Category: treatment issues

Top 10 Bipolar Burble Posts of 2011

Best Bipolar Burble ArticlesLast year was a great one here at the Bipolar Burble and saw a dramatic rise in audience numbers, so welcome readers, new and old. This means that debates were fast and sometimes fierce here on the Burble, and mostly, that’s OK with me. Although it did require the invocation of commenting rules, it also meant that more people had their say on mental illness topics.

So, without further ago, here is the top 10 list of articles people read in 2011:

  1. Worst Things to Say to a Person with a Mental Illness – number one with a bullet two years running is this piece which is a continuation of a piece I wrote on Breaking Bipolar. Everyone, it seems, wants to know what not to say to a person with a mental illness.
  2. Bipolar Disorder Type I: Mania and Delusions of Grandeur – this piece was written at the behest of a reader and includes readers’ experiences of delusions of grandeur during bipolar manic episodes.  This is a topic not widely deal with elsewhere.
  3. Doctors Should Treat the Mentally Ill Without Consent – this highly commented-on and contentious article outlines why I think it’s reasonable to treat the mentally ill without consent in some situations. In spite of all the controversy, I still consider this position reasonable.
  4. Self-Diagnosing Hypomania – I had no idea this article would be so popular, but people are looking for this information. This piece is about how to see hypomania coming or to know once it’s already here.
  5. Suicide Self-Assessment Scale – How Suicidal Are You? – again, I didn’t realize how many people were looking for this information. However, this article is designed to point out warning signs and track one’s own suicidal feelings. It can be hard to tell how severe suicidal feelings are and this scale is designed to help.
  6. How to Get Off Antidepressants Effexor/Pristiq (Venlafaxine/Desvenlafaxine) – this is an update to an article I had written a couple of years earlier and is a huge source of Google hits. I hate to make blanket statements about antidepressants, but it really seems like venlafaxine and desvenlafaxine (Effexor and Prisiq) are bitches to get all for almost everyone.
  7. Depression, Bipolar – Feeling Along with a Mental Illness – this is a feeling that I, and I think everyone with a mental illness, has had. This piece addresses the idea that those with a mental illness are “alone” or are “freaks.”
  8. Psychiatric Myths Dispelled by Doctor – Fighting Antipsychiatry – this is one of the most controversial posts here on the Burble due to the seeming war between those who consider themselves antipsychiatry and those who don’t. This piece earned the most comments, with almost 100 pieces of feedback on this article.
  9. Depression and Lack of Want, Desire – unfortunately, may people with depression experience anhedonia – the innability to feel pleasure. This tends to lead to a lack of want for anything. It’s a devastating condition that I have battled for years.
  10. Bipolar Terminology – The Difference Between Bipolar 1 and 2 – finally, at the number 10 spot we have a piece I wrote not long ago about the difference between bipolar I and bipolar II. This answers one of the basic questions people ask about bipolar disorder every day.

As I’ve said, I consider 2011 to have been a break-out year for the Bipolar Burble and I thank you all for being a part of it.

And don’t forget, if you have questions or if there are subjects you would like addressed here at the Burble, you are welcome to contact me anytime or leave a comment. I am at your service.

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Laura’s Law – Assisted Outpatient Treatment – Follow-Up

Well now, that was quite the number of impassioned comments. I did realize that by writing about Laura’s Law (Assisted Outpatient Treatment) there would be some contention, but I didn’t realize quite how much. Thanks to everyone who wrote in well clear, thoughtful comments. (For those whose comments weren’t of that ilk, please review the comment policy here at the Bipolar Burble.)

Due to the number of responses, I have been unable to address them each individually, but I would like to point a few things out in general.

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Laura’s Law – Forced Treatment, Saved Lives

Some of you may have heard of Laura’s Law in California or Kendra’s Law (similar) in New York. These laws, and similar laws across 42 states, allow for court-ordered treatment of mental illness as a condition of community living.

In other words, they strong-arm people into treatment and this could be seen as treatment without consent. (It’s hard to argue consent when your ability to live outside a locked facility is in jeopardy.)

And this is a very good thing. It is saving lives (among other things).

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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.

Treatment vs. No Treatment OutcomesAnd 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.

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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.

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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.

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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.

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I write a three-time Web Health Award winning column for HealthyPlace called Breaking Bipolar.

Also, find my writings on The Huffington Post and my work for BPHope (BP Magazine).

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