February 2011
93 posts
Most locked-in patients 'happy' →
bbc.co.uk
Mental health in relation to physical illness is something that shouldn’t be forgotten; neither should sampling bias. I think the findings here should be taken with a pinch of salt.The disease “traps” people in their own body, able to think, but incapable of moving or talking.
The study of 65 patients, published in the British Medical Journal’s BMJ Open, found 72% reported being happy, with just 7% wanting help to commit suicide.
Experts said it showed it would be unwise to make assumptions about people’s mental state.
However, they warned that there could be some bias in the study with the most unhappy patients refusing to take part.
The participants, from the French Association for Locked in Syndrome, responded by blinking or moving their eyes.
The majority, 72%, said they were happy and 68% said they never had suicidal thoughts.
The longer people were locked-in, the more likely they were to be happy.
Researchers at the University of Liège, Belgium, said: “We suggest that patients recently struck by the syndrome should be informed that, given proper care, they have a considerable chance of regaining a happy life.
“In our view, shortening of life requests are valid only when the patients have been give a chance to attain a steady state of subjective wellbeing.”
Play
“Although animal rights activist devote most of their concern and activities to the use of animals in research, it should be noted that research and teaching are responsible for less than 1% of the animals killed annually by humans. And more than 90% of those used in research are rats and mice (Miller, 1984). By contract, more than 96% of animals killed by humans are used for food (Nicholl & Russel, 1990).
The animal rights activists also try to convey the idea that most animals used in research suffer pain. The fact is that about 94% of animal in research involves no use of pain. Most of us have seen the gruesome pictures of research animals being operated on. What the pictures do not convey is that the animals have been anesthetized and so feel no pain. The small number of animals that do experience pain in research are contrubuting to knowledge of human diseases such as arthritis that cause pain to millions of humans every day. The opposition to the use of animals in research cannot be justified by the amount of suffering that is being experienced by animals. The regulations on housing of research animals are more stringent than those for human habitation, and there is far more pain, abuse, and cruelty caused to animals by pet owners and farmers that by researchers (Miller, 1984).
There are compellig reasons to use animals in research. First, it should be noted that much animal research has led to an improvement in the welfare of animals themselves, from vaccines against feline leukemia, rabies, and distemper to nonlethal methods to pest control.
Second, although younger people find it difficult to appreciate the fact, there has been tremendous improvement in health care in the past century, much of it in the past few years. About a hundred years ago, around 25% of the US population died by age 25, and half were dead by 50. Today, only 3% fail to live to 25, and only 10% die by 50 (Commitee on the Use of Animals Research, 1991). […]
To eliminate r restrict use of animals in research would mean little or no progress against AIDS, Alzheimer’s, cancer, arthritis, birth defects, traumatic injury, mental illness, and many other diseases and condition that cause pain and suffering to millions of people each year. Whenever you see a picture of a lab animal that appear to be suffering, think of the millions of people who would continue to suffer dreadfully if there were no more medical progress. […]
Those who object that we should not use animals for research should consider that animals have been, and still are, used for work, for food, and as pets. None of these animals volunteers for these services. It may be useful to consider the research animals as draftees in a cause that help society as a whole […]” —
The animal rights activists also try to convey the idea that most animals used in research suffer pain. The fact is that about 94% of animal in research involves no use of pain. Most of us have seen the gruesome pictures of research animals being operated on. What the pictures do not convey is that the animals have been anesthetized and so feel no pain. The small number of animals that do experience pain in research are contrubuting to knowledge of human diseases such as arthritis that cause pain to millions of humans every day. The opposition to the use of animals in research cannot be justified by the amount of suffering that is being experienced by animals. The regulations on housing of research animals are more stringent than those for human habitation, and there is far more pain, abuse, and cruelty caused to animals by pet owners and farmers that by researchers (Miller, 1984).
There are compellig reasons to use animals in research. First, it should be noted that much animal research has led to an improvement in the welfare of animals themselves, from vaccines against feline leukemia, rabies, and distemper to nonlethal methods to pest control.
Second, although younger people find it difficult to appreciate the fact, there has been tremendous improvement in health care in the past century, much of it in the past few years. About a hundred years ago, around 25% of the US population died by age 25, and half were dead by 50. Today, only 3% fail to live to 25, and only 10% die by 50 (Commitee on the Use of Animals Research, 1991). […]
To eliminate r restrict use of animals in research would mean little or no progress against AIDS, Alzheimer’s, cancer, arthritis, birth defects, traumatic injury, mental illness, and many other diseases and condition that cause pain and suffering to millions of people each year. Whenever you see a picture of a lab animal that appear to be suffering, think of the millions of people who would continue to suffer dreadfully if there were no more medical progress. […]
Those who object that we should not use animals for research should consider that animals have been, and still are, used for work, for food, and as pets. None of these animals volunteers for these services. It may be useful to consider the research animals as draftees in a cause that help society as a whole […]” —
Donald H. McBurney & Theresa L. White, ‘Research Methods’, pagg. 65-66.
