Psychiatrist J. Douglas Bremner has weighed in on the Melanie Blocker Stokes MOTHERS Act, an effort to provide voluntary screenings to pregnant women to help identify postpartum depression before it becomes overwhelming. I’ll let Bremner speak for himself:
The problem with this is the attitude that being a mother is a risk factor for a psychiatric disorder. First of all, there is no evidence that women without a prior history of anxiety and depression have any increased risk of getting post partum depression. So to screen all moms as if giving birth is a risk factor for depression is ridiculous.
My BS alert goes off whenever someone tries to change the argument from a reasonable effort to help increase education and information about a stigmatized mental health issue, to hyperbole, suggesting that a piece of legislation is trying to turn motherhood into a psychiatric disorder. It goes off again when a professional makes an extraordinary claim like, “there is no evidence that women without a prior history of anxiety and depression have any increased risk of getting post partum [sic] depression.” Really? Absolutely no evidence? That’s quite a strong statement, and easily proven false with a literature review.
Where shall we begin? (I have limited space and you have a limited attention span, so I’ll just highlight a few studies…)
Ross & Dennis (2009), for instance, in a literature review found that both substance use and current or past experiences of abuse are associated with increased risk for postpartum depression (PPD).
In urban South African women, Ramchandani and colleagues (2009) found the strongest predictors of postnatal depression were exposure to extreme societal stressors (e.g., witnessing a violent crime/danger of being killed) and reporting difficulties with their partner.
Robertson et al. (2004), in a large meta-analysis of research to-date, found that a previous history of depression and anxiety (not just during pregnancy) was predictive of postpartum depression. But they also found that simply experiencing a stressful life event during pregnancy or low levels of social support (e.g., not having any emotional support from your friends or family) could also lead to postpartum depression.
Beck’s (2001) meta-analysis of 84 studies found:
13 significant predictors of postpartum depression: prenatal depression, self-esteem, childcare stress, prenatal anxiety, life stress, social support, marital relationships, depression history, infant temperament, maternity blues, marital status, SES, and unplanned/unwanted pregnancy. 10 of the 13 risk factors had moderate effect sizes while 3 predictors had small effect sizes.
Look at all of those factors which are not depression or anxiety — I count 9. Even if 3 of those are small-effect size factors, that still leaves 6 factors which are not depression or anxiety.
What about the argument that if depressed women are the most at-risk, we should simply focus on them?
Ingram & Taylor (2007) found it wasn’t just a woman’s pre-birth depression severity that was important — poor emotional support and women who had more negative descriptions of their own childhood were additional risk factors that played a role in increased risk for postpartum depression. Who’s going to screen for these things, the obstetrician?
Well, no, because the obstetrician is already not doing a good job at screening for postpartum depression, even in high-risk women. Hatton et al. (2007) found that, among high-risk women, obstetric care providers may be overlooking up to one fifth of women with current major depression. Not exactly great numbers there. If obstetric care providers can’t deal with the obvious cases, I can only imagine how well they do with the more complex or less obvious ones.
Monk et al. (2008) sums the state of our knowledge on PPD:
Depression is relatively common during the perinatal period (Gavin et al. 2005; Ross and McLean 2006). Approximately 8.5 — 11% of women experience either a major or minor depression during pregnancy (Gaynes et al. 2005). Nearly 20% of women have a minor or major depression in the first 3 months following delivery (Gavin et al. 2005).
So up to 1 in 5 women have depression after giving birth, and this isn’t something worth noting or screening for? (For comparison’s sake, 1 in 10 men and women in the general population might have depression at any given time.) Giving birth doubles your risk of depression, and this isn’t an issue? Amazing.
But don’t just take my word for it. Zajicek-Farber’s (2009) study conducted on high-risk women for postpartum depression concluded that:
These findings provide additional supportive evidence that more efforts are needed to identify and assess women’s depressive symptoms to promote health and safety of young children.
These are objective researchers calling for more screenings. Not politicians. And not people (or professionals) with a political agenda.
Now, I understand Bremner’s point — let’s not medicalize and catastrophize ordinary motherhood. I agree. And of course a woman’s pre-birth depression or anxiety is strongly correlated to postpartum depression. But not exclusively, as Bremner claims.
Bremner claims, with no evidence, that all mental health screenings are simply pharmaceutical sales tactics to help increase prescriptions. That’s ridiculous. When I worked in community mental health, we ran annual mental health screenings in the clinic — with no funding from any pharmaceutical company — because it reduces stigma, decreases misinformation and increases education about mental health issues in the general population.
Sorry, but most people don’t have time to keep up with a dozen blogs or read monthly journals on the latest research in mental health. Most people know what they know about mental health largely through mainstream media, or their own first-hand experiences with an issue. How is the promotion of more information and education about mental health issues a bad thing?
Bremner uses teens as an example of screening gone wrong, but conveniently fails to mention the facts about teenagers and mental health. Teens are an “at-risk” population, hence the reason they are sometimes targeted for screenings. Teens are notorious for being limited in their treatment options (especially in the U.S., where their treatment may be covered by their family’s health insurance, meaning a talk with their parents about their mental health issues), and for peer pressure limiting their ability to accept or seek help. (Yes, sorry, if you’re seeing a therapist for depression as a teen, you’re typically not seen as a “cool” kid.)
Sadly, whether people want to admit it or not, mothers are another “at risk” population. Why? Because society has told mothers time and time again that giving birth is supposed to be a joyous, happy occasion. If you’re depressed after giving birth to a child, there must be something wrong with you. Don’t draw attention to yourself or your problems. Just try and deal with it, try and take care of the baby, and make it through each day. Mothers don’t know they might have something recognized as postpartum depression, much less that they can talk to someone about these feelings or that there’s treatment — psychotherapy or medication — readily available for it.
