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Commentary: Getting Off Psych Meds Was The ‘Hardest Thing’ She’d Ever Done

By Dr. Annie Brewster

By the time Laura Delano was 25, she was taking five psychiatric drugs: an anti-depressant, an anti-psychotic, two mood stabilizers and an anti-anxiety medication.

But after years entrenched in the mental health system, and defined by her psychiatric diagnoses, Laura finally got off the medications and, as she says, began “recovering from psychiatry.”

For background: Laura grew up in a wealthy Connecticut suburb in a family of high achievers. She was a nationally ranked squash player and student body president. But in her teen years, life got more complicated as she struggled with questions about her own identity.

Laura Delano weaned herself off psychiatric drugs and says she shed her identity as a “professional mental patient.” (Courtesy)

Laura Delano weaned herself off psychiatric drugs and says she shed her identity as a “professional mental patient.” (Courtesy)

She felt burdened by social and academic expectations, and started to act out. She cut herself as a way to “control” her out-of-control world, and was ultimately sent to a psychiatrist by her parents. At 14, she was diagnosed with bipolar disorder and prescribed powerful psychiatric drugs, including the mood stabilizer Depakote and Prozac.

The medication side effects led to additional problems and “symptoms,” which in turn led to more medications, Laura says, and she began to lose herself. She felt defined by the diagnoses she continued to collect: bipolar disorder, borderline personality disorder, substance abuse disorder and binge eating disorder.

Laura’s early 20s were marked by multiple psychiatric hospitalizations and ultimately a suicide attempt. Her only identity was a self-described “professional mental patient.”

But then things began to change.

Over five years ago, Laura weaned herself off psychiatric drugs and shed her diagnostic labels. For her, this has been a spiritual journey involving the cultivation of self-acceptance, self-love and honesty. “It is the hardest thing I have ever done,” says Laura, now 32. But she feels happier, more connected and more engaged in the world. Here’s a bit more from our interview:

“When you are told that your brain is broken — basically the seat of your soul, your mind, the part of you that shapes everything about who you are — when you’re taught to believe that that’s broken, and that you can’t trust yourself, you can’t trust your emotions, you can’t trust your mind, I mean it instills in you just a profound fear. Over all these years I developed this relationship of faith in the mental health system and no faith in myself, and tremendous fear of myself. And so unpacking that has been at the heart of this whole journey, realizing, ‘Wait a minute…If I’m not broken and if the struggles I’ve gone through aren’t symptoms of an illness, what are they? Maybe they are actually important and meaningful…maybe they are telling me something.’ I began to listen to my pain, and to listen to my darkness and it [has]  brought me back to this spiritual journey which I think was beginning way back when I was thirteen… Who am I? How do I fit into this world? What are the stories I have been taught to believe about how you’re meant to live your life, and what it means to be normal and worthy and acceptable…”

Personally, I’m moved by Laura’s story. As a practicing internist, I often rely on psychiatric diagnoses and medications. In my clinical practice, I have seen psychiatric medications reduce suffering and save lives. But it’s been useful to step back and reconsider my filter on these issues.

From day one of medical training, we are taught to fit our patients into neat diagnostic categories whenever possible. The goal of our patient interactions, we learn, is to sift through and distill all that we see and hear in order to home in on a diagnosis. This categorization can be helpful in directing our care, of course, but it can also be limiting, and even dangerous. Rarely does a diagnosis fit perfectly, yet all too often in our culture one’s diagnosis becomes indistinguishable from one’s identity.

Labels have power. With mental illness, diagnostic criteria are particularly difficult to define and identify. Truthfully, our current understanding of the brain and the biochemistry behind mental illness is limited. There are no clear markers to measure and quantify. Instead, we must rely on subjective interpretation of behavior.

And yet, psychiatric labels abound. It is estimated that one in four adults, or approximately 61.5 million individuals, and one in five teens between the ages of 13 and 18, meet criteria for a diagnosis of mental illness within a given year.  Continue reading

Ted Stanley, Who Donated Hundreds Of Millions For Mental Illness Research, Dies

Ted Stanley is seen in a YouTube video screenshot from the Broad Institute. Stanley has died at the age of 85.

Ted Stanley is seen in a YouTube video screenshot from the Broad Institute. Stanley has died at the age of 85.

Ted Stanley, a billionaire businessman and philanthropist who donated more than $825 million to support research on mental illness, has died at his home in Connecticut. He was 85.

Stanley’s 2014 donation of $650 million to the Broad Institute of MIT and Harvard was billed as “the largest ever donation toward psychiatric research.”

At the time, WBUR’s Curt Nickisch reported that Stanley’s donation to find and treat the genetic underpinnings of mental illness had a personal side: Stanley’s son, Jonathan, suffered from bipolar disorder.

