Borderline Families

Damn! I spoke too soon.

My daughter almost succumbed to the chaos that she found herself in mid-day yesterday. Ex-father abuse, the sublet-er wanting to move in as early as possible, the search for movers and storage facilities (where ? Brooklyn? Lower East Side?), everything needing to be decided – yesterday. Should she pack this here or in that box? Too many little things overwhelming her so that her next move seemed impossible to make. In shambles, she called. Crying and bruised from a verbal fight with the ex-father, starved because she hadn’t taken time to eat and so stressed that her words came out in a jumble,  I could barely make out what she was saying.

It felt like she had made a significant step forward and yesterday plummeted two steps back.

Amazingly, she is not giving up.

She just needed to vent.

Bravo ME for not rushing out to help her. (My first instinct is not always the best. I listened very carefully and held my tongue and didn’t offer anything but support from afar.)

I am hoping that she will step on the flight to Australia and feel like she has learned some life skills that will help her deal with stress along the way.

Fingers crossed. I think it is okay to have big dreams for my daughter.

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Beyond Meds is a blog written by a wonderful researcher. Her hard work has lead me to the concept of the neuroplasticity of the brain. I have learned a few very valuable things in the past couple of days:

My daughter’s brain was injured by the meds, more specifically from the withdrawal, too quick and not tapered as it should have been.

The adult brain, long considered to be fixed in its wiring, is in fact remarkably dynamic. Neuroscientists once thought that the brain’s wiring was fixed early in life, during a critical period beyond which changes were impossible. Recent discoveries have challenged that view, and now, research by scientists at Rockefeller University suggests that circuits in the adult brain are continually modified by experience. – lifted from the June 16, 2010 post on Beyond Meds.

I read here that perhaps my daughter’s belief that she could live on her own taught her brain by experience. Doing gave the power to do.  Dr. Elisha Goldstein, Ph.D. is a clinical psychologist .…. He notes, “We have this exciting news that we can actually change the neural pathways in our brains based on the actions we take in life. Millions and millions of evolutions of the brain have given us this awe inspiring organ that has more connections than we can comprehend.

For thousands of years, Buddhist meditators have claimed that the simple act of sitting down and following their breath while letting go of intrusive thoughts can free one from the entanglements of neurotic suffering. — Now, scientists are using cutting-edge scanning technology to watch the meditating mind at work. They are finding that regular meditation has a measurable effect on a variety of brain structures related to attention — an example of what is known as neuroplasticity, where the brain physically changes in response to an intentional exercise.

A poet, essayist, psychiatrist and psychoanalyst who divides his time between Toronto and New York, Norman Doidge is the author of The Brain That Changes Itself, an international bestseller translated into 14 languages, published in 40 countries and essential primer for anyone who wants to better understand their own brains and the considerable advances in neuroscience of the past two decades.

For 400 years, says Doidge, scientists saw the brain as a machine made up of parts that performed specific single functions. “According to that way of thinking, this meant that if a part was damaged, nothing could be done, and it made no sense to try to preserve your brain as you aged, that was pointless effort. And it regarded human nature, which emerges from the brain, as being as fixed as the brain. This turns out to be spectacularly wrong.”

In fact, we now know that the brain has a remarkable capacity for change, for repair and healing after injury and for learning, from cradle to grave. Gone is the idea that the brain you were born with is the brain you are stuck with and that once you reach your mental peak it’s all downhill into doddery dotage. – lifted from Beyond Meds, September 10, 2008

HOPE! HOPE! HOPE!

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A commenter on a blog referring to my recent posts and the Robert Whitaker book, Anatomy of an Epidemic, wrote “there’s no reason to toss the baby out w/the bath water either. Medication SO helps so many people dramatically,….which I’ve seen with my own eyes, repeatedly. Gosh,..so much of these problems and others that affect behavior are physically caused, period. I haven’t read the book, but I do know that medication can miraculously help people that have previously been blamed or shamed for what’s been their problems.”

Me too, but…

From An Anatomy of an Epidemic – (page 132)

As anyone who has taken a benzodiazepine can attest, it acts rapidly and if a person hasn’t become habituated to the drug, it will numb his or her emotional distress. As such, a benzodiazepine has an obvious utility in helping people through a situational crisis. . . But as clinical trials revealed, that immediate efficacy quickly begins to fade and pretty much disappears by the end of four to six weeks.

There is a quick fix made available by the pharmaceutical industry. But, there is not a medical model available that does not use drug therapy. Without a different approach, one that turns to therapy first, people in acute mental pain feel that they have no choice but to pop the pill.

I feel compelled to note here a comment made by Stephany, the writer of Soulful Sepulcher.