So respectfully, I disagree with Bremner’s assessment of the MOTHERS act and its need in today’s society. And if you’re not going to bother to do the legwork and just make general (false) pronouncements about what the research actually shows (or worse, suggest the all research that disagrees with you must be in pharma’s pocket), then that’s a lazy person’s argument. There are too many logical fallacies at work here to list, so I’ll just suggest that I expect more reasoned and professional arguments –based upon the actual research — about such important legislation.
Psych Central continues to support the Melanie Blocker Stokes MOTHERS Act because the research shows it would help in the efforts to increase education and correct mis-information about postpartum depression.
References:
Beck, C.T. (2001). Predictors of postpartum depression: An update. Nursing Research, 50(5), 275-285.
Hatton, D. C., Harrison-Hohner, J., Matarazzo, J., E.P., Lewy, A. & Davis .L. (2007). Missed antenatal depression among high risk women: A secondary analysis. Archives of Women’s Mental Health, 10(3), 121-123.
Ingram, J. & Taylor, J. (2007). Predictors of postnatal depression: Using an antenatal needs assessment discussion tool. Journal of Reproductive and Infant Psychology, 25(3), 210-222.
Monk, C., Leight, K.L. & Fang, Y. (2008). The relationship between women’s attachment style and perinatal mood disturbance: Implications for screening and treatment. Archives of Women’s Mental Health, 11(2), 117-129.
Ramchandani, P.G., Richter, L.M., Stein, A. & Norris, S.A. (2009). Predictors of postnatal depression in an urban South African cohort. Journal of Affective Disorders, 113(3), 279-284.
Robertson, E., Grace, S., Wallington, T., Stewart, D.E. (2004). Antenatal risk factors for postpartum depression: a synthesis of recent literature. General Hospital Psychiatry, 26(4), 289-295.
Ross, L. E. & Dennis, C-L. (2009). The prevalence of postpartum depression among women with substance use, an abuse history, or chronic illness: A systematic review (PDF). Journal of Women’s Health, 18(4), 475-486.
Zajicek-Farber, M.L. (2009). Postnatal depression and infant health practices among high-risk women. Journal of Child and Family Studies, 18(2), 236-245.
202 comments
My posts are not limited to talking about women being treated for PPD because the Mothers Act disease mongering campaign is aimed at diagnosing and treating women for a multitude of mental disorders, which is one of my biggest complaints.
The whole point of my opposition is being overshadowed by discussions of whether screening and treating diseases like cancer and diabetes can be compared to screening and treating mental illness.
I say it cannot.
As far as now trying to limit the conversation to Alzheimer’s disease Grohol, I am not prepared to discuss it because I readily admit that I do not know enough about the disease, the screening process, the treatments or the costs involved.
My writing campaign against the Mothers Act is not a pleasurable hobby. In fact, I find the work utterly distasteful, when picturing children being dosed with psych drugs in the womb and through nursing mothers.
My sole aim is to try to protect the voiceless victims of this latest off-label drug marketing.
I am of course concerned for the vulnerable and naive women who will be snagged in with this drugging dragnet but at least they will have some say so in the matter.
This is not my first trip around the block by far. I have been investigating and reporting on the off-label marketing schemes for psych drugs using screening tools since 2004.
My first entry into the field was to try and protect teens from the TeenScreen drugging scam.
It’s extremely discouraging to find myself 5 years later trying to prevent the forced drugging of the fetus and infants barely out of the womb.
Evelyn Pringle
Dr. Grohol, Id like to discuss the research Data on this very important issue. I noticed in your original post that you cited 8 studies, are they the only studies, or is there more? I have no desire to debate the findings, i would just like to have an idea of how many more studies are out there. Im not interested at this time, in the medication treatment studies.
Dr. Grohol, I took a little stroll through your website, and found that your site severely lacks patient information in regards to the safety and efficacy of antidepressants in children. May I suggest:
1)With the exception of prozac and lexapro, antidepressants have never been FDA approved to treat depressionin pediatric patient population.
2)”ALL” antidepressants carry an FDA Black Box Warning for children, teens, and young adults.
3) provide a link to FDA Medication Guides in regards to the use antidepressants.
4, Provide your online readers with copies of GSK and Wyeth’s Dear Health Care Provider Letters.
No, Dr. Grohol, a depression inventory test is not scientific. A book with a list of symptoms and categories is not scientific. Here’s an example of science (I’ll use Genetics, as that is my area of study)- the Central Dogma of Biochemistry: “DNA->RNA->Protein” This has been independently validated hundreds of thousands of times by thousands of labs and hundreds of thousands experiments.
The fact that we are even arguing about the validity of these “disorders” is not due to stigma, it’s due to the unscientific nature of the screening, diagnostic, and treatment process.
Evelyn Pringle – I think that’s the likely reason we’re just going to have to agree to disagree. I think that if you’re going to hold up mental disorders to the same yardstick as medical diseases — and demand similar types of lab tests to “prove” they exist — you need to understand the extent of science and practice today in both mental health and medicine.
I actually think that while there may be similarities between mental health concerns and medical diseases like cancer, I think that mental disorders are different and demand a different yardstick than what we use in medicine. I think the psychological measures that have been in use for decades that have decades’ worth of science and research behind them work just fine.
