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Why I Refuse to Read Anatomy of an Epidemic

June 5, 2012 Natasha Tracy

Many people here have read Robert Whitaker’s Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America (New York: Crown Publishers). And some of these people will likely claim that the book changed their lives or, at the very least, their view of psychiatry and psychiatric medication.

Well. Ho there. You would think with such a ground-breaking book I would be all over it.

Guess again.

I refuse to read Anatomy of an Epidemic. And yes, some people will fault me for this. But I have a good reason. I refuse to read Anatomy of an Epidemic as I have no desire to be outraged at a misunderstanding of science for 416 pages.

The Poster Child: Robert Whitaker

Robert Whitaker is the poster-child for antipsychiatry, which is his prerogative. If he enjoys talking to throngs of antipsychiatrists then I say, better him than me.

And part of his criticism of psychiatry is well-deserved. I would say that being concerned with the use, and possibly overuse, of some medications and the prescribing of heavy psychotropic medications to children is quite warranted. I take no issue with the fact that debate and concern is appropriate here.

What I do take concern with is his contention that psychiatric medication actually worsens treatment outcomes and causes disability. This is the reason why antipsychiatrits love him and it’s the reason I probably couldn’t stand to be in the same room as him.

Antipsychotics and Mental Illness

Whitaker’s chief whipping boy is antipsychotics and schizophrenia. He cites studies that he says back up his claim that not taking antipsychotics increases the chances of getting well and that antipsychotics induce the symptoms of schizophrenia.

Well that is complete falderal.

You see, Robert Whitaker, it seems, can’t read a study.

Scientific Studies

Studies are very tricky business and if you don’t actually read and entire study, look at the data and really read what the researchers are saying – you might miss something. In fact, you might miss something that changes the entire meaning of the study. Rarely do the researchers themselves miss it, but for some reason, when reading the study, people draw conclusions contrary to the researchers – like Whitaker does.

How do I know this? Well, rather than reviewing his book I reviewed some of the studies he cites and the claims he says are backed up by those studies and I found them to be fallacious at best. Sure, he cites studies, he just contraindicates what the study actually proves. And nothing ticks me off more than this because people believe him just because there is a linked study – no one ever bothers to check that the study says whatever Whitaker says it does.

Whitaker Contrarians - Doctors

Except, of course, the people who do – the doctors. You know, the people who went to medical school for over a decade. You know, the people actually qualified to understand what all the fancy numbers mean. You know, those people.

And I, for one, rely a lot on what doctors make of medical data and they are the ones most able to refute Whitaker’s claims.

Enter E. Fuller Torrey, MD. He wrote a most excellent piece on how Robert Whitaker got it wrong. And chiefly, how his assertions of medication-induced schizophrenia and treatment outcome improvement without medication is wrong. Fuller uses the very studies that Whitaker cites to prove the very opposite of what Whitaker is saying. Because quite honestly, Whitaker either doesn’t understand how to read a study or his misrepresents the data on purpose.

In one case, Whitaker claims that treatment outcomes for schizophrenia have worsened over the past two decades and are now no better than they were a decade ago.

Well, you know, wrong.

The problem with the study Whitaker cites is that it contains a moving target – namely the definition of schizophrenia over time. The way schizophrenia was diagnosed in the 1950s isn’t how it was diagnosed in the 1970s or the 1990s. The diagnostic criteria differed substantially as we learned more about the disease at there was progression of the Diagnostic and Statistical Manual of Mental Disorders. Earlier on, diagnostic criteria for schizophrenia were very broad and so more people who were less sick were diagnosed with schizophrenia whereas now, the criteria are much stricter and people in the category of schizophrenia are much sicker. Fuller states:

When a broad definition of schizophrenia was in vogue, outcomes were better but when a narrow definition was in vogue, outcomes were worse, as would be expected.

In fact, in that very study it showed that treatment outcomes improved in the 1960s and 1970s specifically coinciding with the usage of antipsychotics. At no time in the study do the authors suggest that treatment outcomes have worsened over time. That was just Whitaker’s unsupported claim.

And Fuller goes on to explain more about how Robert Whitaker got the science wrong – and he does – over and over. He gets it wrong, wrong, wrong, wrong. One really starts to wonder how he can call himself a journalist at all.

OK, I’m Getting Worked Up

And see, this is why I can’t stand to read the book because I would have to dissect all of his claims and find out where he was wrong simply because I would feel compelled to do so. I’m that kind of girl. I don’t like falsehoods hanging around for people to pick up and inadvertently digest.

In short, if you like Whitaker’s work, that’s fine, but you might want to read some doctor’s reviews of his work before you start believing everything he wrote because by-and-large, for many of the claims, the science isn’t there. It just isn’t.

Please read Anatomy of a Non-Epidemic - a Review by Dr. Torrey for all the details. More critique here.

You can find Natasha Tracy on Facebook or GooglePlus or @Natasha_Tracy on Twitter.

APA Reference
Tracy, N. (2012, June 5). Why I Refuse to Read Anatomy of an Epidemic, HealthyPlace. Retrieved on 2024, March 29 from https://www.healthyplace.com/blogs/breakingbipolar/2012/06/why-i-refuse-to-read-anatomy-of-an-epidemic



Author: Natasha Tracy

Natasha Tracy is a renowned speaker, award-winning advocate, and author of Lost Marbles: Insights into My Life with Depression & Bipolar. She's also the host of the podcast Snap Out of It! The Mental Illness in the Workplace Podcast.

Find Natasha Tracy on her blog, Bipolar BurbleTwitter, InstagramFacebook, and YouTube.

