Depression Hurts, Cymbalta Can Help

Sounds great, right? Until you read the side effects including nassau and fatigue and many more equally crappy feelings. "Severe liver problems, sometimes fatal, have been reported. If you experience dizziness or fainting upon standing due to a sudden drop in blood pressure. This may happen especially

when first starting Cymbalta, when increasing the dose, or when used in combination with certain other drugs." and wait, that's not the least of your trouble. Scroll down to the last page where it reads: "WARNING-- In clinical studies, antidepressants increased the risk of suicidal thinking...."

And this is JUST for cymbalta, and quoted directly from the cymbalta website (with lots of happy smiling people playing with children placed through out their add-- oh wait, yes, I said add, because they are SELLING you a product. This isn't a doctor in a white coat here recommending you check it out, this is a drug company's attempt at selling you happiness in a pill)

Now, what do the drug manufacturers forget to mention in their adds? Withdrawal. What about withdrawal from this medication? For many reasons, you don't just stop taking antidepressants cold turkey. It can be dangerous (and depending on the medication, life threatening), and at the very least, can make you feel terrible for not just days and weeks, but sometimes MONTHS after discontinuing the medication. Extreme fatigue, nausea, headaches, dizzy spells, change in appetite, insomnia, brain zaps, loss of concentration, irritability, oh the list goes on.

So here we are, happy (or not so happy in this case) American consumers looking for the next best thing since sliced bread to make us Fell Better and Be Happy and to Feel Good Again. And we sign up for this? Pretty much all the symptoms of depression are side effects of this medication. So why do I want to take this medication if it's going to make me feel like the suicidal piece of shit worthless use of space that I already feel like? I thought this was supposed to make me feel better.

But recent studies have shown that the amount in prescriptions in psychiatric medication has doubled in a decade, yet the amount of people being treated with psychotherapy along with medication is decreasing dramatically, and about 80% of patients getting treatment through medication were not even being treated by a psychiatrist. Why? Direct drug to consumer advertising rose from 33 million to 122 million, leading more patients to talk to their general practitioners about medications which they've seen advertised. Which here in lies the next obstacle. Often, insurance companies won't allow permission for GP's to refer patients to psychiatrists, so patients are left no choice but to see their GP to manage their psychiatric medication. And psychotherapy? Insurance is a pain about covering that, too. Mental health is on the back burner even though it causes more disability than any other medical condition. And no, that wasn't a typo, I did say "medical condition", NOT mental illness.

So the quest to happiness begins again.

Parents Give 9 Year Old Pot

I Give my Autistic Son Pot--

Don't know what to think about this, yet. Interesting article though. Can't wait to discuss it in my group tomorrow, I'll edit and add what we discussed.

Dancing in the Light of the Moon

So, as I've stated previously, while this blog is to chronicle my journey of writing a term paper about psychotropic medication in American popular culture, I have a strong tie to Eating Disorders, so I will occasionally post about new literature, DSM V updates, and art/photographs that I have done pertaining to Eating Disorders.

I remember talking to my psychiatrist about mental illness, and she asked me what I thought defined it. In short, I supposed that it's characterized by maladaptive behaviors. We were discussing how when we hear "mental illness" our first instinct is not to think "eating disorders", though anorexia nervosa is by far the number one killer in mental illness.

So perhaps eating disorders pertain more to this project than I originally thought. I will make a note of how to incorporate that into my paper.

A new art piece (my first ever oil painting): "Real Women (Dance)", inspired by those lovely nights of dancing under the moon in Tucson, Arizona where I did my residential treatment.

Diagnoses' Crossing the Line Between Normal and Abnormal... Wait, What's Normal?

Reading through "Better than Well: American Medicine meets the American Dream", and "Brave New World" in the library at school today, intermittently oohhing and ahhing when I found a quote that I was interested in (to which the man sitting across from me occasionally gazed upwards from his studies and looked over my way as I sunk deep within my books, hardly aware at all that he may be thinking I am a disturbance to him), I got to thinking about psychotropic medications (good thing! it is what I'm studying...) but more so than just that it's an anti-depressant, but that perhaps psychiatrists are treating what may be "normal". I don't have my quotes in front of me right now, but I will add to this blog later what I discovered in "Better than Well". Fascinating.