I don’t think or see women as “voiceless victims” just because some are trying to empower them with information and more data — data that comes from screening measures. A woman’s choice about what she does with that information and data is just that — her choice. I would never imagine it is my right to come between a doctor and their patient and their right to choose any treatment they want (or no treatment at all). It’s their choice, not yours, not mine.
Screening provides women with more data to make an informed decision. Lack of screening keeps women in the dark. Since this bill only provides for voluntary screenings (and doesn’t mandate any sort of treatment whatsoever), I will very much continue to support it.
I have spent the past six months researching the various websites of the main supporters of the Mothers Act.
In response to the request for sources to back up my claim that social workers are now running treatment centers and providing therapy for mental illness, and using websites to recruit customers, while promoting the use of screening tools equal to a pop quiz, and advising women on what drugs to take, I will gladly submit the following.
The websites discussed below all refer to each other back and forth with live links.
This from social worker Susan Stone’s website:
“Welcome to Perinatal Pro, the website presence of Blue Skye Consulting, LLC, posted by women’s reproductive mental health expert Susan Dowd Stone, MSW, LCSW, to help educate and inform women, families and health care providers about the often unexpected challenges of mood changes during pregnancy, the postpartum and throughout a woman’s reproductive life.”
Susan is a past president of Postpartum Support International. She maintains a private practice, “specializing in women’s reproductive mental health across the life cycle,” according to her bio.
The “Clinical Focus” of treatment advertised with PerinatalPro includes: Perinatal Mood Disorders and Postpartum Depression; Perimenopause and menopause; Bereavement associated with child loss, stillbirth or miscarriage; Lifestyle changes and loss (divorce, remarriage, health issues); Depression associated with medical conditions; Disordered Eating and Body Dysmorphic Disorder; Trauma/PTSD; and Affective Disorders including depression and anxiety.
Potential patients can click on a link on the website to schedule an appointment.
Blue Skye offers half-day workshops for professionals “to help develop a specialty in perinatal mood disorders,” including two titled: “Identifying Perinatal Mood Disorders,” and “Treating Perinatal Mood Disorders.”
Karen Kleiman, another social worker, runs a treatment facility called the “Postpartum Stress Center,” in Rosemont, Pennsylvania.
“The Postpartum Stress Center specializes in the diagnosis and treatment of prenatal and postpartum depression and anxiety disorders,” Kleiman’s site says.
“The Postpartum Stress Center specializes in the diagnosis and treatment of prenatal and postpartum depression and anxiety disorders,†the homepage says.
Services offered include, “Screening for prenatal and postpartum depression and anxiety,†and “Psychiatric evaluation and follow-up.â€
At the Center,” Kleiman teaches seminars for professional training with ads on her website and the heading: “Become an Expert in the Treatment of Postpartum Mood Disorders.”
The first sentence in “Highlights” for this training states: “This is a crash course on diagnosis, screening, assessment, treatment options.”
The fee is $750 for a 10-hour course, but they do throw in a book titled, “The Postpartum Stress Center’s Guide to Enhancing your PPD Private Practice: A checklist for successful practice.”
Karen could make $7,500 per seminar by simply recruiting 10 trainees. Nearly all the websites pitch in to promote conferences and seminars, so rounding up 10, or even 20, trainees would likely not be too difficult.
The site shows 4 seminars a year, meaning Karen could earn roughly $30,000 for 40 hours of teaching people how to “Become an Expert.”
And if she could round up 20 trainees per class, she could make $60,000 a year, putting her up there with all the other highly paid speakers within the new industry.
In a June 4, 2007, blog, Kleiman reported a new study that found 79% of doctors were unlikely to formally screen for postpartum depression and noted that the co-author of the study “reminds us that in addition to the Edinburgh (EPDS) Screening tool (most commonly used), healthcare practitioners can check for signs of PPD by a simple 2-question tool, developed by Whooley et al.”
Further elaborating on this quiz, Kleiman wrote: “It has been shown that these two questions may be as effective as longer instruments,” and listed the questions as: (1) “Over the past 2 weeks, have you felt down, depressed, or hopeless?”, and (2) “Over the past 2 weeks, have you felt little interest or pleasure in doing things?”
“A positive response to either question indicates a positive screen and should be followed by an comprehensive history and assessment to confirm the diagnosis of depression,” she wrote.
Kleiman is listed as a postpartum depression “expert” on another website called StorkNet, complete with her own bio page, where she posts advice for pregnant and nursing mothers to access over the internet and provides a live link to her treatment center.
In response to the question, “what are the best drugs for a breastfeeding mom with postpartum depression?”, Kleiman wrote in part:
“Keep in mind that this information is based on MY practice and will vary considerably from doctor to doctor.”
“The SSRI antidepressants (Selective Serotonin Reuptake Inhibitors) we are most comfortable using based on the research we have are: Zoloft (Sertraline) and Paxil (Paroxetine). Other antidepressants (tricyclics) that are used are Pamelor (Nortriptyline) and Desipramine (Norpramin), although it seems that the SSRIs are preferable these days because they have fewer side effects and are easily tolerated.”
In answering questions on “How Long to Take Medication,” Kleiman said to think of antidepressants as a “Serotonin vitamin,” and cited a recommendation from the American Psychiatric Association for staying on antidepressants for 6 to 9 months after the woman is feeling better.
“That’s not 6-9 months after you start taking the pill, it’s after you start feeling better!” she wrote. “The reason they recommend that you remain on it that long is because studies show there is a high risk of relapse if you get off the meds too early. And if you relapse, the symptoms are often harder to treat.”
“Antidepressants are one of the most efficient and effective treatments for PPD,” Kleiman tells women reading her StorkNet advice.