Holly
September, 5 2015 at 5:48 am

betty, just like psychiatrists are not the only one who can treat mental illness, neurologists aren't the only ones who can treat migraines. Read this article at webmd about alternate treatments. And again, nobody can force a migraine sufferer to decide to utilize these alternative treatment, but the same is not always true for psychiatry.
http://www.webmd.com/migraines-headaches/nontraditional-headache-treatments

betty sainz
September, 4 2015 at 10:33 pm

Why do neurologists treat migraine headaches? We can't see pain under a microscope or with any of our best, most modern, hi-tech equipment. Ask Whitaker.
I will answer more questions when the antis begin to try to answer mine--with evidence.

betty sainz
September, 4 2015 at 10:23 pm

Dear Please Explain,
You ask, why is this relevant? Let me ask you, why do you think it is relevant? Any guesses?
I said earlier, "T’is the proof of all the iatrogenic illnesses you lack."
We have established over time the tremendous dangers of drinking alcohol and driving. Over 10,000 deaths result from such behavior every year in America. Plenty of scientifically based data proves this is true. Tons and tons of it.
But, when antis state as fact that psych meds have destroyed long term memory, working memory, processing speed or created other mental illnesses, and simultaneously insist that mental illness doesn't exist for lack of a biological marker, they have a problem. Can't have it both ways.
And, while their rage boils over for the harm psych meds supposedly cause, they use and tolerate the widespread use of drugs that we know, without doubt, kill and seriously harm tens of thousands annually (millions since the end of prohibition) and yet remain strangely silent and passive about it. Based on the literature, many combine alcohol and their prescribed psych meds, even when clearly and adamantly, warned not to do so. And, then they blame the psych meds for the damaging side effects.
In a true debate, we must stay focused on the credible evidence or we waste each other's time. The intent of many antis is not to dig and to study so as to uncover truth as much as it is a demand that they be believed, no matter what.

betty sainz
September, 4 2015 at 9:37 pm

"whereas an in psych, just having a diagnosis by itself deems you less competent"
Stating that as a fact reduces your credibility even further. Gobs of "facts" are tossed around by opponents of psychiatry without supporting evidence. Real, honest debate is not possible as a legitimate exercise in the pursuit of truth without respect for peer reviewed scientific data. It is, therefore, more profitable for your side to be still and then to begin to study, carefully, the factual basis for the views you eventually will hold. IOW, start from scratch. We all have much to learn. Be diligent not to blurt out opinions as facts.

Please Explain
September, 4 2015 at 2:50 pm

Betty
How is this relevant?
As per Betty's post of
September 4, 2015 at 4:40 pm
ANNUAL CAUSES OF DEATH IN THE UNITED STATES
Motor Vehicle Accidents —- 35,369
On average, 6 people died every day from alcohol poisoning in the US from 2010 to 2012. 6 X 365 = 2190 deaths from alcohol poisoning annually.
Every day, almost 30 people in the United States die in motor vehicle crashes that involve an alcohol-impaired driver. This amounts to one death every 51 minutes or nearly 11,000 people every year. Over 10 years that is more than 100,000 deaths related to alcohol impaired drivers. The annual cost of alcohol-related crashes totals more than $59 billion. That is over one-half trillion dollars in 10 years.

betty sainz
September, 4 2015 at 1:17 pm

Why do neurologists treat migraine headaches? We have no proof they cause any pain. Ask Whitaker.

Please Explain
September, 4 2015 at 12:40 pm

Betty are you a doctor? Do you even understand what all this means?
Perhaps you would be kind enough to summarize your post of Sep 4 @ 11:37 AM for us in layman's terms?
As per your post of
September 4, 2015 at 11:37 am
Background: The serotonin transporter (5-HTT)-linked polymorphic region (5-HTTLPR) has two frequent alleles, designated long (L), and short (S). The S allele is associated with lower levels of 5-HTT mRNA and lower 5-HTT expression in human cell lines. A functional single nucleotide variant was detected within L, designated LA and LG. Only LA is associated with high levels of in vitro 5-HTT expression, whereas LG is low expressing and more similar to S. We examined the possible influence of the long (A/G) variant on 5-HTT density in the living human brain using 3-(11)C-amino-4-(2-dimethylaminomethylphenyl-sulfanyl) benzonitrile ([11C]DASB) positron emission tomography.
Methods: The 5-HTT binding potential (5-HTT BP), an index of 5-HTT density, wasfound in 43 healthy subjects genotypedfor 5-HTTLPR long (A/G), and in an ethnically homogenous subsample of 30 Caucasian-Canadians.
Results: The LA/LA was associated with higher 5-HTT BP in putamen (p .026, not corrected). This association became stronger in the Caucasian subsample (p .004) and was significant even after correcting for multiple comparisons.
Conclusions: The 5-HTTLPR long (A/G) polymorphism influences 5-HTT density leading to higher putamen 5-HTT BP in healthy LA/LA carriers of Caucasian ancestry. This finding extends the role of this polymorphism from in vitro reports of higher 5-HTT expression with the LA/LA genotype into in vivo brains of healthy human subjects.
Project funding and funding for Dr. Praschak-Rieder was provided by a Young Investigator Award by the National Alliance for Research on Schizophrenia and Depression, and the Funds
for the Advancement of Scientific Research (FWF), Austria (granted to Dr. Praschak-Rieder), the Ontario Mental Health Foundation (type B grant) and a Canadian Institute for Health
Research New Investigator Award (granted to Dr. Meyer). We thank all the subjects who generously donated their time for participation in the study. We thank Armando Garcia for the assistance in radiochemistry
And perhaps you could also explain how your post of Sep 4 @ 4:40 is relevant to the topic on this blog.

betty sainz
September, 4 2015 at 11:40 am

ANNUAL CAUSES OF DEATH IN THE UNITED STATES
Motor Vehicle Accidents ---- 35,369
On average, 6 people died every day from alcohol poisoning in the US from 2010 to 2012. 6 X 365 = 2190 deaths from alcohol poisoning annually.
Every day, almost 30 people in the United States die in motor vehicle crashes that involve an alcohol-impaired driver. This amounts to one death every 51 minutes or nearly 11,000 people every year. Over 10 years that is more than 100,000 deaths related to alcohol impaired drivers. The annual cost of alcohol-related crashes totals more than $59 billion. That is over one-half trillion dollars in 10 years.