The example they used was shyness. What crosses the line between someone who is normally shy and someone who suffers from social anxiety? I don't know, honestly, as I'm not a psychiatrist nor am I anywhere near the point in my psychology studies to diagnose someone, but it did get the wheels turning.

So, I sat down tonight with this thought, about shyness and how much we are treating for normal behavior, and thought about all the famous people (artists, musicians, leaders) that suffered from a mental illness. What would they be like today if they were treated for their disorder(s)? I don't think we can ever actually answer that, but nonetheless, it's an interesting topic.

It is one more thing to add to my study of popular culture and American psychiatry.

Mother's Little Helper: Introduction of Valium in the 1960's Revolutionized the Use of Anti-Anxiety Medication

Valium (diazepam) was introduced by Hoffmann-La Rouche in 1963. It is one of the most commonly prescribed anti-anxiety medications of all time, and as the Rolling Stones coined in their song "Mother's Little Helper" released in 1966, it's commonly known for the use among middle aged housewives in the mid 1960's.

Mother's Little Helper

Rolling Stones 1966

What a drag it is getting old

"Kids are different today"

I hear ev'ry mother say

Mother needs something today to calm her down

And though she's not really ill

There's a little yellow pill

She goes running for the shelter of a mother's little helper

And it helps her on her way, gets her through her busy day

"Things are different today"

I hear ev'ry mother say

Cooking fresh food for a husband's just a drag

So she buys an instant cake and she burns her frozen steak

And goes running for the shelter of a mother's little helper

And two help her on her way, get her through her busy day

Doctor please, some more of these

Outside the door, she took four more

What a drag it is getting old

"Men just aren't the same today"

I hear ev'ry mother say

They just don't appreciate that you get tired

They're so hard to satisfy, You can tranquilize your mind

So go running for the shelter of a mother's little helper

And four help you through the night, help to minimize your plight

Doctor please, some more of these

Outside the door, she took four more

What a drag it is getting old

"Life's just much too hard today,"

I hear ev'ry mother say

The pursuit of happiness just seems a bore

And if you take more of those, you will get an overdose

No more running for the shelter of a mother's little helper

They just helped you on your way, through your busy dying day

"Drugs and Drug Culture"-- IntDis 2 Term Project

This blog, in large, is a place to dissect the topic of "drugs and drug culture"-- a group term project in which me and five other individuals in Dr. Rudinow's Interdisciplinary Studies class on Popular Culture in the United States make a collaborative effort to present the impact that drugs/medication have on American popular culture.

Now, my topic, geared towards psychology and psychiatric care, is in a world of its own compared to the four people who's term paper is on marijuana/legalization and one persons study of the history of illicit drugs in America. However, we are all in one group, therefore I found it necessary to try and incorporate our subjects into the same presentation (as is the assignment). I took the role as group leader in order to do so. Not that it would have been impossible for any of the others to structure this presentation, but perhaps, it might have been, and my topic would have been left by the way side because it is so different from the majority of my groups subjects.

Some interesting group statistics that I observed: out of a group of six people (myself included)

1. three of us have been on psychotropic medication to treat mental illness
2. two of us have been placed on a 51-50
3. two of us have been to treatment/rehab
4. two are heavy users of marijuana
5. one person is on medicinal marijuana
6. one person struggled with marijuana addiction
7. one person is a user of marijuana (with out specific conclusion on extent of use)
8. one person is an unknown

Now, I realize that the group statistics are not an accurate representation of medication/drug use in the United States, as this is the group who signed up for drug and drug culture. But I thought it was an interesting foot note.

Back to topic:

The start of the presentation (for which we are all responsible for 20 minutes of speaking/presenting leading to a total of about an hour and a half to an hour and forty five minutes of presenting) I will make a small introduction (to which we all add our own two cents) on how we determine what "normal" is. This is the platform for our topic.

