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Obama’s and McCain’s Positions on Mental Health Care

by Mike on August 6, 2008 · 52 comments

mccain obama sm2 Obamas and McCains Positions on Mental Health CareThis is not a political blog. But you probably know that!

However, the 2008 Presidential election is probably the most important election we have had in decades. The candidates, Barack Obama and John McCain, have very different views of how they will lead the country and the direction they will take it.

Nowhere is this difference more pronounced than in the candidates’ views on health care and in particular, mental health care. Whatever candidate wins in November, we will see radical changes in the way health care is paid for in America and who is covered.

This post lays out each candidate’s mental health care plan along with their general health care plan. It is not done in a partisan manner, so that you can be free to choose which plan you consider the best.

Barack Obama’s Health Care Plan

Obama’s health care plan is spelled out in great detail on his web site. In essence, his positions are:

Stated goal

  • Affordable and high-quality universal coverage through a mix of private and expanded public insurance

Overall approach

  • Require all children to have health insurance. 
  • Require all employers to offer health benefits of contribute to the cost of the new public program. 
  • Create a new public plan, and expand Medicaid and State Children’s Health Insurance Program (SCHIP).
  • Create the National Health Insurance Exchange through which small businesses and individuals without access to other public programs or employer-based coverage could enroll in the new public plan or in approved private plans.

Requirement to obtain or offer coverage

  • Require all children to have health insurance.
  • Require employers to offer “meaningful” coverage or contribute a percentage of payroll toward the costs of the public plan. Small businesses will be exempt from this requirement.

A detailed analysis of Obama’s health care plan is provided on the Kaiser Family Foundation’s web site.  

John McCain’s Health Care Plan

McCain’s health care plan is also spelled out in detail on his campaign web site. Its essential points are:

Stated Goals

  • Provide access to affordable health care for all by paying only for quality health care.
  • Have insurance choices that are diverse and responsive to individual needs.
  • Encourage personal responsibility.

Overall Approach

  • Remove the favorable tax treatment of employer-sponsored insurance.
  • Provide a tax credit to all individuals and families to increase incentives for insurance coverage.
  • Promote insurance competition.
  • Contain costs through payment changes to providers, tort reform, and other measures.

Requirement to obtain or offer coverage

  • No provision.
  • Opposes mandates for coverage.

A detailed analysis of McCain’s health care plan is provided on the Kaiser Family Foundation’s web site. 

Barack Obama’s Position on mental health issues as stated in his health care plan

Obama specifically includes mental health care in his health care plan. It states:

Improve Mental Health Care. Mental illness affects approximately one in five American families. The National Alliance on Mental Illness estimates that untreated mental illnesses cost the U.S. more than $100 billion per year. As president, Obama will support mental health parity so that coverage for serious mental illnesses are provided on the same terms and conditions as other illnesses and diseases.

John McCain’s Position on mental health issues as stated in his health care plan

McCain’s health care plan does not mention mental health.

Barack Obama’s response to an email asking about mental health

In a reply to an email sent to Obama asking about his mental health care plan and his position on mental health care issues, he wrote:

Dear Friend,

Thank you for contacting me about mental health and the treatment of mental illness. As you may know, mental illness affects approximately one in five American families, and we must do more address this issue. The National Alliance on Mental Illness estimates that untreated mental illnesses cost the U.S. more than $100 billion per year. As a member of the Senate Health, Education, Labor, and Pensions (HELP) Committee, I worked to improve mental health services for people with serious problems who are going untreated and undiagnosed.

It is important to end discrimination against those with mental illness, and that’s why I support the bipartisan Paul Wellstone (D-MN) Mental Health and Addiction Equity Act of 2007, an updated version of legislation that Senator Wellstone championed for over a decade in Congress. This bill works to end discrimination against people suffering from mental illness and addiction.

I also support mental health parity. When suicide is responsible for more deaths in America than AIDS and homicides combined, we must act. That’s why I have championed efforts to improve awareness of mental illnesses and provide timely and appropriate treatment, and why I cosponsored the Mental Health Parity Act of 2007. Parity means that we don’t allow group health plans to impose treatment or financial limitations on mental health benefits that are different from those applied to medical or surgical services. The bill closes the loopholes that allow discrimination in coverage that does not apply to other illnesses.

I’m proud of my record on this issue. I helped pass mental a health [sic] parity bill as an Illinois state senator that requires coverage for serious mental illnesses to be provided on the same terms and conditions as are applicable to other illnesses and diseases.

Thank you again for contacting me on this important issue.

Sincerely,

Barack Obama

John McCain’s response to an email asking about mental health

McCain did not reply to an email asking about his mental health care plan and his position on mental health care issues.

Obama’s and McCain’s response to The National Alliance on Mental Illness questionnaire

The National Alliance on Mental Illness sent a questionnaire to the 2008 Presidential Candidates asking if they would support 24 issues under the headings:

  • Increase America’s Coverage and Improve Treatment for Mental Healthcare
  • Provide Opportunities for Homes and Jobs for Americans Living with Mental Illness
  • End the Inappropriate Jailing of Americans with Mental Illness

Obama answered all the questions with a “strongly support” answer. 

McCain, rather than answer the questions, sent the following statement:

The next President will face a great challenge due to the rising cost of health care of all types. America has the finest doctors and medical science, and the treatment of mental health has shared in these advances.  However, as with other aspects of our health care system, spending on mental and behavioral health treatments is rising rapidly.  The challenge is to ensure high quality care, establish incentives to control the growth of costs, and thereby permit greater affordable choices.   

Mental health is a necessary complement to physical health in all aspects of our daily lives. Fortunately, the path to greater quality and lower costs is to recognize this fact and where possible provide incentives to treat physical and behavioral health together.  Chronic disease is a dominant component of the growth in spending on health care and many of our citizens with chronic illnesses have a behavioral health problem as well.  For example, untreated depression raises dramatically the cost of treating the physical ailments of a diabetic.  A sensible goal is to design reimbursement for taking care of the whole patient, whatever ails them, and recognize the essential role mental health treatment plays in the overall health of the patient and the reduction in physical health needs. 

I have stressed the central role of personal responsibility in leading to lower health care costs. Personal fitness and better lifestyles, especially reduction in addictions of all types – food, narcotics, or cigarettes – can yield dramatic improvements in the cost of chronic illness and high‐cost medical care. We can do a better job of treating addictions, but we also have an obligation to do a better job of teaching our children the benefits of good lifestyles and the perils of addictive activities. 

I have a strong record fighting for the needs of America’s most vulnerable including those seeking better mental health.  I have consistently supported public housing programs that play a significant role in helping meet the housing needs of many seriously mentally ill Americans, and have been a leader in the effort to eradicate homelessness among our Nation’s veterans – many of whom are fighting mental illness.  I believe America needs strong leadership and a commitment to bold solutions to address the challenges that it faces.  We can provide quality mental health that is more responsive to our needs and is delivered to more people at lower cost.   

Obama and McCain on H.R. 1424/S558 “Paul Wellstone Mental Health and Addiction Equity Act of 2007″ bill

One of the great injustices of the current mental health care system is its lack of parity among payments for medical, surgical and mental health care services. If mental health care services are offered by an insurance plan at all, they often come with lower payments and more restricted coverage than for medical issues, as well as a lifetime cap on payments for services.

Obama co-sponsored, along with 56 others, the bipartisan Senate’s S558 version of H.R. 1424 “Paul Wellstone Mental Health and Addiction Equity Act of 2007″ bill. McCain did not co-sponsor the bill. The White House is opposed to it. 

The bill passed the House of Representatives on March 5, 2008 and has been placed on the Senate Legislative Calendar under General Orders. This legislation would require health insurers to offer mental health benefits equal to the coverage offered for medical and surgical benefits. 

Summary

Whatever else you think of Obama’s health care plan, it does address mental health issues directly. It seeks to end discrimination against people with mental illnesses. It specifically states that he will work toward parity of coverage among mental health, medical and surgical services in the health care system. Obama’s plan does not change the current relationship between primary care doctors and mental health professionals.

