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General Interest => Feed Your Head => Topic started by: Anonymous on September 19, 2005, 11:25:00 AM

Title: Lincoln's Melancholy
Post by: Anonymous on September 19, 2005, 11:25:00 AM
Lincoln's Melancholy:
How Depression Challenged a President and Fueled His Greatness

by: Joshua Wolf Shenk

The year is 1860. In a makeshift meeting hall, the Illinois delegation to the approaching Republican Convention is meeting to consider which of their own to back as a favorite son for the Presidential nomination. There is no clear-cut favorite. Moreover, it?s widely acknowledged the choice will be an empty gesture. The nomination is virtually a done deal. William Seward of New York, the party?s leading light, has nearly all the delegates he needs for a first ballot victory.

But then something completely unexpected happens. Abraham Lincoln is introduced. A distant relation enters carrying two split log rails. From them hangs a banner:

Abraham Lincoln
The Rail Candidate

The crowd goes wild. The hall shakes so much that the canvass roof flies off the building. The image of a humble rail-splitter is all this group of delegates needs to give Lincoln its enthusiastic backing. The dynamics of the nomination has completely changed. Illinois? freshly-minted favorite son is on his way to becoming a serious contender.

The meeting breaks up the next day. In the nearly empty hall, a man sits alone, elbows bent, hands pressed to his face. He confides to someone who approaches him, "I?m not feeling too well." The man is Abraham Lincoln. He is battling a crushing depression.

The event is recounted in Joshua Shenk?s outstanding new book, "Lincoln?s Melancholy: How Depression Challenged a President and Fueled His Greatness." Writes Mr Shenk:

"Lincoln?s look at that moment ? the classic image of gloom ? was familiar to everyone who knew him well. ? He often wept in public and cited maudlin poetry. He told jokes and stories at odd times ? he needed the laughs, he said, for his survival. As a young man he talked of suicide, and as he grew older, he said he saw the world as hard and grim, made that way by fates and forces of God. ?No element of Mr Lincoln?s character,? declared his colleague Henry Whitney, ?was so marked, obvious and ingrained as his mysterious and profound melancholy.? His law partner, William Herndon said, ?His melancholy dripped from him as he walked.?"

Mr Shenk relates that depression was a constant throughout Lincoln?s adult life. He never overcame it. He never rose above it. His life was one long unceasing litany of sorrow. At times, he completely gave in to his condition. He would fail to get out of bed. He would behave very strangely. He would alarm his friends and associates.

"I am now the most miserable man living," the 31-year-old Lincoln confessed. "Whether I shall ever be better I can not tell; I awfully forebode I shall not; To remain as I am is impossible; I must die or be better."

But other forces were also at work, Mr Shenk contends. Depression turned him into a hard-headed realist, untainted by the pitfalls of misguided optimism. His uncanny melancholic third eye allowed him to think like a visionary. And even though he was a religious skeptic, his tribulations would imbue him with a higher wisdom and deeper humanity, so much so that he occupies a unique place in history as an American saint.

It is easy to fall into the trap of romanticizing Lincoln, but the facts speak for themselves. As his life unfolds, one cannot help but have the impression of being in a higher presence. It?s almost a religious experience. Mr Shenk makes the experience all the more moving by allowing us to view the great man through the eyes of our illness. The result is both inspirational and heartbreaking. To begin ?.

The Early Years

Abraham Lincoln was different from day one. A voracious reader, intellectually curious, and a sensitive individual in a rural environment that only saw merit in physical labor, the young Lincoln was regarded as lazy and in need of discipline.

There was much cause for sadness in Lincoln?s life. His only brother died in infancy. His mother and aunt and uncle succumbed to an epidemic when he was age nine. Ten years later his sister died giving birth to a still-born infant. His father and mother were disposed to melancholy, and one side of the family "was thick with mental disease."

Despite this, young Lincoln made it into adulthood showing few signs of depression. His first major episode coincided with the death of Anne Rutledge in 1835 when he was 26. Lincoln had long since left the family farm to seek his fortune in the one-horse town of New Salem, Illinois. Many historians contend that there must have been a love interest between Rutledge and Lincoln, but Mr Shenk says there is no evidence.

Depression is not as simple as cause and effect, Mr Shenk reminds us, citing a number of psychiatric sources, especially in someone predisposed to the illness. Any number of apparently innocuous occurrences can set off an episode, including several converging at once. According to one account, Lincoln bore up to Anne?s death fairly well. Then came heavy rains that seemed to unnerve him. He took to walking the woods alone with a gun and talking of suicide. Everyone in the village became aware of his strange behavior, and one concerned couple took him in for a week or two.

Finding His Way in the World

By Lincoln?s late twenties, friends and colleagues regarded him as "melancholic." The condition was virtually indistinguishable from the modern conception of depression, but did not carry the same stigma. Back in those days, despite an individual feeling "unmanned" by his affliction, there was considerable leeway for males to express their feelings in public, especially with the Romantic movement entering full flower.

In Lincoln?s case, his sorrowful demeanor induced people to come to his aid.

Nowhere was this more apparent than when the young man turned up to practice law in Springfield, Illinois with all his worldly possessions in two saddlebags. A store proprietor, Joshua Speed, urged his forlorn customer to take the bags upstairs to his room and the two became fast friends.

In an age when contact with the opposite sex was severely circumscribed, young men were encouraged "to pair off and form a special bond" as part of their grooming for greater responsibilities. Lincoln and Speed even shared the same bed for four years, but this was fairly common practice not to be mistaken for homosexuality. Nevertheless, gender roles were defined quite differently. It was acceptable for young men to display their affection for one another. This kind of intimacy encouraged the _expression of one?s innermost thoughts and feelings, including depression.

Mr Shenk points to a number of forces at work when Lincoln was coming of age. On one hand, it was an age of hope. The new economy for the first time gave ambitious young white men like Lincoln the opportunity to realize the dreams of the Founding Fathers. Steam power and the telegraph effectively shrunk the world and created a whole new mobile labor force. Advances in medical science instilled the belief that God was not punishing an individual, which effectively destigmatized illness. This spawned a whole new movement in self-improvement.

At the same time, thanks to a new religious revival, a loving redemptive God replaced the harsh vengeful God of John Calvin. Rather than predestination to hellfire and brimstone, men and women had the power to make moral choices and find their way to God?s favor.

For the first time in history, the individual did not have to subsume his needs to the needs of the tribe or community. But with this new freedom came new fears and anxieties. Gone was the communal security blanket. Ever present was the specter of failure, with full responsibility borne by the exposed individual. America, the land of opportunity, led the world in mental illness.

It was in this heady atmosphere of hope and insecurity that young Lincoln, now a hotshot lawyer and rising star in the state legislature, was to become badly unhinged.

Lincoln?s Breakdown

Many historians attribute Lincoln?s depressive episode of the winter of 1840-41 to his breaking off his engagement with Mary Todd. But much more was happening in Lincoln?s life, Mr Shenk points out.

In the legislature, Lincoln had hitched his political wagon to ambitious public works projects designed to open up the hinterlands to economic development. This included an elaborate network of rails, canals, and roads.

Then came the economic depression of 1837. Revenues dried up and the debt exploded. Lincoln used up all his political capital urging the legislature to stay the course, which proved a disaster. By the end of 1840, the state was teetering on the brink of bankruptcy, forcing the abandonment of Lincoln?s beloved projects. The rival Democrats rode into power on the aftermath of the debacle, and Lincoln was cast as one of the scapegoats. He barely held onto his seat in the legislature, his political career virtually finished.

At the same time, he was laboring under a heavy workload as a lawyer, with nine cases before the state supreme court.

As for Mary Todd, the exact time of the break-up is unknown, obviating a simple cause and effect. Another woman had turned him down, and he may have had an interest in yet another. On top of this, his dear friend Joshua Speed was making plans to move back to Kentucky. Then the weather turned bitterly cold.