I will then introduce my subject-- Psychotropic Medication in American Culture (which includes: the over-priscription of anti-depressants, anti-anxiety medications, over-daignosing of patients, etc.) To conclude this discussion, I'll look at statistics of how many are actually un-treated and make connections to stigmas, and even lack of proper insurance can lead people who suffer from mental illness (depression, etc) that seek self-medicating: illicit drugs in America.

My peer will take in from there and introduce her topic-- Culture/History of Recreational Drugs in American Culture. I'm excited for this: with clips from TV shows like "Addicted", "Intervention" and "Celebrity Rehab", we'll get to see inside the world that popularizes treatment, and to see the extent to which people are self medicating in America.

From there, another peer will look at the history of hemp/marijuana, from ancient to present, when it was brought to America and how it relates to present culture. In this section, a power-point presentation will take place.

It follows with the topic of current laws on marijuana-- talking about the upcoming ballot, discovering economic value of legalization, and a small peek into the prohibition of alcohol. He will bring in the upcoming ballot for people to view.

Then, we will look at the physiological effects of marijuana. Harmful effects. This person has yet to decide how they will present (but that's another story), so we will move on.

Finally, medicinal marijuana will be introduced-- why it's used, conditions in which someone can use it, myths about it, and some data. This will be represented by graphs.

whew! Looks good to me. I must admit, I was so frustrated that I be placed in "a group of stoners" but that is my stereotyping and judgment. In fact, the only person I'm struggling with is the "unknown". She happens to be the person who wanted Robert Crumb's brother on Lithium. Maybe I have preconceived notions about her, too.

A Look at Eating Disorders: An Introduction to the Disease Before Analyzing New DSM V Criteria

I have a feeling it will take me a while to gather all the information I need to write this journal entry, but I'd like to look at the revisions proposed for the DSM V. Think of this post as a work in progress.

First, perhaps, we should take a peek into the DSM IV criteria for some "popular" mental disorders. I say "popular" because I don't want to dig into rare personality or psychiatric disorders that are not recognizable by the lay man. While I may have interest in them, I currently have no time to dive into the wide array of mental illnesses listed within the DSM IV, let alone look at the revisions in the DSM V.

With that being said, my most personal connection and interest lies within the world of eating disorders. There has been much criticism that the DSM IV only represents a small percentage of people who suffer from disordered eating. In fact, there are only two diagnosable disorders: Anorexia nervosa and bulimia nervosa. This makes seeking treatment for individuals who suffer from disordered eating but do not fit the rigid criteria for either disorder nearly impossible, as insurance companies want a diagnosis in order to treat the patient, and with out that diagnosis, they see no point in paying for services that could save millions of lives.

ok, ready for this? be prepared to read a long lengthy, and perhaps at times opinionated piece--

Eating disorders are estimated to affect up to ten million women and one million men in the United States alone. Multi-faceted diseases, eating disorders are present in men and women of all shapes and sizes. Symptoms vary from heavy restriction of calories, bingeing on large quantities of food, to purging calories through excessive exercise, self induced vomiting, misuse of laxatives and diuretics and fasting are all forms in which an eating disorder can take. In a society that emphasizes an unrealistic portrait of what people’s bodies “should” look like, all too often we see people struggling with their size and body shape; women and men of all sizes suffer from a broad spectrum of disordered eating. Although society has come a long way in recognizing eating disorders, the prevailing belief is that eating disorders fall into one of two categories, anorexia nervosa or bulimia nervosa, leaving many who suffer from life consuming thoughts and behaviors of disordered eating to remain undiagnosed and therefore untreated. Eating disorders are progressive diseases; frequently, people who suffer from one form of disordered eating engage many behaviors.