NAMI is being investigated by Senator Grassley for receiving pharma funding.http://bipolarsoupkitchen-stephany.blogspot.com/2010/06/fuller-torreys-tacy-booth-at-nami-2010.html

NAMI (National Alliance on Mental Illness) is NOT a support group for patients, it’s a pro-drugging group that influences family members to KEEP their loved ones ON meds, all the while receiving 75% of funding from PHARMA companies.

Be careful who you believe.

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I have been trying to figure out why I am so upset after reading Robert Whitaker’s book. Websites and blogs telling the honest truth about the fraud were right there – in my blogroll and tweeted to me daily. They even tugged at my attention a couple of times, but I just kept holding onto the medical model that had driven me for years to continue to seek help for my daughter.

I was all about “therapeutic doses” and getting the correct diagnoses. Wishing that my daughter had an antipsychotic for when she was symptomatic. Angry that the first psychiatrist she saw put her on benzodiazepines and lamenting her subsequent addiction. (Not brain shrinkage, memory loss or  the fact that her life will probably be 25% shorter as a result of psychiatric drug use.) I was in the game up to my eyeballs. I bandied about “mental illness” stats and knew the criteria for getting diagnosed with this or that. I was calm and composed as I went about my crusade for my daughter.

Maybe I read articles exposing the deceit of the pharmaceutical companies all the while assuming that they were written by people who had been pushed off the deep end and were now fixated on correcting the injustice perpetrated on them. Like they were isolated incidences; the writers all individuals with personal grievances to lodge, a bone to pick, a wrong to right. Everyone had been made a little crazy by their experiences and came off  a little zealous in their pursuit.

My daughter could have joined them to complain about the despicable conditions in psych wards or the over-drugging she experienced at Austen Riggs or any number of humiliating experiences she suffered at the hands of the mental healthcare industry. But, making a scene? Haven’t we had enough of that?

Suddenly, I really want to make a Big Scene.

Since the abrupt shift in my world view, I have become one of them.

I read a comment on a blog that was referring to Robert Whitaker’s book and I didn’t know how to moderate my new enthusiasm.

The writer is borderline bipolar and his/her psychiatrist adjusts meds on a regular basis to keep things manageable. This person is “very grateful for meds today, even though (she) hate(s) being dependent on them to live a reasonable life.” This, despite the meds creating “holes” in his/her memory.  ”It helps a lot with sleep issues, but I need my memory. ”

I wanted to write a long explanation gleaned from Whitaker’s research about what is going on in his/her brain when the psychiatrist tweaks the cocktail. I wanted to call this person on the phone! I wanted to look up psychotherapists in his/her  area of the country. I clicked out of the comments section instead.

A friend told me yesterday that both she and her husband had positive experiences with antidepressants. They were both on meds for about a year and “recovered”.

From Robert Whitaker’s Anatomy of an Epidemic – (page 158)

… investigators reported again and again that people treated with an antidepressant were very likely to relapse once they stopped taking the drug.

It was as though a person treated with the drug gradually became less and less able, in a physiological sense to do without it. Investigators in Britain came to the same sobering realization; “After stopping an antidepressant, symptoms tend to build up gradually and become chronic.”

Quoting G. Fava, Psychotherapy and Psychosomatics (1995) – (page 160)

Antidepressant drugs in depression might be beneficial in the short term, but worsen the progression of the disease in the long term, by increasing the biochemical vulnerability to depression… Use of antidepressant drugs may propel the illness to a more malignant and treatment unresponsive course.”

Another friend’s life was unexpectedly hijacked by very scary  panic attacks and with a cocktail of benzos, antidepressants and psychotherapy, she is feeling much better.

She will never know if the psychotherapy alone would have “saved” her. She will now have to taper off the meds that gave her the quick fix. They settled her brain down enough to sleep and live her days anxiety free. But, at what cost? Will it be quantifiable? The efficacy of the drugs versus the therapy? I am very happy that she found relief.

Like I was when my daughter was out of her mind, ranting and screaming at the nurses at Austen Riggs to DO SOMETHING. The cocktail that they finally gave her turned her into a docile calm passenger in the car. We did some errands, our lives momentarily returning to a semblance of “normal”.

From my book, Collateral Damage, written about the search for relief throughout the mental healthcare industry in the U.S.

Clearly, I had an inkling of what I discovered recently – drugs are not the answer -

What was weird was that her body was still agitated. She jerked along in quick, faltering steps. Her right arm continuously slashed out into space. But, her brain was slow and lethargic. She was owl-eyed and struggling to dispatch the words from her brain to her mouth. Ideas formed but drifted away, only parts arriving in sequence. What a vicious cycle: drugs to combat the anxiety, more drugs to combat the side effects, higher and higher doses. I vowed to ask Emily (social worker and our liaison with Austen Riggs) if drugs are really the way to go. What about therapy? Going into the pain, figuring out the root. What about getting to the source instead of masking it with drugs?

