Mental-Health

Bossewitch, J. (2010). Pediatric Bipolar and the Media of Madness. Ethical Human Psychology and Psychiatry, 12(3), 254-268. doi: 10.1891/1559-4343.12.3.254 I am finally published in a peer-reviewed journal! Ethical Human Psychology and Psychiatry (available for purchase here - but my cut is exactly 0%). I wasn’t expecting much, and it’s mildly anti-climactic, but I have heard from a few people I never would have communicated with otherwise, and worked really hard to polish up this paper. Anyway, now its traditionally citable, which still means something (for the next few years, at least). This paper is at least 2 years in the making.  It began when Rasmus Nielsen forwarded me a call for papers about drugs as a form of media for NCA ‘09, and I participated in a panel  organised by Robert MacDougall (my slides). Around the same time as NCA, I also attended ICSPP and had the pleasure of meeting James Tucker and Peter Breggin. This meeting eventually led to my submission to EHPP - a journal that typically publishes articles by and for psychologists, psychiatrists, and social workers.  I was thrilled to help bring a dash of media and communications theory/research to that audience. Special thanks to Annie Robinson, Sascha Scatter, Bonfire Madigan, Brad Lewis, Biella Coleman, Philip Dawdy, Nicholas Mirzoeff, Julia Sonnevend, Ben Peters, and the Icarus Project for ideas, inspiration, and edits. I have also reworked the main arguments in this essay into a chapter in the upcoming: Drugs & Media: New Perspectives on Communication, Consumption and Consciousness (edited by Robert C. MacDougall). I even worked on a McLuhanesque Tetrad around Prodromal diganoses (a.k.a. Psychotic Risk Syndrome). Unfortunately, I was unable to convince Springer to go open access with my paper, but I tried and was able to deposit an open-access pre-print in the Columbia institutional repository, and also have a pre-print available here. If enough people make noise about open access, I hope the editors and publishers will eventually start to get the idea. The issues raised in this paper are beginning to percolate into the mainstream. Last month Harpers published a (flawed) long  piece on predictive diagnoses: Which way madness lies: Can psychosis be prevented? Wired just ran a great piece on the backlash against DSM5, especially Psychotic Risk Syndrome, by one of the DSM IV contributors: Inside the Battle to Define Mental Illness. A good friend of mine from the Journalism school also just produced an investigative short-documentary on antipsychotics use among foster home children that just aired this weekend on PBS: The Watch List: The medication of foster children. Finally, Crooked Beauty is coming to town next month for the 3rd  annual Reelabilities Film Fest - c’mon out to the launch party or one of the screenings: Thursday 02/03/2011 1:00pm JCC of Mid-Westchester Friday 02/04/2011 1:30pm Bellevue Hospital Center Friday 02/04/2011 6:00pm New York City College of Technology Saturday 02/05/2011 7:00pm The JCC in Manhattan Monday 02/07/2011 6:30pm Solomon R. Guggenheim Museum Tuesday 02/08/2011 7:00pm JCC of Staten Island It’s going to be a great year.

This season Fox premiered a new television series called Mental (this post has nothing to do w/ AMC’s fabulous Mad Men):

a medical mystery drama featuring Dr. Jack Gallagher, a radically unorthodox psychiatrist who becomes Director of Mental Health Services at a Los Angeles hospital where he takes on patients battling unknown, misunderstood and often misdiagnosed psychiatric conditions. Dr. Gallagher delves inside their minds to gain a true understanding of who his patients are, allowing him to uncover what might be the key to their long-term recovery.

A recent post at Furious Seasons on the spooky future of psychiatry prompted me to dig a little deeper into the origins of prodromal diagnoses. A prodrome is “a symptom or group of symptoms that appears shortly before an acute attack of illness. The term comes from a Greek word that means “running ahead of."” A spooky emerging trend in clinical psychiatry is the appropriation of this concept under the paradigm of “early intervention in psychosis” for “at risk” patients. Psychiatrists are preventively diagnosing mental illness and treating people prior to them exhibiting any behavioral symptoms.