It is not unusual for people who suffer from eating disorders to switch from one maladaptive behavior to another. Commonly, those who suffer from eating disorders have other mental health illnesses, such as major depression, bi-polar disorder, obsessive compulsive disorder and anxiety disorders. “We (2) found that 71% of 271 current subjects with eating disorders had lifetime comorbidity with at least one anxiety disorder (64% for Dr. Kaye et al.)” (Godart, Berthoz,Perdereau, Jeammet 1) Along with other mental disorders, it is also known that people who suffer from disordered eating can suffer from other addictive behaviors such as drug or alcohol use. “Many studies have documented the high rate of cooccurrence of eating and substance-related disorders in clinical (1-6) and community (7,8) patients” (Varner 224)

Eating disorders as a diagnosable psychiatric disorder are relatively new, first appearing in the DSM in the 1980‘s. “The recognition of the diagnosis was due in large part to a dramatic increase in cases in the 1970s and '80s. Experts often attribute the increase to the intense focus in the popular media on thinness as an ideal for young women and to a greater recognition of the condition by health care professionals.” (Encyclopædia Britannica online) The initial recognition of eating disorders in the DSM was limited to two diagnosable illnesses, anorexia nervosa and bulimia nervosa. Though currently many who suffer from disordered eating are unable to obtain a diagnosis, as their patterns of disordered eating and thought do not fit within the DSM IV’s narrow criteria for either anorexia or bulimia nervosa, newly acknowledged disordered eating patterns are on their way to recognition.

Other disruptions in eating patterns include orthorexia, which is “Similar to anorexia nervosa, the well-known eating disorder in which someone stops eating or eats very little to become thinner, orthorexia significantly restricts what a person eats in order to be supposedly healthy and to feel 'pure."” (Choquette 16), night eating syndrome, where “The core criterion is an abnormally increased food intake in the evening and nighttime, manifested by (1) consumption of at least 25% of intake after the evening meal, and/or (2) nocturnal awakenings with ingestions at least twice per week.”, and compulsive overeating and binge eating disorder, where individuals are drawn to continue eating, trying to feed an insatiable hunger, leading to bingeing much like someone who suffers from bulimia nervosa does. While these eating disorders vary greatly in symptoms, often the underlying causes of the disorder are very similar.

Eating Disorder Not Otherwise Specified is a category that encompasses individuals who do not meet or fit in the diagnostic criteria for anorexia nervosa or bulimia nervosa. “At least half of all people diagnosed with an eating disorder do not meet the full criteria for either of the two main categories described above. The diagnosis of eating disorder, not otherwise specified, or EDNOS, is given to those with clinically significant eating disturbances that meet some, but not all, of the diagnostic criteria for either anorexia nervosa or bulimia nervosa.” (Encyclopedia Britannica Online) For example, an individual can severely restrict their calories and may be underweight, but continues to have their period, therefore would not fit in the diagnostic criteria for Anorexia Nervosa. “Many clinicians report that some girls and women with symptoms of anorexia do not lose their periods, yet the current DSM requires amenorrhea as a condition of diagnosis, he explains. This criterion is also irrelevant to men and difficult to apply to women on birth control pills, Walsh notes.” (DeAngelles 44) Some individuals suffer from binge eating disorder or compulsive overeating. In these disorders individuals experience bingeing much like a someone who suffers from bulimia nervosa, but do not do anything to compensate for the calories consumed. There are plans, however, to address the holes in the diagnostic criteria for eating disorders in the DSM V. “Psychologists are playing a major role in work to revise the eating-disorders criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, due out in 2012.” (DeAngelles 44)) With hopes to include disorders such as binge eating disorder, psychologists are searching to find the best ways to redefine the symptoms and criteria for diagnosis. There are such an array of symptoms that individuals can suffer from that do not meet or fit into the diagnostic criteria for either Anorexia Nervosa or Bulimia Nervosa, and therefore the category EDNOS developed.

