I just watched the television ad for treating Bipolar Depression using the recently FDA approved psychiatric medication for depression in adults when other drugs fail Seroquel XR. In it average looking citizens are shown in various situations zoned out and in need of help. Even more disturbing is the alarming sounding list of potential side effects listed for what seems to be the last quarter of the commercial. These ads for psychiatric medications are concerning on so many levels the biggest one being the direct to consumer marketing of major psychiatric drugs like Seroquel. The availability and marketing of medications this powerful for the general population is another paradigm shift in how we view emotional distress in our culture and conflate so many types and levels of suffering with having a psychiatric disorder.
As I have said many times we have cast such a broad net over who we think has some form of mental illness. We are being convince through these marketing campaigns and the power of Big Pharma that we are sick and need a pill for what ails us. Some people do need medication, but not as many of us as this industry and its advertisers lead us to believe. And as always, all of these psychiatric medications should be taken and monitored in conjunction with ongoing therapy. Read more…
Our increasing need to diagnose and label children and adolescents with psychiatric disorders should cause us pause. ADHD, bipolar disorder, and depression are three diagnoses you hear so often being given to children and teens. Then there is always the more immediate concern of suicide. We have talked about how child and adolescent developmental stages and behaviors need to be better clarified to help clinicians, parents and educators understand who a child and teenager is and why he or she may be thinking, feeling, and behaving, a certain way. Understanding how infants, toddlers, children, pre-teens, and adolescents behave and view themselves, others, and the world around them helps us distinguish who is in fact acting their age and who may have deeper, more problematic, issues to contend with and treat. The question we always want to ask when investigating the circumstances involving children and adolescents is who and/or what are they reacting and/or responding to? Read more…
One of the central themes of this site, my research, and our work as an agency is identifying the ways in which psychiatric diagnoses are named and how they are treated by all of us, professionals and laypersons alike. This quest for insight and answers is why you see the naming and treating logo in childrens’ blocks in the banner above. Throughout these many posts we survey the progress being made on behalf of people who are truly suffering from mental disorders and where the harm is being done when too broad a net is being cast over our population in terms of who in fact has a mental illness and who does not. Why is this particular focus so important to us? The answer is that we have seen so much damage being done in the ways we name and treat each other and nowhere is this more apparent then in the rising tide of diagnosing mental disorders since the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) came into power, leading to the dramatic rise in psychiatric diagnoses and use of psychiatric medications. Read more…
Kay Redfield Jamison remains a major influence on my life’s work. In this video she openly and courageously describes her own experiences with manic depressive (bipolar) disorder. In sharing her experiences and how she views manic depression (bipolar) disorder Dr. Jamison has transformed the way so many of us understand this diagnosis and as importantly given those who have it some solace that they are not alone.
(See the list of her books and you can watch an interview with her on Charile Rose from 1999.)
The New Atlantis has an interesting article by Ari N. Schulman titled “Why Minds Are Not Like Computers.” We do tend to use the computer as a dominant metaphor for the human mind in the age of computer technology, neuroscience and cognitive behavioral therapy (CBT). It is a comparison that on some levels makes sense, but once you actually analyze it and dig deeper, as Shulman does, the idea of mind as a computer cannot hold up. He writes in the introduction to the article:
People who believe that the mind can be replicated on a computer tend to explain the mind in terms of a computer. When theorizing about the mind, especially to outsiders but also to one another, defenders of artificial intelligence (AI) often rely on computational concepts. They regularly describe the mind and brain as the “software and hardware” of thinking, the mind as a “pattern” and the brain as a “substrate,” senses as “inputs” and behaviors as “outputs,” neurons as “processing units” and synapses as “circuitry,” to give just a few common examples.
Those who employ this analogy tend to do so with casual presumption. They rarely justify it by reference to the actual workings of computers, and they misuse and abuse terms that have clear and established definitions in computer science—established not merely because they are well understood, but because they in fact are products of human engineering. An examination of what this usage means and whether it is correct reveals a great deal about the history and present state of artificial intelligence research. And it highlights the aspirations of some of the luminaries of AI—researchers, writers, and advocates for whom the metaphor of mind-as-machine is dogma rather than discipline.
Read more…
I feel compelled to post our admiration for and commitment to the parents out there struggling to meet the demands of their challenging child, especially all of the mothers we have come in contact with over the years. A “challenging” child if not clearly defined can be any child because the broader understanding is aren’t they all. Yes, children are challenging and if we aren’t careful we can and do lump many of their challenging emotions and behaviors into psychiatric diagnostic categories rather than view them as normal childhood responses and (re)actions. I spend a great deal of time trying to figure out if a child is responding and acting normally to their situation/circumstances or if they have crossed the threshold into pathology where a diagnosis and treatment plan is needed by a clinical professional to help stabilize him and the family that is affected by his emotions and behaviors. So the challenge in making this distinction between normal or pathological is what can the parents/family do for a child and for themselves once professionals have helped establish that he has crossed this threshold into a psychiatric diagnosis? Read more…
An article titled “Helping Children Hospitalized for Rages” by Gabrielle A. Carlson, MD at Stony Brook University School of Medicine in New York, Michael Potegal, PhD at University of Minnesota, School of Medicine and Paul J. Grover, RN at Stony Brook University Hospital from the Psychiatric Times provides insight for where mental health/psychiatric professional are at right now in terms of treating explosive children. Rage is defined as follows:
Temper outbursts, sometimes called rages, are a major reason for outpatient and inpatient referral. These behaviors have also been a focus of assessment in child psychology and psychiatry since rating scales were developed. In fact, items consistently loading on the same factors in frequently used behavior rating scales for children reflect negative mood (mood changes quickly/explosive, easily angered/ stubborn, sullen, irritable), oppositionality (being demanding, uncooperative and disobedient) and aggression (argumentativeness, having temper tantrums).1
Rages have been associated with extreme irritability or mania, Tourette disorder, intermittent explosive disorder and conduct disorder, autism/Asperger disorder, and other conditions.2-6 Rages are part of a syndrome of severe mood dysregulation, which is defined by markedly increased and frequent reactivity to negative emotional stimuli (eg, response to frustration with extended temper tantrums, verbal rage, and/or aggression toward persons or property) that occurs at least 3 times a week in the context of chronic anger or sadness.7 This co-occurs with other symptoms, such as those related to attention-deficit/hyperactivity disorder (ADHD) or anxiety (ie, hyperarousal, dis- tractibility, rapid speech/racing thoughts, insomnia).
Read more…
In the photo above “Anya Bailey is among a growing number of children given antipsychotic drugs by doctors who are paid by the makers of those drugs,” from a May 10, 2007 NYT article “Psychiatrists, Children and Drug Industry’s Role.” Over two years later an article in the June 22, 2009 San Francisco Chronicle titled “Antipsychotic drugs for kids raise hope, worry” provides more information about what is happening to children who are prescribed psychiatric medications. Read more…