(via scipsy) For relevance to this blog; it’s absolutely no coincidence that deinstitutionalization occurred at the same time as the rise in medications for mental illness such as antipsychotics. Without these breakthroughs, the mentally ill would still be locked away in asylums. If you refuse painkillers, antibiotics, psychiatric medication, chemotherapy etc, then more power to you, but is it not hypocritical to buy into pharmaceuticals & at the same time complain about / campaign against them? Surely all animal rights activists should be entirely homeopathic & not consume so much as a Lemsip? Is anyone reading this a current / former user of psychiatric meds? What is your opinion? Would you rather have had them or not? Have you refused psychiatric meds because they were tested on animals?
Psychological debriefing for preventing post traumatic stress disorder (PTSD) - Rose et al (2002) →
www2.cochrane.org
What a brilliant quote. Thank you for adding that! It’s definitely true that some clinicians still use debriefing, but it’s actually prohibited in the National Institute of Clinical Excellence guidelines for PTSD in the UK. Presumably this means that NHS psychiatrists / clinical psychologists will be held to account for doing so. Sadly, however, I think private practice may be exempt from this, though I don’t know. Anyone care to educate me?Single session individual debriefing did not prevent the onset of post traumatic stress disorder (PTSD) nor reduce psychological distress, compared to control. At one year, one trial reported a significantly increased risk of PTSD in those receiving debriefing . Those receiving the intervention reported no reduction in PTSD severity at 1-4 months, 6-13 months, or 3 years. There was also no evidence that debriefing reduced general psychological morbidity, depression or anxiety, or that it was superior to an educational intervention.
Single-session debriefing is actually prohibited in the NICE guidelines following trauma. It can actually makes things worse. It is thought that it might actually interrupt peoples’ normal, adaptive coping mechanisms. The recommended model is ‘screen and treat’ i.e. wait to see who develops PTSD symptoms and treat them accordingly. This might sound like a glorified ‘wait and see’ tactic, but it works much better.
This is something that has been on my mind lately in the wake of the terrible Christchurch earthquake. I really hope that debriefing isn’t offered to it’s victims.
“The more we understand, sometimes, the less we seem to know. Years ago there was little guidance as to what clinicians should do in the aftermath of trauma. Now, despite a plethora of competing models, there still is confusion as to what constitutes best practice. Decades ago, a schism in practice began to develop, with two very different approaches to early intervention. The best known approach, and subsequently most criticized model, to guide efforts in the aftermath of trauma was termed Critical Incident Stress Debriefing. Born from work with paramilitary/emergency organizations (e.g., ambulance, fire brigades, police) this protocol advocated a one-size-fits-all, seven-step approach for all who have been exposed to trauma. In the original debriefing model, there was to be a one-off intervention, of one to three hours, to be delivered within 72 hours of the trauma. Despite the growing literature that calls into question the use of debriefings, many mental health professionals continue to remain attached to the model. This attachment has been maintained, in part, by the exaggerated claims of those who have an interest in promoting debriefing workshops and other related products. Just as importantly, if not more so, attachment to the debriefing model has been maintained because of our urgent compulsion to bring whatever skills and information we might hold to bear on the human aftermath of crisis, cataclysm, and catastrophe. We have historically rushed, usually with the very noblest of intentions, to piece together whatever we may have heard, deduced, or simply believed to be useful and effective in such circumstances and to mount aggressive efforts to deliver such ministrations en masse at the times and places of visible turmoil. We bring what we sincerely believe to be the best of our tools and the best of our intent to the worst of times and the most difficult of situations—not surprisingly, we also tend to believe that we deliver in the process the best of care. Once we have mounted such an effort, we typically seek to share what we believe we have learned with other practitioners. Despite such noble intentions, it is important that clinicians deliver evidence-informed interventions. In the case of critical incident stress debriefings, it is clear that good intentions are not enough. Thus, studies have repeatedly found that these widely prescribed prophylactic interventions are not only inert with respect to prevention of PTSD, but they can actually inhibit recovery in at least some recipients. These findings present a compelling case for reexamination—not simply of the techniques and their application, but, more pressingly, of the axioms, assumptions, and pragmatics on which the entire debriefing model was constructed” - Gist, Devilly Clinician’s Guide to Posttraumatic Stress Disorder
I am the one asked about BPI and II/cognitive deficits and the connection to Parkinson's. If really are interested, I have some personal stories related to both. You can visit my tumblr and click "let's discuss" if you'd like. I have read both articles, am fairly knowledgable on the subject given I'm not studying nueropsych right now but really personal accounts are what matter, and it's hard to find a good personal account when all these sites are up asking psych. patients to review their meds...etc. Yes, we all know the side effects suck and each drug is different for each person! Anyway, hope to hear from. Do you do run neuropsych testing on people with mood disorders?
