Art

So don’t give me the bullshit argument that medications are “bad” because they hamper creativity. Because you know what really kills your creativity?

Death.

——————————————————————————————————————–

A Little Bit More

* There’s a study showing this but I seem to have misplaced it.
I’m not saying it’s never the case that medication inhibits creativity, just that it’s a poor argument and misses some of the fundamental reasons why people get treatment in the first please.
Creative people who have publically stated they are in treatment for a mental illness. Including Patty Duke, “She says that she’s more creative now because she can organize a thought.”

Depressed People Who Take Antidepressants Do Better Long-Term – Part 2

→ May 16, 2011 - 5 Comments

As I mentioned last week, it’s very difficult to measure long-term outcomes of depression treatment due to the confounding depression variables like severity of depression, duration of depression, number of depressions and so on.

In short, the sicker you are, the more depressed you are, the more likely it is you’ll get treatment.

Antidepressant Treatment Outcomes Long-Term, A Study

I discussed the basic outcomes of this study: The association between antidepressant use and depression eight years later: A national cohort study by Colman et al. (you may have to select Science Direct to see the study, you don’t need a subscription) which tries to take these variables into account.

Colman et al. showed those who took antidepressants had better depression treatment outcomes than those who didn’t, eight years later, once confounding variables were taken into consideration.

I’ll now point out the strengths and weaknesses of this study as well as some other interesting tidbits shown or cited in the study. Oh, and I’ll give my opinion on what it all means.

Strengths of this Depression Treatment Outcome Study

No study, of course is perfect, but each has its strengths. In the case of this study on depression treatment outcomes, some of the strengths include:

  • An attempt to quantify and account for factors we know will affect treatment outcomes
  • Study uses a large, heterogeneous, real-life, population base
  • Quality, fairly comprehensive data available
  • Replicated findings of a British study involving anxiolytics (anti-anxiety medication) and antidepressants

Weaknesses of this Depression Treatment Outcomes Study

Weaknesses mostly bias the outcome towards the conservative. In other words, the relationship between antidepressant use and a positive long-term outcome may be stronger than reported.

  • Does not have 100% data over eight years (Those who dropped out had worse depressions. This biases the data likely indicating a stronger relationship than shown.)
  • Not a randomized controlled trial (not likely possible)
  • Does not capture comorbid (co-occurring) disorders (likely indicating a stronger relationship than shown)
  • Does not specifically capturing other treatments*
  • Didn’t control for perception of need for treatment. In other words, those who were able to identify the need for, and seek, treatment took antidepressants and had better outcomes. So a factor then would be the person’s treatment-seeking behavior.

For all the nitty gritty on the strengths and weaknesses of this depression treatment outcome study, see here.

Outcomes of Antidepressant Treatment of Depression, Facts

In addition to their main findings, here are some other interesting depression treatment outcome facts either shown or referenced in the study:

  • Antidepressants are particularly useful for those with severe symptoms
  • Of 285 depressed patients, those using higher levels of antidepressants were significantly more likely to recover from symptoms in the short term (from a 20-year study)
  • British study found that of 204 depressed patients, those using antidepressants or anxiolytics (anti-anxiety medication) were significantly less likely to be suffering from symptoms of depression ten years later
  • Maintenance use of antidepressants has been shown to reduce future depressions
  • Those with partial remission (still having some depression symptoms) are far more likely to experience future depressions
  • The longer depressive symptoms persist before treatment the worse the long-term prognosis
  • The most strongly correlated value to better outcome was recent antidepressant use

Depression Long-Term TreatmentFunding of Depression Treatment Outcome Study

Because I knew you’d want to know (I did too):

Funding for this longitudinal depression treatment outcome study was provided by government, grant and award money. Study was cleared through the Health Research Ethics Board of the University of Alberta.

So Long-Term Antidepressant Use is Good?

Well, I can’t say that. What I can say is this study is suggestive^ of the fact that people who are depressed and take antidepressants do better over the long-term than those who don’t. But remember:

  1. People weren’t necessarily on antidepressants the whole eight years.
  2. The key (shown in studies and in my opinion) is to treat the depression as soon as possible and get all symptoms into remission.

