Time to learn another three new things about mental health. This week we have:
- Further discussion on Antidepressant Effectiveness (vs. Placebos)
- Infographic on influential depression information sources
- Depression prognosis over 10 years
Drug Trials, Antidepressants and Placebo Effect – Is it Bad?
When drug trials are conducted, the gold standard (and requirement for FDA approval) is a double-blind placebo-controlled study. In this kind of drug study participants are randomly assigned to receive either the medication or an inert (does nothing) pill known as a placebo. Neither the doctor not the patient knows whether they are getting the placebo or the real drug.
The study then compares what happens to those who received the real drug versus those who received the placebo and determines the efficacy of the real drug.
The Placebo Effect
This is critical because of something known as the “placebo effect.” The placebo effect is this odd scenario where people get better just because you give them a pill, even if the pill does nothing. Doctors and scientists don’t understand the placebo effect but not only will people get better on a placebo, but they will even experience side effects – something that isn’t possible given that the placebo is inert. But the brain is a powerful thing and something we don’t fully understand.
And one of the problems with antidepressants (and many medications) is that sometimes they aren’t better than the placebo. Additionally, sometimes when they are better than the placebo, it’s only by a small margin. Drug companies have to prove that their drug is statistically significantly better than a placebo in order to get FDA approval but even this statistically significant amount can be very small.
However, this isn’t a piece about how effective are when antidepressants are compared to placebos. This is a piece about how effective antidepressants are compared to no treatment.
Personal Story of Medication Noncompliance
It is politically incorrect to say medication “noncompliance.” I suppose this is because it gives the idea that the person taking medication is “complying” to some authority figure and not consciously making the decision on their own.
I get that. But whether you call it medication noncompliance or medication non-adherence, the result is the same – the person is not taking their medications as prescribed by a doctor.
And medication noncompliance can lead to devastating consequences not only in the short-term but in the long-term as well. One reader shares her experience in her own words.
What’s up at the Bipolar Burble? Good News
I don’t like to write too many self-referential posts because I’m pretty sure masturbatory navel-gazing isn’t why people come here. However, now and then people like to know what’s up.
And right now there are exciting things afoot at the Bipolar Burble and for me as well so I thought I’d let you know about them.
Doctor Background Checks; ECT in Film; New Borderline Criteria – 3 New Things
Today we return to my 3 New Things series so I can touch on three new pieces of information I’ve found this week. This week I talk about:
- How to get a background check on a doctor
- The sorry portrayal of electroconvulsive therapy (ECT) in film
- The newly-proposed diagnostic criteria for personality disorders in the DSM-V
A Damaged Brain and a Mind Trying to Deal with It
My Twitter bio says I have, “a damaged brain and a mind trying to deal with it.” This confuses a lot of people. It’s OK. I get it. Most people don’t differentiate between the mind and the brain. But I do. In fact, I consider it a critical distinction for people with a mental illness.
Your mind is who you are; your brain is just what you are.
Bipolar Disorder Attacks the Brain
People don’t like that I say I am bipolar. People argue this suggests that all I am is bipolar. Well, it doesn’t. What it suggests is a grammatically correct English sentence that expresses exactly what it needs to – I am a person who has bipolar disorder. Much as diabetics aren’t just diabetic alone, being bipolar doesn’t make you bipolar alone either.
But again, I understand their point. I am more than bipolar. Of course I am. I’ve spoken of it many times. But I make that distinction without difficulty or without the need for wordplay. I understand innately that bipolar disorder has attacked my brain and I yet I am still as me as I ever was.
Defending Psychiatry
I often find myself in the unenviable position of defending psychiatry. This, in spite of the fact that I am not a psychiatrist nor do I even play one on TV.
Nevertheless, I feel compelled to speak on psychiatry’s behalf. Maybe it’s because when left to their own devices, psychiatrists aren’t very good at it. Or more likely it’s simply because an unreasonable number of people attack psychiatry unreasonably and I think someone ought to bring the concept of reason into the discussion.