betty sainz
September, 4 2015 at 6:37 am

Background: The serotonin transporter (5-HTT)-linked polymorphic region (5-HTTLPR) has two frequent alleles, designated long (L), and short (S). The S allele is associated with lower levels of 5-HTT mRNA and lower 5-HTT expression in human cell lines. A functional single nucleotide variant was detected within L, designated LA and LG. Only LA is associated with high levels of in vitro 5-HTT expression, whereas LG is low expressing and more similar to S. We examined the possible influence of the long (A/G) variant on 5-HTT density in the living human brain using 3-(11)C-amino-4-(2-dimethylaminomethylphenyl-sulfanyl) benzonitrile ([11C]DASB) positron emission tomography.
Methods: The 5-HTT binding potential (5-HTT BP), an index of 5-HTT density, wasfound in 43 healthy subjects genotypedfor 5-HTTLPR long (A/G), and in an ethnically homogenous subsample of 30 Caucasian-Canadians.
Results: The LA/LA was associated with higher 5-HTT BP in putamen (p .026, not corrected). This association became stronger in the Caucasian subsample (p .004) and was significant even after correcting for multiple comparisons.
Conclusions: The 5-HTTLPR long (A/G) polymorphism influences 5-HTT density leading to higher putamen 5-HTT BP in healthy LA/LA carriers of Caucasian ancestry. This finding extends the role of this polymorphism from in vitro reports of higher 5-HTT expression with the LA/LA genotype into in vivo brains of healthy human subjects.
Project funding and funding for Dr. Praschak-Rieder was provided by a Young Investigator Award by the National Alliance for Research on Schizophrenia and Depression, and the Funds
for the Advancement of Scientific Research (FWF), Austria (granted to Dr. Praschak-Rieder), the Ontario Mental Health Foundation (type B grant) and a Canadian Institute for Health
Research New Investigator Award (granted to Dr. Meyer). We thank all the subjects who generously donated their time for participation in the study. We thank Armando Garcia for the assistance in radiochemistry

Holly
September, 3 2015 at 5:16 pm

Betty, I'm not sure anyone here has said mental illness isn't real. Yes, you hear that over at Mad in America, but that's not what this discussion has been about. The people you have attacked have presented their negative experiences with psychiatric treatments and how they have chosen to utilize alternate approaches to wellness. And yes, you can criticize many other drugs for serious/fatal side effects (and I would also advocate alternate treatments there too), however in other areas of medicine, you can't force people to take them unless deemed incompetent (whereas an in psych, just having a diagnosis by itself deems you less competent)

Guy
September, 3 2015 at 4:30 pm

Betty, do you care about the mentally ill or do you not care? You seem to know a lot about what causes mental illness and the best treatments for it, which would make me think you care, but at the same time you make derogatory remarks about the mentally ill; the worst, I believe, have been deleted. Do you truly care about the mentally ill? If so, why all the abusive attacks towards people sharing their stories of mental illness?

betty sainz
September, 3 2015 at 12:47 am

"I have seen over and over again with the schizophrenic population / schizoeffective people slowly reducing meds with psychiatric instruction and these people with profound symptoms going from speaking in clear sentences to word salad speech.
As well as dangerous threatening behaviors towards others when while on meds being kind and non threatening. This makes me question if some people really need to be on these as quality of their lives are adversely impacted as well as society at large being put at risk. They eventually get arrested and involuntarily committed.
I have seen people very sick start clozapine and 6 months later being devastated that they felt and acted the way they did prior to medication because it was so effective.
I am conflicted by what I have witnessed over and over again."
Lois
Why be surprised? Of course meds make profound beneficial changes in the sick. Psychiatric drugs are saving peoples' lives and helping them to resume normal activity again.
"...every little quirk is not a disorder to be treated and medicated..." Susan
Why would you say this, Susan? Have you ever met a doctor who says she prescribes meds that way?