So, that doesn’t mean get and stay on antidepressants forever, nor does it mean go on and off antidepressants. Those are individual choices depending on the person’s situation. If you can achieve #2 then your prognosis (in my opinion) is very good. And generally this is done with antidepressants, but depending on your personal situation, you may be able to achieve it through other means.

This also shows people taking antidepressants don’t do worse. This matters because there is a meme out there that taking antidepressants will somehow eat your brain and create mental illness.** This study suggests not.

A Little Bit More

* Study also talks about the role of therapy in depression treatment but no relationship was found between those who got therapy and those that had more positive outcome, suggesting there was no benefit to therapy. However, this is likely due to the broad definition of the word “therapy.” This is why I chose to omit information therapy findings.

^ This is not a causational relationship (where we know one thing causes another) as causation is hard to ascertain without real double-blind placebo controlled randomized study. And we don’t have that.

** Antidepressants actually increase the creation of neurons (neurogenesis) and increase brain volume.

Depressed People Who Take Antidepressants Do Better Long-Term

→ May 12, 2011 - 17 Comments

Recently the controversy over long-term outcomes of those who use psychotropic medication has flared up again. Some people argue depression/bipolar/mental illness patients do the same, or better, when they don’t take psychiatric medications long-term. However, the statistics they use to assert this claim are often faulty.

A study from Calgary, Alberta, Canada (yes, we do research up here too, select Science Direct to see the study) has attempted to fix some of the bias seen in other long-term depression treatment outcome statistics. I’ll cut to the chase for you:

Over the course of eight years people with depression who took antidepressants had better outcomes.

Depressed People Do Not Do Better by Taking Antidepressants

The reason people say those with depression who take antidepressants do not do better, or do worse, goes something like this:

We looked at 100 people with depression and over five years those who didn’t take antidepressants were less depressed.

Put that in the middle of some persuasive text and the villagers gather with pitchforks at the doors of psychiatrists everywhere.

Why are they Wrong? What’s the Problem with This Data?

Treatment Outcomes in Depression

Um, OK. Anyone see the problem here? Anyone?

It should be obvious. Those who don’t take antidepressants (or who go off antidepressants) are typically less sick than those who do take antidepressants. If you’re sicker, you’re more likely to get treatment. It’s not rocket science.

For some reason everyone wants to gloss over that bit.

This is what you call sampling bias.

Measuring Depression Treatment Outcomes Long-Term

Trouble is, you can’t randomly assign people people with a mental illness to treatment/no treatment over the course of a year or more. Sure, the depression treatment outcome data would be better, but the people might not fair so well.

We have to think smarter. If you can’t assign people at random, can you account for variables like duration of mental illness and severity of depression symptoms?

The association between antidepressant use and depression eight years later: A national cohort study by Colman et al. tried to take these variables into account.

Confounding Depression Variables

As I’ve mentioned in the past, depression is not one thing, depression is a spectrum disorder. You may have a variety of symptoms with a variety of severities and still be “depressed” (bipolar is the same). Somehow, we have to quantify that.

We do know some variables that correlate to depression treatment outcomes. Colman et al. measured:

  • Severity of depression
  • History of depression
  • Duration of past depression
  • Suicidal behavior
  • Physical health
  • Demographics (gender, education, etc.)

Depression variables were measured based on scientific scales derived from various methods including personal interviews. You can read all about it here.

Population of People with Depression

For this study, patient population data used was collected by a Canadian agency in the National Population Health Survey in 1998/99 through 2006/2007 every two years. 486 people (of 17,276) were identified as having depression in 98/99 and were followed, 66% of which provided complete data in 06/07 (321 people). Population was all ages, treatments and representative of general population.

Colman et al. analyzed the above variables for all 486 so they could ascertain who was most likely to drop out of the study (or give incomplete information) based on their variables; however, obviously only 321 were used to determine treatment outcome measures.

Depression Treatment Outcomes and Adjusting for Variables

As I said above, if you do not adjust for variables that lead to treatment likelihood, you get statistics that aren’t valid (they’re too biased). Sicker people get treatment.

So, the numbers when you do not account for bias look like this in the depressed population over eight years:

  • Those who took antidepressants were as likely to be depressed as those who didn’t take antidepressants.