McCain does not mention mental health care in his health care plan, and his approach to it is not clear. His response to the National Alliance on Mental Illness questionnaire seems to combine mental and physical health together in a more holistic approach. He states that he would, “where possible provide incentives to treat physical and behavioral health together.” This implies that he would favor the first line care of mental health issues to be handled by family physicians or primary care doctors rather than by mental health professionals.

What do you think?

  • Do you favor Obama’s or McCain’s approach to mental health care funding?
  • Do you like McCain’s more holistic treatment of health care, or Obama’s staying with the current relationship between primary care doctors and mental health specialists?

As always, your comments are welcome!

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Resources used in this post:

2008 Presidential Primaries: Bringing Mental Healthcare to the Ballot – National Alliance on Mental Illness questionnaire results  

Barack Obama 2008 Presidential Campaign Site  

Barack Obama’s Health Care Plan: “Plan for a Healthy America“  

Barack Obama’s Response to the National Alliance on Mental Illness questionnaire (PDF) 

John McCain 2008 Presidential Campaign Site  

John McCain’s Health Care Plan: “Straight Talk on Health System Reform“  

John McCain’s Statement in Response to the National Alliance on Mental Illness questionnaire (PDF)

Kaiser Family Foundation – 2008 Presidential Candidate Health Care Proposals: Side by Side Summary  

Kaiser Family Foundation – Health08.org  

National Alliance on Mental Illness questionnaire 

Sparks, Alicia – “What Do You Think of Barack Obama’s Stance on Mental Health Parity?“ 

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{ 46 comments… read them below or add one }

Pete August 6, 2008 at 9:04 pm

Mike,

Like many, many Americans I feel a sense of great foreboding as election day approaches. No one is convincing anyone else of anything in this climate. The candidates talk (or yell) past each other and no dialog seems possible. I don’t have high hopes for whatever “debates” will be held in the presidential election.

Obama was not my candidate during the primaries, but he is the party’s candidate now. I therefore support him. I wish I could be more enthusiastic about him, however, because McCain terrifies me. My “problem” with Obama is that I never respond well to charisma. Obama has it in abundance, and I am spectacularly poor at seeing beyond it. I simply neither trust nor believe it.

As for the candidates’ positions on mental health, I find little to surprise me. After what McCain endured as a POW, he is certainly psychologically damaged by any measure. Apparently his unwillingness to look at that leads him to avoid discussion of the whole subject of mental health. That’s scary. So, we await developments.

On another note altogether, you mentioned on Time Goes By that most of your spam comes from a single IP address. I can provide you with code for the .htaccess file on your host server that should effectively block that IP address or a range of IP addresses if necessary. I did this on another blog I used to write, and spam fell off by more than half almost over night.

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Darlene August 10, 2008 at 5:05 pm

I think it’s obvious that Obama has the best health care program, including mental health.

Having said that, I think both lack the real solution of a single payer plan. Until everyone in this country is afforded good health care at a reasonable cost there will always be room for improvement.

Private industry has failed us miserably on health care and for McCain to embrace any part of privatizing our health system is an abomination.

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Mike August 11, 2008 at 2:43 pm

It is my concern that, whoever wins the election, they are going to have a fight on their hands with the insurance and drug companies, to name just two. These industries are long-entrenched and have powerful lobbies. They have been aided and abetted by previous administrations to become what they are today — powerful monoliths that will not give up their lucrative empires without a monumental battle.

Health care reform will come, but it won’t come easily or quickly. And given the strength of the insurance and drug companies, I wouldn’t be surprised if the next president will have to compromise his stated health care plan. Both candidates have formed their health care plans with the existing insurance and drug industries in mind, but I don’t think that will be enough to avoid a conflict of epic proportions.

As Darlene says, scrapping the whole shoddy business and starting over with a single payer plan would be the best solution, but given the political realities, that is nigh impossible.

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Kay Dennison August 12, 2008 at 10:04 pm

The bigger problem than the presidential candidates is all the Congress and Senate Critters who have been bought and paid for by the health care industry. Getting a program past these thieves will be an exercise in frustration. I look at any candidate’s proposal on anything (except a pay raise for themselves and deduct about 75%. Am I cynic? You betcha! Sixty-one years on the planet has taught me a little.

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Pat Luefan August 27, 2008 at 3:51 pm

I don’t feel either has put enough thought into forming anything workable. This will be a issue that is defered to someone in the cabinet.

On the face of it I prefer McCain’s stance but feel that either will be played out to be virturally indistguishable in the end.

I am not in favor of the insurance and health care agencies working together as I believe it should be a private matter.

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Judy Ortscheid August 27, 2008 at 11:13 pm

Hi. I favor McCain’s holistic approach to mental health care.

I don’t see that the current mental health practitioners are really helping anyone. It seems to me that the harmful drugs they prescribe are making mental illness worse.

The school shootings and many of the suicides are committed by people on these harmful psychiatric drugs.

The drugs don’t work and we need to look to other methods of rehabilitating people with mental illness.

Sincerely,
Judy

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Mike August 27, 2008 at 11:28 pm

Judy, thank you for your comment!

I do disagree with you that psychiatric medications and therapy do not help anyone. They help millions to live a productive, successful and fulfilling life.

There are incidents with people who have had psychiatric drugs or therapy, or who were under some sort of psychiatric care when those incidents occurred. But we cannot judge the effectiveness of mental health care just by those people whose names reach the headlines.

Just as it is in most things, we read or hear only of those who are failures or who commit atrocities — never of those who are successful and who are kind, compassionate and thoughtful people. Those sad people who kill others or themselves are only a small handful of the millions who have been helped to live fully through adequate mental health care.

And to make it personal, without many years worth of the right psychiatric medications and good therapy, I would not be here writing you now, nor would there be a blog for me to write in!

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Eileen August 28, 2008 at 6:37 pm

Dear Judy,

In response to your thoughts on psychiatric drugs, I offer my own experience.

I attribute my overall health today to the use of psychiatric medication. Just like a diabetic cannot live a healthy life without insulin, I cannot live a healthy life without psychiatric medication of several types.

Mental illness is a medical disease of the brain involving chemical imbalances. Without psychiatric drugs, this chemical imbalacne may
persist. For me, medication has been a blessing.

I have a masters degree in education and have taught for 34 years.
At times during these years, I have felt useless, hopeless and unloveable and thought I would never teach again. It did’t matter that I had family, friends and students that loved me, my depression told me none of this was true. There were periods of time when I couldn’t even get out of bed. At those times I thought “Is there really any reason to go on living this way.”

I walked into my doctors office and said “I don’t think anything can help.” Thanks to my doctor, she and I were able to find a psychiatric medication that worked without negative side-effects. I am now of retirement age and feel the best is yet to come!

As a teacher I have seen on the faces of students the look of dispair, hopelessness and alienation. I have tried to get help for those students, if they were willing. We need more education in our schools about mental illness and its treatment, so that students do not suffer in pain alone or at the worst commit violent acts against themselves or others. This is also true for adults.

I hope you can look at mental illness like every other illness, including cancer–with compassion and understanding of the ways the illness can destroy not only and individual but their families and those around them.

Please support mental health education in our schools and equal funding for mental health care in our nation.

One in ever five American has some form of mental illness. We never know who’s next. It could be a family member, a friend it could be you.

I have a masters degree in education and have taught school for thiry- four
overall health at this time in my life ot psychiatric drugs. Like a diabetic who can not live a healthy life without his insulin

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Eileen August 28, 2008 at 6:50 pm

Dear Judy and All,

Please ignore the last paragraph of my experience with psychiatric medication. THIS WAS MY FIRST BLOG EVER!

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Mike August 28, 2008 at 9:32 pm

Thank you, Eileen, for your comment — and congratulations on making your first blog comment! I feel honored!