In January 1841, Lincoln was confined to his bed, and his condition was the talk of the town. He put himself in the care of a physician, which likely made him much worse. Standard medical treatment involved purging the body by aggressively drawing blood, ingesting mercury and other poisons, inducing vomiting, starving the patient, and plunging him in cold water.

A concerned Joshua Speed told Lincoln that if he did not rally he would die. Lincoln replied he was not afraid to die. Yet, ironically, his perceived failures may have stoked his will to live. He confessed to his friend an "irrepressible desire" to accomplish something before he died that would "redound to the interest of his fellow man."

Some 20 years later, Lincoln would remind his friend of that conversation.

Finding Himself

In late 1842, Lincoln bit the bullet and married Mary Todd. His way of dealing with his depression was by throwing himself into his family and his work, but it wasn?t until he reached his mid-forties that he found a cause that animated him. The Missouri Compromise of 1820 had regulated the extension of slavery in the western territories. In practice, it operated as a containment policy that implicitly recognized slavery?s wrong. Lincoln foresaw slavery?s eventual end, but it was not a process, he believed, that could be speeded up.

That all changed in 1854 with the passage of the Kansas-Nebraska Act. Suddenly the northern territories were in play. Three years later, the Supreme Court?s infamous Dred Scott decision held out the prospect of legalized slavery in the northern states, as well. Slavery was no longer a wrong. It was about to become a universally recognized right. Passions on both sides were awakened, but the situation clearly favored the south.

Lincoln?s melancholia allowed him to see events with preternatural second sight. Southerners with a vested interest in the outcome stood a clear chance of having their way over largely indifferent northerners. It was the thin edge of the wedge that could put an end to free labor markets everywhere and dash the dreams of the Founding Fathers. The clock was being rewound back to the Dark Ages, and Lincoln was not confident of his ability to put a stop to it. Nevertheless, he felt compelled to speak out against the madness, even at the risk of his career.

Paradoxically, his political career took off, though true to melancholic form he saw every slight setback as a major failure. The new political reality spelled the end of Lincoln?s Whig party. In its place stood the newly-formed Republican party. In 1858, Lincoln found himself in the national spotlight in his series of debates with the author of the Kansas-Nebraska Act, Stephen Douglas. Both were contesting the same Senate seat.

The Senate was Lincoln?s lifelong dream. In an era of lackluster Presidents, this was the forum of his heroes such as Daniel Webster and Henry Clay. But Lincoln was prepared to sacrifice his ambitions for the cause. His antislavery position ran ahead of public opinion, but he strongly felt the greater interest was better served by enlightening the voters.

Lincoln also saw ahead to 1860, when Douglas was likely to be the Democratic standard-bearer in the Presidential election. In the debates, he forced his rival to expose himself as too moderate for his southern backers. The next Republican candidate for President, he knew ? certainly not he ? would benefit.

Lest we mistake Lincoln as morally flawless, he neither viewed African-Americans as biologically equal to whites nor did he envision the two races living together in harmony. The world was a stupid place back then, arguably only slightly more stupid than it is today.

In early 1860, Lincoln traveled to New York to deliver an address to the Cooper Institute. He brilliantly succeeded in linking the dreams of the Founding Fathers to the anti-slavery position, and threw down the gauntlet on right versus wrong. He brought down the house, and achieved rave notices everywhere. No one was quite ready to seriously consider him as Presidential timber. Yet ?

Improbably, on the strength of his new-found image as the rail-splitter, Lincoln won his party?s nomination on the third ballot. The election was a shoo-in. Thanks in part to the Lincoln-Douglas debates, an irreparable schism had formed in the pro-slavery ranks. The Democratic party splintered three ways, allowing Lincoln to win with just 40 percent of the popular vote.

Even more improbable, Lincoln?s well-known melancholia was not seen as a character flaw. Today, the immensity of a Lincoln-sized depression would disqualify a candidate from virtually any elected office save dog-catcher. Back in Lincoln?s time, living successfully with a mental illness was viewed in the same context of his rags to riches story, as evidence of a character virtue. Maybe they weren?t all that stupid back then, after all..

The Presidency

By the time Lincoln was sworn in, seven southern states had bolted from the Union. Facing the Republic?s gravest crisis, he assumed office with no executive experience, forced to govern from an untenable position. One slight overstep, and the border states would join the South, ending all hope of reunification. When hostilities broke out, the North lost far more battles than it won, forcing all and sundry to second-guess his leadership. As the terrible carnage mounted, much of the population lost its resolve, leaving Lincoln with a very weak bargaining hand. When he pressed his position harder, rebellion threatened to erupt on the home front. Few believed there would be a successful conclusion to the war. No one thought he could be reelected.

Of all things, a lifetime of living with depression admirably prepared him for the task. He possessed both the intestinal fortitude and the moral will. And the insights he had acquired from a lifetime of sorrow seemed to connect him to a higher power. As Joshua Shenk explains, over the course of his adulthood, Lincoln passed from fear to engagement to transcendence.

In other words, having decided that he WOULD live, he then decided HOW to live. When faced with the challenge of a lifetime, he proved more than ready.

But first came more personal tragedy. During his term of office, two of his sons died. Of his four sons, only one would live to adulthood. On learning of the death of Willie, his favorite, he wept convulsively.

In 1862, Lincoln deviated from a previously-held position by proposing to his cabinet the emancipation of slaves from all union-held southern territory. The move risked alienating the border states, but would serve to give the war a higher moral purpose. Lincoln entertained no delusions about whose side God was on. Death had visited far too many northern households for him to believe that the Almighty was playing favorites. "My greatest concern is to be on God's side," he advised a colleague.

The Emancipation Proclamation would be the first step toward universal freedom and enfranchisement. Soon after, Joshua Speed would pay a visit, and Lincoln would remind him of their conversation some twenty years earlier, when only his desire to accomplish something great gave him the will to live.

"I believe in this measure my fondest hopes will be realized," he confided to his friend.

Sainthood

On assuming his second term of office, Lincoln spoke the finest words ever uttered in the English tongue:

"With malice toward none, with charity for all, with firmness in the right, as God gives us to see the right, let us strive on to finish the work we are in, to bind up the nation's wounds."

He had six weeks to live, his last days filled with a transcendent lightness of being. It was as if, his mission on earth accomplished, he were ready to be taken up into heaven. On April 14, 1865, a man with a gun obliged. Now he belonged to the ages.

Final Words

In Lincoln?s depressions, we see the illness in its full destructive horror, one that nearly succeeded in cutting short the life of a promising young man and made the rest of his existence miserable. This is the side of depression with which we can all unfortunately identify. But we also see an aspect to his depressions that equally resonates with us ? how our suffering can strengthen us, ennoble us, and embolden us, often to achieve the impossible.

Our sense of achievement need not be the same as Lincoln?s, nor for that matter what our families may expect of us. It is simply enough that we survive from day to day with the kind of grace that is used to define courage. Believe me, if Lincoln were to visit you right now, he might admonish you to make your bed, but he would do it in the way of a funny story. And he would let you know how proud is of you. No doubt about it. Take heart. Lincoln lives in us all. Walk tall.

Book:
http://www.amazon.com/exec/obidos/tg/de ... s&n=507846 (http://www.amazon.com/exec/obidos/tg/detail/-/0618551166/qid=1127143439/sr=8-1/ref=pd_bbs_1/002-7838867-5710400?v=glance&s=books&n=507846)

Audio CD:
http://www.amazon.com/exec/obidos/tg/de ... s&n=507846 (http://www.amazon.com/exec/obidos/tg/detail/-/1598870041/qid=1127143439/sr=8-2/ref=pd_bbs_2/002-7838867-5710400?v=glance&s=books&n=507846)
Title: Lincoln's Melancholy
Post by: Anonymous on September 20, 2005, 12:44:00 AM
Did medications and psychiatrist cause Lincoln's depression?
Title: Lincoln's Melancholy
Post by: Antigen on September 20, 2005, 01:20:00 PM
Did medications and shrinks cure Lincoln's depression? I remember reading somewhere years ago that he had been advised by a doctor to try eating raisins.