In another blog Kleiman wrote: “Women who experience depression during pregnancy are at an increased risk for PPD.”
“Current research supports the use of antidepressants immediately after delivery to reduce the likelihood of PPD.”
“Many women and their doctors choose this option,” Kleiman said, “to start their medication right after the baby is born, and I mean right in the delivery room!”
In a March 11, 2009, blog on Postpartum Progress, Katherine Stone plugs herself for speaking jobs, along with a study that concluded “the Internet is a viable and feasible tool to screen for PPD.”
“I’ll be adding this study to the speech I give on how women with perinatal mood and anxiety disorders use the Internet,” she reports, and then adds:
“If you’re interested in having me speak at your event, let me know!”
On March 16, 2009, Katherine posted a “Quick Survey on Postpartum Anxiety,” and wrote:
“The fabulous Karen Kleiman has asked me to ask you to participate in a short, five-question online survey on anxiety. She says ANYONE can answer it, regardless of the age of their baby(s) and regardless of diagnosis or lack thereof. ANY mother should answer the questions. It’s super quick — I know because I took it myself.”
Kleiman’s survey is a good example of the methods used to con women into suspecting they are mentally ill via the “expert” blogs.
The preface states: “The questions on this survey can be answered by a new mother of an infant or an empty-nester with good recall of the early days with her baby. Please answer as honestly as you can.”
The question, capital letters and all, reads: “When you were carrying your baby down a flight of stairs, did you EVER, at ANY time, have ANY thought, image or concern that you could accidentally drop your baby?”
The survey further tells women:
If you answered YES to the first question, please describe the type of worry you had: Scary thoughts about dropping the baby, Scary images about dropping the baby, Both thoughts and images, Other.
How much distress did this cause you? A Great deal of distress, Some distress but I quickly got over it, Some distress that seemed to linger, Not much stress
Did this thought or image occur once or did it recur? Only once, It recurred frequently, It recurred persistently, It occurred off and on, Did you ever tell anyone about the fear of dropping the baby? (Please describe why you chose to tell someone or why you chose not to)
Women who take the survey are told nothing about what the results mean at the end.
But clearly the seed is planted that something is wrong if you “EVER, at ANY time, have ANY thought, image or concern that you could accidentally drop your baby”.
In September 2008, the Postpartum Support International website ran the news flash: “3 Questions Can Spot Possible Postpartum Depression.”
A three-item anxiety sub-scale of the Edinburgh Postpartum Depression Scale turned out to be a better screening tool than the two other abbreviated versions which are almost the same as the commonly used Patient Health Questionnaire, PSI reported.
On September 8, 2008, Katherine ran a blog with a headline of: “Researchers Find 3-Question Screening Test Effective in ID’ing PPD.”
She explained that for this sub-scale of the Edinburgh Postpartum Depression Scale, new mothers were asked to answer “Yes, most of the time,†“Yes, some of the time,†“Not very often†or “No, never†to the following statements: I have blamed myself unnecessarily when things went wrong; I have felt scared or panicky for not very good reason; I have been anxious or worried for not very good reason.
“The subscale identified 16 percent more mothers as depressed than the original, longer questionnaire,” Stone reported, in the best news for the psycho-pharmaceutical industry.
The StorkNet site carried the headline “Postpartum Depression: Three Simple Questions to Ask Yourself,” for the same quiz. “A simple new 3-question test has proven very reliable at detecting postpartum depression,” it reported.
In a July 8, 2009, blog on her website, Lauren Hale reported on the latest screening tool and wrote: “This morning I discovered an iPhone app which includes the Edinburgh Postpartum Depression Scale along with three other depression scales.”
“Chances are many new moms either have an iPhone or know someone who does,” she said. “What’s really cool about this app is that it stores the last 30 entries so you can take the results straight to your doctor.”
The above information is taken from excerpts from my past articles on the Mothers Act and my new four part series titled, “The Mothers Act Disease Mongering Campaign.”
I rest my case.
Evelyn Pringle
Dr. Grohol says, “I think the psychological measures that have been in use for decades that have decades’ worth of science and research behind them work just fine.”
I wish I could agree with that but I most assuredly can’t. If the measures we are using are so great why is there such a brouhaha brewing over the newest DSM? Why can’t diagnoses be reliably “replicated” from one doctor or counselor to another? Why do treatments seem to be as arbitrary as the diagnoses and depend more on what is the “drug du jour” than on a valid treatment for a specific diagnosis? A few years ago Paxil was the favored drug, then Lexapro. Now it’s Abilify or Seroquel. Why are there over 3000 stories of harm in treated people on ssristories.com if the tools we are using to diagnose and treat are “just fine.”
And no, women are most assuredly not “voiceless victims” but the system is not well set up for them to be turning down the recommendations of medical figures of authorities like doctors, psychiatrists and counselors. Even these authorities don’t have all the facts due to the corruption and conflicts of interest that are now rampant in clinical research. So patients surely aren’t going to have them either. True informed consent is simply not available at this point in time.
Sara – I think you make a reasonable point — that our current diagnostic systems are imperfect and sometimes (often?) err. But I’d also point out that general medicine is little better. Despite the belief that doctors all recognize the same signs, symptoms and lab tests results for a medical disease, they don’t. They disagree about diagnoses all the time, and they make bad decisions based upon those disagreements. Something like 100,000 people die each year from preventable medical mistakes.
I think we have to realize that our knowledge and ability to understand the complexity of the human body and the mind has a long way to go. I understand that, as do most researchers and clinicians. But what are we to do in the meantime, as our we try and increase our knowledge? Stop trying to help people in emotional pain who want treatment?? Or do the best we can with the tools and treatments we have available?