The only way we will ever get rid of the stigma of mental illness and all that it causes, will be to educate all of our citizens, young and old, about the realities of mental illness. And those realities are not just bad, but good: As your story shows, a person with a mental illness can live a successful, productive and whole life!

And yes, the best is yet to come!

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Becky August 31, 2008 at 11:49 am

Although I do not like McCain overall as a candidate, I would have to agree that the right way to approach health care is to do it from the positive way of avoidance of the addictive and bad health habits we as a society have become guilty of. If we do not feed our bodies correctly, and we ingest things which are bad for it (drugs, cigarettes, alchohol, foods filled with chemicals and hormones, etc) then how can we expect to remain healthy. And why should those of us who do go out of our way to live a healthy lifestyle then have to help pay for the “fixing” of those who chose not to. As far as including mental health in all health coverage, I am against it. I see no problem with those who want that coverage paying extra to get it, but do not think all of us should have to help bear the costs of what I see as a group who has done little good, and great harm. Psychiatry has gone from trying to help people work through their problems to an industry with huge pharmacutecal ties that now mainly dispenses pills to cure everything. They claim it helps with chemical imbalance, yet they can not show a single test that actually shows an imbalance of any type. Diabetes can be tested for, cancer can be tested for, cholestoral can be tested for, but mental illness is adjudicated only, and more and more illnesses are now included into their book of illnesses….entered into that book by vote, not by any proof. I do not want to forward this tactic. We have become a society addicted to the quick fix instead of finding the real cause and fixing that. Let those who want mental health care pay for mental health care in their own coverage….do not make me pay for it through my premiums or through my taxes.

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Mike August 31, 2008 at 2:59 pm

Becky, thanks for your comment!

Obama’s health plan does have a significant component of prevention, both through education and through proactive medical means. I didn’t mention it because it didn’t have a direct bearing on his mental health policies.

I couldn’t agree with you more about the need to have as a first priority getting the public to realize that many diseases are preventable with just a few lifestyle changes. It would save millions of lives and billions of dollars!

However, we’ll have to agree to disagree about mental health and whether it should be part of any health plan. There have been hundreds, maybe thousands, of studies that have shown real evidences of physical reasons for mental illnesses — from chemical imbalances to genetic differences. I believe that mental illnesses have a physical component just as much as I believe that diabetes does.

Around 40% of the American people will have a mental illness during their lifetimes, and there are very few lifestyle choices that directly influence whether one has a mental illness or not. Aside from education on how to handle stress, there is very little that the medical establishment can do to prevent mental illnesses entirely.

And many cancers and cases of diabetes can be the direct outcome of unhealthy habits. Should we refuse to pay for these people’s care as well? Certainly, many mentally ill people lead unproductive lives and have to be cared for by others, but the same can be said about many of the mentally and physically disabled. Should we refuse to pay for the insurance of the disabled as well? If we insured only healthy people with healthy lifestyles, it would leave millions uninsured!

I believe that a health plan that benefits all Americans must cover both physical and mental health. There should be education and proactive medical treatment to encourage healthy habits and lifestyles. There also should be education on how to combat stress, among other things, which is one of the main triggers for many mental illnesses.

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Robin September 1, 2008 at 3:14 pm

Where do both candidates stand on mandatory “mental health screening” ? I am very much opposed to this as it funded by drug companies, and violates our rights. The questions on these screening tests are very suggestive and pretty much anyone, for instance, who has “felt nervous speaking in front of a large group” or has “thought they were not as pretty as others people” will be labeled mentally ill and required to take strong, often addictive, expensive medication that has sometimes serious negative side effects. I suppose if someone WANTS to subject themselves to such tests, that is their right, but to make it mandatory is criminal and totalitarian.
Also, has anyone considered ortho-molecular psychiatry? These people say that all mental “illness” or “disease” is caused by (or rather, able to be treated by remedying) an often severe mineral or vitamin deficiency in the body/brain. Vitamins and minerals of course are not patentable and drug companies cannot make their huge profits by promoting them, so they are not. I myself have had some experience with something along these lines recently where I thought I was going insane, I felt an incredible sense of doom, my vision was strange, and I had all manner of foreboding thoughts and strange pressure in my head, and a sort of sweaty fear. It was solved in less than 20 minutes when my chiropractor/nutritionist gave me a good dose of trace minerals, in particular manganese. Amazing.

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Mike September 1, 2008 at 5:32 pm

Robin, thank you for commenting!

I’ve not seen a mention of mandatory mental health care screening anywhere, in all the news, science and medical sources I read. There is no mention of mandatory health screening of any type in either candidate’s health care plans. I agree that mandatory screening for physical or mental health would raise serious constitutional issues.

I’ve heard of ortho-molecular treatments, but I frankly don’t know much about them. I am gathering information for a series of article on non-traditional treatments, and I’ll be sure to include them. Thank you for the tip!

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Robin September 1, 2008 at 5:53 pm

In NJ where I live, our legislators have just passed mandatory mental health screening for all pregnant mothers. We are the first state to do that. I will certainly be moving out of state if I get pregnant!
Last I knew, there are 6 states that have a mental health screening program called “Teen Screen” in schools. Pennsylvania and Indiana are among them, I can’t remember the others. Under this program, the schools get money for each child on psychiatric medication. The goal of this program is to get every state in the Union to enforce this test on every child, ages 5-22. Some parents who challenge the need for and efficacy of the drugs that their children have been put on through this program have had their children removed from their custody with the charge of “child abuse.” These issues are beginning to be addressed in court. Teen Screen is funded by drug companies. Those questions I quoted in my earlier post are straight out of the questionnaire that children are required to take. Some of the states differ in how mandatory the test is – for example, there is a “tacit consent” — a form is sent home with the children and if the parents do NOT sign it and send it back, it means that the parents are saying they agree to allow their children to take the test. But of course, that brings up the issue of what if the form never made it home to the parent for whatever reason, and also, since the drug companies offer “gifts” to the students to entice them to take the test, such as pizza, money, candy, etc., then some children might not be inclined to bring the form home to their parents if they think the parent will say no and they won’t get their “gift!”
A really cool website you might want to check out on some orthomolecular psychiatry is: http://www.truehope.com
It might be a starting point for more research for your articles.
I appreciate you working toward presenting the facts of the candidates’ health care plan and approach to mental health. It is often difficult to make an informed decision on issues and candidates since mostly what is heard is other people’s opinions of the candidates… of course, I do appreciate a good debate and exchange of ideas, as well… but it is refreshing to have that begin with some facts!

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Mike September 1, 2008 at 6:07 pm

Thank you again, Robin, for the comments and information.

I had not heard of the “Teen Screen” but I will make it a high priority to get informed about it. I’m embarrassed to say that it evaded my attention — but I wonder whether it was even mentioned on the many sites I read? I must read 25 science, medicine and news sites almost daily, and I promise you that there was not a word about it on any of them! This would be a good subject for a post.

Thank you for the truehope site. I’ll check it out right away.

Another thanks for the compliment about this article. I tried my very best to be completely neutral about the presentation so that people could make up their own minds about the candidates’ views on mental health. It would be interesting to see if anyone could tell what my party is and what candidate I support from the article. I hope not!

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Robin September 1, 2008 at 9:48 pm

Great, and I will try to get you some info on Teen Screen, too. (I’m kind of busy right now, sorry!)
In your response to Becky above you stated that, “Around 40% of the American people will have a mental illness during their lifetimes, and there are very few lifestyle choices that directly influence whether one has a mental illness or not.” Where did you get that figure of 40% and what exactly does “mental illness” mean in this context? Also, by lifestyle choices do you mean things like not drinking too much alcohol or smoking cigarettes? Or do you include things like sitting at a desk all day at a job one hates and staying in a relationship with someone who is abusive or other such things? I know some could argue that the reason one stays at a job one hates is because they are depressed and mentally ill and maybe can’t muster the umph to find a new job, but I suggest it may often be the other way around! Or getting away from a mentally or physically abusive partner can do wonders for a person’s morale. Lifestyle choices to me include choosing whom one associates with, and yes, it can be tough to end relationships, but taking medication won’t solve the fact that associating with certain people is damaging to a person, and can really drag you down! I mean, who WOULDN”T be depressed or anxious if you have abusive and destructive partners or bosses or friends or family members? Ending or changing these relationships requires support and education, but I think THAT would be a great part of a “mental health” program for America! You know the saying — give a man fish and he eats for a day, teach a man to fish and he eats for a lifetime!