Point is, despite prevailing opinion, mankind has been dealing w/ a range of issues from depression to substance addiction for thousands of years now. Modern psychiatry is just not the end all, be all. Much like other modern technology, it has been received as a miracle of science, but there are some down sides. Who knew that the noxious smoke and waste water coming off of various factories could actually kill a river? Read up on the Donora Fog for early 20th century thinking about that. Same w/ psyche drugs. For all the early perceived benefits, there are down sides. It's foolish to pretend otherwise.

Penalties against possession of a drug should not be more damaging to an individual than the use of the drug itself
--Jimmy Carter

Title: Lincoln's Melancholy
Post by: Deborah on September 20, 2005, 08:34:00 PM
Psychiatric Drugs: An Assault on the Human Condition
Street Spirit Interview with Robert Whitaker
Interview by Terry Messman
http://thestreetspirit.org/August2005/interview.htm (http://thestreetspirit.org/August2005/interview.htm)

Excerpt:
Street Spirit: Your new line of research indicates that there has been an enormous rise in the incidence of mental illness in the United States, despite the seeming advances in a new generation of psychiatric drugs. Why do you refer to this increase as an epidemic?

Robert Whitaker: Even people like the psychiatrist E. Fuller Torrey wrote a book recently in which he said it looks like we're having an epidemic of mental illness. When the National Institute of Mental Health publishes its figures on the incidence of mental illness, you see these rising numbers of mentally ill people. Some recent reports even say that 20 percent of Americans now are mentally ill.

So what I wanted to do was two-fold. I wanted to look into exactly how dramatic is this increase in mental illness, and particularly severe mental illness. Part of this rise in the number of people said to be mentally ill is just definitional. We draw a big wide boundary today and we throw all sorts of people into that category of mentally ill. So children who are not sitting neatly enough in their school rooms are said to have attention deficit hyperactivity disorder (ADHD), and we created a new disorder called social anxiety disorder.

SS: So what used to be called simply shyness or anxiety in relating to people is now labeled a mental disorder and you supposedly need an antidepressant like Paxil for social anxiety disorder.
RW: Exactly. And you need a stimulant like Ritalin for ADHD.

SS: This increases psychiatry's clients, but doesn't it also increase the number of people that giant pharmaceutical companies can sell their psychiatric drugs to?
RW: Absolutely. So part of what we're seeing is nothing more than the creation of a larger market for drugs. If you think about it, as long as we draw as big a circle as possible, and expand the boundaries of mental illness, psychiatry can have more clients and sell more drugs. So there's a built-in economic incentive to define mental illness in as broad terms as possible, and to find ordinary, distressing emotions or behaviors that some people may not like and label them as mental illness.

SS: Your research also shows that there is a real increase in people who have a severe mental disorder. Now, this seems counterintuitive, but is it true that you believe much of this increase is caused by the overuse of some of the new generations of psychiatric drugs?
RW: Yes, exactly. I looked at the number of the so-called severely disabled mentally ill -- people who aren't working or who are somehow dysfunctional because of mental illness. So I wanted to chart through history the percentage of the population who are considered the disabled mentally ill.

Now, by 1903, we see that roughly 1 out of every 500 people in the United States is hospitalized for mental illness. By 1955, at the start of the modern era of psychiatric drugs, roughly one out of every 300 people was disabled by mental illness. Now, let's go to 1987, the end of the first generation of antipsychotic drugs; and from 1987 forward we get the modern psychiatric drugs. From 1955 to 1987, during this first era of psychiatric drugs -- the antipsychotic drugs Thorazine and Haldol and the tricyclic antidepressants (such as Elavil and Anafranil) -- we saw the number of disabled mentally ill increase four-fold, to the point where roughly one out of every 75 persons are deemed disabled mentally ill.

Now, there was a shift in how we cared for the disabled mentally ill between 1955 and 1987. In 1955, we were hospitalizing them. Then, by 1987, we had gone through social change, and we were now placing people in shelters, nursing homes, and some sort of community care, and gave them either SSI or SSDI payments for mental disability. In 1987, we started getting these supposedly better, second-generation psychiatric drugs like Prozac and the other selective serotonin re-uptake inhibitor (SSRI) antidepressants. Shortly after that, we get the new, atypical antipsychotic drugs like Zyprexa (olanzapine), Clozaril and Risperdal.

What's happened since 1987? Well, the disability rate has continued to increase until it's now one in every 50 Americans. Think about that: One in every 50 Americans disabled by mental illness today. And it's still increasing. The number of mentally disabled people in the United States has been increasing at the rate of 150,000 people per year since 1987. That's an increase every day over the last 17 years of 410 people per day newly disabled by mental illness.

SS: So that leads to the obvious question. If psychiatry has introduced these so-called wonder drugs like Prozac and Zoloft and Zyprexa, why is the incidence of mental illness going up dramatically?
RW: That's exactly it. This is a scientific question. We have a form of care where we're using these drugs in an ever more expansive manner, and supposedly we have better drugs and they're the cornerstone of our care, so we should see decreasing disability rates. That's what your expectation would be.

Instead, from 1987 until the present, we saw an increase in the number of mentally disabled people from 3.3 million people to 5.7 million people in the United States. In that time, our spending on psychiatric drugs increased to an amazing degree. Combined spending on antipsychotic drugs and antidepressants jumped from around $500 million in 1986 to nearly $20 billion in 2004. So we raise the question: Is the use of these drugs somehow actually fueling this increase in the number of the disabled mentally ill?

When you look at the research literature, you find a clear pattern of outcomes with all these drugs -- you see it with the antipsychotics, the antidepressants, the anti-anxiety drugs and the stimulants like Ritalin used to treat ADHD. All these drugs may curb a target symptom slightly more effectively than a placebo does for a short period of time, say six weeks. An antidepressant may ameliorate the symptoms of depression better than a placebo over the short term.

What you find with every class of these psychiatric drugs is a worsening of the target symptom of depression or psychosis or anxiety over the long term, compared to placebo-treated patients. So even on the target symptoms, there's greater chronicity and greater severity of symptoms. And you see a fairly significant percentage of patients where new and more severe psychiatric symptoms are triggered by the drug itself.

SS: New psychiatric symptoms created by the very drugs people are told will help them recover?
RW: Absolutely. The most obvious case is with the antidepressants. A certain percentage of people placed on the SSRIs because they have some form of depression will suffer either a manic or psychotic attack -- drug-induced. This is well recognized. So now, instead of just dealing with depression, they're dealing with mania or psychotic symptoms. And once they have a drug-induced manic episode, what happens? They go to an emergency room, and at that point they're newly diagnosed. They're now said to be bipolar and they're given an antipsychotic to go along with the antidepressant; and, at that point, they're moving down the path to chronic disability.

SS: Modern psychiatry claims that these psychiatric drugs correct pathological brain chemistry. Is there any evidence to back up their claim that abnormal brain chemistry is the culprit in schizophrenia and depression?
RW: This is the key thing everyone needs to understand. It really is the answer that unlocks this mystery of why the drugs would have this long-term problematic effect. Start with schizophrenia. They hypothesize that these drugs work by correcting an imbalance of the neurotransmitter dopamine in the brain.

The theory was that people with schizophrenia had overactive dopamine systems; and these drugs, by blocking dopamine in the brain, fixed that chemical imbalance. Therefore, you get the metaphor that they're like insulin is for diabetes; they're fixing an abnormality. With the antidepressants, the theory was that people with depression had too low levels of serotonin; the drugs upped the levels of serotonin in the brain and therefore they're balancing the brain chemistry.