There’s no doubt nor argument that treatment can harm as well as help. The question then becomes, How do we minimize likelihood of harm and increase the likelihood of help? And this is true of any treatment, psychotherapy too.
Yes, I agree with you there about general medicine and that the problems are not limited to psychiatry although I think they are particularly egregious in that field. Problems of diagnosis, selling sickness and overtreatment are rampant throughout medicine, no doubt about it, and it’s why I consider it nearly a full time job to stay away from the doctor and avoid iatrogenesis, probably the biggest problem that exists in our health care system today and the one that is going to bankrupt our country if someone doesn’t get a grip on it and start measuring outcomes of treatments more precisely.
Sara – no one wants to look at outcome data because outcomes in psychiatry as a whole are dismal. Since thorazine was invented in the ’50s the rate of people disabled from mental illness has quintupled. To be fair, in some ways, that’s not a good comparison, because you’re comparing those institutionalized (in the 50s) to those on SSI and SSDI (now), which isn’t the same. However, the rate of people disabled from mental illness on SSI/SSDI has DOUBLED since the 1990s and the invention of the SSRIs. Something is horribly amiss. I would think that the goal of psychiatry would be to help people with mental illness live full, integrated, productive, self-actualizing lives. If meds are so good at doing just that, why do we see such a dramatic increase in the rate of people on SSI/SSDI for mental illness in the past 10-20 years? Why has the average lifespan of a person with mental illness gone DOWN by 10 years (now 25 years less than the avg. person, 10 years ago it was only 15 years… we are going the opposite direction)? Why do people with Schizophrenia in India and Nigeria recover at twice the rate they do in the US, despite the fact that only one out of six is on medication in those countries? Why is it that 27% of people who commit suicide have SOUGHT “professional” help in the year leading up to their suicide? Better outcomes, show me better outcomes, and THEN I will support “education” and “screening”.
kimbriel, you claim “However, the rate of people disabled from mental illness on SSI/SSDI has DOUBLED since the 1990s and the invention of the SSRIs.”
I’m curious where are you getting that information from? SSI/SSDI is not just for those with mental health disabilities, but also includes those with physical disabilities. Just by looking at SSI/SSDI numbers, there is no way for you to know why a person has SSI/SSDI, unless you actually work for SSA and can access all their records.
As a result, I would not measure the prevalence of mental health disabilities by using SSI/SSDI, as you will artificially inflate your numbers.
I would like to address the financial end of this debate, If this bill becomes law, (which I dont believe it will,.. the votes just arent there) is, who is going to pay for it? The American taxpayer like Dr. Grohol or katherine, or those in favor of this bill, maybe, thats if they make over 250,000 dollars a year! So I would like to offer up this proposal: Lets all meet up for lunch,.. and dont forget your checkbooks, we will compare State and Federal Tax Returns, I would like you to write the US Govt a check for the same amount of money as I do; If you want to waste money that is your perogative, It is not your perogative to waste mine.
Dr. Wayne,
This article has a different focus but seems to give support to Kimbriel’s contentions.
As an FYI, I only glanced at it so please keep that in mind.
http://tinyurl.com/llsq8h
“Individuals with psychiatric disabilities are the fastest-growing
subgroup of Social Security Administration disability beneficiaries
and have negligible rates of return to competitive employment”
By the way, not a very encouraging article regarding employment for people with psychiatric disabilities.
Back on topic – Obviously causation doesn’t equal correlation but if meds are as effective as professionals claim they are, this shouldn’t be happening.
AA
The data I got from an excerpt of a book yet to be published, “Anatomy of An Epidemic” by Robert Whitaker. You can find this excerpt on the web if you do a search for it- the data is very clear.
AND THIS IS exactly my point (thanks AA): “Obviously causation doesn’t equal correlation but if meds are as effective as professionals claim they are, this shouldn’t be happening.”
Psychiatry/Psychology needs to do some serious introspection because CLEARLY what they are doing is not getting us where we need to be.
Interesting anecdotal story for what’s it’s worth: re: AA’s above link to the article that says
“Individuals with psychiatric disabilities are the fastest-growing subgroup of Social Security Administration disability beneficiaries
and have negligible rates of return to competitive employment”.
It’s a good idea to look to the long-term outcome of more women medicated and focus on the possible errors and wrong dx that could come of it.
Comparing it to my daughter’s case, which is wrong dx (confirmed by chief of staff of a prominent hospital with 30 yrs experience according to the doctor)for pediatric bipolar at age 11…is now a 21 year old disabled from the psychiatric medications and is a recipient of SSI as well as medicaid. She is still on psych meds.
Just makes me wonder about the long term outcome of a screening where a woman’s hormones are all over the map anyway, and I am concerned with people being wrongfully medicated, only to possibly find out years later they really didnt need to be.
(Note, she is still on psych meds, due to inability to withdraw successfully, many doctors have thought out loud about the change in the brain and the possibility of the brain being addicted to the drug)
SHOW ME THE MONEY,… who is going to pay for this etremely expensive legislation. Id like to see the proponents of this bill cough up some major dough. It is selfish to expect others to when your not willing yourselves.
I can assure you that Senator Menendez is not winning over NJ voters with this type of legislation. May I remind you its the NJ Vote that counts not the votes Ms. Stone, Melanie Stokes’s mother or even Brooke Shields. Not even you Dr. Grohol. Them’s Politics.. A Headline,. Menedez’s Legislation will treat woman like criminals
Stephany’s daughter’s story is one of the saddest illustrations of misapplied “science” compounding mistake after mistake… THIS is why we are wary of any intrusion psychiatry might have into our lives. There’s a reason that so many psychiatric survivors are upset with the profession. And no, it doesn’t have to do with our “lack of insight”.