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Robin September 1, 2008 at 10:31 pm

Here’s something funny… truly not meant to upset anyone, so hopefully it can be taken as intended. But it also does make one think about the money and effort saved by employing some simple “lifestyle” choices :)

Psychiatrists vs. Bartenders

Ever since I was a child, I’ve always had a fear of someone under my bed at night. So I went to a shrink and told him . . . ‘I’ve got problems. Every time I go to bed I think there’s somebody under it. I’m scared. I think I’m going crazy.’

‘Just put yourself in my hands for one year,’ said the shrink. ‘Come talk to me three times a week and we should be able to get rid of those fears.’

‘How much do you charge?’

‘Eighty dollars per visit,’ replied the doctor.

‘I’ll sleep on it,’ I said.

Six months later the doctor met me on the street. ‘Why didn’t you ever come to see me about those fears you were having?’ he asked.

‘Well, Eighty bucks a visit three times a week for a year is an awful lot of money! A bartender cured me for $10. I was so happy to have saved all that money that I went and bought me a new pickup!’

‘Is that so!” With an attitude he asked, “And how, may I ask, did a bartender cure you?’

‘He told me to cut the legs off the bed! – Ain’t nobody under there now ! ! ! ‘

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Mike September 1, 2008 at 10:55 pm

Robin, I’ve already looked up almost a dozen references for Teen Screen, both pro and con. But if you want to send me more, I would welcome them. I’m still amazed that I didn’t know anything about it! Shows me that a little more humility about my being on top of the news would be in order!

The National Institute of Mental Health (NIMH) estimates that 40% of Americans will have a diagnosable mental illness of some type in their lifetimes. They also estimate that 26% of Americans have a diagnosable mental illness in any given year. There are a lot more facts and figures in The Numbers Count: Mental Disorders in America from the NIMH. This document also lists the illnesses that go into their “diagnosable mental illnesses” percentages.

To me, lifestyle changes include the obvious — maintaining a healthy weight, not smoking, getting exercise, etc — and some not so obvious ones, such as reducing stress, learning to live more simply, and attending to your spirituality. (Incidentally, I’m not a new-age tree-hugger!)

Stress triggers many of the Anxiety Disorders, as well as depression and other mental illnesses. I agree with you that choosing to alter or end relationships with “crazy-making” people can lower your stress level significantly, hence lower your risk of getting some sort of mental disorder.

And I agree that educating the public about these sorts of non-obvious lifestyle choices would reduce the number of people who go on to suffer from mental disorders. Despite the frequent mention of medications in this blog, I actually am a big advocate of seeking counselling or therapy first. A good therapist can teach you how to deal with stress, how to cope with the things that are complicating your life, how to manage your mental illness. And many therapies are very effective without the person having to take drugs. This, too, illustrates the saying, “Give a man a fish…”

I believe that the American public is far too dazzled by the latest wonder-drug, and consider drugs as magic bullets to make all their problems just go away. They don’t want to do the hard work of changing their lifestyles or really working with a therapist to make their lives better. So they look to psychiatric (and other) medications as they look at aspirin: just take a couple and your headache’s gone! Never mind that drinking a six-pack the night before caused it!

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Robin September 2, 2008 at 8:38 am

I just got an email from a friend who mentioned that Obama co-sponsored a piece of legislation called the “Mother’s Act” which (among other things) mandates psychiatric screening for all expectant and just delivered mothers. Of course, this bill seems so wonderful, because who could possibly be against mothers? So, in fact, Obama does support mandatory mental health screening. Disturbing and disappointing. The trouble with the “mental health” screening that this bill advocates is that it is funded by drug companies and is cloaked in sympathy language… these poor mothers, we don’t want mothers to suffer, we have to put them on drugs. And it is even more frustrating to me that many problems with pregnancy and post partum depression can be completely handled through handling the thyroid. But ironically, the main synthetic drugs for thyroid do not work or do not work fully, so few people know that post partum depression can be solved.
Okay, I see where you got your statistic of 40% of Americans. It would be interesting to see what percentage of people from other countries “suffer from mental illness.” Also, I noticed that NIMH even calls mild depression a “mental illness.” I would question whether that is a “mental illness” – meaning, does it have a physical cause (very often) and does it have a behavioral cause? Is someone “mentally ill” if they have a low thyroid or are deficient in minerals or vitamins? (I had low thyroid function and I bet you if I had walked into a psychiatrist’s office they would have diagnosed me with “mild depression” and given me anti-depressant drugs. I have read many such stories, and not only does the person’s depression not get better, their other physical symptoms get worse.) Are they “mentally ill” because their life sucks and they don’t know how to change it? I can certainly concur that medical problems or a sucky life can MAKE someone depressed! What I’m getting at is whether the person’s depression is a separate “illness.” Maybe it is a natural response to something else? And the most important thing is how to address it. We are getting into a whole other topic here, but I’m skeptical of all the designation of mental illness – especially when it is given by people or groups that are funded by drug companies. I haven’t checked into NIMH yet, but I do know that NAMI (which professes loud and clear to be a non-profit, grassroots based organization) has many big drug and pharmaceutical companies as “corporate partners” if you go check out their annual report. I’m sorry, but that is just a HUGE conflict of interest. Of course, the drug companies will profess that they care deeply about humankind and only want to be of service. They care so much that they are even willing to kill people in the process – go check out some of their drug studies and how sometimes side effects from the drugs can be death.
That’s quite a side effect!!
I don’t know why you hadn’t heard of Teen Screen before… maybe because it’s carefully shrouded? It’s actually part of a larger government initiative, I forget the name now…

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Caralyn Percy September 2, 2008 at 11:35 am

I would ask both candidates to view the DVD PSYCHIATRY AN INDUSTRY OF DEATH. This is a documentary and therefore all information regarding the history of psychiatry is included. I am sure that neither candidate has really, personally LOOKED into the actual practices of psychiatry (which is nothing more than drug pushers for big pharma). Do people need help? Most Definitely. Is psychiatry actual help or is it a MONEY MAKING LIFE THREATENING SCHEME THAT HAS BEEN PERPERTRATED ON THE AMERICAN PUBLIC FOR WAAAAY TOO LONG.
The other DVD they need to spend 11 minutes looking at is PSYCHIATRY PRESCRIPTION FOR VIOLENCE. No one wants to be part of a school shooting yet the true facts behind EVERY ONE is again, documented in this dvd.
Citizens Commission on Human Rights is where you can get both.

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Mike September 2, 2008 at 2:59 pm

Robin, thank you for your latest comment!

The National Institute of Mental Health (NIMH) is a government organization, and is funded by the government alone.

Among the tests my psychiatrist had done was a test for my thyroid’s function. So at least he was aware of the thyroid-depression link.

And Caralyn, thank you for your comment, too!

For the record, the Citizens Commission on Human Rights is an anti-psychiatry organization founded by the Church of Scientology. Its views on psychiatry are a straightforward reflection of the position put forward by L. Ron Hubbard, the founder of Scientology.

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Mary September 5, 2008 at 10:37 am

As the sibling of a schizophrenic, I can assure you that the drugs used to treat the mentally ill are not only necessary, but vital to their everyday lives. The drugs are not without side effects but when given the choice of living with daily hallucinations and paranoia or taking a drug that can give one a relatively normal life, there really isn’t a choice. These drugs do come with a multitude of side effects and are outrageously expensive. A patient who takes the medication to control this horrible illness risks heart problems, tardive dyskinesia, kidney disease and a host of other negatives.