betty sainz
September, 2 2015 at 9:16 pm

Let's not forget. Pain isn't real because it can't be seen under a microscope. Can't see the pain of a migraine, but neurologists treat migraines all the time and they do so based on what a client tells them, not a "medical test." I suppose that makes all neurologists hucksters, too.
Ayres JG, Fleming DM, Whittington RM "Asthma death due to ibuprofen." Lancet 05/09/87 (1987): 1082
Fatality After Deliberate Ingestion of Sustained-Release Ibuprofen
2 cases of ibuprofen overdose characterized by cardiovascular collapse, acidosis, and hypothermia despite the use of vasopressors and renal replacement therapy.
We found that most NSAIDs are associated with increased cardiovascular mortality and morbidity," says researcher Emil Loldrup Fosbol, MD, of Gentofte University Hospital in Hellerup, Denmark. study's most disturbing finding: Diclofenac (brand names include Cataflam, Voltaren) is as risky as the now-banned Vioxx. Both diclofenac and Vioxx nearly doubled the risk of death from heart disease among healthy people in the Fosbol study.
Pain Management Trends: Muscle Pain Sciatica Fibromyalgia Chronic Pain Abdominal Pain Shoulder Pain
Pain Management Health Center
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Common Painkillers Raise Heart Death Risk
Ibuprofen Increases Stroke Risk; Diclofenac as Risky as Vioxx, Study Finds
By Daniel J. DeNoon
WebMD Health News Reviewed by Laura J. Martin, MD
WebMD News Archive
June 8, 2010 -- High doses of common painkillers raise the risk of heart death in healthy people, a huge Danish study finds.
It's the first evidence that so-called NSAID (nonsteroidal anti-inflammatory drug) pain relievers -- including some sold over the counter -- increase the risk of heart disease and death in people without underlying health conditions.
The risks are dose related and are mostly associated with high doses of the drug. However, for most of the drugs, the deaths occurred in people who had been taking the drugs for only two weeks.
"We found that most NSAIDs are associated with increased cardiovascular mortality and morbidity," says researcher Emil Loldrup Fosbol, MD, of Gentofte University Hospital in Hellerup, Denmark.
The study's most disturbing finding: Diclofenac (brand names include Cataflam, Voltaren) is as risky as the now-banned Vioxx. Both diclofenac and Vioxx nearly doubled the risk of death from heart disease among healthy people in the Fosbol study. Although diclofenac is available in the U.S. only by prescription, it's sold over the counter in many nations.
Ibuprofen Heart Risk
Perhaps of concern to more Americans is the finding that ibuprofen (brand names include Advil and Motrin) increased risk of stroke by about 30% in the Fosbol study.
One of the country's most popular over-the-counter painkillers — acetaminophen, the active ingredient in Tylenol — also kills the most people, according to data from the federal government. Over 150 Americans die each year on average after accidentally taking too much. And it requires a lot less to endanger you than you may know. We reported this alongside ProPublica.
aspirin, a commonly used, over-the-counter medicine, causes hundreds of deaths each year. - See more at: http://www.drugwarfacts.org/cms/Causes_of_Death#sthash.y9Mri7MH.dpuf
"Each year, use of NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) accounts for an estimated 7,600 deaths and 76,000 hospitalizations in the United States." (NSAIDs include aspirin, ibuprofen, naproxen, diclofenac, ketoprofen, and tiaprofenic acid.) - See more at: http://www.drugwarfacts.org/cms/Causes_of_Death#sthash.y9Mri7MH.dpuf

betty sainz
September, 2 2015 at 7:14 pm

When the system falters.
Brain cells usually produce levels of neurotransmitters that keep senses, learning, movements, and moods perking along. But in some people who are severely depressed or manic, the complex systems that accomplish this go awry. For example, receptors may be oversensitive or insensitive to a specific neurotransmitter, causing their response to its release to be excessive or inadequate. Or a message might be weakened if the originating cell pumps out too little of a neurotransmitter or if an overly efficient reuptake mops up too much before the molecules have the chance to bind to the receptors on other neurons. Any of these system faults could significantly affect mood.
Kinds of neurotransmitters. Scientists have identified many different neurotransmitters. Here is a description of a few believed to play a role in depression:
Acetylcholine enhances memory and is involved in learning and recall.
Serotonin helps regulate sleep, appetite, and mood and inhibits pain. Research supports the idea that some depressed people have reduced serotonin transmission. Low levels of a serotonin byproduct have been linked to a higher risk for suicide.
Norepinephrine constricts blood vessels, raising blood pressure. It may trigger anxiety and be involved in some types of depression. It also seems to help determine motivation and reward.
Dopamine is essential to movement. It also influences motivation and plays a role in how a person perceives reality. Problems in dopamine transmission have been associated with psychosis, a severe form of distorted thinking characterized by hallucinations or delusions. It’s also involved in the brain’s reward system, so it is thought to play a role in substance abuse.
Glutamate is a small molecule believed to act as an excitatory neurotransmitter and to play a role in bipolar disorder and schizophrenia. Lithium carbonate, a well-known mood stabilizer used to treat bipolar disorder, helps prevent damage to neurons in the brains of rats exposed to high levels of glutamate. Other animal research suggests that lithium might stabilize glutamate reuptake, a mechanism that may explain how the drug smooths out the highs of mania and the lows of depression in the long term.
Gamma-aminobutyric acid (GABA) is an amino acid that researchers believe acts as an inhibitory neurotransmitter. It is thought to help quell anxiety.
Figure 2: How neurons communicate
How neurons communicate
An electrical signal travels down the axon.
Chemical neurotransmitter molecules are released.
The neurotransmitter molecules bind to receptor sites.
The signal is picked up by the second neuron and is either passed along or halted.
The signal is also picked up by the first neuron, causing reuptake, the process by which the cell that released the neurotransmitter takes back some of the remaining molecules.
Genes
Every part of your body, including your brain, is controlled by genes. Genes make proteins that are involved in biological processes. Throughout life, different genes turn on and off, so that — in the best case — they make the right proteins at the right time. But if the genes get it wrong, they can alter your biology in a way that results in your mood becoming unstable. In a genetically vulnerable person, any stress (a missed deadline at work or a medical illness, for example) can then push this system off balance.
Mood is affected by dozens of genes, and as our genetic endowments differ, so do our depressions. The hope is that as researchers pinpoint the genes involved in mood disorders and better understand their functions, treatment can become more individualized and more successful. Patients would receive the best medication for their type of depression.
Another goal of gene research, of course, is to understand how, exactly, biology makes certain people vulnerable to depression. For example, several genes influence the stress response, leaving us more or less likely to become depressed in response to trouble.
A 2003 discovery supports this idea. Researchers found that people with a particular variant in a serotonin-transporter gene (5-HTT) were more likely to become depressed in response to stress. Each person inherits two copies of this gene — one from each parent. The gene comes in “short” (less efficient) and “long” (more efficient) versions. No combination of short or long variants leads directly to depression, but short versions of the gene put people at a distinct disadvantage if they experience stressful life events. In tracking more than 800 young adults over a five-year period, the researchers found that 33% of those with at least one “short” gene became depressed after a series of stressful life events, such as divorce or the loss of a job. People with two copies of the short variant fared worse than those with a single copy, and their risk of depression rose steadily as their lives became more stressful. By contrast, only 17% of those with two “longs” grew depressed in similar circumstances — and their risk of depression remained unchanged as stress levels rose.
In 2008, researchers studied a gene that influences a person’s reaction to childhood abuse. This gene (CRHR1) provides the code for one of the stress hormones — corticotrophin-releasing hormone or CRH (see “How stress affects the body“). For this study, published in Archives of General Psychiatry, researchers interviewed 621 adults and tested their DNA. Among people who suffered childhood abuse, those with the relatively protective versions of the CRHR1 gene had half the symptoms of depression as participants without this genetic variation. This study not only added to knowledge about protective genes, but also lent further credence to the theory that stress hormones play an important role in depression.
Another interesting discovery is the identification of a variation in the DNA sequence named G1463A. People with this atypical DNA sequence are more likely to have major depression than those who don’t.
Perhaps the easiest way to grasp the power of genetics is to look at families. It is well known that depression and bipolar disorder run in families. The strongest evidence for this comes from the research on bipolar disorder. Half of those with bipolar disorder have a relative with a similar pattern of mood fluctuations. Studies of identical twins, who share a genetic blueprint, show that if one twin has bipolar disorder, the other has a 60% to 80% chance of developing it, too. These numbers don’t apply to fraternal twins, who — like other biological siblings — share only about half of their genes. If one fraternal twin has bipolar disorder, the other has a 20% chance of developing it.
The evidence for other types of depression is more subtle, but it is real. A person who has a first-degree relative who suffered major depression has an increase in risk for the condition of 1.5% to 3% over normal.
One important goal of genetics research — and this is true throughout medicine — is to learn the specific function of each gene. This kind of information will help us figure out how the interaction of biology and environment leads to depression in some people but not others.
Temperament shapes behavior
Genetics provides one perspective on how resilient you are in the face of difficult life events. But you don’t need to be a geneticist to understand yourself. Perhaps a more intuitive way to look at resilience is by understanding your temperament. Temperament — for example, how excitable you are or whether you tend to withdraw from or engage in social situations — is determined by your genetic inheritance and by the experiences you’ve had during the course of your life. Some people are able to make better choices in life once they appreciate their habitual reactions to people and to life events.
Cognitive psychologists point out that your view of the world and, in particular, your unacknowledged assumptions about how the world works also influence how you feel. You develop your viewpoint early on and learn to automatically fall back on it when loss, disappointment, or rejection occurs. For example, you may come to see yourself as unworthy of love, so you avoid getting involved with people rather than risk losing a relationship. Or you may be so self-critical that you can’t bear the slightest criticism from others, which can slow or block your career progress.
Yet while temperament or world view may have a hand in depression, neither is unchangeable. Therapy and medications can shift thoughts and attitudes that have developed over time.
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A few excerpts from:
Harvard Health Publications
Harvard Medical School