But when you adjust for the mentioned variables, that changes to:

  • Those who took antidepressants in 98/99 were less likely to be depressed eight years later (OR = 0.36, 95% CI: 0.15–0.88)

(There are other findings and statistics (not overly significant and in scientist-eze) here.)

Long-Term Depression Outcomes Better with Antidepressants

All that is a fancy way of proving the people who took antidepressants were less likely to be depressed eight years later.

In part two, discussion about the strength and limitations of this study and other interesting findings and citations.

Are All Doctors, Psychiatrists and Scientists Lying All the Time?

→ April 28, 2011 - 91 Comments

One of the problems with the antipsychiatry movement is they assert all of psychiatry, all doctors, all science is lying, pretty much all of the time. Any biological evidence for mental illness must be wrong, because if it isn’t, then psychiatry might make sense. Any evidence antidepressants help a brain must be wrong, because otherwise antipsychiatry views might come into question.

But seriously, does any rational, thinking person really believe all of science, all over the world, is lying?

Read more

Is There a Blood Test for Schizophrenia? – VeriPsych Tests for Schizophrenia

→ April 18, 2011 - 7 Comments

Hot on the heels of the Bipolar Burble’s post about the neurobiological evidence for major depressive disorder comes this: the first blood-based diagnostic aid for schizophrenia.

Um, what’s that again?

[At this time I’m forced to remind you that I am not a doctor or researcher and everything stated is my opinion or interpretation. Thanks.]

A Blood Test for Schizophrenia

A company VeriPsych, affiliated with Rules-Based Medicine Inc., is offering a blood test for schizophrenia. Or, more specifically, they are offering to test your blood and supply a likelihood that you have recent-onset schizophrenia.

A sample VeriPsych Conditional Probability of Schizophrenia report can be found here.

VeriPsych and a Blood Test for Schizophrenia

The VeriPsych folks, through Rules-Based Medicine, apparently in conjunction with the US Military, ran a study to look for biomarkers of schizophrenia and then develop a test for them. (I should mention here the only thing VeriPsych appears to do, according to their web site, is offer this “diagnostic aid for schizophrenia.”)

Now, admittedly I am not a doctor or a researcher, but here’s what I make of the VeriPsych schizophrenia biomarkers study.

[FYI: Biomarker: a protein measured in blood whose concentration reflects the severity or presence of some disease state.]

Blood Test for Schizophrenia Research

Specifically: Validation of a Blood-Based Laboratory Test to Aid in the Confirmation of a Diagnosis of Schizophrenia by Emanuel Schwarz et al. Biomarker Insights 2010:5 39–47

The study was in two phases, in the first phase researchers looked for reproducible schizophrenia biomarkers and in the second phase, a test was developed to use these biomarkers to test for schizophrenia.

Phase One: Schizophrenia Biomarker Selection

  • Assed 181 biomarkers
  • Used 806 clinical samples
  • Participants were in multiple countries, some from the US military

Initial assessment resulted in the finding of 22 biomarkers. These were retested in 63 subjects 3 months later and showed a correlation of 0.83 (83%).

Nine addition biomarkers were added for phase two due to known association with schizophrenia.

VeriPsych then did something odd: they included 20 biomarkers they felt indicated bipolar disorder, “to facilitate the future development of a test with differential diagnosis capability,” and to “enhance[d] the accuracy of VeriPsych.” (The former is from the research paper, the latter is from the website.)

Notes on Schizophrenia Biomarker Selection

This says to me they are really testing 31 biomarkers of schizophrenia, and 20 for “other reasons.” So when they claim to use a 51 biomarker test, that stretches the truth a little.

Also, the numbers on these seem to vary from the paper to the website making it difficult to deduce exactly how many biomarkers are used for each purpose. A spot on the website says: 36 identified and 15 added. Sorry, it’s just not clear.

Phase Two: Validation of Schizophrenia Biomarkers

  • Phase two used 480 samples for biological test validation
  • Biomarkers appear consistent for paranoid and nonparanoid schizophrenia
  • Biomarkers test seems to work even after 4-6 weeks of antipsychotic treatment (85% accurate)
  • Accuracy increases with chronic schizophrenia
  • Appears (to me) to have more false-positives than false-negatives
  • “Overall sensitivity of 83% and specificity of 83%”

Accuracy of Schizophrenia Blood Test?