The families of the mentally ill fight every day for treatment against the archaic stigma attached to mental illness. Most mental illnesses are not caused by a “lifestyle” and cannot be treated with holistic treatment. I wish it were that easy. Also, the individuals who have participated in school shootings etc., were NOT being treated for their illness, thus the paranoia and anger.

To say that mental illness does not have a physical component is absurd. Anyone with any knowledge of mental illness knows that severe mental illnesses are diagnosed through brain scans, blood tests and a variety of other diagnostic measures. Someone with mental illness should be afforded the same insurance benefits and compassion as someone suffering from cancer.

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Robin September 5, 2008 at 1:23 pm

Mary,
I’m sorry for your travails with your sibling, and you sound very passionate and believe it or not, I understand the painful struggle that families go through. My brother too was diagnosed with schizophrenia.

I do agree that there are people who have “severe” mental illness… but the VAST majority of people (millions) being put on anti-psychotic medication are NOT severe and are absolutely NOT diagnosed by brain scans, blood tests, or ANY physical medical test whatsoever.
I am not sure where you got your information that “Most mental illnesses are not caused by a “lifestyle” and cannot be treated with holistic treatment.” And what you consider “holistic treatment,” – does that include treating a person’s thyroid, or other such things, for example? Again, I would submit for review something as simple as the Super Nanny TV show. I am willing to bet my bottom dollar that if you brought anyone of those kids into see the vast majority of psychiatrists, they would be declared gravely mentally ill and immediately drugged heavily with dangerous medication, with no blood tests, brain scans, or any such thing at all. Yet, “lifestyle” changes prescribed by the Nanny handles these kids amazingly – not to mention, their parents as well! Please note, that I am NOT saying your sibling falls into this category, and s/he may well have a severe physical brain problem. What I am saying is that the VAST MAJORITY of cases of “mental illness” are NOT based on an abnormality in the brain, and even with medical tests, no such abnormality can be found. That is, if any such tests are done at all, which is hardly the norm… I could walk into a psychiatrist’s office today and say, “Oh, you know, I just don’t feel like my old self, I feel kind of bummed out about life. I just dont’ feel like anything inspires me anymore.” As terrible as this sounds, I could even be PRETENDING to feel mopey and disgruntled, and I would be handed a prescription for medication.
Your sibling is in the minority if s/he had brain scans, blood tests, and other tests. The vast majority of children being put on heavy anti-psychotics are absolutely NOT given any physical medical tests. Often, they are seen for a one hour office visit by a psychiatrists and labeled and drugged.

Of COURSE people who have a physical mental condition should be treated with dignity, and of course they should have health care. And anyone who simply needs to make some difficult changes in their life should be treated with dignity as well.

What strikes me as odd is that hardly anyone is asking the question of why the heck are millions upon millions of people “mentally ill”? If everyone really did have a severe mental physical abnormality of the brain, and the only cure was an expensive new drug, how could we possibly have evolved as humans and survived? Natural Selection would have killed us off. And say that all the millions upon millions of people with “mental illness” suddenly cropping up actually DO have a physical abnormality of the brain – suddenly recently in human history (like the last two generations?), it begs the question, what on earth is causing THAT? Is there something in our environment that is causing millions upon millions to have abnormal brains? There is no way that evolution would have allowed… Unless you do not believe in the Theory of Evolution and believe instead in Creation (which is totally fine with me and I’m not saying that is incorrect) – in which case, do you think God would have created millions upon millions of defective brains that have as their only cure an expensive dangerous drug? To me, there is just something odd about the whole bigger picture. We can argue for this or that “side” of the issue, whether people deserve dignity and help, but what the heck is going on a larger scale?

There are many reports that the kids involved in mass shootings WERE indeed on anti-psychotic medication, and it is documented that many were under the care of a psychiatrist at the time of the shooting or had been in the past. Possibly they were not taking the medication properly? Often if you read the drug studies, suicide and violence is a “side-effect” of the drug, even as per the drug company literature. Also, unfortunately, drug companies LIE about their drugs in order to make profits. There are now huge lawsuits in progress against several drug companies over many anti-depressants. 30 state governments are currently suing Eli Lilly. Actually, make that 29, since the state of Alaska just settled out of court for 30 million dollars. (Based on the strong evidence, the judge advised Eli Lilly to settle out of court.)

In total fairness to you, you may have really only been talking about severe mental illness and not the vast majority of people who are carelessly diagnosed with one of the many new “mental illnesses” designations cropping up. There are indeed cases were there is a physical abnormality in the brain, but all the various shades of the many many “mental illnesses” are not testable through a physical test… they are diagnosed based on the opinion of the psychiatrist. Although, I am curious to see if orthomolecular psychiatrists have documented these “physical abnormalities” and handled them through administering high doses of minerals and vitamins. I could certainly attest to having PHYSICAL symptoms in addition to mental ones that subsided within 20 minutes of taking the large does of manganese given to me by my nutritionist, as I mentioned in an earlier post.

If I might ask, what tests were done on your sibling and what was the result of the tests? Did they mention what chemicals, or physical features were abnormal?

Thanks.

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Robin September 5, 2008 at 1:45 pm

Hi Mike,

Sorry, been busy, thanks for replying!
That is great that your doctor looked at your thyroid as a possible cause… do you recall what tests he did? (Don’t mean to invade your privacy, but I’m curious.) My doctor did standard thyroid blood tests too, but they didn’t show anything. I found out the long and hard way that the standard blood tests often totally don’t show low thyroid function, and there are other tests that work better. That is a whole other topic, but it’s pertinent because thousands have been cured of their depression (including me) and even other more severe symptoms like audio and visual hallucinations, bi-polar symptoms, aggressive behavior, etc. by getting properly diagnosed and more importantly, properly treated! I wonder if many people poo-poo other medical conditions as the cause of mental malaise because the tests are not correct or effective and often the treatment is not either. There is fascinating stuff I’ve researched about the thyroid in particular. The current standard medical treatment for it is often very inadequate, so many people say, oh, I had my thyroid checked, or I’m on thyroid medication and my doctor says my blood levels are fine… yet they are still suffering from depression and a host of other symptoms – so of course assume it is some other cause or they have “mental illness.” Well, one fascinating medical tidbit is that thyroid hormones don’t work in the blood, so testing the level in the blood doesn’t matter if your cells are using them!

Also, you may have figured it out by now, but Teen Screen is part of a government initiative called the “Freedom” commission… George Bush was promoting it. It sounds like a great thing and might be motivated by the desire to help, but government mandated psychiatric screening is just sketchy!

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Mike September 5, 2008 at 8:21 pm

Mary, thank you for your post!

I am sorry for all the trouble your brother has had. Although I do not have schizophrenic symptoms, I can really empathize with the trade-offs in terms of side effects that taking psychiatric medications entail. I, too, have tardive dyskinesia, and have quarterly blood tests to make sure my medications are not adversely affecting my liver, heart and other organs. These and other side affects are annoying, to say the least.

But the medications I take, along with therapy, have given me my life back, and I am willing to make that trade-off.

It is my hope that health care will become more equitable in terms of mental health, whoever wins the Presidential election. There are millions out there suffering who are underinsured or uninsured for mental health problems, and it is costing the nation many tens of billions of dollars each year in lost productivity alone.

Perversely, I see some of the stigma of mental illness lifting if we do have an equitable system of reimbursements for mental health issues. I believe that part of the stigma comes from that very system that treats mental illness as something less serious than physical illness, which in turn discourages people from getting the care they need.

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Mike September 5, 2008 at 8:35 pm

Robin, thank you for your reply!

I do not recall the type of tests my psychiatrist had me undergo, but they were all blood tests. “Tests” plural because he had my thyroid and other functions checked several times. He was testing every possible thing that could be contributing to my mental condition while trying to get me some relief for my symptoms.

Research is in its infancy as regards mental illnesses, and there are new studies coming out every day about what is happening in the body when one has a mental illness. There was a study released just this week that details how the common over-the-counter supplement NAC can help with the depressive cycle in bipolar disorder. See Add-On Therapy Improves Depressive Symptoms in Bipolar Disorder.