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My therapist made my discovery of the Psychiatric Drug Deceit look like I had just figured out that I could change the channel on the television with a remote OR on the box itself. Obvious and rudimentary. (This kind of pissed me off…)

I searched for years to find help for my daughter and NEVER along the way did anyone insinuate that she might be better off without the endless trial and error drug treatments.

It might be too late for my daughter; it is not too late for millions of new patients being diagnosed and starting on psych meds this year. Robert Whitaker’s research revealed that it is “a fact that  the mentally ill are now dying twenty-five years earlier than their peers, and that it is clear that the atypical antipsychotics, which regularly cause metabolic dysfunction, are contributing to that early death problem.”

From psychiatrist and author Dr. Daniel Carlat – Carlat Psychiatry:

Few laypeople realize how little we actually know about the underpinnings of [psychiatric] disorders….In virtually all of the psychiatric disorders including depression, schizophrenia, bipolar disorder, and anxiety disorders, the shadow of our ignorance overwhelms the few dim lights of our knowledge.

Doesn’t this frighten you like it does me? For years I blindly followed the medical model that seem driven by smart, trustworthy people.

Our diagnostic process is shallow and is based on an elaborate checklist of symptoms, leading us sometimes to over-diagnose patients with disorders of questionable validity, or, conversely, to miss the underlying problems in our rush to come up with a discrete diagnostic label that will be reimbursed by the insurance company. We tend (Dr. Carlat asserts, as he is a member of the psychiatric community) to treat all psychological problems the same way – with a pill and a few words of encouragement. Because of this rote approach to treatment, patients are often misdiagnosed and medications are over prescribed. In the end, we miss- serve our patients, failing to offer them psychotherapies that are sometimes more effective than drugs.

My therapist said that some of the worst offenders are the GP’s who get fifteen minutes or less to discuss problems with their patients before the next in a long line of clients passes through their office.   “My friend tried …” Or, “I saw an ad for…” The GP doesn’t have time to ask why the patient feels they need the drug; they just write a prescription. Who, my therapist asked, is going to invest hours a month to work out of their depression with psychotherapy, when a pill can be taken. The quick and easy method of relief wins out each time. No one, he insisted, is thinking long-term.

The resulting frenzy of psychiatric diagnoses has damaged the credibility of everyone in the field.

I only wish that this was true. I think the mental health profession is getting off scott-free. My little voice certainly isn’t going to sway anyone or start a revolution. Robert Whitaker’s book is getting buried by APA, NAMI, praise for Judith Warner, etc.

Who is paying attention to the fraud? No one is discrediting the psychiatric field because few people in the general public even know that they have placed their trust in a faulty system.

We like to see ourselves as neuroscientists, rationally manipulating levels of neurotransmitters like serotonin in order to get patients better. But the fact is that we have no clear evidence that chemical imbalances are at the root of any mental disorder…. We don’t know if changing levels of serotonin [by prescribing Zoloft or Celexa, or any other drug] is the actual curative mechanism. Nonetheless, we give patients elaborate explanations of how the drugs work chemically. It makes psychiatrists feel more scientific, and gives patients a feeling of confidence, but it’s little more than made up neuro-babble.”

As Robert Whitaker’s research revealed, psychiatrists wanted the magic pill just the the Real Doctors have – an antibiotic to cure the troubled mind, to correct the “chemical imbalance”.  Never mind that there isn’t an imbalance, we, the unsuspecting public doesn’t know better. I was won over by the neuro-babble just like millions of other believers.

The fact is that psychopharmacology is primarily trial and error, a kind of muddling through different candidate medications…. depending upon which company’s sales rep or which academic “Hired Gun” recently made a pitch for one or another drug. Indeed, when our most esteemed colleagues have essentially joined the marketing teams, it makes it that much harder for us to practice our craft responsibly.

“The fact is” should make everyone sit up and take notice. Do  psychiatrists ever admit to one another that long-term results are not favorable for psych meds? Maybe not to us, the unaware public, but among themselves, do they nod and wink as they are writing out the prescriptions?

From Robert Whitaker’s book, Anatomy of an Epidemic:

The pharmaceutical companies would not have been able to build a $40 billion market for psychiatric drugs without the help of the psychiatrists at academic medical centers. The public looks to doctors for information about illnesses and how best to treat them, and so it was the academic psychiatrists – paid by drug companies to serve as consultant, on advisory boards, as as speaker – who in essence acted as the salesmen for this enterprise.

Bipolar/BPD Daniel Carlat, Robert Whitaker