There are some super-math algorithms and statistics going on here, but from what I can tell:

  • You get a “score” from the blood test
  • Depending on the score, you get a percent chance of having schizophrenia
  • Some tests are inconclusive

Who Tested the Validity of These Results?

Good question. No one except the lab (Rules-Based Medicine) from what I can tell. This is not an FDA-approved test as it is a “laboratory-developed test.”

Laboratory-developed tests are:

  • The activity of a single laboratory, not a traditional device manufacturer
  • Not commercially marketed to other labs
  • Wikipedia says: assays developed in the laboratory for internal use, or research use only, and not intended for diagnostic or medical use, and therefore treated differently by regulatory agencies; describes most current genetic testing.

Blood Test for SchizophreniaSo, Is This a Blood Test to Diagnose Schizophrenia?

No. It isn’t. This isn’t a blood test to diagnose schizophrenia. They mention this on their home page. This test is to, “aid a psychiatrist in the diagnosis of recent-onset schizophrenia.”

In other words, it’s a freaking guess with a number attached.

This test can’t tell you whether you have schizophrenia, it can provide a somewhat-accurate statistical likelihood. So how useful is that? You have an x% chance of schizophrenia plus-or-minus some variable. Based on one study by one company Does that sound useful? Actionable?

It doesn’t to me.

In Natasha Tracy’s Opinion:

This is a money-grab taking advantage of desperate mentally ill people.

I actually find this “diagnostic aid” blood test for schizophrenia to be bordering on unethical. VeriPsych can cover their ass with math and statistics and probabilities and legal-eze and I’m sure that makes it “OK,” but if you ask me, they are a hair’s breath away from lying. It feels irresponsible to me to hand out these kinds of results about a very serious illness based on one study. One. And there is so much math needed to make this model work that I would fall down dead if there wasn’t a mistake in there somewhere. Nobody gets it right the first time.

This test should be in a lab, used for further research and study, and not be used on the paying public.

(I have other reasons why I don’t like this test too, but as this has gone on long enough, I’ll save them for another day.)

Psychiatric Myths Dispelled by Doctor – Fighting Antipsychiatry

→ April 5, 2011 - 198 Comments

Or How Antipsychiatry Groups are Wrong

If you’ve been reading my writings here at the Bipolar Burble for a while, you’ve probably gathered that I don’t like antipsychiatry groups. These groups are often under the “mad pride” flag or “psychiatric survivors” or people for “human rights” or people fighting psychiatric abuses. Often the language they use is solely designed to convince you that psychiatry is evil, psychiatry should be stopped, no one should take psychiatric medication and in many cases, psychology is also evil. Many antipsychiatry groups are sneaky. Antipsychiatry groups sounds reasonable on first glance but it’s only once you dig into them that you see how insidious they are.

Psychiatry and Psychology are Not EvilAntipsychiatry groups are ridiculous.

I’ve tried to look into antipsychiatry groups to see if there’s something worth understanding but they have no evidence. Just ardent supporters that make wild claims without proof. And their tactics of cruel, personal, abusive attacks are not worth my time. It assures that their groups have no credibility whatsoever.

I Fight Antipsychiatry Groups

And sometimes I spend entire days fighting antipsychiatry people. Antipsychiatry shows up on the Bipolar Burble, antipsychiatry finds me on Twitter, antipsychiatry follows me to Facebook, antipsychiatry shows up on Breaking Bipolar. And these charming antipsychiatry folks, for whatever reason, read all about me and then use those personal details to ensure their personal attacked will be as nasty as possible.

Yes, antipsychiatry groups are ridiculous.

Who has Time to Scientifically Refute Every Cockamamie Antipsychiatry Argument?

I don’t have time to research every one of their outragous claims and make cogent counter-arguments. Because it’s endless. It can always be done but it’s more work than I have time for.

Myths About Psychiatry by Nada Logan Stotland M. D. – Huffington Post

Luckily for me and for you, Dr. Nada Logan Stotland M. D. has written the most amazing anti-antipsychiatry article I’ve ever read. (She doesn’t say she’s anti-antipsychiatry, but this piece is certainly a shot across the bow of antipsychiatry.)