I have not had time to properly investigate Teen Screen and the psychological testing of pregnant women, but they are high up on my to-do list.

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Robin September 6, 2008 at 12:13 am

Hi Mike,

Thanks for the answer! Just a quick note for now… I went to the link you gave and as far as I can tell, this new piece of treatment is basically glutathione, right? That is basically amino acids, which is not a drug! Cool! I googled glutathione to find out more about it and I came across a couple of interesting websites – not sure if you are aware of them. I haven’t had time to look through them totally, but they seem to have a tone of data. The sites are: http://www.theroadback.org
http://www.prozactruth.com/gluta.htm
Well, the second link is specifically about glutathione, but you can scoot around the site. Are you familiar with these sites? I’m not on any medications myself, so they don’t directly pertain to me, but I do have a couple of friends who have expressed an interest in getting off their medications.

I don’t know if you are interested, but it’s very likely that if you have a thyroid condition, it was not picked up by standard blood tests. I am having great success with my many mental and physical symptoms by doing a nutritional protocol for my thyroid. Amazing changes in body and mind. Yet more than one doctor dismissed my glaring symptoms and my suspicion of low thyroid function, based on all the available blood tests. Don’t mean to be intrusive, but I can’t tell you how thrilled I am to have my symptoms finally handled and I can’t help wanting to share the things that helped with others!

Did you have any tests directly to diagnose your symptoms as caused by a mental illness (brain issue I guess?) or were the blood tests to rule out other medical causes of your mental symptoms? I’m becoming more and more curious about the physical abnormalities you mentioned as being shown through studies to cause mental illness. I have reread most of the posts here and can’t seem to find where you said it. Do you have some direct studies that show these physical brain abnormalities in mentally ill people? I can tell you as a woman that unbalance HORMONES can wreak havoc with one’s mental state! But I have not seen studies that show chemicals other than hormones cause mental illness. I am also curious to see if the studies show that these imbalances CAUSE mental illness or are simply associated with them, or if the mental illness (or a physical illness) causes the imbalances.
Thanks!
P.S. It’s interesting to me that you did not know about Teen Screen or the Mother’s Act, since you do a lot of homework and are interested in these issues. They are rather carefully veiled. The state legislatures that HAVE passed Teen Screen are now getting a lot of flack from parents who have realized what it means, but drug companies are powerful lobbyists!

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Gail September 8, 2008 at 2:28 am

Dear Mike, Robin,

Here is one more piece of research I thought you might be interested in. This group performed some very good work regarding mental health hospital treatment last December. Here is a summary:

In December 2007, the Ethan Allen Institute (EAI), an independent non-profit Vermont policy research and education organization, issued a report providing solutions to a major issue facing the state’s 2008 legislature: What to do about the 110-year-old Vermont State Hospital (VSH). There have been repeated calls to close VSH, based on its long history of patient abuse. The question in Vermont is whether to replace VSH with a costly new facility or to replace it with effective, lower cost community-based services.

The EAI report provides substantial data in support of the latter, in the form of community-based “peer-support” programs.

Safe Haven, in Randolph, Vermont has been in operation for ten years and is noted for its “good successes” with mental patients that “no one else wants.” This program utilizes no professional mental health workers, no locked wards, no restraint, seclusion or forced drugging. All residents of this program successfully transitioned back into the community and to private apartments or other housing. One guest stayed in the program 230 days at a cost to the state of $7,360. This same stay in the state hospital would have cost the state $241,000. A cost analysis prepared by Safe Haven of six guests who stayed there during 2006-07 found that savings to the state totaled more than $2 million.

Compared to the state hospital’s failings and high cost, the benefits and low cost of the peer support model bring one to the inescapable conclusion that such a change in the treatment of the mentally ill would result in a level of patient recovery that rarely, if ever, is attained in the state hospital model-not to mention enormous savings to the state and thus, relief for taxpayers.

You can see the full report here: http://www.ethanallen.org/home.html

I was very hopeful when I saw this and I thought you might be interested in this information.

Best,
Gail

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Christina September 8, 2008 at 2:50 pm

Hello Mike,

I am wondering what exactly is the name of the physical brain/serotonin test that determines a person’s mental illness? I am curious because it seems that brain chemistry can vary so widely even within the same individual and be dependent on so many factors.

It seems that the DSM is simply filled with symptoms. I agree that dignity and massive respect for ALL people, in whatever mental condition they are is the most important issue. I think though, that nutrition does not receive the attention and research that could actually make a positive and comprehensive change in many cases of ‘mental disorder’, due to a lack of potential profitability to the pharmaceutical industry.

Thank you for your time.

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Mike September 8, 2008 at 6:43 pm

Christina, thank you for your comment!

All the testing for serotonin’s role in mental illness has been in research, and there’s been a lot of it! However, there is no publicly available test for mental illness through testing for serotonin levels that I know of. Research has provided a lot of implications for what are the right levels of serotonin, but no definitive evidence that would lead to a test that could be administered to individuals.

I agree that bad nutrition is overlooked as a cause of mental disorders. I cited new research in a comment above that found that a common over-the-counter dietary supplement could greatly help bipolar sufferers with their depression.

There is research being carried out on dietary links to mental illnesses with promising results, but it takes a back seat to research on the newest wonder drug. I believe this is a direct result of a large portion of research being funded by the drug companies.

It’s my opinion that mental health research must find other sources of funding from private and government sources in order to be completely free of the pharmaceutical companies’ influence.

Both candidates call for more research funding, but only Obama mentions increased government funding. And both candidates mention research on only physical illnesses such as cancer, and not mental illness research.

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Robin September 12, 2008 at 6:20 pm

Wow, Gail, that is really neat! Thanks for that info.
What is tragic is that the drug companies (and unfortunately many psychiatrists) have no incentive to get people better… it is to their advantage to keep them not well and on drugs… yuck!

Also, my question is, if indeed researchers are finding a definite “brain chemistry” issue for mentally ill people, what is causing this imbalance? A deficiency in Prozac? :)

Mike, do these research studies you mention show the same
“chemistry imbalance” for everyone who is “mentally ill?” Also, which came first, the imbalance or the depression? Is it a definite CAUSATION, or is it just a correlation? Thanks!

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Mike September 13, 2008 at 9:32 pm

Research into the biological and genetic causes of mental illnesses is in its infancy. There are major findings seemingly reported every week. There is a growing understanding of these causes, along with the role different body chemicals have to play in mental illnesses. Of course, there is no biological or genetic single cause of all mental illnesses any more than there is a single cause for all physical illnesses.

People who have mental illnesses have both biological and genetic vulnerabilities to the disorders even before the disorders are triggered by life events. In addition, it has been found that a person’s environment and life events, such as severe trauma, change the actual physical, biological makeup of the brain in ways that add to the vulnerabilities and/or exacerbates existing conditions.

Biological Vulnerability: Chemicals known as neurotransmitters which help to pass on messages to areas of the brain have been found to be out of balance; there is an over- or under-production of these chemicals. Some mental illnesses have an over-production of hormones, such as cortisol.

Genetic Vulnerability: There are genetic factors for various mental illnesses being discovered. It is definitely known that certain mental illnesses run in families. There have been discoveries of single genes that contribute to mental illnesses, but it is likely that there are a complex of genes responsible rather than a single one for any disorder.

These vulnerabilities exist before the mental illness is triggered by a person’s environment or life event. For example, the vulnerability to PTSD remains dormant until a person experiences a severely traumatic event that triggers it.

There are many triggers that are being investigated, both biological and environmental. If there is a single trigger that seems to play a part in the activation of many mental illnesses, it is stress.

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Gail September 14, 2008 at 8:57 pm

Robin, that’s a good point. If you look at it — are that many people suffering from a lack of Class II narcotics? That is my main concern, that the psychotropic drugs are in the same category as Cocaine.