First of all, those theories never arose from investigations into what was actually happening to people. Rather, they would find out that antipsychotics blocked dopamine and so they theorized that people had overactive dopamine systems. Same with the antidepressants. They found that antidepressants upped the levels of serotonin; therefore, they theorized that people with depression must have low levels of serotonin.

But here is the thing that one wishes all of America would know and wishes psychiatry would come clean on: They've never been able to find that people with schizophrenia have overactive dopamine systems. They've never been able to find that people with depression have underactive serotonin systems. They've never found consistently that any of these disorders are associated with any chemical imbalance in the brain. The story that people with mental disorders have known chemical imbalances -- that's a lie. We don't know that at all. It's just something that they say to help sell the drugs and help sell the biological model of mental disorders.

But the kicker is this. We do know, in fact, that these drugs perturb how these chemical messengers work in the brain. The real paradigm is: People diagnosed with mental disorders have no known problem with their neurotransmitter systems; and these drugs perturb the normal function of neurotransmitters.

SS: So rather than fixing a chemical imbalance, these widely prescribed drugs distort the brain chemistry and make it pathological.
RW: Absolutely. Stephen Hyman, a well-known neuroscientist and the former director of the National Institute of Mental Health, wrote a paper in 1996 that looked at how psychiatric drugs affect the brain. He wrote that all these drugs create perturbations in neurotransmitter functions. And he notes that the brain, in response to this drug from the outside, alters its normal functions and goes through a series of compensatory adaptations.

In other words, it tries to adapt to the fact that an antipsychotic drug is blocking normal dopamine functions. Or in the case of antidepressants, it tries to compensate for the fact that you're blocking a normal reuptake of serotonin. The way it does this is to adapt in the opposite way. So, if you're blocking dopamine in the brain, the brain tries to put out more dopamine and it actually increases the number of dopamine receptors. So a person placed on antipsychotic drugs will end up with an abnormally high number of dopamine receptors in the brain.

If you give someone an antidepressant, and that tries to keep serotonin levels too high in the brain, it does exactly the opposite. It stops producing as much serotonin as it normally does and it reduces the number of serotonin receptors in the brain. So someone who is on an antidepressant, after a time ends up with an abnormally low level of serotonin receptors in the brain. And here's what Hyman concluded about this: After these changes happened, the patient's brain is functioning in a way that is "qualitatively as well as quantitatively different from the normal state." So what Stephen Hyman, former head of the NIMH, has done is present a paradigm for how these drugs affect the brain that shows that they're inducing a pathological state.

SS: So the paradox is there's no evidence for modern psychiatry's claim that there is any pathological biochemical imbalance in the brain that causes mental illness, but if you treat people with these new wonder drugs, that is what creates a pathological imbalance?
RW: Yes, these drugs disrupt normal brain chemistry. That's the real paradox here. And the real tragedy is, that even as we peddle these drugs as chemical balancers, chemical fixers, in truth we're doing precisely the opposite. We're taking a brain that has no known abnormal brain chemistry, and by placing people on the drugs, we're perturbing that normal chemistry. Here's how Barry Jacobs, a Princeton neuroscientist, describes what happens to a person given an SSRI antidepressant. "These drugs," he said, "alter the level of synaptic transmission beyond the physiologic range achieved under normal environmental biological conditions. Thus, any behavioral or physiologic change produced under these conditions might more appropriately be considered pathologic rather than reflective of the normal biological role of serotonin."

Read the entire and very lengthy interview at the link above.
Title: Lincoln's Melancholy
Post by: Anonymous on September 21, 2005, 07:44:00 AM
Comparing Schizophrenia Drugs
THE NEW YORK TIMES
http://www.nytimes.com/2005/09/21/opini ... ?th&emc=th (http://www.nytimes.com/2005/09/21/opinion/21wed3.html?th&emc=th)

Published: September 21, 2005
A government-financed study has provided the strongest evidence yet that the system for approving and promoting drugs is badly out of whack. The study compared five drugs used to treat schizophrenia and found that most of the newest, most heavily prescribed drugs were no better than an older drug that is far cheaper. The nation is wasting billions of dollars on heavily marketed drugs that have never proved themselves in head-to-head competition against cheaper competitors.

The whole class of antipsychotic drugs has had undeniable value in blunting the symptoms of schizophrenia, enabling many patients to leave mental hospitals and move into the community. But the first generation of these drugs fell into disfavor because they often caused neurological side effects, like tremors and other involuntary movements.

That spurred the development of a new generation of drugs known as atypical antipsychotics, which now dominate the market and rake in some $10 billion in annual sales. The trouble is that these new drugs were approved largely on the basis of short-term clinical trials that compared them primarily with placebos, so there was little if any evidence that they were any better than many of the older drugs.

That gap has been filled by an 18-month clinical trial involving more than 1,400 adults around the nation. The study, sponsored by the National Institute of Mental Health, measured how long patients were able to keep taking their assigned drugs before deciding to change, usually because a drug wasn't working or had intolerable side effects. Three-fourths of the patients, a shocking number, stopped taking the drug they had been given, suggesting that there is a clear need for better treatments.

The study found that the oldest drug, perphenazine, was as effective and caused no worse side effects than three of the newer drugs. Zyprexa, a new drug made by Eli Lilly, helped patients control symptoms slightly better than the others, but at the cost of serious side effects.

Doctors should find a trove of useful data in the study to help them decide which drug might be best for a particular patient. But Congress and the Bush administration ought to pay attention as well. Surely it would make sense to force manufacturers to test their drugs not just against placebos, but against existing drugs that they are seeking to displace. And surely it would be cost-effective for the government to sponsor large studies comparing a slew of expensive drugs with their cheaper alternatives.
Title: Lincoln's Melancholy
Post by: Anonymous on September 21, 2005, 04:30:00 PM
The new england journal of medicine
n engl j med 353;12

http://www.nejm.org (http://www.nejm.org) september 22, 2005 1286

editorials

The Choice of Antipsychotic Drugs for Schizophrenia

Robert Freedman, M.D.
Since the discovery of the effects of chlorpromazine in the 1950s, treatment of schizophrenia has relied on antipsychotic drugs that target dopamine D2 receptors.

The effectiveness of these agents in reducing
the intensity of patients? delusions and hallucinations permitted outpatient treatment instead of lifelong institutionalization in state mental hospitals.

The many antipsychotic drugs introduced during
the next decade were increasingly potent, as medicinal chemists improved the drugs? affinity for the D2 receptor. However, the efficacy of the drugs was similar, since all had the same mechanism of action. (1)

A troubling problem was that the blockade of
dopaminergic neurotransmission in the basal ganglia caused parkinsonian syndromes. A long-lasting movement disorder, tardive dyskinesia, also occurred with prolonged treatment. More fundamentally, the early promise that these drugs might dramatically improve patients? psychosocial and cognitive disabilities was only partially fulfilled. (2)

Although many mental hospitals were closed, mental
health centers were filled with outpatients who
could not live successfully in their communities.
By the early 1970s, the European experience with
one drug, clozapine, suggested that it might be significantly more effective than other antipsychotic drugs and that it did not cause movement disorder to the same degree as the others. Clozapine indeed proved to be more effective at reducing symptoms than other neuroleptic agents. (3)

However, the potential of clozapine to cause toxic side effects, including agranulocytosis, has limited its prescription to about 10 percent of persons with schizophrenia. Clozapine was labeled an atypical antipsychotic agent because it caused less movement disorder than other antipsychotics.