UNIQUE
September, 2 2015 at 10:39 am

FYI
Here's an excerpt from a MEDICAL dictionary
DISEASE /dis·ease/ (dĭ-zēz´) any deviation from or interruption of the normal structure or function of any body part, organ, or system that is manifested by a characteristic set of symptoms and signs and whose etiology, pathology, and prognosis MAY BE KNOWN OR UNKNOWN.
Betty, I suppose you have your own definition? If so, offer it up! I'd like to hear it

betty sainz
September, 2 2015 at 4:47 am

What's his name, Szasz? The idiot who says that running around a classroom is not a disease. Yes him. No one ever said running around a classroom was a disease.

Unique
September, 2 2015 at 1:39 am

As most of us here already know Bipolar Disorder Is a spectrum mood disorder, meaning different people experience it differently, for example
Bipolar 1, Bipolar 2, Cyclothymia,
N.O.S., Rapid Cycling
See http://www.dbsalliance.org/site/PageServer?pagename=education_bipolar_types
and therefore it goes without saying that treatment can be quite different for everyone. There is no one size fits all. Some opt for medication(s) to help control the more severe symptoms while others can find relief in a more holistic approach or in some cases a combination of both works best. We are all individuals each with our own unique biology . It is up to us to find the type of help we need to improve our quality of life. Sometimes that means employing a professional and sometimes not. But ultimately the choice is ours. We are the ones having to live with this disorder day in and day out
As the saying goes, don't judge me for my choices in life until you've walked a mile in my shoes...

betty sainz
September, 1 2015 at 10:26 pm

Whitaker has no clue, but he knows how to sell books.

Holly
September, 1 2015 at 4:38 pm

Amen, LJ
And Betty, NOBODY, whether they have had bad experiences with psychiatry or not, deserves the abusive antics you have displayed here. It's not an issue of coddling, it's called basic decency and respect for others.

betty sainz
September, 1 2015 at 3:50 pm

Dearest Renee My One True Love,
You typed, "I agree with Juan Diablo. 15 + comments this month on the same thread alone and counting… and that’s not including the ones that got deleted. Seriously, must you go on and on and on and on? Maybe take a deep breath and relax a little. Let someone else comment for a change."
I am deeply sorrowful that you feel this way. (But I do treasure the thought that you count my posts, you big sweetie pie.) I must stand firm, however, no matter the cost. Therefore, I will not give anyone else a chance to comment! No way. I can't, my love. I just can't do it. There is no room for those who disagree with me. (Sort of like Big Bad Bobby Boy)

betty sainz
September, 1 2015 at 3:35 pm

[moderated]
The following pre-posted data are impressive. Perhaps a bit esoteric but let me strongly recommend Bobby Boy give his best shot to explain what they mean. Oooops! Almost forgot. He ain't an M.D. Shucks. Maybe he could site the biomarkers for that host of iatrogenic mental illnesses.
"In depressed patients who had received 40 to 60 mg per day of fluoxetine for 6 weeks, the cerebrospinal fluid concentrations of the metabolites of 5-HT (5-HIAA), dopamine (HVA), and norepinephrine (HMPG) were reduced by 46%, 14%, and 18%, respectively. Because uptake inactivates serotonin by removing it from the synaptic cleft, uptake inhibition by fluoxetine enhances serotonergic function." eMedExpert
Those who think they despise psychiatry would do well to examine these findings.