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Robin September 15, 2008 at 11:52 am

Thanks for the responses! Mike, are you (or researchers) saying that because a mental illness runs in families that it is genetic? The reason that I would question that assertion as a foregone conclusion is because families pass “traditions” down all the time, some good some not so good. Violence and all kinds of things are passed down through generations… just as bad health habits are. To me, just because something “runs in families” in no way proves that there is a PHYSICAL genetic component. (I’m not saying you are claiming this, I just wanted clarify what the researchers mean.) And indeed, as you mentioned, there is evidence that trauma can change brain chemistry. So if you take a perfectly normal baby and let some violent, unethical, or troubled parents take care of it, and it suffers various traumas, and then its brain starts to function abnormally and it has an overload of cortisol for instance from all the trauma it is enduring, then a psychiatrist may come along and say, “Look! This person has a chemical imbalance in the brain!” Well, yeah….
I still question whether we would survive as a species if we had millions upon millions of people with genetic defects in their brains. Something seems odd about that.
I’m curious about the genes you mentioned. How are they isolated and how do the researchers know that they cause mental illness? Or is it that they are present in people who have a specific disease? Do the genes CAUSE the disease? Do the genes make a person “susceptible” to the disease in an unknown way? Are these mutant genes?

I guess “mental illness” is similar to physical illness, in that, as a species, our bodies did not evolve on our modern diets and current polluted environment, and while we were constantly being bombarded by “stress” of survival, trying to find food, shelter, etc, or fight off predators, the nutrition we received from our food was superior and there were not such things as massive toxins in the food, water, air and soil that our bodies are having to contend with today. Honestly, there are so many new chemicals in our environments, it’s a wonder we don’t have MORE chemical imbalances in our bodies and brains! Maybe these “genetic vulnerabilities” only come in to play with the assault of all the toxics we are now enduring on our planet? Also, can toxins make genes mutate?

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Robin September 15, 2008 at 12:09 pm

Gail, I share your concern. And I highly doubt that any mentally ill person is suffering from a Class II narcotics deficiency :) I guess this seems obvious, but you made me realize that drug addicts and alcoholics are just doing the same thing that drug companies are doing – trying to manage symptoms… only drug companies get to pretend they have the moral high ground and then make obscene amounts of money to boot! Although I don’t doubt that many many people have found relief from their unbearable symptoms from using drugs pushed by drug companies, and it is not that I don’t want people to have relief. It is just that they are still drugs and highly addictive and damaging to the body, and are not naturally found in the body. Although many people have found relief, it is still a horrendous crime that these hard core narcotics are being pushed on children on such a massive scale. I still point people to look at the Super Nanny TV show if they insist that millions upon millions of children are suffering mental disease that can only be cured by heavy narcotics.

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Mike September 15, 2008 at 7:22 pm

The heredity studies for mental illness are done with both extended families (including aunts, uncles and cousins), and twins.

For many, many years twins (identical and fraternal) have been tracked all over the world. They offer a unique way of studying the heredity of both mental and physical diseases. Many of the genetic studies for heredity involve twins who were not raised by their birth families and/or were separated at birth, so the family environment does not enter the equation.

The family studies involve large groups of up to 2,000 families, especially in Scandinavia and Iceland, where excellent records of family medical history have been kept for 50 or more years. Since such large groups are studied, family environment is a very small factor in the determination of the heredity of mental illness.

Besides trauma, there is evidence of many other life events causing brain changes that predispose people to mental illness. For example, the brains of depressed people are physically (not just chemically) different from those of people without depression. That does not mean that every person with these brain changes will get depression — it just means that they are vulnerable to it.

Evolutionary biologists and psychologists have several theories of how the human race has survived and flourished despite mental illnesses. I do not have space to cover their theories here. However, the gist is that, either the mental illnesses somehow served the survival of the species, or that mental illness was not a large factor in the survival of humans over the eons.

I do not know the exact process used by scientists to determine the genes that might predispose people to mental illness. I do know that these tests involve large populations, both mentally ill and “normal” people, rigorous review and the cross-reference of findings to existing genetic information.

And remember that none of the genes so far discovered can be called a single “crazy” gene: It is suspected that it takes many genes to make up a predisposition to mental illness. Since these genes involve large populations of subjects with mental disorders, the possibility that they are mutated is small; it is more likely that they are inherited.

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Jocelyn October 27, 2008 at 11:29 pm

I fully support Barack Obama’s stance on mental health care. I am in the field myself, and see first hand the damage done by George Bush. The inpatient hospital stays are cut shorter in an effort to save money, which only denies people with mental illness the support they need, ultimately sending them out into the community and back into the system sooner.
While I disagree with the use of psychiatric drugs in children, unlike Robin, I do see the effects first hand, that are very beneficial to the adult population. Next, it is unfair to classify all psychiatric medicines as “narcotics.” The mood stabilizers Depakote and Lithium contain chemicals that are naturally found in the body. The medication simply helps the brain regulate as it processes these chemicals.

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Robin October 27, 2008 at 11:49 pm

Jocelyn, that is part of the point I am making: that a person could be deficient in minerals or vitamins. “Medications” that are minerals are different from drugs. And no brain is deficient in narcotics, except I suppose if the person is addicted to them.

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Mike October 28, 2008 at 8:53 am

@Jocelyn, thank you for your comment. I have been helped by psychiatric medications tremendously. After 5 years, I have a combination that keeps me stable, has diminished the wild bipolar cycles I was having, has enabled me — along with therapy — to overcome the symptoms of many of my Anxiety Disorders, and has let me have the longest “normal” period I have had in over 8 years.

I would classify none of these medications as a narcotic. The dictionary definition of narcotic is “a drug or other substance affecting mood or behavior and sold for nonmedical purposes, especially an illegal one.” Certainly, my medications affect mood, but they are given to me legally for a definite medical purpose. They literally have given me my life back.

@Robin, welcome back! I agree that it looks like a number of mental illnesses that might be helped with vitamins, minerals and other natural supplements. There’s a lot of research going on right now about dietary supplements that can affect mental illnesses positively. For example I wrote about oxytocin last month in the post Social Phobia Fear Inhibited by Hormone Oxytocin. Many researchers also think that vitamins, such as B12, are connected to some mental illnesses.

As you might note in my reply to Jocelyn, I am of the opinion that my medications are not narcotics. In all the years I have been taking various ones, I have never been addicted to any medications. While there are some that are addictive (ex. Xanax), the vast majority are not addictive in any way.

You might counter that I am psychologically addicted to my psychological medications. It is true that I count on them to keep me mentally healthy. But if that is so, I am also addicted to the diabetic medications that I rely on to keep me physically healthy. Depending on drugs to keep you healthy is not addiction. An addiction is where you can’t stop taking a drug without adverse results or side effects. I could stop any or all of my medications at any time and the only result would be a less healthy me.

It would be wonderful if we could treat mental illnesses with natural substances such as minerals and vitamins and leave the psychiatric drugs behind. That day may come, but I don’t think that’s going to happen any time soon. In the meantime, psychiatric medications are preventing the suffering of many millions of people.

I agree with you that psychiatric drugs are over-prescribed, especially by family physicians. I think that the effectiveness of therapy is vastly under-rated, especially by insurance companies, for whom drugs are cheaper. Neither people nor insurance companies want to take the time to get effective therapy, though it can help you learn to cope with your problems for a lifetime. I believe that the idea of holistic medical treatment, or wellness treatment, could change this notion over time. Fortunately, this approach is championed in both Presidential candidates’ health plans.

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Robin October 28, 2008 at 5:13 pm

Hi Mike!
Yes, I’m back.
That is fascinating that the word “narcotic” does not have any scientific pharmaceutical meaning. I totally was under the impression that it was a specific class of drugs with specific chemical properties. Interesting. It’s also so weird that the pharmaceutical industry would have a class of drugs called Class II Narcotics.