Amazing! I am actually running an experiment right now. I will be over to your page later!
Hi!
This blog is wonderful, thank you for it.
What do you think about the connection between high intellect but low emotional intelligence in those who have suffered or currently suffer from eating disorders? I am interested in articles featuring living with both high intelligence and anxious/neurotic behavior. It's an unfortunate pairing. Personally, I have found myself to have developed extremely unconscientious patterns as a means of dealing with my high levels of anxiety. Thoughts?
Thank you! That’s very kind.
I’ll level with you: EDs are not my specialty. I am more acquainted with mood / psychotic disorders. I have read and can recommend ‘Working with Emotional Intelligence’ by Daniel Goleman, and I do know that there is some relation between alexithymia and EDs. There are also a few studies that AN populations may actually have higher IQs than controls. It would be interesting to see a model of how alexithymia as an independent construct from intellectual intelligence may contribute to EDs in vulnerable individuals: are the genetic polymorphisms responsible for alexithymia related to those for EDs or is this a cognitive contributor i.e. the internalisation of emotion upon oneself in the face of difficulty expressing it verbally to others.
What do you think? As I said, I’m pretty naive on the matter! What do you mean by “unconscious patterns”? Do you think that neurotic behaviour is a consequence / coping strategy in the highly intelligent? Studies that I have seen indicate slightly higher intelligence on average in EDs; not that these people are far more likely to be on the ‘genius’ end of the spectrum…
Psychological debriefing for preventing post traumatic stress disorder (PTSD) - Rose et al (2002) →
www2.cochrane.org
Single session individual debriefing did not prevent the onset of post traumatic stress disorder (PTSD) nor reduce psychological distress, compared to control. At one year, one trial reported a significantly increased risk of PTSD in those receiving debriefing . Those receiving the intervention reported no reduction in PTSD severity at 1-4 months, 6-13 months, or 3 years. There was also no evidence that debriefing reduced general psychological morbidity, depression or anxiety, or that it was superior to an educational intervention.
Single-session debriefing is actually prohibited in the NICE guidelines following trauma. It can actually makes things worse. It is thought that it might actually interrupt peoples’ normal, adaptive coping mechanisms. The recommended model is ‘screen and treat’ i.e. wait to see who develops PTSD symptoms and treat them accordingly. This might sound like a glorified ‘wait and see’ tactic, but it works much better.
This is something that has been on my mind lately in the wake of the terrible Christchurch earthquake. I really hope that debriefing isn’t offered to it’s victims.
French guy says Parkinson’s drug induced gambling and gay sex addiction, tries to sue GSK for $610,000 - The Medical News →
news-medical.net
This is being written about a lot in the news, I think as a light-hearted / funny piece. I myself found out about it when on the underground a while ago and someone, reading an article on this in a newspaper, turned to his friend and commented on “this chump” who was “blaming medicine for turning him gay”.
I assume papers like The Daily Mail (which this commuter was reading. Sigh.) included this story for its sensational qualities, but it’s not the first case of its kind. ”In 2010 former IT manager Peter Shepherd, then 60, ended up in court after he underwent an astonishing personality change when prescribed Cabergoline by his GP in 2001. Mr Shephard told how he became a sex-crazed transvestite after taking Cabergoline, also a Parkinson’s disease drug, and also blew £400,000 on a luxury lifestyle.”
Of course, I’m not qualified to infer causation, but the risky behaviour began when these men started taking the meds and ended when they stopped taking them. Both drugs are dopamine agonists. This means that they increase levels of dopamine in the brain, which are depleted in those with Parkinson’s. This article cites a study which reads “after taking dopamine agonists, six of the patients felt a strong desire not just to gamble but also to engage to excess in other behaviors such as eating, drinking alcohol, having sex, and making purchases. And once these patients stopped taking the drug or took less, their urges in all of these domains declined dramatically”.