Bulimia Nervosa is characterized by episodes of bingeing, which is defined as eating a much larger portion of food in a short amount of time than a normal individual would, followed by purging, which can take many forms, such as self induced vomiting, misuse of laxatives and diuretics, fasting, and excessive exercise. While it is known that individuals suffering from Anorexia Nervosa are unable to maintain a healthy weight, Bulimics are often in the healthy weight range to overweight. Within bulimia nervosa, there are two sub-categories: bulimia purge type and bulimia non-purge type. Though both of these forms include a way of compensating for the calories consumed, non-purge type bulimics use excessive exercise and/or fasting opposed to purge type bulimics who induce vomiting, and/or misuse laxatives and diuretics. The DSM IV’s diagnostic criteria for Bulimia Nervosa states than an individual must binge and purge at a minimum of two times per week for three consecutive months. (Encyclopedia Britannica Online)

Anorexia nervosa is an eating disorder in which an individual severely restricts their calorie intake, leading to dramatic weight loss. As noted in the DSM IV, anorexics fail to maintain at least 85% of their body weight. In post-monarchal women, the lack of body fat due to self starvation causes cessation of menstruation. It is also noted that anorexics suffer from severe distorted body image; unable to see how thin they are, they believe themselves to be too heavy or “fat”, and have an intense fear of gaining weight. Much like bulimia nervosa, there are two sub-categories of anorexia nervosa: binge/purge type and restrictive type. “The binge-eating/purging type is characterized by regular engagement in binge eating (eating of a significantly large amount of food during a given period of time) or purging (self-induced vomiting or misuse of laxatives, diuretics, or enemas) during the current episode of anorexia nervosa. The restricting type is characterized as unhealthy weight loss due to food restriction.” (Encyclopedia Britannica Online)

Having experienced a variety of disordered eating behaviors, I’ve experienced first hand the many forms which an eating disorder can take. As my behaviors changed, my body morphed; going from emaciated to normal weight, the fluctuations of emotion and frequency of my behaviors did not subside the thinner, or heavier for that matter, I became. These feelings support my belief that eating disorders are not about weight, and are, in fact, buried deep with in an individual’s emotions.

My experience with eating disorders was similar to the research in that it was not the only mental disorder I faced. Depression is found on both sides of my family and has affected me greatly. In addition to my eating disorder, I faced a long battle with self-injury and addictive tendencies towards drugs and alcohol. “Krahn suggested (2) that eating disorders and substance-related disorders may represent different expressions of the same underlying problem, that is, a predisposition to addictive behavior patterns.”

With the pending publication of the DSM V, estimated to be published in 2012 with anticipated inclusions of diagnosable criteria for eating disorders will hopefully enable these suffering from an eating disorder to seek the treatment they need. Though hopeful for the new DSM’s standards for diagnosis's, much more than editing the diagnostic criteria for eating disorders will have to change before people can receive the treatment they need. Insurance companies rarely, if ever, have adequate coverage for even those who fit into the diagnosable criteria for anorexia nervosa or bulimia nervosa. Often, treatment companies deny patients the care they need to make a full recovery. Being one of the lucky individuals able to attend all forms of treatment, from hospitalizations, residential treatment centers, partial hospitalization programs, intensive out patient programs to out patient programs, it was not because my insurance recognized the severity of my illness, but that I had a treatment team and parents willing to do whatever it took for me to get the treatment I needed, resulting in over 80% of treatment being paid for out of pocket.

What can be noted is this-- the advances in diagnosis and treatment of eating disorders since their debut in the DSM in 1980 are monumental. We have discovered that eating disorders are often coupled with other psychological disorders as well as addictions. That the prevalence in eating disorders is on the rise, with eleven million suffering in the United States alone. We also know that weight is completely irrelevant to the degree in which someone is suffering, and that there are many more than just two eating disorders that people suffer from. From anorexia nervosa, to binge eating disorder, and everything in between, eating disorders are life threatening illnesses that are incredibly prevalent in today’s society.

Depression and the Media: pharmacology is put to the test in their advertisements

In a nation plagued with psychological disorders, many of which pertain to popular culture in the United States, be it from stigmas or cultural ideals, patients undergo an array of psychological treatment including the fad over medicating which seems to be present in today’s society. With such complex disorders and the evolution of pharmaceutical technology, psychiatrists and doctors alike have conformed to the notion that more is better, especially in the field of diagnosing and medicating patients. With this new technology comes marked advances in treatment options for psychiatric patients, much of which helps individuals suffering from these disorders make astounding recoveries. However, with the power that drug companies hold over the industry, doctor’s are being force fed information and regurgitating it out to their patients. The advances in pharmaceutical technology are incredible, however the overmedicating phenomena has inhibited these advances by over diagnosing and medicating patients.