Stephany,.. If you would like to talk to a support group in regards to antidepressant withdrawal, check out paxilprogress.org. They are a wonderful group of individuals from all over the world, there is always someone avilable to chat with.
I resent that the post in which I referred to “voiceless victims” has been twisted into conveying that I meant the women who will be taking the drugs.
I specifically said:
“My writing campaign against the Mothers Act is not a pleasurable hobby. In fact, I find the work utterly distasteful, when picturing children being dosed with psych drugs in the womb and through nursing mothers.
My sole aim is to try to protect the voiceless victims of this latest off-label drug marketing.
I am of course concerned for the vulnerable and naive women who will be snagged in with this drugging dragnet but at least they will have some say so in the matter.
This is not my first trip around the block by far. I have been investigating and reporting on the off-label marketing schemes for psych drugs using screening tools since 2004.
My first entry into the field was to try and protect teens from the TeenScreen drugging scam.
It’s extremely discouraging to find myself 5 years later trying to prevent the forced drugging of the fetus and infants barely out of the womb.”
No one seems to want to address the most of important issue here; that of the unborn children and nursing infants who will being forcibly drugged against their will.
Perhaps it’s too “utterly distasteful” for some people to even think about, much less address head-on.
Evelyn Pringle
Evelyn, to me that is absolutely horrifying to think about… I really can’t even address THAT aspect of it.
Kimbriel, I have a strong sense that a lot of people are avoiding the issue for the very same reason.
Which is why I so strongly believe that I cannot.
Believe me when I say it is no less horrifying to me.
1. Evelyn Pringle calls herself an investigative journalist but I can see no evidence that she’s ever been involved with a legitimate news organization — only Scoop Independent News, which is a news aggregator out of New Zealand.
2. Just because people presents anecdotal reports of how they or their loved ones were ruined by Big Pharma, it doesn’t mean these reports are true. Granted, every day the psychiatrists get it wrong with too many patients, often prescribing the wrong medications (or none at all). Horrible mistakes and misjudgements happen. But we do not know how the people cited in these blog posts would have fared without treatment. In short, some people are born with mental illness and sometimes it only gets worse, despite psychiatric intervention. This is common sense, which is always sorely lacking in these “discussions.”
Being a Brit, I’m not familiar with this particular piece of legislation, nor this particular argument (being a Brit doesn’t preclude me from understanding either of these things, of course, but they’re not big news, here in the UK). Let me see if I have this right:
First, women may get depression when they’re pregnant, or immediately afterwards, we’re told. Not all women, though. It is claimed that there is a series of factors that appear to influence the likelihood of a prospective mother experiencing depression and they are… a, b, c, whatever. Because somebody or other believes that they can identify (reasonably accurately?), which individuals are most at risk from postpartum depression, it is being proposed that *all* mothers take some kind of depression rating test, in order to assess the extent of the risk to them.
It is further (counter), argued that postpartum depression is not an illness, in and of itself, and that a woman experiencing depression at or around the time of birth will be predisposed to depression, as a general concept, and that having depression at the time of birth is purely coincidental.
Hmmm. I’d like to point out that nobody appears to have had much success in treating depression, postpartum, or otherwise (I’m talking cures, here – “once diagnosed, never undiagnosed,” and all that). Who is the prospective beneficiary of this new assessment program, if one accepts that it’s unlikely to be the patient?
Matt
Okay then, let’s look again at the data… here’s Robert Whitaker on the rates of disability from mental illness as a number of persons per hundred of the population:
“rom 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.”
What is the deal? Why is the rate of people disabled from mental illness going up so dramatically? Don’t we have better health care and awareness than ever before?
FYI, psychotropic drugs change the structure and size of the brain… this has been shown in humans as well as lab animals. Or maybe the lab animals have mental illness too?
A reliable source who goes by the name, “Anonymous” stated:
1. Evelyn Pringle calls herself an investigative journalist but I can see no evidence that she’s ever been involved with a legitimate news organization — only Scoop Independent News, which is a news aggregator out of New Zealand.
Although I would ordinarily not respond to anyone who blogs under the name “anonymous,” I will take this opportunity to demonstrate the sleezy and dishonest tactics used by the opposition.
I went and did a couple google and yahoo searches of my name and the pharmaceutical industry, because frankly I do not keep track of where my articles and reports have been published. Below is a list, available to anyone who wants to do the same.
Alternet
Axis Of Logic
Best Syndication
Buzzflash
Compleat Mother
Conspiracy Planet
Consumer Health Digest
Counter Currents
Counterpunch
Covenent News
Dayton Daily News
Democratic Underground
Dissident Voice
Education Reporter
Health News Journal
Holistic Junction
Independent Media TV
Information Clearinghouse
La Leva
Lawyers and Settlements
Lincoln Daily News
Looking Glass News
Media Monitors
Medical Veritas
MWC News
Natural News
Online Journal
OpEd News
Reliable Answers
Scoop
Spinwatch
The Madison St Clair Record
The Intelligence Daily
Todays Seniors Network
Truthout
Uruknet
Web Health Answers
Yubanet
Awards
2007 Distinguished Investigative Reporting; International Center for the Study of Psychiatry and Psychology
2009 CCHR International Human Rights Award
Articles cited in:
Source Watch
Wikipedia
Brief of respondent for Wyeth v Levine, 07-0689
I am so glad you corrected anonymous, Evelyn Pringle, because without the ‘facts’, I would have had absolutely zero cause to not completely and entirely trust ‘ano’s’ opinion and judgement about what a liar you are, as opposed to her style and grace. (LOL)
I never took Paxil, nor did my daughter.