Here’s a bit of Nickisch’s story:

CURT NICKISCH: Ted Stanley founded a company whose first product was a series of medals commemorating the biggest scientific achievement of its time – the moon landing in 1969. While his collectibles business grew, his son Jonathan Stanley grew up a normal Connecticut kid, until, at age 19, Jonathan came down with bipolar disorder with psychosis, which got worse over the next three years.

JONATHAN STANLEY: We’ll call it the epiphany from my dad’s standpoint at least. I went three days straight running through the streets of New York – no food, no water, no money, running from secret agents. And not surprisingly – after I stripped naked in a deli – ended up in a psychiatric facility.

NICKISCH: Jonathan was a college junior.

J. STANLEY: My dad came to visit and got to see his beloved son in a straitjacket.

NICKISCH: The Stanleys were lucky. Jonathan responded well to the drug lithium. He went on to graduate from college and then law school too. Meanwhile, his father had met other fathers whose sons did not respond to treatment – other families who had to keep living with uncontrolled mental illness. Ted Stanley says that gave him a focus for his philanthropy.

TED STANLEY: There was something out there that our son could take and it made the problem go away. And I’d like to see that happen for a lot of other people and that’s why I’m doing what I’m doing.

NICKISCH: The $650 million donation represents the bulk of his fortune. The Broad Institute is a partnership of Massachusetts Institute of Technology, Harvard University and Harvard’s five teaching hospitals. Its head, Eric Lander, wants to begin using Ted Stanley’s money to catalog all the genetic variations that contribute to severe psychiatric disorders. He says the Broad has already collected the DNA from 100,000 psychiatric patients.

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From 2014:

Dr. Mark Vonnegut: On Creativity, Being ‘Crazy’ And Getting Help

By Mark Vonnegut, M.D.
Guest Contributor

Being related to a famous person is somewhere between a cruel joke and a minor distraction. My father was immensely talented and worked very hard at his writing, but the degree of his success was a fantastically unlikely bit of luck. There are lots of talented, hard-working artists who don’t make it.

The important thing in overcoming mental illness, whether or not you have a famous last name, is to want things to be better — and being willing to get help to make that happen.

Dr. Mark Vonnegut (Courtesy)

Dr. Mark Vonnegut (Courtesy)

Both of my parents’ families advised them to stay away from one another, as mental illness was rumored to be in each other’s family. The rumors were true, but it wasn’t like anyone then or now comes with any guarantees. It makes us feel more alive to be able to see, listen to and read great art, partly because great art is often the result of great struggle. The idea that artists and “the mentally ill” have inner demons while the rest of us do not is part of what has made it — and continues to make it — so hard to come to terms with mental illness.

The reason the arts and craziness run in families is because crazy people who can sing and dance and paint pictures and write well do a much better job of convincing others to have babies with them than if they’re just plain crazy. Thus has it ever been.

In my career as a mental patient, I started with schizophrenia, worked my way up through manic depression, and have now settled at bipolar disorder. I can joke about it because I recovered sufficiently to get into and through medical school, internship and residency, and have had the enormous honor and privilege of being trusted by parents to help them and their children. I make no bones about it; I make mistakes just like everyone else, but am very proud of how well I do my job.

I’m also very aware of how easily I could have ended up otherwise — a suicide statistic or just another broken young man who never got well enough to have a life. Continue reading

A Musical On Mental Illness So Powerful You Can ‘Ask The Doc’ After

 

A scene from the SpeakEasy Stage Company production of Next to Normal, running March 9 – April 15 at the Boston Center for the Arts. (Saglio Photography Inc.)

Diana seems at first like merely a classic harried mother who happens to be staying up all night. She’s worrying as she waits for her teenaged son to come home; then fretting that her brilliant daughter is up at 4 with a can of Red Bull to finish her schoolwork; then having quickie sex with her husband. She sings about keeping the plates all spinning and holding the house together as she starts to make her family’s bag lunches for the dawning day.

It is only when Diana starts making sandwich after sandwich after sandwich, laying the bread out rapidfire not just on the table but unstoppably along the floor, that we in the audience realize this is not just a garden-variety harried mother. This is a woman in the midst of a full-blown manic episode rapidly spinning — like the plates — out of control.

So begins “Next To Normal,” a pop-rock musical about a family living with mental illness that has won three Tony awards and the Pulitzer for drama — and that premieres in Boston beginning this Friday, put on by the Speakeasy Stage Company. Already, ticket pre-sales are setting records for the Speakeasy — and here’s my theory on why, after watching a rehearsal this weekend:

A music box brings back some painful memories for a mother and son (Kerry A. Dowling and Michael Tacconi) in a scene from Next to Normal (Saglio Photography Inc.)