Guy
September, 1 2015 at 2:52 pm

I'm more than half way through reading Anatomy of an Epidemic. Whitaker makes some very valid points and seems sincere in truly wanting to help the mentally ill recover and live productive and fulfilling lives. Thank you healthyplace for bringing Whitaker's work to my attention.

Juan Diablo
September, 1 2015 at 2:48 pm

Bravissima, L.J. Very graciously stated.

L.J.
September, 1 2015 at 1:18 pm

Oh, but they are honest with themselves.
They courageously share their stories so others are not blind sighted. I notice you had not one ounce of compassion for the mothers who lost their children from the link I posted.
On Healthy place, this site, just the other day, I read a post by Dana, whose husband lost two decades, of his life because of a misdiagnosis; the problems with the DSM and misdiagnosis are as great as the issues of inappropriate and over medication.
He was diagnosed with bipolar when he was not and given a cocktail of medication.
They made the decision not to have children because of that misdiagnosis of bipolar and the medication regimen that came along with it. He is angry and rightly so.
Now he is being treated properly and dealing with the loss.
That is how it is for many of us. We are able to find and choose what is appropriate and sometimes that is with another type of mental healthy therapy or spiritual practice, or just healthier coping tools. It will be individual for each of us.
We have to first acknowledge the truth of our experiences, accept what happened and find meaning in it, moving forward.
One way to do that is to share our truth.
In my opinion based on my own experience of it, your harassment and mocking speaks really more about the site and moderator than it does anything else.
Trolls and bullying do take place online and each site needs to decide what they stand for in allowing or disallowing it.
So, I agree with you, "being honest *is* the key to recovery.
We are.

betty sainz
September, 1 2015 at 11:10 am

While these antis enjoy their special status as deeply wounded and abused folks who must be treated with kid's gloves, they are incapable of being honest with themselves, the key to begin recovery.

Holly
September, 1 2015 at 10:36 am

Hey Betty,
Is this how you typically interact with others offline who may disagree with you or have different perspectives? If so, does this style of communication serve you well in your relationships?
Wish You Well has some great points in his post- might be good to think about them, as well as show your posts to whoever is supposedly treating you. Perhaps you could gain some insight as to why your totally out of line posts towards LJ and others earlier on made others not so nice to you (even so, nobody has matched the level of your insults...especially that hamburger/onion post that was deleted).
Also, FYI, this is a blog for bipolar disorder. You told us you have ADHD, so I'm curious what drew you to this blog. Or are you here solely here for the purpose to pick fights?

Wish You Well
September, 1 2015 at 4:31 am

Healthyplace's words, not mine:
Borderline Personality Disorder
"People with borderline personality are unstable in their self-image, moods, behavior, and interpersonal relationships"
"People with a borderline personality tend to see events and relationships as black or white, good or evil, but never neutral"
Anoaognosia
"There is a type of denial of mental illness that goes beyond mere psychological denial – this is called anosognosia and it is the clinical term for the lack of insight required to understand you have a mental illness"

betty sainz
August, 31 2015 at 5:27 pm

Juan Diablo says:
Geez. Give it a rest, “Betty.
”I agree with Juan Diablo
15 + comments this month on the same thread alone and counting… and that’s not including the ones that got deleted. Seriously, must you go on and on and on and on? Maybe take a deep breath and relax a little. Let someone else comment for a change." [moderated]
Cruel, vicious, gang attacks by those incapable of such despicable and atrocious bullying--of a sufferer

betty sainz
August, 31 2015 at 5:14 pm

The antidepressant, antiobsessional, and antibulimic effects of fluoxetine are thought to be related to its effects on serotonergic neurotransmission. It is a potent and selective inhibitor of serotonin (5-HT) uptake, but not of norepinephrine or dopamine uptake, in the central nervous system (CNS). In depressed patients who had received 40 to 60 mg per day of fluoxetine for 6 weeks, the cerebrospinal fluid concentrations of the metabolites of 5-HT (5-HIAA), dopamine (HVA), and norepinephrine (HMPG) were reduced by 46%, 14%, and 18%, respectively. Because uptake inactivates serotonin by removing it from the synaptic cleft, uptake inhibition by fluoxetine enhances serotonergic function. As a consequence, the 5-HT 1 receptors are desensitized or downregulated after long-term fluoxetine administration. Fluoxetine does not interact directly with postsynaptic serotonin receptors, muscarinic-cholinergic receptors, histaminergic receptors, or alpha-adrenergic receptors. It does not appear to cause downregulation of postsynaptic beta-adrenergic receptors or a decrease in beta-adrenergic–stimulated cyclic adenosine monophosphate (cAMP) generation as do older antidepressants.
Fluoxetine is an atypical SSRI. Studies have shown that plasma norepinephrine, epinephrine and dopamine levels are significantly increased after acute and chronic treatment with fluoxetine 7.
Let's be clear. "we had not been fully informed potential for serious risks/impairment (as much of that data is still unpublished!)" How much is "much" of that data? If it isn't published, how do you know about it? What had been published when you started taking those drugs?
"or they were minimized by the prescriber" What does that mean specifically? How did she minimize the side effects that even she didn't know about because much of the data still isn't published?
"so we listened to our health care provider, who was usually eager to support our self-perceptions of impairment and encourage the drugs." How do you determine that your HCP was eager to support your version of reality? What specifically did she say or do that led you to believe she was eager to get you on drugs?
She is right. She cannot speak for LJ,

betty sainz
August, 31 2015 at 4:44 pm

"...the only part of betty’s last post that is worthy of being addressed..."
That's judgmental, harsh, unnecessary, insulting and bashing. Without the faintest whiff of respect, she criticizes someone who has suffered terribly. Then, if that weren't bad enough, she accuses the target of her bitterness with the same despicable behavior in which she's engaged.
"...as for the rest, not going to try to reason with nonsense."
Another cruel, evil, nasty and unnecessary poison dart thrown by an innocent victim at someone all too familiar with excruciating pain the likes of you cannot begin to imagine. I can spot a "fellow sufferer" a mile away and trust me, Natasha is the real deal. She is honest and has tasted murderous suffering. Guaranteed.