I would like to note, however, that these marked advances in pharmaceutical technology have helped millions of people who suffer from the wide range of psychological disorders found through out the United States. Though what seems to be developing in this country is a habit of over medicating and diagnosing, I do not want to clump all doctors and psychiatrists who treat psychiatric patients into one category. I think it’s important, and relevant, to address that with these new found technologies and advances in medication, many in the medical field have used this knowledge to help their patients recover and integrate their treatment into their lives.

As a patient who has had a wide variety of treatment, from holistic remedies to “medication cocktails”, I have found that the view of medical caregivers can range from simplistic treatment methods to prescribing a different medication for every symptom a patient has. And I must admit, though as a patient the prescribing of medication does feel as if the doctor is addressing issues and treating symptoms, the sheer amount of medication and diagnosis's that I have gone through over a single year frightens me. I much prefer the holistic approach to treating psychological disorders, where medication is used but coupled with modalities that heal the body and mind, such as acupuncture, polarity, spirituality, and animal assisted therapy.

With the prominence of commercials and advertisement regarding psychotropic medications, it isn’t hard to see that perhaps drug companies have created a commodity targeting vulnerable and egger American’s who wish to fix or better themselves through the use of drugs, most commonly, to treat depression and anxiety. Appealing to society by listing common symptoms of these psychological disorders, American’s often relate to many of the noted symptoms which are listed in the commercial, symptoms such as insomnia, reduced energy, and anxiety (as well as anxiety pertaining to certain situations). What hasn’t been acknowledged is that many of these symptoms are found in completely healthy individuals who do not suffer from a mental illness. Treating natural human reactions through medication has been normalized. Doctors and psychiatrists are bombarded by patients who have viewed these advertisements and self-diagnosed themselves with a psychological disorder, and patients are being cornered by doctors and psychiatrists who pathologize their patients and think that medication is the cure all. In a sense, either way we look at it, bottom up or top down, the overmedicating of America has reached an all time high, leading many in today’s society to be taking a wide variety of medications that are, in a sense, unnecessary.

Although I may seem bitter about the sheer amount of medications that are administered to American’s, I am not anti-medication. It would be more accurate to say that I am anti-overmedicating. In fact, I think that medication can be a vital tool in an individuals recovery from mental illness. The transformation in psychotropic drugs is incredible, and their ability to treat a variety of different disorders remarkable.

Lithium?

The past year and a half I have battled recovery, and even so boldly to put it, from mental illness. Yes, that's right, mental illness.

In a recent class discussion in my Interdisciplinary Studies class on Popular Culture of the United States, a peer remarked after viewing a documentary on Robert Crumb (and perhaps, if you have seen this film you may think the same as her) that the main character's brother "NEEDS TO BE ON LITHIUM". While perhaps he was suffering from a mental illness, supported by his honest divulgence of being on psychotropic medication, and later the disclosure he committed suicide, her remark actually made me squirm in my seat. Lithium? I was shocked not only because I know what Lithium is and what it's used for, but the fact that she did her own personal diagnosis of this man who she had seen in a documentary and paired him up with, maybe the only, psychotropic medication she knew about (which, I have to point out, is not actually used to treat the diagnosis that she provided)

But this is our culture. You're sick? Oh here, take this. Side effects? That's ok, we have another pill for that. Still experiencing depression? Let's ad X,Y,Z to your "medication cocktail"

And here in lies the problem. In American culture we lust for bigger, better, faster ways to accomplish the "American Dream". And I want to make sure that it is understood I am not dismissing the use of anti-psychotic and psychotropic medications, because they are an invaluable tool in treating mental illnesses, helping millions of people every year. However, this American Right to do things the American Way and to be Always Happy and possibly be Better Than Everyone Else has me questioning the drive of Americans and their psychiatrists and primary doctors. This isn't as simple as bottom up or top down culture, this is a combination from both ends of the spectrum amounting into an undeniable explosion of the over-medication of American psychiatric patients.