The mechanism of action of clozapine differs in many ways from that of other dopamine D2 receptor antagonists; the most popular hypothesis is that it has weaker D2 antagonism and stronger antagonism at serotonin 5-hydroxytryptamine receptors. (4)

Pharmaceutical companies, acting on this hypothesis, have developed new drugs, attempting to capture the enhanced therapeutic effect of clozapine without its toxicity. The resultant second generation of drugs now accounts for the majority of antipsychotic drugs prescribed
for all psychiatric uses, including schizophrenia.
Concerns have emerged about this new generation
of drugs. First, although clozapine was introduced
after studies indicated that it had more
efficacy than first-generation drugs, the other new antipsychotic agents were marketed after studies showed efficacy that was only comparable to that of older drugs. Thus, the issue of whether they, like clozapine, were truly more effective remained largely unanswered. Second, although the newer drugs fulfilled their promise of causing less movement disorder, new problematic side effects ? severe weight gain, often accompanied by type 2 diabetes mellitus and hypercholesterolemia ? emerged. (5,6)

Weight gain had occurred with the older drugs, although it was generally less substantial. Third, the cost of newer medications caused payers to question their purported value. Therefore, the National Institute of Mental Health undertook a multisite, double-blind comparison between an older drug, perphenazine, and a series of the newer drugs; clozapine was omitted because it had already been observed to have superior efficacy.

The results of this work, the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE), are reported in this issue of the
Journal. (7)

What to measure in such a trial is itself problematic. Schizophrenia is a chronic disability of mental and social function, with superimposed
episodes of exacerbated psychotic symptoms. In
addition to hallucinations and delusions, affected
patients have characteristic neuropsychological difficulties, including problems in paying attention, learning new information, and recognizing social cues, such as the emotional meaning of facial expressions.

Their social isolation, loss of sense of
pleasure, inability to make decisions, and poor selfcare forms a third symptom complex. Patients who carry the diagnosis of schizophrenia vary markedly in these various aspects of their illness. Efficacy is therefore difficult to measure. The time to discontinuation of medication for any reason ? a side effect, poor efficacy, or the patient?s decision about adherence ? was the principal outcome variable in CATIE. Its advantage as a primary measure is that it is relatively definable and less subject to the vicissitudes
of patients? descriptions of their symptoms
and the perception of these symptoms by others,
even those trained in assessing them. CATIE used a
single scale, the Positive and Negative Syndrome
Scale (PANSS), to rate patients? symptoms as a secondary outcome. Side effects were recognized as
an important issue in the design of CATIE.

The results could be viewed as discouraging.

No drug provided the majority of patients a treatment that lasted the full 18 months of the study.

Thus, treating schizophrenia, even with new-generation drugs, is only partially effective and is associated with problematic side effects.

Only 36 percent of the patients receiving the most effective drug, olanzapine, completed the trial.
 
Twenty-five percent of those receiving perphenazine completed the trial. Patients receiving other second-generation antipsychotic drugs ? quetiapine, risperidone, and ziprasidone ? did no better than those receiving perphenazine.

Thus, there was a small improvement with olanzapine as compared with the first-generation drug perphenazine, but this advantage was not observed with the other second-generation drugs.

This difference was reflected in the other clinical measurements, including PANSS ratings.
The greater efficacy of olanzapine, as compared
with that of these other drugs, is consistent
with the results of a recent meta-analysis. 8

However, olanzapine was also associated with notable metabolic effects. Thirty percent of the patients receiving olanzapine gained more than 7 percent of their body weight during the trials, as compared with 7 to 16 percent of those receiving the other drugs. There were comparable problems revealed in measured blood glucose, cholesterol, triglyceride, and glycosylated hemoglobin levels.

Thus, the patient with schizophrenia and his or
her doctor face difficult choices. Two drugs, olanzapine and clozapine, appear to be more effective than other agents.

However, both drugs induce a significantly greater number of serious side effects.

Even the most feared side effect of first-generation drugs, tardive dyskinesia, seems less troubling than potentially fatal metabolic problems.

Does the apparently moderate increase in the efficacy of olanzapine and clozapine justify the use of these agents for treating patients?

The answer to this question is a matter of clinical judgment and informed patient
preference.

Most clinicians offer patients several
possibilities over the course of their illness.

Few clinicians offer patients first-generation
drugs initially because the immediate problems with movement disorder are associated with poor adherence.

The relative absence of side effects with risperidone, quetiapine, and ziprasidone make them
frequent choices for initial treatment for many patients.

However, over the duration of the illness, it is
striking that olanzapine and clozapine often result in an increase in cognition that can lead to alterations in its course, although in some patients these improvements occur with other drugs as well. (9,10)

With these agents, patients resume vocational and
social interests that seemed irretrievably lost early in the course of their illness. Heavy cigarette smoking often remits during treatment with olanzapine and clozapine, indicating decreased reliance on the effects of nicotine. (11)

Because metabolic problems are likely to occur, dietary and exercise counseling should be introduced before the initiation of treatment
with these two drugs.

Although no one postulates that the biologic effects of clozapine and olanzapine are permanent,
the positive effects often persist when, because of metabolic effects, treatment is switched to other second-generation or even first-generation drugs.

CATIE does not capture all these clinical points,
but it provides data consistent with these clinical observations.

It would thus seem reasonable to try
olanzapine and clozapine in any patient with schizophrenia who has not had a full clinical remission of the illness, which includes the reversal of cognitive and psychosocial disabilities.

However, it is also prudent to switch treatment from these drugs to one of the others if a metabolic syndrome is threatening the patient?s general health.

The problem of which antipsychotic agents to
use is particularly poignant for patients with childhood-onset schizophrenia. These young patients, who are often initially referred to pediatricians for school problems, begin experiencing hallucinations
and delusions before the age of 13 years. (12)

Olanzapine is frequently the medication that provides optimal remission of their mental symptoms.

A child who is less disturbed, despite the nearly
inevitable massive weight gain, appears at least at first to have a better outcome. However, as the obesity continues to increase over a period of several years, affected children and families eventually ask to switch to other drugs, to restore normal weight, even at the cost of exacerbated psychosis.

Of course, new drugs that do not have metabolic
side effects but that do confer the antipsychotic
effects of clozapine and olanzapine would be desirable.

Just as the second generation of drugs moved
beyond D2 antagonism, aripiprazole ? a partial
agonist at dopamine D2 receptors that facilitates
low levels of receptor activation while blocking
higher levels ? as well as other new drugs in development have mechanisms that move beyond the
dopamine D2?5-hydroxytryptamine (2A)
hypothesis.

How these drugs perform in comparison with
olanzapine is still unknown. The value of CATIE is
that it provides solid evidence to help clinicians and their patients make the difficult decisions needed to optimize the treatment of schizophrenia with the compounds currently available.

From the Department of Psychiatry, University of Colorado Health Sciences Center, and the Veterans Affairs Medical Center ? both in Denver.

1.
Creese I, Burt DR, Snyder SH. Dopamine receptor binding predicts clinical and pharmacological potencies of antischizophrenic
drugs. Science 1976;192:481-3.

2.
Green MF. What are the functional consequences of neurocognitive deficits in schizophrenia?
Am J Psychiatry 1996;153: 321-30.

3.
Kane J, Honigfeld G, Singer J, Meltzer H. Clozapine for the treatment- resistant schizophrenic: a double-blind comparison with
chlorpromazine.
Arch Gen Psychiatry 1988;45:789-96.

4.
Meltzer HY. Clinical studies on the mechanism of action of clozapine: the dopamine-serotonin hypothesis of schizophrenia.
Psychopharmacology (Berl) 1989;99:Suppl:S18-S27.

5.
Sernyak MJ, Leslie DL, Alarcon RD, Losonczy MF, Rosenheck R. Association of diabetes mellitus with use of atypical neuroleptics in the treatment of schizophrenia. Am J Psychiatry 2002;159: 561-6.

6.
Lindenmayer JP, Czobor P, Volavka J, et al. Changes in glucose and cholesterol levels in patients with schizophrenia treated with
typical or atypical antipsychotics. Am J Psychiatry 2003;160:290-6.