Holly
August, 31 2015 at 9:32 am

the only part of betty's last post that is worthy of being addressed is the issue of why people seek psychiatric care if they have "functional lives". i can't speak for lj specifically, but my own experience and that of others is that even though we were functional, we felt or (others made us feel) we were not optimally handling things in our lives and there WAS some degree of perceived impairment present. we had not been fully informed potential for serious risks/impairment (as much of that data is still unpublished!) or they were minimized by the prescriber, so we listened to our health care provider, who was usually eager to support our self-perceptions of impairment and encourage the drugs. I remember thinking, "Well, what do I have to lose?". Only after having adverse reactions that really put our lives into chaos, did we fully learn to appreciate our pre-medication existence, even if in many ways not ideal.
as for the rest, not going to try to reason with nonsense.

betty sainz
August, 30 2015 at 6:06 pm

"I was prescribed psychiatric medication while a functioning adult, working, having connections and meaning in my life, respected in my community."
Why did she seek medical intervention?
"Healthy place needs to put the disclaimer, not all sufferers are welcome, so people are warned of the risk of sharing. Not a safe place."
It has been the same place for years and suddenly someone decided to post a comment about her experience, then immediately complains that it wasn't safe for her to have done so.
"I praise Whitaker for his courage and steadfast integrity and I think the rest of you need to educate yourselves, his evidence is solid, but then that is why ignorance is bliss, yes?" That is quite a nasty insult and it is untrue.
Take care." Why did she bother to share her experiences here in the first place?
"your experience is your own, and your seeming lack of willingness to honor the experience of other sufferers is distressing.
You might want to actually read the book before you trash a man who has given a voice to millions of us who were ignored."
Natasha made her point of view clear years ago, right here, for all to see. What made this person decide to post here right now in the first place?
"I am not anti-psychiatry, I am for responsible psychiatry. And you should be, too." To suggerst that Natasha isn't in favor of responsible psychiatry is a personal attack and further, it is incorrect. This person said reaching out to the mental health community-psychiatry- was the worst decision she ever made. Which "psychiatry", the "responsible" one or hers?
"I was prescribed psychiatric medication while a functioning adult, working, having connections and meaning in my life, respected in my community." She believed she needed medical intervention? For what?
"Healthy place needs to put the disclaimer, not all sufferers are welcome, so people are warned of the risk of sharing. Not a safe place."
It has been the same place for years and suddenly someone decided to post a comment about her experience, complaining that it wasn't safe for her to have done so.
"I praise Whitaker for his courage and steadfast integrity and I think the rest of you need to educate yourselves, his evidence is solid, but then that is why ignorance is bliss, yes?" That is quite a nasty insult and it is untrue.
"Done with these *un* healthy place blogs, I don’t bash other sufferers. Nor do I promote stigma." Yes, she does both bash and stigmatize.
Take care." Why did she bother to share her experiences here in the first place?
"betty,
You say Whitaker does not abide by his own posting guidelines. Prove it. You can’t, so stop saying it. Very simple."
Whitaker doesn't abide by his own published guidelines, thank you very much, and I will not stop saying it.
"Honestly, your post sounds like shilling. Combined with the way you viciously attack everybody who had problem with Pharma drugs in the past………… I am not buying it." Another insult and personal attack.
"You’re just honked off because your personal attack aren’t tolerated over there like they are here. Learn to form a cogent argument. Think! Use that “functioning, wide awake brain” that you claim medication has miraculously bestowed on you.
Hugs,
Chief"
He has no idea who is honked off or why, but, he does accuse a fellow sufferer of not posting "cogent' comments which is judgmental and an insult.

Renee
August, 29 2015 at 2:49 pm

I agree with Juan Diablo
15 + comments this month on the same thread alone and counting... and that's not including the ones that got deleted. Seriously, must you go on and on and on and on? Maybe take a deep breath and relax a little. Let someone else comment for a change. [moderated]

Juan Diablo
August, 29 2015 at 9:55 am

Geez. Give it a rest, "Betty."

betty sainz
August, 29 2015 at 6:38 am

"I don’t know if that’s true or not. (If he takes money from drug companies. She says he claims he doesn't, so she is challenging his integrity.) I do know that Torrey is I don’t know if that’s true or not. I do know that Torrey is a prime source of misinformation, mainly in the form of fear- and hate-mongering against people with the scarier psychiatric labels.." Dee Jacobsen
Let's be clear. Antis don't insult or belittle others. That's all you need to know.
" I do know that Torrey is a prime source of misinformation..." Dee
"mainly in the form of fear- and hate-mongering..." Dee
"against people with the scarier psychiatric labels." Dee

betty sainz
August, 28 2015 at 10:13 pm

Natasha, is Prozac prescribed for bipolar? Have you ever been on it for 4 to 6 weeks, minimum? Keep us updated on your progress, dadio. You have established a caring base of supporters.

VenusH.
August, 28 2015 at 6:05 am

So when "my nastiness and viciousness is in fact bravery" didn't work out for betty, she goes and claims it was not her who made these statements.
And the hole is dug deeper and deeper. But maybe it's good all that nasty abusive crap gets deleted.

betty sainz
August, 27 2015 at 6:00 am

Anyone who wants to may share her experiences with psychiatry. Always could. I Never Promised You A Rose Garden was published 61 years ago.

betty sainz
August, 27 2015 at 2:31 am

Natasha, someone is posting using my name and making false statements attributed to me.