It’s not just a prize-winning show. It has doubly powerful drawing power beyond sheer quality. First, if you take the tens of millions of Americans who have a diagnosable mental illness and add in their relatives and friends, you get to pretty nearly the country’s entire population potentially interested in a well-done show on the topic.

And second, the portrayal of mental illness and its treatment in “Next to Normal” is so contemporary and in many ways so realistic — yes, even in musical form — that it inevitably creates buzz that spreads far and wide, rippling outward from activist circles.

Consider:

  • A song with overtones of The Sound of Music’s “My Favorites Things” that goes: “Zoloft and Paxil and Buspar and Xanax…Depakote, Klonapin, Ambien, Prozac…Ativan calms me when I see the bills — these are a few of my favorite pills.”
  • A tango-like song about a common relationship: “My psychopharmacologist and I…Call it a lover’s game. He knows my deepest secrets — I know his…name.”
  • A devastating song about depression: “Do you wake up in the morning and need help to lift your head? Do you read obituaries and feel jealous of the dead? It’s like living on a cliffside not knowing when you’ll dive…Do you know, do you know what it’s like to die alive?”

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Special Report: Do Psych Drugs Do More Long-Term Harm Than Good?

It was an explosive question: Might it be that the overuse of psychiatric medications is making many people sicker than they would have been, and preventing their recovery? Are the medications causing an epidemic of long-term psychiatric disability?

And it was about to be debated at a pinnacle of psychopharmacology, the top-rated psychiatry department in the country.

The match had drawn a full house to the fabled “Ether Dome” at Massachusetts General Hospital, the historic medical amphitheater where ether was first demonstrated as an anesthetic in 1846.

Against a vintage backdrop of glass cases holding a mummy and a well-used skeleton, the two adversaries were about to engage in a “grand rounds” debate — academic medicine’s intellectual equivalent of hand-to-hand combat.

“Thank you,” Massachusetts General Hospital psychiatrist Andrew Nierenberg said wryly, “for coming to the belly of the beast.”

The question is, author Robert Whitaker responded just as wryly, “Will I survive?”

End of humor. The stakes were too high for jokes. In his new book, “Anatomy of an Epidemic,” Whitaker doesn’t just ask whether long-term medication might often do harm. He presents study after mainstream study that inform his thesis, and he calls for the psychiatry establishment to discuss it openly.

‘The ‘Silent Spring’ of Psychiatry?

A science journalism maven at Harvard told me recently, “Mark my words, this book is going to be the ‘SIlent Spring’ of psychiatry” — a reference to the classic Rachel Carson book that opened the country’s eyes to the harmful effects of DDT.

“Anatomy of an Epidemic” only came out in April; it remains to be seen how widely its ripples will spread. But one thing is already clear: It has set Bob Whitaker, an award-winning local journalist and author of four books, on a personal journey into unexplored territory, to the Ether Dome and beyond.

It is taking him to a national conference on his hypothesis led by psychiatrists and providers of mental health services in Oregon next month. And to a line-crossing move for any journalist: the founding of a non-profit,“The Foundation for Excellence in Mental Health Care,” that will aim to present the science on various psychiatric treatments in a clear and unbiased way.

Most recently, that journey led him last week to stand in the Ether Dome beneath the curved rows of stadium-style seats, speaking upward to the full audience. Most of his listeners looked like students, except for a cluster of older men in the front whose bow-ties or suits gave them the look of staff.

Looking up at the Ether Dome

As the psychiatry establishment goes, this truly was “the belly of the beast”: Massachusetts General’s psychiatry is consistently ranked as the top department in the country by U.S. News and World Report. Sitting at the very front in a dark navy sweater was Jerrold Rosenbaum, the department chair.

Whitaker began with the plot-line about psychiatric drugs that tends to dominate in American society: The introduction of Thorazine in 1955 kicked off a “psychopharmacological revolution” that has included a march of new antipsychotics and antidepressants that are “sort of antidotes to these disorders.” They make it possible to empty institutions, and prevent people from becoming chronically ill. All in all, a positive picture of progress.

Troubling questions

Except that there’s a troubling puzzle: Why, then, did the number of Americans on the disability rolls for mental health reasons triple between 1987 and 2007?

And more troubling questions: Yes, the drugs often help people short-term, and sometimes, longer term. But why do some data suggest that schizophrenics who take anti-psychotics fare worse, long-term, than those who don’t? Why do so many people with depression who take anti-depressants seem to flip into bipolar disorder? And why is the disability caused by bipolar disorder rising so sharply, anyway? Continue reading