7.
Lieberman JA, Stroup TS, McEvoy JP, et al. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med
2005;353:1209-23.

8.
Davis JM, Chen N, Glick ID. A meta-analysis of the efficacy of second-generation antipsychotics.
Arch Gen Psychiatry 2003;60: 553-64.

9.
Bilder RM, Goldman RS, Volavka J, et al. Neurocognitive effects of clozapine, olanzapine, risperidone, and haloperidol in patients
with chronic schizophrenia or schizoaffective disorder.
Am J Psychiatry 2002;159:1018-28.

10.
Green MF, Marder SR, Glynn SM, et al. The neurocognitive effects of low-dose haloperidol: a two-year comparison with risperidone.
Biol Psychiatry 2002;51:972-8.

11.
McEvoy JP, Freudenreich O, Wilson WH. Smoking and therapeutic response to clozapine in patients with schizophrenia.
Biol Psychiatry 1999;46:125-9.

12.
Schaeffer JL, Ross RG. Childhood-onset schizophrenia: premorbid and prodromal diagnostic and treatment histories.
J Am Acad Child Adolesc Psychiatry 2002;41:538-45.

Copyright 2005 Massachusetts Medical Society. All rights reserved.

Downloaded from http://www.nejm.org (http://www.nejm.org) at UC SHARED JOURNAL COLLECTION on September 20, 2005.
Title: Lincoln's Melancholy
Post by: Anonymous on September 21, 2005, 04:52:00 PM
MINDFREEDOM NEWS ALERT - 20 September 2005
http://www.MindFreedom.org (http://www.MindFreedom.org) - please forward

Below is an article from the front page
of today's _Washington Post_ about a new
federal study that "challenges widespread
assumptions" about one of psychiatry's
most frequently-used drugs, the neuroleptics,
also known as "antipsychotics."

The _Post_ quotes David Oaks, Director,
MindFreedom International. AT BOTTOM is
MindFreedom's full public statement.

Article link posted here for Fornits,
instead of full article for brevity for
those who have already read article:

http://www.washingtonpost.com/wp-dyn/co ... 67_pf.html (http://www.washingtonpost.com/wp-dyn/content/article/2005/09/19/AR2005091901867_pf.html)

Statement by David Oaks, Director

MindFreedom International

I have heard zealots lobby for a massive
increase in involuntary psychiatric
drugging by claiming that the newer
neuroleptics are far more effective and
that the side effect nightmare that
plagued older neuroleptics had been
solved.

But this new federal study shows that
many of our members who have been
desperately trying to say "no" to forced
neuroleptics have had a better grip on
reality than the medical community.

The drug industry hype about miracle
wonder pills turns out, once more, to be
fraud. The drug industry has seriously
mis-informed the public, the medical
community, government decision-makers,
families and patients. This fraud has
caused serious suffering among a very
marginalized group. The bizarrely high
costs of these drugs threaten to bankrupt
many state and local health care systems.

The New England Journal of Medicine
official editorial warns that patients
face "difficult choices" about drugs that
can potentially cause "fatal metabolic
problems" and therefore the answer is
"informed patient preference." But when the
rubber hits the road, patients and their
families are routinely lied to about
efficacy and hazards of these drugs, and
far too many patients are forced and
coerced to take neuroleptics, including
with court orders on an outpatient basis
in their own homes.

And of course, families in crisis are seldom
offered humane and safe alternatives to
psychiatric drugs.

I have personally experienced
forced neuroleptics and the experience
can feel overwhelmingly horrible, a
profound intrusion of our basic human
rights, like a wrecking ball to the mind.
That qualitative experience doesn't tend
to get out in these studies.

The controversy here is beyond being pro
or con drugs. Some of our members willingly
choose to take prescribed psychiatric drugs.
The issue is really about freedom. And the
drug corporation domination threatens basic
human rights in our society.

The big picture is what we at MindFreedom
call the take-over of the mental health
system by the drug industry, which
impacts research, conferences, medical
associations and choice of treatments.

While it's good to see a study focus on
efficacy and side-effect problems such as
weight gain and diabetes, the biggest
story that the public hasn't heard yet is
that taking long-term high-dosage
neuroleptic is associated with actual
structural damage to the higher level
parts of the brain. These brain changes
can make it very difficult to quit
neuroleptics by creating dependence.

It would also be good to see far more
studies about non-drug alternatives that
have been shown to be effective, safer
and more sustainable, especially ten,
twenty or thirty years down the road. A
core recommendation of President Bush's
New Freedom Commission was more study of
the long-term effects of psychiatric
drugs but we haven't seen that happen yet.

A drug-based approach to psychiatric
problems is also poised to globalize as
never before. There ought to be open,
honest and public debate about these
questions to prevent that from happening.
It's time for democracy to get informed
and hands-on with the mental health
system.

After thirty years of watching the
psychiatric drug industry I've come to
see it as a traveling medical show.
Whenever their current approach is
finally debunked they already have a load
of new drugs waiting in the pipeline. We
expect to see a number of new
neuroleptics produced in the next few
years and the public's skepticism ought
to be on high alert.

- end statement -

http://www.mindfreedom.org/ (http://www.mindfreedom.org/)
Title: Lincoln's Melancholy
Post by: Anonymous on September 21, 2005, 07:05:00 PM
Well, the answer according to those that
bask medications and chose not to read
the editorial to the research study ...

Bring back the asylum's, remove the MI
from the streets and any housing they may
have.

Those that are working, get them off the
damn harmful meds and back in the hospital
fully symptomatic where they belong.

---

The truth, prior to medications we needed the mentally ill in those mental institutions.

After medications the number of inpatient
patients was slashed about 95% ...

They are now outpatients ...
Are these medication really that bad if they
got them out of a permanent hospital stay?
Title: Lincoln's Melancholy
Post by: Deborah on September 21, 2005, 07:43:00 PM
Let's see....

Permanent hospital stay

OR

Potentially fatal metabolic problems... Weight gain... Diabetes... Structural damage to the higher level parts of the brain... Drug dependence... Involuntary muscle movements...  
not to mention the Bizarrely high
costs of these drugs.

Sounds like a toss up to me.... And a real bitch if you ended up in a permanent hospital stay AND forced to take the drugs.

But wait... wasn't there a THIRD option?

YES!!!

Humane and safe non-drug alternatives that
have been shown to be effective, safer
and more sustainable.

Whew... anon would have us believe that it's either 'freedom' via drugs or a lifetime pass to the asylum.
Title: Lincoln's Melancholy
Post by: Anonymous on September 21, 2005, 08:26:00 PM
Quote
On 2005-09-21 16:43:00, Deborah wrote:

"

Let's see....



Permanent hospital stay



OR



Potentially fatal metabolic problems... Weight gain... Diabetes... Structural damage to the higher level parts of the brain... Drug dependence... Involuntary muscle movements...  

not to mention the Bizarrely high

costs of these drugs.



Sounds like a toss up to me.... And a real bitch if you ended up in a permanent hospital stay AND forced to take the drugs.



But wait... wasn't there a THIRD option?



YES!!!



Humane and safe non-drug alternatives that

have been shown to be effective, safer

and more sustainable.



Whew... anon would have us believe that it's either 'freedom' via drugs or a lifetime pass to the asylum."


Anon is quoting the real facts.

There where asylums, now there is a fraction
of them left.

Deborah would have us believe that all those
on medication are going to have these horrible
complications. Meds have been around since the
50's so where are all these victims of medications?

You do research all the time, correct, just
how many have been harmed?

Regarding the safe and human treatments.
 
Where are they?

Have they been studied for efficacy?

People have a choice to flock to these
treatment centers, where are they?
Why are not psychiatric patients demanding
these treatments that you so fondly speak of?

Patients can simply stop taking medications
if they wish, the study said what, 85% of
those with schizophrenic disorders do not
take meds. If this world is really rounding
up people and forcing them to take medication
then why are they not interested in rounding
up these 85%.

In your research just how many people in
just the US are "forced" to take medications?
Title: Lincoln's Melancholy
Post by: Anonymous on September 22, 2005, 09:28:00 AM
Anon, Deborah will never understand the seriously
mentally ill. These feel good programs that she
idealistically talk about are pretty much non
existant. The few that have been tried also used
meds when the patients cycled.

She won't give up though, and she won't read the legitimate literature like Dr. Freedman's editorial
that you posted on this thread.
Title: Lincoln's Melancholy
Post by: Anonymous on September 22, 2005, 11:56:00 AM
http://www.amazon.com/exec/obidos/tg/de ... 67-5710400 (http://www.amazon.com/exec/obidos/tg/detail/-/047143499X/002-7838867-5710400)

This book is about so much more than bad medicine. As well as covering, in good but not overwhelming detail, many 'alternative medicine' topics (such as homeopathy which he gleefully destroys) it also covers a wide range of simple misunderstandings, 'old-wives tales' and folk hokum to do with the human body - ranging from the classic, "Don't sit too close to the TV or you'll damage your eyes!" to why we go grey/get fat/go bald/etc/etc.

Wanjek writes with flair and gentle humour. On that note, however, I have noticed in some reviews posted here that people who actually hold any of the pseudoscientific beliefs that Wanjek so neatly destroys may take his humour more seriously. Personally I am heartened by this - Wanjek has clearly touched a nerve.

This book provides an excellent overview of the current state of play in alternative medicine, excellent refutations of AM's sacred cows and, most importantly, some damn good advice. It is hard to overstate the harm done by people's unquestioning belief in alternative medicine - the number of treatable cancers that don't get detected early enough because of someone's misplaced trust in an iridologist, the masses of beneficial medication that never get prescribed because people would rather take water endowed with mystical 'quantum memories' of some unproven herb that used to be there before getting diluted into practical non-existence, ... Wanjek, through this book, provides a serious and valuable tool for sufferers of serious illness to cut through the haze of crap on offer from every late night infomercial peddling false hope.

For those of us fortunate enough to NOT be suffering serious illness, and for those less fortunate who ARE, the book is thought provoking, funny, interesting and informative. And hey - sooner or later we all know someone who gets taken for a ride by some medical scam - this book will definitely come in handy.
Title: Lincoln's Melancholy
Post by: Anonymous on September 22, 2005, 02:34:00 PM
Bad Medicine? Bad book, too.

The book purports to contain "Misconceptions and Misuses Revealed, from Distance Healing to Vitamin O," which immediately provoked the "Ooh!" response in me, as I'm also a big fan of skeptics like James Randi, Penn & Teller and the like. But the book itself disappoints in a major way.

The book is divided into seven sections. The first deals with body parts and common misconceptions about them, including the idea that certain areas of the tongue can only sense certain flavors, for instance, or that big brains aren't necessarily better. Sections two and three deal with aging and diseases, respectively. Sure, to some extent this stuff is entertaining, but it doesn't exactly seem to fall within the realm of "debunking myths"--in fact it almost seems common-sensical.

Section five is what I was "looking for" when I picked up this book--info on medicine quackery. Finally, I thought, I'd get to read about Professor Miracle Q. Crazypants' Magic Elixir For All What Ails You! But the section is surprisingly weak, sticking to topics like homeopathy, ayurveda, aromatherapy and qigong. While Wanjek does, for the most part, do a solid job of explaining why these "remedies" aren't valid, including a rather amusing explanation of how homeopathic medicine invalidates itself, the author takes a sharp detour into a chapter on herbs (which, as the author astutely points out, sometimes actually do things--duh) and how people used to be "a-feared" of vaccines.

The book, written by a guy who doesn't really have any academic credentials to speak of, aside from serving as an in-house science writer for NASA, MIT and the NIH (his bio also plugs his joke-writing skills as provided to both The Tonight Show and Saturday Night Live), is definitely funny in places, to be sure. But he relentlessly hammers on his pet peeves in the book, regardless of whether or not they're relevant to the topic at hand--including his opinion of how anyone who watches TV is apparently "brain dead." Plus there are fundamental weaknesses in the text, primarily consisting of faulty logic, or a dearth of actual research and facts, or both. (A glimpse at the footnotes reveals that Wanjek is guilty of quoting his own medical stories, which almost entirely discredits him in my own mind.)

I can't entirely pan the book, as it wasn't a terrible read--I did finish it, after all. But, at the same time, it has serious flaws and is much, much too weak to stand on its own as any kind of an authoritative tome on the subject of quack medicine--especially considering that all of 42 pages is spent on this particular element of the book. Middle school students looking for an interesting book to do a book report on would do well to grab this text, but for those who hold more than a passing interest in medicine, this book is very nearly an insult to the intelligence.

http://www.86st.net/archive/2004/08/ (http://www.86st.net/archive/2004/08/)
Title: Lincoln's Melancholy
Post by: Anonymous on September 22, 2005, 03:34:00 PM
Excellent information, thank you!

Do you have any recommendations along
the lines of debunking these feel good
types of wishful thinking therapies that
don't exist:

"Humane and safe non-drug alternatives that
have been shown to be effective, safer
and more sustainable."
Title: Lincoln's Melancholy
Post by: Anonymous on September 22, 2005, 03:43:00 PM
Also, if you could provide a source
to debunk this type of statement:

"Potentially fatal metabolic problems... Weight gain... Diabetes... Structural damage to the higher level parts of the brain... Drug dependence... Involuntary muscle movements...not to mention the Bizarrely high costs of these drugs.

Sounds like a toss up to me.... And a real bitch if you ended up in a permanent hospital stay AND forced to take the drugs."

Obvioulsy, she refused to read Dr. Freedman's editorial.

The weight gain, diabeties and movement disorders
are well know and are being worked on.

Why still give the meds?

For the huge amount of people benefiting from the
medications these side effects are in small numbers.

Medications did get the MI out of hospitals.

There is very little involuntary treatment in this
country, and even a smaller number on "forced" medication rituals. Heck, even patients in jail can refuse meds.

So what is the problem here?

Folks like Deborah refuse to read, and/or acknowledge the fact and just put a damaging twist on these issues that can only serve to hurt people
and delay treatment.
Title: Lincoln's Melancholy
Post by: Anonymous on September 22, 2005, 04:40:00 PM
Drugs apparently aren't working for Paul.

He continues to possess multiple anon personalities.

http://www.fornits.com/wwf/viewtopic.ph ... 11&forum=9 (http://www.fornits.com/wwf/viewtopic.php?topic=10711&forum=9)
Title: Lincoln's Melancholy
Post by: Anonymous on September 22, 2005, 04:52:00 PM
Is it is so important to you to not stay
on topic and to shift the thread to
someone else who is not involved.

How about staying on topic, instead?
Title: Lincoln's Melancholy
Post by: Anonymous on September 22, 2005, 05:45:00 PM
Of course Anon wants to accuse another
Anon of being someone who was smashmouthed
by Deborah.

Once a dolt can't win a debate they revert
to dirty tactics.

In this case attacking the messenger, whether
or not, he is even the messenger.

It has worked here in the past, on many different threads and it works in politics.

It won't prove anything though, those that
need treatment for mental illness will hopefully
find it, without too much diversion from the naysayers.

The anti-psychiatry activists will continue their
ideologue regardless of the facts.

That is just the way it is ...
Title: Lincoln's Melancholy
Post by: Anonymous on September 22, 2005, 08:42:00 PM
Culled from the article:

Paulina, born in Orange, was diagnosed with bipolar disorder when she was 17. Her mother said she had been off medication for about two months when she drove to Mexico the night of Aug. 8.

Recently, Paulina told her mother she felt well enough to go off medication. She also said she was thinking of moving out and she and her boyfriend were talking marriage.