You can dazzle some idiots with that, Evelyn, but some of us know better. Keep writing, though, folks….you’re hoisting yourselves well on your own petards.
Excuse me while I pop a ritalin dose. I lost my place on this forum and Gina Pera vehemently claims Ritalin is the only remeidal option for my distraction.
Just use your magical ADHD ability to “hyperfocus”… and it’s not just Ritalin… there’s Concerta, Strattera, Adderall too… ask your doctor which one is right for you 😉
Yep, and all of the side effects that go along with the aforementioned narco-stimulants. Must be nice to have the pharmaceutical industry finance lies and deceit.
Now, it is time for me to dope my five year old before his brain evolves into a free thinking machine.
anonymous wrote:
“You can dazzle some idiots with that, Evelyn, but some of us know better. Keep writing, though, folks….you’re hoisting yourselves well on your own petards.”
LOL. Where is the stress in that first clause? Is it on the word “some,” by any chance? The implication (or is that “inference”? I’m never quite sure about these things!), being that you are one idiot who is not fooled by Evelyn’s credentials!
Incidentally, I neither own nor need a petard – much too crude for my tastes… I prefer more subtle devices.
Matt
anonymous wrote:
“…This is common sense, which is always sorely lacking in these “discussions.—
Ah, now: there’s a gauntlet that I’d like to pick up… I had no idea that anybody was interested in having a discussion, let alone a “common sense” discussion – in fact, I suspect that nobody is interested in such a thing, for fear that they may be obliged to leave the ground that they are attempting to defend.
As an opening gambit, I would like to suggest to you that the objective of mental healthcare is to cure patients of mental illness. That may not be the stated objective, but it is the ultimate objective, I should have thought, irrespective of whether it is believed to be possible to achieve. If it is not the objective, then the field is populated with charlatans.
If it (achieving cures), *is* the objective, then we should proceed towards it, with all due haste. Are we able to agree on that, you and I?
Matt
NO ONE talks about cures in mental health. The cancer people get “cure cancer” the AIDS people got “cure AIDS”, even the fibromyalgia people get talk of a cure and that’s another one of those diseases they can’t really prove (like mental illness)… We nutcases get “take your meds (for the rest of your life) and please go away”
Honestly, the treatment isn’t even working… unless the goal is to get more people on federal disability… someone please post a metric that indicates/correlates with the premise that our current mental health system is working on a widespread basis… have suicide rates declined?
Something? Anything? Really… I’d like to see something that would show that our current system has progressed past the 19th century… when recovery rates were actually higher.
I see your point, Kimbriel, and I agree especially regarding the matter of ‘not curing’ mental patients.
In fact, I think, that perhaps in most instances, when mentally ill patients get cured, this may not be so much from the treatment they received, but rather ‘in-spite’ of the treatment they received?
I also find it quite disgusting, that a ‘psychiatric diagnosis’ tends to be placed more ‘permanently’ vs. a physical illness, that is possible to cure?
That is complete nonsense, and I also think it is often the people who do not suffer distress, get sick, and/or seek help, who are not only a lot more ‘sick’ than those who are like you and me, but who are in the category of the ones who feed on ‘making sick’ others.
Yes, thank you, Katrin… I would not be labeled had I not sought “help”– obviously I did not know the things I know today about psychiatry, otherwise I would have stayed away by any means necessary. It is not stigma. It is the fact that I did not get better, I got worse. Seeking psyhiatric help remains the only decision I made while manic that I regret. I know many others who fought the same emotional distress I went through, but fought it on their own, and therefore did not end up with a lifelong diagnosis and a year of their life down the drain. Are some people grateful for their treatment? Absolutely. Good for them- it worked out. I was not so lucky.
And I am sincere here… I want to see a metric posted that indicates we are making progress on treating mental illness on a widespread basis… surely something exists? I have read three books on the history of psychiatry as well as countless clinical psychology articles in journals… I’m just not impressed… but maybe someone can show me what I’m missing?
Until then, I will not support screening or education. I think OBGYNs should foster an open, trusting relationship with expectant moms… no screening or questionnaires needed.
I understand, Kimbriel!
I recently read a really great book, and I think many would find it quite valuable as I did, and on both sides of the fence.
It is called: ‘Against Medical Advice’ by James Patterson.
And, believe it or not, the very fist person I handed this book to, and on tape, so she would be more likely to read it, while driving, was my son’s psychiatrist. (She prescribed for years Luvox for my son and which made him bipolar, and all our lives ‘Hell’)
it was discontinued only, because my son got into trouble, and the case worker from DHS told the psychiatrist something that made her order me to stop it.
From that moment on, he was never manic depressive again.
Anyway, she actually read the book and loved it, and I never got it back because she then gave it to another psychiatrist, and he to another, and so on.
The book is not one to be ‘against all and everything’, it’s the story of a boy who was diagnosed with Tourettes and OCD at an early age, and his journey through the medical and psychiatric system, AND, with wonderful parents.
GREAT BOOK! and ‘true story’
Katrin, kimbriel: Allow me to present you with a double bind: what is mental illness? That is the problem that mental healthcare has set the patient, at its most basic level.
Mental illness, then, is a problem that is insoluble, as far as the experts in the field are concerned (they have no cures, in other words), so they have passed the current state of the art on in precisely that package: “here is an insoluble problem; kindly solve it. In fact, don’t solve it, because it is insoluble.” What kind of madness is this?