M
August, 26 2015 at 2:12 pm

Betty & Horace
I honestly don't get why you're so stuck on biological markers or need proof of iatrogenic illness. Please explain. Are you saying that without evidence of a biological marker there's no proof you have a mental illness to begin with? That if you take a medication and have a bad reaction to it you are making it up?
My biological mother had a mental illness, was in and out of hospitals her whole life. Obviously medication didn't work for her because she eventually took her life. I on the other hand have benefited for the most part from medication although I did have a life threatening reaction once to a paricular medication ages ago that caused neuroleptic malignant syndrome. I am adopted so it would appear that I inherited my biological mother's illness as illnesses do tend to run in families. Isn't that the reason why doctor's are so interested in our family histories?
Perhaps more science research is needed to provide what you appear to be looking for. But just because the science may not there yet doesn't necessarily mean what people report to be true for them is a fallacy.
An honest respectful answer is appreciated

Holly
August, 26 2015 at 10:59 am

Betty/horace/donald,
I was going to try to have an ounce of sympathy (as someone who knows at thing or two about what it is like to deal with unmedicated adhd and people not accepting there is something biological going on, though I'm with venusH and think that's likely not true and you are just doing this for "fun"). but adhd or not, clearly that would be a waste of time. All I can say is that ADHD medication is known to cause aggressive behavior/mania/psychosis, and if you are truly taking those meds, it may be wise to show your prescriber your responses on this post.......

Horace Wamplestein
August, 26 2015 at 9:34 am

T'is the proof of all the iatrogenic illnesses you lack. That's your problem. Sorry. I do hope LJ will return, once again, when she can produce it.
VanusH. Why ere yue poding here whan you shuld folow adfise of LJ?

VenusH.
August, 26 2015 at 7:30 am

And do you have a "proof" of medication giving you life? Biological one? No? So maybe stop pushing the drugs and defending them so... viciously towards others?
ANd what kind of life it is, where civility is considered a bull? Or is it your nature? Glory, glory, glory doesn't seem to go behind you. Others have felt pretty unglorious under your venonous attacks.
And why not consider the fact to others meds are not miracle, exclamation mark and glory? But the oposite? Where does this inability to grasp the fact psychiatry is not so perfect and the drugs don't work for everybody come from?
Honestly, your post sounds like shilling. Combined with the way you viciously attack everybody who had problem with Pharma drugs in the past............ I am not buying it.

Chief
August, 26 2015 at 7:00 am

betty,
You say Whitaker does not abide by his own posting guidelines. Prove it. You can't, so stop saying it. Very simple.
You're just honked off because your personal attack aren't tolerated over there like they are here. Learn to form a cogent argument. Think! Use that "functioning, wide awake brain" that you claim medication has miraculously bestowed on you.
Hugs,
Chief

betty sainz
August, 26 2015 at 5:29 am

Yes. I have ADHD. Medication has given me life. I can think and hear and focus and follow conversations and stories and discussions. I can read. My brain works. I know what it's like to have a functioning, wide awake brain. It is like a miracle. A miracle. When hope was gone, I was prescribed medication which turned my brain on, like a switch. Glory! Glory!

M
August, 26 2015 at 4:25 am

I'm curious Betty...
Do you have a mental illness? Do you take medication?
Fair questions to ask don't you think since you seem to have such strong opinions about both
Simple question. Yes or no?

betty sainz
August, 26 2015 at 12:50 am

MIA Guidelines
MIA lies. Whitaker has a standard for his adoring fans and lies to those who challenge him. He does not abide by the following.
"Honestly articulate your opinions and experiences. Your unique perspective is a welcome contribution to the issues discussed on the site.
Keep comments civil. This includes refraining from posting personal attacks, sarcasm, spamming, hyperbole, misrepresentations of oneself or others (including strawman arguments), illegal material, profanity, hate speech, disparaging assertions about a person's character, and discrimination based on a person’s identity or occupation. We ask for good faith and the benefit of the doubt in our effort to allow anybody who wants to join the dialogue to do so without fear of abuse. Please respond to and criticize ideas, not character.
Honor differing viewpoints. This website intentionally brings together individuals with varying backgrounds and values. We believe civil, inclusive dialogue to be crucial to finding solutions to our current paradigm of mental health care.
Remain relevant to the present article/topic. Off-topic comments are disruptive and derail the discussion. These may be removed by the moderator. Readers who wish to initiate a new conversation are invited to submit an Op-Ed blog. Keep self-promotion to a minimum and post no more than one link to your own website per comment. Please note that in most cases discussion of comment moderation in a thread is considered off-topic. Contact us directly to report problematic posts or offer feedback about moderation."
All bull
It is difficult to attack someone who comments anonymously. Just show the proof with the biological marker which demonstrates the harm the meds did. That's all. Since you can't, stop saying the meds damaged you. Very simple.

VenusH.
August, 26 2015 at 12:03 am

Really bettsy? I don't know LJ, I came to this blog after some time and saw these disgusting attacks. Many probably did too.
Why does somebody's story make you so mad? Why do you care about "purity" of whole entire field of practice more than about one individual being?
You are not the brave one. Nothing brave about insulting people online.

betty sainz
August, 25 2015 at 8:44 pm

LJ promised she was done posting here. Not only has she posted, she's reread the disgusting posts that caused her such grief, she would never post again. She even recruited her watchdogs to try to silence someone who had the unmitigated gall to point out that she had no proof she reacted to psychotropic medication as she claimed.

Relieved
August, 25 2015 at 9:38 am

Natasha
Thank you for helping to stomp out stigma by removing the comment in question.
Andrea Pacquette would be proud!

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