Dopamine is implicated in the neural representation of reward, in areas such as the limbic system and frontal cortex. It is released by rewarding experiences such as food, sex, drugs and neutral stimuli that become associated with them. I remember when I was at Oxford reading a book by my tutor, who was big in the field of computational neuroscience. He found that rodents, when given the opportunity to stimulate their own ‘pleasure centres’ in their brain (thus releasing dopamine), would do this relentlessly, not stopping even to eat, drink, or sleep (they were getting all the pleasure they needed neurally, without needing this things to trigger it). Might it be that taking dopamine agonists triggers some kind of dopamine sensitivity in the brain, leading some patients to seek out anything to continue to stimulate their limbic system (gambling, sex, shopping etc)? It’s an interesting thought.
As for the drug ‘turning him gay’, I need to dig out the reference but I’m sure it’s a type of amygdala lesion that leads to non gender-specific or even species or object-specific sexual interest in primates. I need to find the reference. I personally believe that sexuality is a continuum, but that’s a whole other matter.
Sumbit!
A friendly reminder to submit an account of your mental health / illness experiences! Go go go!
Are you familiar with the connection between bipolar I and II and cognitive deficits? Do you think it's caused by the disease or the medication used to treat the disease? Also, what do you think about the argument that bipolar is more similar to Parkinson's than it is to schizophrenia? Just throwing those out there. I guess tumblr isn't the best place for "discussion" but I'd be curious to know you and your followers responses.
There’s a great paper here which looks at cognitive function across clinical state (manic, hypomanic, depressed, euthymic), and there does seem to be well replicated evidence of impaired cognitive function in acute bipolar disorder. I wouldn’t personally be able to comment on whether this is due to the disorder itself or pharmacological intervention, as I have no clinical experience of this. What I will say, however, is that the study I have cited found no significant difference in cognitive performance between those participants taking Lithium and those not. They concluded the same about anticonvulsants but Thompson et al (1982) have found impairments associated with the administration of valproate and carbamazepine. The obvious caveat is that this is a small number of studies, so extrapolation is something that should be taken with a massive pinch of salt. Goswami (2009) concluded that “medication, predominantly mood stabilizers, was found to have small to medium, but statistically insignificant, effect sizes on the neurocognitive test performance of euthymic bipolar disorder subjects when residual mood symptoms were controlled”, but they only used 44 patients. Go figure.
I’m really interested in phenomenological accounts here; I spend my ‘day job’ at university reading and carrying out well controlled analyses of mood scores etc etc, but I want to know what it feels like for people who are actually on these medications; do they feel different? Do they feel better or worse?
There’s a good article on the links between BP and PD here. The literature connection BP with PD is more recent and sparse than that connecting it with SZ; I think a lot more research needs to be done before this manifests itself as any diagnostic changes.
Depression as 'Godlessness' →
mindovermatterzine.tumblr.com
Yet no one realizes the very vocabulary of today’s youth is filled with LGBT stigmatization. When someone uses the words “fag,” “queer,” and “gay” in a derogatory manner, it certainly perpetuates, although at a subconscious level, hetero-normativity and homophobia. If you switch the title of this post from “Depression as ‘Godlessness’ ” with “Homosexuality as ‘Sin’ “, one can clearly see this other issue I have raised. Unfortunately, not even those who voiced their opinions so vehemently on the OP’s topic will rise against this subliminal hate speech. Too many ignorant bigots walking this earth, leaving behind nothing but unwarranted prejudice, spreading like a malignant cancer to all those who fail to see what is happening.
Are you implying that, in reblogging something on my dash that is stigmatizing to the mentally ill, that I don’t care about LGBTQ stigmatization? If that’s the insinuation, I resent it. My blog is mental health-based; and if you read back a bit you’ll see that I’ve called for submissions from people about how coming out or living in fear thereof has affected their mental health, and from those who see themselves as gender queer and resent its pathologization (I’ve had some brilliant contributions on this matter), because I don’t want my zine to be a heterocentric account of living with mental illness.
The girl I found this post via expressed similar views about attutudes towards the mentally ill: the original post was not about the LGBTQ community, so in her not mentioning the LGBTQ community I didn’t take it to mean that she cares about them less, because I know that it is a cause very close to her heart (she has two mothers).
To say that “no one realizes” how detrimental it can be to use words such as ‘gay’ as a synonym for ‘bad’ is a bit of a stretch. I’ll admit that, in popular culture these words fly around all to readily, but there are people out there who care. It’s not a competition for ‘most oppressed’, and I don’t see how being wary of the language we use that might affect one population means we have to be ignorant of the effects on other populations.
On a lighter note:
