Mental Illness

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There are rich stories of human suffering all around us couched in terms of financial crisis – stories we encounter in our news media, in the streets and even in our own families.

Nevertheless things are getting worse all the time and I have been in the middle of the battle on the same losing side as the mental health patients.

I have been in the middle of mass human suffering which nobody seems to have the power to alleviate.  For many years, as the situation worsens, I have done what I could.  I have been on every front of the battle known to me and accessible to me – in community mental health centers, the VA, state prisons and private, for-profit, insurance-driven treatment centers. Read more on The Cost Of Not Caring…

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It gets pretty evident pretty fast, to any psychiatrist who deals with the general public, that depression is daily bread.  I mean, with current estimates at 19 million patients per year coming down with a depression — even with less than one half of them seeking treatment — it is a pretty sure bet that depressed people are common.

This in no way diminishes the anguish I have seen in patients having that disease. The anguish is real and dramatic.

I remember one of my earlier newspaper columns written for the Wichita Eagle-Beacon — the largest daily newspaper in Kansas — asking this simple question:

Why — when someone broke their leg — a salt-of-the-earth next-door neighbor would never fail to bake a pie.  But when someone had a depression, nobody would bake anything.

The depressed person was basically treated like someone with a contagious disease. Read more on Why Some Get Depressed And Some Do Not…

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The medicating of Americans for mental illness has continued to grow over the last decade.  And while that’s not exactly a news flash, I have seen no approach as fresh as the one taken by the folks at CrazyMeds”.

They are not doctors.  They are presumably patients or potential patients, then, just as some doctors are or should be.  Their approach is so fresh that I am amazed to notice the grain of truth in it.  This is the same way I felt when I visited the Psychiatry Kills” Museum in Los Angeles, operated by the Scientology folks.  They had a distorted view, but I saw where they were coming from. Read more on Psychotropic Drugs, According to their Users…

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Army veteran Galmiche, who served his country for 20 years, was diagnosed with post-traumatic stress disorder in 2002. He says he worked with a counselor and took medication for years, but did not find relief from his symptoms until he was matched with a PTSD service dog.

The first time I met a patient with a service dog was when I was doing social security examinations, as a psychiatrist.  The woman was about 60 years old, motherly and white-haired, and she told me that she was nervous about the interview and was being treated for an anxiety disorder.  She did not think she could “make it” unless I saw her with her “service dog.”  Many years before, when my allergy to dog-hair was in flower, I would have declined.  I had since treated it effectively with alternative methods, so I told her we could try it. It was a tiny dog, the kind my husband would call a “barfy” dog.  The dog had the cutest little blue coat with very official looking embroidery — including the wheelchair picture that is usually used to mark places that are reserved for such vehicles.  The little dog wouldn’t stop staring at me. I did a customary and very basic psychiatric interview.  I started with questions that involved little or no stress, like name and diagnosis.  Eventually, I ramped up to questions about the topics that generated anxiety, such as past traumas.  The pooch stood on its hind legs while she rubbed it vigorously, staring at me.  I stared back. Read more on Service Dogs for PTSD Veterans…

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The psychological ability to adjust to chronic medical illness is an area where there has been very little study.  Lately, I find myself working mostly with this population of people.  I’m noticing that some adjust very well and some do it very poorly.  It depends on a lot of factors.

The situation is clearest when the illness we’re talking about is back or neck pain.  Back pain, more than neck pain, has been clearly correlated to the presence of major depression.  If a person walks into the office crying and says they’re having trouble controlling what’s going on, it’s a pretty sure bet we’re dealing with depression.

Most back pain patients aren’t prepared for the kinds of life adjustments they are required to make.  Generally, many will need to switch from a job that has involved lifting or other physical work to a job that is more sedentary.  Quite honestly, most back pain patients are in no way prepared to do this.  Mostly, this is because anything that is sedentary is going to require a higher level of education.  Most of the folks I’m seeing are not highly educated, so the back pain leads to incapacity. Read more on Adjusting to Medical Illness…

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I can’t say exactly what is going on in the case of the Colorado movie theater shooter — I just do not have all the knowledge and all the facts. I am happy this young man was able to find the psychiatric services at  his local institute of higher education.  Many students cannot.  Sometimes I even  have to alert my patients who are eligible for such services that such services exist. Psychiatrist Lynne Fenton’s past as an acupuncturist is colorful, at least.  I have been to so many places and done so many things, that I do not  think anyone should be condemned by their past.

In the past, Dr. Fenton has been disciplined by her medical board for prescribing rather strong drugs to herself and family.  I suppose people are sometimes overcome in circumstances such as the death of a relative like Mom.  She is back practicing with not more than a slap on the wrist and a mark on her  record.  Appropriate for this level of wrongdoing I think, if there are really no other circumstances.  As for the accused shooter’s notebook with the stick figures and the shooters, I have seen many such notebooks — but never from a patient.  I saw them in 2nd, 3rd or more rarely in 4th grade on the desks of male classmates who fantasized about such things. The operative word here is “fantasize.” Read more on Colorado Shooter’s Drawings May Have Been A Warning…

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The intersection of law and medicine can be a real sticky wicket.

Most people have heard of someone being “not guilty by reason of insanity” and most people know that some defendants might be found incompetent to stand trial.

But the processes are sometimes vague and often confusing – especially to the lay audience. Read more on Mentally Retarded But Comptetent To Stand Trial…

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