To: Sandy Walsh <sandy.walsh@fda.hhs.gov> Cc: World Subject: Establishing the Validity of Pediatric Bipolar Disorder Dear Miss Walsh, I am a professional educator, software architect, and a doctoral candidate at Columbia University’s School of Journalism. I am outraged that the FDA is abusing its power and violating the public trust by supporting the corporate interests of the pharmaceutical lobby. The drug companies are shamefully maneuvering to expand the market for the multi-billion dollar a year anti-psychotic industry by extending the diagnostic criteria of the purported mental illnesses their toxic pills are prescribed to treat. The FDA has recently taken the unprecedented action of effectively legislating the existence of a disease, a disease whose existence is denied by many experts on both mind and body. The diagnosis of Pediatric Bipolar Disorder does not exist in the DSM IV, is not recognized by public or private insurance companies, and is the subject of intense debate between psychiatrists, psychologists, social workers, and therapists. When did the FDA become authorized to construct/validate new diagnoses or decide who is mentally ill? I have been closely following the heated controversy surrounding the diagnosis of Bipolar Disorder in children since the tragic death of Rebecca Riley. Rebecca was diagnosed with Bipolar disorder at 2 years old, and was killed when she was 4 by an overdose of anti-psychotics. This past year, Frontline aired The Medicated Child, a provocative investigation of the widespread experiment being conducted on the innocent children of America. I beg you to watch this documentary before making any more decisions about the existence of this alleged disorder. The piece demonstrates how our children are being chemically swaddled, and how these drugs are being systematically deployed as instruments of discipline and control. The public has a right to full disclosure on this important matter of public health! I am shocked that you have still not issued a statement explaining your position on Pediatric Bipolar Disorder - What behavioural symptoms constitute this alleged disease, and how were these criteria arrived at? What is the progression of this illness and what are the mechanisms are involved in its treatment? Who was consulted in the validation of this disease, and have their research findings been vetted by a disinterested scientific community? The FDA’s complicit involvement in a mass experiment on an entire generation of American children demands transparent accounting. It is absolutely imperative that the FDA shine some light on its backroom dealings with the Big Pharma. Sincerely, Jonah Bossewitch

Last week I paid tribute to Albert Hoffman at an event hosted by Reality Sandwich. I have been following the site for a while, and really enjoyed the screenings and the conversation (led by John Perry Barlow and Daniel Pinchbeck). I was a bit startled to encounter a perspective that I hadn’t thought about for a while. There were psychedelic enthusiasts who faithfully imagined the world being a better place if we all took a little trip (slight caricature, but bear with me). After a few years working on the Icarus Project and immersed in academia I found this attitude slightly jarring. Talk about technological determinism - our salvation in the form of an external molecule? I happen to think that a bit of psychedelic experimentation might certainly help make the world a better place, but for one thing, if society were truly tolerant of freaks and drugs, we wouldn’t need them so badly in first place. For another, psychedelics are arguably more available now than ever before, and they haven’t (yet) catalysed the transformation imagined. But what really bugged me is how this counter-cultural rhetoric would play directly into the hands of Big Pharma. Their message for years is that happiness can be found at the bottom of a pill bottle. Try to vividly imagine what these drugs would look like in their hands - the clinical administration of extracted active ingredients, outside of the usual cultural sacred context. This wouldn’t accelerate the evolution of consciousness, just the flow of capital into Pharma’s coffers. I also found it interesting to trace the genealogy of LSD back to psychiatry. To be completely fair, Reality Sandwich’s message isn’t so simple, but I do feel its important to imagine how these messages might be appropriated. I’ll leave you with one of the shorts from Post Modern Times: Consciousness is the Key

Analyzing humor is like dissecting a frog. Few people are interested and the frog dies of it. – E.B. White

I don’t want to spoil the punchline of this Onion story, Woman Overjoyed By Giant Uterine Parasite, but let’s just say that there is nothing like the power of irony to drive a stake through the distinction between empirical observations and value judgements. This is really the best argument I have come across to explain what’s wrong with the psychiatric medical model. It’s not that mental conditions aren’t correlated with changes in biochemistry or neural brain state. Its the value judgment that is implied in labeling the phenomena an illness. And this little Onion article does a great job of conveying that. It’s got me wondering what other naturally occurring conditions can be explained/judged in more than one way?

A few months ago the giant pharmaceutical company Pfiezer laid off 10,000 people, or about a tenth of its global workforce. There are many factors that are draining the industry of profits including the fact that patents eventually expire allowing generics to compete, it is extremely costly to develop new drugs, and the industry is caught in a vicious advertising/marketing arms race that is diverting significant percentages of development costs (in similar proportions to the marketing of a big budget Hollywood movie). There is plenty to chew on here in terms of how intellectual property laws are impacting human rights (keeping lifesaving drugs out of many patient’s reach) and the notion that as “mission critical” drugs come out of patent, drug companies are busy inventing new “lifestyle illnesses” for which they conveniently sell the cure. The concept of illness has become a major US export, as the documentary Does Your Soul Have a Cold? begins to explore. But what really caught my attention in this story is the idea that the pharmaceutical industry is witnessing a phenomena that is becoming familiar to the media/entertainment industry - the death of “hits” or the multi-billion dollar blockbuster.

Freeculturenyu.org is covering an unfolding story laced with greed and deciept in the pharmaceutical industry. The freeculture angle here is that Lilly will predictably try to control this information by abusing copyright laws. However, there is another important angle to this story relating to the relationship between anonymity and free speech, especially in a world of omniscient surveillance. Tor users must remember to install both Tor and Privoxy (instructions). There is also a firefox plugin, torbutton, which makes using Tor a bit easier. From freenetproject.org’s philosophy section