The young woman could become verbally abusive when off her medication. But Saucedo said her daughter never had shown violence toward herself or others.

Ensenada police said Paulina, fluent in Spanish, resisted arrest and showed "an aggressive attitude." They said the young woman, wearing a pink skirt and black top, appeared to be on drugs when they found her in the car on Avenida Ruiz between Fourth and Sixth streets.

...

For weeks, Saucedo had been urging Paulina to resume her medication because she was becoming increasingly disturbed.

A week before she drove to Ensenada, Saucedo took Paulina to an emergency room because she was showing signs of paranoia. She kept telling her mother about the need to keep doors locked and said someone was after her.

But Paulina refused medication at the ER, and later refused to see her doctor.

--------------------------------------------------

http://www.ocregister.com/ocr/2005/08/2 ... 651764.php (http://www.ocregister.com/ocr/2005/08/27/sections/news/news/article_651764.php)

Saturday, August 27, 2005

Prosecutors in Ensenada investigate death in jail
Authorities skeptical of police reports that woman from Irvine committed suicide.

By GREG HARDESTY, GWENDOLYN DRISCOLL, MONICA RHOR and SALVADOR HERNANDEZ
The Orange County Register

IRVINE ? Alone in Ensenada late at night, without her car or purse or shoes, 20-year-old Paulina Baeza found an unlocked Chevy Blazer at a downtown car lot, climbed inside and fell asleep.

A few hours later, after police had arrested her for trespassing and locked her in a cell, Baeza was dead.

Contradicting initial reports from Ensenada police that Baeza - who suffered from bipolar disorder - committed suicide in her cell Aug. 9 by banging her head against the bars of the door, Mexican authorities said Friday that the Irvine woman may have died from improper use of force by police.

The Ensenada district attorney said suicide has been ruled out. Three Ensenada police officers face possible charges of negligent homicide and abuse of authority. Authorities said the investigation is continuing.

The abuse charge carries a maximum penalty of five to eight years; the homicide charge three to five years.

Baeza, a theater-loving student at Irvine Valley College and graduate of University High School, was in the main jail in Ensenada for 20 minutes when police reported her dead at 11:15 p.m., said Lorena Balco, spokeswoman for the U.S. Consulate in Tijuana.

A jail surveillance camera showed Baeza's head slamming on the ground and her body being dragged after officers apparently dropped her while carrying her down a hallway to her cell.

"We're keeping track of the case and following up with the Mexican authorities and waiting for a final statement that will be released early next week," Balco said.

Nine police officers - eight men, one woman - have been detained for questioning. Six are considered witnesses.

NO VENGEANCE

Baeza's parents are struggling to digest the details of their only child's death.

"After this, what could I possibly go through that could hurt me more?" said Baeza's mother, Carmen Saucedo. At the family's home in Turtle Rock, her daughter lived in a meticulously kept loft bedroom - her clothes and shoes organized by color.

Saucedo, 60, and her husband, Pablo Baeza, 57, buried Paulina on Aug. 14, two days after her body arrived from Mexico.

They said they want justice, not vengeance.

"I'm not into revenge or hurting people," Saucedo said. "That wouldn't do me any good. ... There are some things that can't be changed.''

Paulina, born in Orange, was diagnosed with bipolar disorder when she was 17. Her mother said she had been off medication for about two months when she drove to Mexico the night of Aug. 8.

Recently, Paulina told her mother she felt well enough to go off medication. She also said she was thinking of moving out and she and her boyfriend were talking marriage.

The young woman could become verbally abusive when off her medication. But Saucedo said her daughter never had shown violence toward herself or others.

Ensenada police said Paulina, fluent in Spanish, resisted arrest and showed "an aggressive attitude." They said the young woman, wearing a pink skirt and black top, appeared to be on drugs when they found her in the car on Avenida Ruiz between Fourth and Sixth streets.

But there is no evidence of a struggle on the video taken when Paulina was at the police station, according to the district attorney.

QUESTIONS

What happened while she was in custody is not entirely clear, but at a news conference in Ensenada on Thursday, prosecutors showed reporters a computerized simulation of how, they say, officers carried Paulina by the feet and hands down a jailhouse hallway.

One officer held her by her handcuffed arms and two grasped her shackled feet.

Face down, Paulina twisted her head and body in an apparent attempt to look up. She then either slipped out of the officers' grips or was dropped.

The cause of death was "craniofacial trauma with fracture to the base of the skull," according to the District Attorney's Office.

A coroner's report prepared in Mexico and reviewed by Baeza's parents detailed other injuries indicating Paulina may have been beaten.

The report said there were hairline fractures on both of her forearms, bruises on her legs and arms, a broken front tooth, and several bruises and contusions on her face.

Paulina was the third person to die in the custody of Ensenada police in less than a year. A district attorney spokeswoman said two of those deaths were suicides.

Paulina, who grew up in Irvine but lived on and off with her grandmother in Durango, Mexico, between the ages of 5 and 8, had made three trips to Mexico by herself before her final one. Her parents said she usually visited friends in Rosarito.

GOODBYES

For weeks, Saucedo had been urging Paulina to resume her medication because she was becoming increasingly disturbed.

A week before she drove to Ensenada, Saucedo took Paulina to an emergency room because she was showing signs of paranoia. She kept telling her mother about the need to keep doors locked and said someone was after her.

But Paulina refused medication at the ER, and later refused to see her doctor.

Monday, Aug. 8, was the last time her parents saw her.

That evening, Saucedo, director of sales at a cosmetics company, recalled her daughter asking for the title of her gray 2001 Chevy Blazer. Puzzled but preoccupied with a business appointment at her house, Saucedo handed her the pink slip. She asked her mother for $20 before she left.

"OK, I'll see you later," Paulina said.

"God bless you, m'ija(my daughter)," her mother said.

Paulina drove away, never saying she was going to Mexico.

Her father called her on her cell phone around 8 p.m.

"I'm about to cross the border, Daddy," Paulina told him.

She then hung up because of a poor connection. That was the last time he spoke to her.

Around 6 a.m. the next morning, when Paulina was in Ensenada, the battery in her car died. She was ticketed for partially blocking a driveway, and her car was impounded.

Sometime around 1 p.m., witnesses told her parents that Paulina went to an Internet cafe and tried but failed to reach friends through e-mail. She left without taking her briefcase. Around 11 p.m., roughly the time police reported finding her dead in her jail cell, an Ensenada resident called Paulina's parents, saying he had found her purse on the street at about 7 or 8 p.m. Inside her purse was her driver's license, the parking ticket and about $60 in cash.

Alarmed, Saucedo and her husband drove to Ensenada, arriving at the police station at around 2 a.m.

Police told them their daughter was dead.

"I felt like I was suffocating," Saucedo said. "I went outside and just started running down the street."

Police wouldn't let them see her body.

Their daughter's body arrived Aug. 12. At the mortuary, two days before her funeral, Pablo Baeza gently lifted up Paulina's head.

"It felt loose, like her neck had been broken," he said.

Paulina's mother bathed her and applied makeup to her face. She dressed her in her favorite outfit: a pink skirt and a pink top.

In her room, Paulina kept a string of white lights around a vanity mirror - a tribute to her love of Broadway.

A ballet and flamenco dancer, Paulina acted in college productions, including lead roles in "Fiddler on the Roof" and "Joseph and the Amazing Technicolor Dreamcoat."

The 5-foot-4, 120-pound brunette with blond highlights idolized Lucille Ball.

"She loved being in the limelight - the center of attention," Saucedo said.

A large poster of life-affirming messages hung above Paulina's bed.

Said one: "Every day I count my lucky stars.''

Register news researcher Colleen Robledo contributed to this story. Hernandez reported from Ensenada; Hardesty, Driscoll and Rhor from Santa Ana.

CONTACT US: (714) 796-2286 or ghardesty@ocregister.com