Psychiatry Myths Dispelled by a Doctor

Aren’t mental health diagnoses randomly added to the Diagnostic and Statistical Manual (DSM) and applied to individuals?

When deciding what to include in the DSM, “. . . specialists have to look at the evidence and then make judgments about the criteria for medical diagnoses. The difference between a benign tumor and a cancer is a matter of how many sick cells appear under the microscope. “

“Differentiating them [psychiatric disorders] from normal is no different than deciding what level of blood pressure is ‘hypertension,’ how many pounds add up to ‘obesity,’. . . A condition rises to the level of disease when it handicaps a person, is associated with bad outcomes, and/or can be treated — in psychiatry just as in the rest of medicine.”

We don’t understand mental illness the way we understand other illnesses.

“We all know that diabetes is caused by the failure of the pancreas to secrete normal amounts of insulin. But what causes that? We say it’s an autoimmune condition — the body attacks its own insulin-secreting cells. Why does that happen? We don’t know.”

And, of course, we treat diabetes in spite of this lack of knowledge just like we treat mental illness.

Psychiatry illnesses aren’t real, don’t exist, because there are no diagnostic tests for mental illness.

“The substrate, the physical location, of thought, mood, and behavior, is the brain. That’s not a part of the body we like to biopsy without an extremely good reason . . . Using brain scans, however, we now can distinguish between the brain of a person with depression and a person who is not depressed — and make many, many other such observations.”

This is something antipsychiatry groups bring up all the time. But as Dr. Stotland points out, we can distinguish depressed brains from non-depressed brains in a brain scan. In fact, there are many illnesses that show on brain scans (and sometimes blood tests) but it is early days and brain scans aren’t the kind of thing people can afford (or necessarily even get access to).

Don’t psychiatrists have a vested interest in making everyone “sick” so they can make more money?

“There is a shortage of psychiatrists. I don’t know any psychiatrists with time on their hands. Our incomes are at the lower end of the medical totem pole, along with family medicine and pediatrics . . .”

No one is saying they don’t make oodles of money, they do. But the notion they are not trying to help people and they are trying to create more patients is ludicrous. It takes months to see my psychiatrist because he’s so busy. He doesn’t need any more sick people. Not to mention the fact that in Canada, many profit motivation arguments just don’t hold a lot of water.

There is no science behind psychiatry.

“The New England Journal of Medicine some years ago published a paper demonstrating that far fewer than half the treatments used for cardiovascular diseases are supported by good scientific evidence. Psychiatric treatments work about as well as other medical treatments.”

I’m kind of shocked about cardiovascular disease, but if you think about it, they are in the same position. They are trying to save people’s lives, just like psychiatry is, in the best way they know how.

Please read Dr. Stotland’s full article.

The Motives of Doctors, Psychiatrists and Psychologists

And as many problems as I have with psychiatry, psychiatrists, doctors and psychiatric medication, I believe that psychiatrists are trying to help. They’re not always successful, but their motive is not evil and it’s not money – it’s making people better.

 

Breaking Bipolar Articles You Should Read – Updated Resources

→ March 29, 2011 - 2 Comments

Breaking Bipolar at HealthyPlaceAs most of you know, in addition to the Bipolar Burble I also author Breaking Bipolar on HealthyPlace.com. I write a column there twice a week as well as produce one bipolar-themed video and two audio files per month. It’s a fairly well-received bipolar blog often with much discussion, feedback and sharing.

Recent Breaking Bipolar Blog Highlights

If you haven’t had a chance to check out Breaking Bipolar lately, here are a few of the highlights:

Upcoming Bipolar Burble Articles

I’m sure that’s more than enough for now. Upcoming pieces on the Bipolar Burble will likely be about hypomania and delusions and possibly regarding the black box warning on antidepressants actually increasing suicides (you can yell at me about that after I write it). There will probably be a piece about my own ECT experience as well as that’s not really covered here (I wrote quite a bit about it on another blog.)

If you’d like to see a topic covered on the Bipolar Burble or Breaking Bipolar or have a question you can always contact Natasha Tracy. I can’t promise I’ll respond but I’ll do my best.

New Mental Health Resources Added

The bipolar and mental health resources page has also been updated. These are good resources you should know about.

Page 20 of 25« First...510...1718192021222324...Last »