Antipsychiatry
There is a faction of folks out there who are antipsychiatry and every time I mention them I get hate mail. But here I am again. Antipsychiatry. Antipsychiatry. Antipsychiatry.
N-Acetylcysteine (NAC) – Inexpensive Treatment for Bipolar Depression
N-acetylcysteine, also known as N-acetyl-L-cysteine or just acetylcysteine is a supplement that shows promise in the treatment of bipolar depression. This is really big news because there are very few drugs, supplements or anything else that show promise in the area of bipolar depression. But N-acetylcysteine (NAC) is even better than most because:
- N-acetylcysteine is an over-the-counter supplement
- N-acetylcysteine is cheap
- N-acetylcysteine has very few known side effects
Generic Olanzapine (Zyprexa) and Generic Drug Benefits – Guest Post
Today’s piece is written by Elaine Hirsch of MastersDegree.net. She writes today about the benefits of generic drugs for patients. Note: This is in no way an endorsement of, or advertisement for, olanzapine (Zyprexa).
The Food and Drug Administration (FDA) must approve any medication before it is made available to patients, this includes generic medications. As highlighted in one of Natasha’s earlier articles (Are Brand Name Drugs Better than Generics? – Drugs are not Cornflakes), generic drugs must go through rigorous FDA tests just as their brand-name counterparts do. The approval of generic olanzapine (Zyprexa) for bipolar disorder the FDA has taken a step forward in providing better healthcare to men and women who suffer from mental health issues.
Free Drug Samples – Do they Cost More in the Long-Run?
I was recently made aware of an article on MSNBC which alleges free drug samples provided by doctors actually end up costing the patient more money over time. This, of course, is completely counter-intuitive, and I, not in the habit of taking health information from news sources, looked it up.
And yes, it is, in fact, the case that some studies indicate that those who get free drug samples from their doctor actually end up paying more money in the long-run.
How can this possibly be?
Mental Illness Words You Can’t Say
As a writer I take claim to any and all words. They are mine and I do with them as I please. This includes mental illness / mental health terms. However, some people would argue that as a mental health writer and advocate, it is my responsibility to promote certain language and verbiage.
I did not agree to that.
I agreed to be a writer. I agreed to be opinionated. I agreed to be passionate. I agreed to be well-researched. I agreed to be intelligent. I did not agree to push a political agenda.
Mental Illness Words You Can’t Say
Nevertheless, people still insist that I not use the following words / phrases:
- Whackjob
- Nutjob
- Nutbar
- Crazy
- Bonkers
- Off his rocker
- Mentally unstable
- “The mentally ill”
- Bipolars
- “I’m bipolar”
And about a million other things. The politically correct people have told me I’m not allowed to refer to anyone’s mental capacity in anything but the most politically correct way. Which is, in case you were wondering, a person with a mental illness or a person with bipolar disorder, etc.
Again, not to flog a horse that happens to be dead, but I have poetic license which means I get to do whatever I want with words.
The Daily Athenaeum Response Regarding the Depression Article
Last night I received a response from John Terry, the managing editor at The Daily Athenaeum. While I am rather disappointed to its content as it seems to have missed my points, I do appreciate someone from the paper taking the time to answer my email.
Objection to the Depression Article and Abusive Comments
One of the points John makes is that they cut off comments because the comments became “abusive, attacking.” While I don’t agree, the comments seem pretty tame to me, I will say that I do agree with his point that it isn’t acceptable to abuse or attack the author of the article or other commenters. In my opinion, the issue with The Daily Athenaeum’s piece has more to do with editorial permission to publish and less to do with the individual author. Any one person can be ignorant and uninformed but that’s when it’s up to the editor to step up and make sure that such content does not get published.
Moreover, my objection is around the content and the effect it has on others. This takes precedence over even editoral judgement. That multiple people that such stigmatizing and minimizing remarks were acceptable to print at all is the problem, not the individuals, per se.
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