By the way, I would not argue that you are addicted to medication in a “psychological way” if you can stop them and have no physical symptoms. What I am concerned about and have heard from various people is that getting off the drugs is something to be done slowly and dangerous if you do it cold turkey. I have even heard some professionals say it is easier to get someone off heroin than some of the psychiatric drugs! It didn’t seem necessarily that the people had withdrawal symptoms like heroin or other drugs like that, but that they had mental symptoms that were worse than before they took the drugs. Again, I do not have personal experience because I have never taken any. What is interesting is that you and Jocelyn both say how you know of so many people who are greatly benefitted from these drugs, but I only seem to know people who feel dissatisfied. (Some more than others.) The best I have heard is that the person doesn’t feel the medication is doing anything much, except they feel sort of wooden and they gained weight. You mentioned psychiatric drugs are preventing suffering of millions of people… I don’t know how to ask this without the fear of it sounding flippant, but I am sincerely interested to know how you know this? I’m assuming you haven’t talked to millions of people? Was this info gotten by survey? Was the survey done by the drug companies? Or doctors on the take from drug companies? Did the surveys include side effects? Do I just have a weird ability to only find people who are at best conflicted about their medication? I’m not saying that there is not a portion of people who are helped, and maybe others whose lives were so bad that side effects are worth it to them. I just haven’t found things to be so rosy for all as it seems that you and Jocelyn are saying. Or maybe I don’t have contact with a certain segment of the population?
Yet, I just heard a commercial for the drug Abilify and the ad states that 2/3 of people suffering from depression still have symptoms even though they are taking medication. I get that it is an ad and they want to sell stuff, and maybe they are proving that it only means you need MORE drugs, but doesn’t that also mean that drugs are not helping?

Also, I don’t know why I missed your previous answer to my query about hereditary research, so thank you so much for your reply!

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Robin October 28, 2008 at 5:17 pm

And when I say that it’s interesting that you have contact with so many people who say they are benefitted and I have contact with so many people who say they are not benefitted, or there is some problem, I didn’t mean to infer that you are not truthful or anything… I just found it interesting. Maybe it is why we have our various opinions,…. or maybe it is because we have our various opinions that we find certain types of people?

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Mike October 28, 2008 at 8:20 pm

Robin, I was surprised also that the dictionary definition of narcotics called them illegal. The “Class II Narcotics” (actually Schedule II Controlled Substances) comes from the DEA, which simply lumps all drugs, legal and illegal, into a single group, that they then divide into narcotic and non-narcotic classes. See a list of the Schedules at DEA Controlled Substances: Appendix I.

Therefore, in Schedule II, there are the narcotics cocaine and opium, and the non-narcotic amphetamine. I would not describe Adderall (an amphetamine which I take daily) as being addictive like cocaine and opium, but I suppose the DEA has a reason other than addictive qualities for classing them together as Schedule II Controlled Substances.

My numbers for people receiving relief from psychiatric drugs are extrapolated from the many, many research papers that say that psychiatric medications help people, multiplied by the number of people taking them. That translates into millions. Maybe I shouldn’t have said “millions,” but I am confident that there are many more people receiving a benefit from these drugs than are not.

I am in contact with literally hundreds of people taking these medications. Some of them are dissatisfied, but most of them are getting at least some relief. I have observed that the ones that are dissatisfied are expecting that the first drug they try is going to completely relieve them from symptoms.

What most people don’t realize is that it takes time and experimentation to find the right psychiatric medication(s) for an individual. Each of us is different, and the drug that works fine for one will not work for another. As I said, it has taken 5 years to find the combination that works for me. People expect instant relief such as you get with headache pills, but psychiatric medications are different — it takes time.

I’ve not seen the Abilify ad but I think that they are hyping the numbers of people who take depression medication and not getting relief. That being said, no medication is a silver bullet that will completely take away all your symptoms. For complete relief, drugs should be combined with therapy, which will teach you how to manage your mental illness. I’ve even written a post about it: Drugs Are Not a Silver Bullet! There’s Another Way to Gain Relief!

I take a combination of six psychiatric drugs, and although they relieve most of the symptoms of my ailments, they do not relieve them all. I am able to cope with this state because I have had effective therapy that enables me to manage those symptoms. If I relied on the medications alone, I’d be complaining, too.

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Robin October 29, 2008 at 2:43 pm

Hi, thanks for the reply. I was actually curious about the definition of Narcotic, so I called my friend who is a chemist and has worked at several pharmacies. He said that the word “narcotic” comes from the Greek word for “sleep” and a narcotic is substance that induces sleep or drowsiness. It has nothing to do with legal vs. illegal, or for medicinal purposes or not. Maybe your dictionary was giving a colloquial usage? I looked it up in my Oxford American Dictionary and it states that narcotic means “causing sleep or drowsiness.” I notice cocaine is classified as a narcotic, and I was under the impression that cocaine did anything but induce sleep, so either I am wrong about cocaine (I’ve never taken it), or someone or some entity is using definitions however they wish!

It is interesting that you say the makers of Abilify are probably hyping the numbers to say that so many people are not getting relief. Wouldn’t that also suggest that they or other drug companies are hyping the numbers is other ways? Like, to suggest that so many people are getting such amazing relief and that everything is so rosy?

Anyway, I am heartened to know that drug companies are now being sued for millions upon millions of dollars for their false advertising and for hiding severe side effects. I think it is any adults right to take whatever substance he or she wishes, but that it is not okay to downplay or hide side effects, and a person has a right to be informed and then to make their own decision.

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Mike October 29, 2008 at 5:43 pm

Robin, the dictionary I used was the Oxford (American?) on my computer and it gave only the one definition — probably the colloquial one. After reading your comment, I was interested to see now the DEA defines narcotic, so I looked it up. On the site Narcotics it says that “the term narcotic refers to drugs that produce morphine-like effects,” which are sleepiness, etc. It specifically discusses cocaine as a stimulant in a separate section. Scanning the page (it’s very long), it seems to refer to them as addictive, which is the reason why they are controlled substances.

I take Abilify and it has really helped in stabilizing my bipolar cycling. However, I wonder if the television ad — you could help me here — mentions side effects such as tardive dyskinesia, which is continual involuntary movements of the mouth and jaw. I click my teeth and purse my lips, which drives my wife crazy! Personally, I consider it a trade-off for the benefits of the drug, but others might not look at it that way.

The drug companies tout the benefits of their product like any other advertiser. Every advertiser stretches the statistics as far as they can without actually lying. I imagine the ad agency for Abilify searched the research journals until they found a study that says what they wanted. Unlike other companies, though, drug companies are required to state the negative effects of their products. But they are going to skim over them as fast as possible and to minimize them as much as possible.

Fortunately, my psychiatrist is very good about giving me the complete rundown on the good and bad of each medication she proposes to give me. Still, I research the drug and actually have a big chart that lists all the side effects, as described in Take Charge of Your Medications!

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Bob January 11, 2009 at 4:10 pm

Mike & Robin:

I work in healthcare and am profoundly dismayed by the overuse or misuse of psychotropic drugs. I’m also quite saddened by groups like the “Church” of Scientology who claim to have definitive treatments for mental illness.

A few points:
1) Scientology has referred to the DSM reference as a work of “fiction.” A truly ironic description, as none of Scientology’s treatments for mental illness (centered around “auditing” and “purification” rituals involving vitamins and sauna) have been subjected to little, if any, credible, peer-reviewed research.

2) Scientology has a long and storied history of pressuring people into running up credit cards, getting second mortgages on their houses and the like. Why? Because their “treatments” can easily run up bills that surpass tens of thousands of dollars.

3) Scientology is keenly interested in quashing criticism of its practices. Excellent examples of this are retold especially well by Time Magazine’s “The Thriving Cult of Greed and Power” and by the BBC’s Panorama documentary series. In an era where we’re already working hard to ferret out good research from bad, the last thing we need is any organization quashing free and open discussion of a topic as critical as mental health care.

There are many examples of medicine practiced badly, but that is hardly a reason for anyone to replace it with specious and costly practices by Scientology.

Bob’s last blog post..wiki.pdxanon.info

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