Let’s take depression as a case study… You feel lonely/isolated? You don’t take pleasure in the stuff that you used to enjoy? You feel sad? Presto! You’re depressed! The problem being that having made this somewhat presumptuous diagnosis, we must acknowledge that there is no known cure, so take these drugs and fuck off.
Except that there is a solution. If a person feels lonely/isolated, then one should have them feel *not* lonely/isolated, and there will no longer be a symptom of depression, and so they will no longer be depressed – infallible logic. At least, to me, this seems logical, but the current model seems to assume that loneliness/isolation is an immutable thing: a fact, when this is surely absurd?
No, the current model *does* have a beneficiary, but it sure as hell isn’t the patient.
Matt
I’ll have to check it out, sounds interesting… your son’s story is in fact not uncommon, though still sad. I’m very glad that it worked out for your family in the end.
Thanks, Matthew, for your comment. Katrin
Katrin wrote:
“Thanks, Matthew, for your comment. Katrin”
You’re welcome. Having been through the system, I can speak with authority about its failings. Oddly enough, the system doesn’t appear interested in addressing those failings. I’ve lost interest in understanding why that is – the system is not fit for purpose and should be de-looped from the process (Pharma and all), as far as I’m concerned.
Matt
Matthew, I hear what you’re saying and very good points. A lot of the symptoms of depression are just lists of behaviors. The disease is defined by its symptoms. This would be analogous to complaining of chest pain, going to a cardiologist, and getting diagnosed with heart disease (where heart disease is listed as = chest pain). I’m sure that depression is real but psychosocial supports are much more promising than chemicals- antidepressants beat the placebo by 10%, and an active placebo (one that causes benign side effects) by no margin at all…
I just have a problem with evidence-based medicine in general. It amounts to this: “uh, we have no idea what causes this problem, or the mechanisms by which it works, and we don’t know how this medicine works, but this medicine DOES seems to work for it, so it’s all good”. (and sometimes they go a step further and say that the medicine working for it proves that the problem is caused by the mechanism they hypothesize is behind the drug- such as “Take this Ritalin, and if you can focus better, that proves you had ADD”, or sometimes they say that if, for example a dopamine blocker treats some symptoms of Shizophrenia, then Schizophrenia must be an excess of dopamine… it just goes on and on)
I mean, I realize that people are looking for relief and some DO get it from psychiatry… but then to say that we haven’t accepted our diagnosis because we don’t want to take the meds or because we feel stigma is ridiculous. I HOPE they find the genetic mechanism behind these things, because at least if I had a genetic test that proved I had a problem, it would be something.
Yes, with me, I consider myself one of those who has come out the other end ‘in-spite’ of the ‘help’ I got.
Sometime, you can learn so much from all the mistakes, right?
Katrin
Oh, incidentally: the “system” very nearly succeeded in killing me, a couple of years ago. I’m going to repay the compliment – that’s all.
Matt
Actually, Matt, it almost succeeded in killing me as well, followed by many years of severe PTSD as a result. (I think when I said the above I was still trying to avoid the memories once again)
xxxKatrin
When you go to a doctor, or have surgery, you are required to sign such things as that you are aware a procedure may kill you.
And, this should really also have to be signed the very first time you step into a shrink’s, or psychiatrist’s office.
And it’s not merely a ‘maybe’. You have from that moment on lost all of your ‘legal rights’, ‘civil rights’, etc…..
So, If someone murders you, they just write, (without more than a couple’s days of investigation) that you killed yourself, and that this is no big deal, and certainly not worthy of a ? mark, as once in your life, you took Prozac for a couple of months?
I really don’t think people get that aspect. Being labeled mentally ill has huge legal, financial, and social implications. If “personal judgment” is deemed a necessary part of the job, you can even be excluded from a job, without protection under the ADA. And unfortunately, a mental illness label is not likely to go away even though it cannot be verified. They can use it to take your child away. They can treat you against your will (something that does not have an equivalent in any other fields of medicine). You matter less.
But you know what? I would have put up with all of it, if the treatment had just worked. It did not, and it certainly was NOT worth the tradeoff. Quite frankly, I’m pretty sure I’ve got PTSD from it too.
Matt- you’re right on. Psychiatry is tautological. It’s akin to going to a cardiologist complaining of chest pain and having them diagnose you with cardiac disease, where cardiac disease is listed in some book as being equivalent to chest pain. Then imagine them saying, “There are no lab tests to verify that you have cardiac disease, but take this medicine and see if it helps. And by the way, you’re going to need it forever.”
We deserve better than that from the system.
Katrin/kimbriel: Well, the memories are still there for me, too. And I know what brought them about, too: people for whom the Truth is a foreign country.
In (my), reality, there is no such thing as mental illness – every thing that troubles one is somebody else’s problem that one has taken on, because one was kind enough to do that… Watch them squirm when one gives them the problem back, though. The mental healthcare system has a problem: it has no idea what it’s doing – it doesn’t know what the objective is, nor how to achieve it. This problem is now the patient’s, and every effort has been made to ensure that the patient may not give the problem back, because the patient has no right to say what is real about their own experience.
I know what causes mental illness: it’s every problem that one has never solved; still rolling around in one’s mind, awaiting resolution. Who’s skilled enough, from the current crop of “experts,” to resolve that? None that I’ve seen in action – they’d have to capable of leaving their own reality in order to see a problem through somebody else’s eyes, and they’re too afraid to do that. And too arrogant to acknowledge that somebody else might know something that they don’t.
Well, I don’t want to see the world through their eyes, either.
Matt