The Writers' Block

"Lost"

2008-10-22T18:50:00.001-07:00

Prologue

There is a place in the darkest alleys
lost and abandoned centuries ago,
where it twists and turns and winds so deeply
there’s no hope of finding one’s way to go

Within this unfamiliar Babylon,
this gateway of passages intertwined
if escape should evade you ere the dawn
the urban scape you knew you’ll never find

For once here, when you should turn around
you’ll find your residence far from the city
in a terrene which has yet to be found
by cartographers or those who seek it

To find this place one must be so far lost
that every way to go’s an equal toss

Some have reached this place through labyrinth or forest
others through turbulent storm and rapacious sea
Those who seek this place will have no rest
if they hold knowledge of where they be

Yet search they still for the notorious bridge
which all those lost are said to’ve crossed before,
An arch across neither river nor gorge
whose vanity urges to be explored

On our side of this bridge shall we begin
with the aid of all but dear Urania,
for all leave her might find their way within
the starless land of Reven Erehwè

So Urania, fair muse, be on your way.
In you I invoke neglect for Lost’s prey.

Canto I

It was a day at the cusp of winter
sapped of life and grey with overcast skies.
Late in noon when the cool mist grew thicker,
and the clouds veiling the sun lost their light.

The streets of London had thinned of their crowds
and the alleys left all but abandoned,
Only pigeons still flooded the city in bounds
save a soul present as a wisp of air; disturbing no one

He wore clothes of the darkest shades; heavy
and loose, with a coat reaching past his knees
and fingerless gloves worn frayed and dirty
from countless days of rugged wandering.

His face and build betrayed a man yet young,
though his ageless eyes told a different tale;
so dark with witness to a world of wrongs,
the yellow-green within could not rebel.

This pair gazed far beyond reality,
on a place he’d vowed to never return.
A place where peace is short-lived fantasy
between long years of struggle undeserved.

Lost’s cherished land of broken wings
In his heart he felt her calling him through
dreams lost, and lives lost, of loss in all things
His home forever, an unwelcome truth

But why after years of untroubled thoughts
had his mind once again fallen to dreams?
After all this time condemned and forgot
so ill an omen was the worst of things

These thoughts churned through his mind uneasily
though his step felt nothing of this heaviness
His walk and smile still came naturally
like a commander used to such distress

and to liken him to such might not be
so far off as one might first imagine
for there isn’t much of peace in the stories
of Reven, one known to all in that land

Reven forced his harrowing thoughts from mind
and took a moment to breathe it all in.
Then released it, letting his tightened chest untwine
as he started home where Lost awaited him.

Yet even there was no sanctuary
for she was of the land of Erehwè
and though of her land she recalled nothing
His thoughts were uncured by her amnesia

Only a greater burden did it rest
on a mind already struggling with weight
for how could he tell her of their dark past
and keep her where he knew she would be safe?

Yet how could he lie to her loving face
when she asked him of how things once were?
Struggling to remember that special place
that had only been a shared dream in war?

And how many times could she be convinced
by explanations that could never be?
How should he explain that their home exists
yet hasn’t since the nineteenth century?

How should he explain why she gets no mail?
or phonecalls or visits from friends?
That her parents are in the depths of hell,
with tombstones of fine dust; so long since dead

Best to start before she was known as Lost
but even then she’d known only her name
Seraya Alexandris Aizenghast
the first of Erehwè, or so they say

He’d told her her name, but had said no more
to protect her life he would damn the rest
but as his hand reached for the door
He nailed the cause of his mind’s unrest.

Fury of the Spirits [Novel Excerpt]

2008-10-22T18:28:00.000-07:00

Neirus stroked a finger across the strip of bare skin that ran down the center of his expertly trimmed goatee. He was a tall, lean, muscular man pampered and chiseled by luxurious severity. The obnoxiously perfect arrangement of every paper, pen, lamp and book in his ornately furnished office made these two traits abundantly clear to anyone he called in to see him. He also seemed to rather enjoy flaunting how much more cushioning, gilding and craftsmanship his armchair had undergone in comparison to the one on the other side of his desk where his visitor was seated. For that very reason, Rekia always chose to stand. Every word he spoke seemed to seethe with condescension. All she could think about as he drawled was lunging over the desk and hitting him as hard as she could. “Again. After you are finished with him, you must leave that weapon behind. And no matter what you do, you must not undo the wrapping on the hilt. Understood?”
Rekia’s lightning blue eyes glared at him through the stray locks of black hair that partially hid her face. Her lips were tightly crushed into a grimace that openly displayed her agitated boredom at the ignorant prattling she had been forced to endure for several minutes longer than she could stand. “You keep dwelling on the simplest point as if everything else will fall into place perfectly just because you wish it. If Akordin or you had the sense to stage this anywhere else, then that might be my only concern. But as it stands what you’re asking me to do is impossible.” Her hands had a white-knuckled grip on the back of the chair across from his desk as she tried desperately to channel her elevating aggravation and keep her voice calm. Her very presence threatened to light the whole office on fire. “I can’t get within arms reach of an ambassador at an invitations-only dinner catered by personal servants. There’s no way for me to be seen there without being immediately plucked out as an uninvited guest. And there’s no way not to be seen by that many people while still managing to get close enough to put this in his chest.” She motioned with the knife she had been given. “Let alone escape alive after killing him in plain sight of everyone there! Do you even know how many guards he has? Thirty-eight. I know. I counted them myself.” Rekia’s brow lowered. “Or is this merely the Circle’s way of retiring me without getting its own hands dirty? Because if I find out that’s the case, I’m coming after you first.”
Neirus’ eyes sparkled with menacing humor as he spoke. “Even if it were, it changes nothing. Your empty threats mean nothing.” He cradled his chin in one hand as if appraising her as the fingers of his other methodically drummed on his mahogany desk. “Or have you finally freed yourself of your stake in this, Circle’s Child?”
Rekia had been in a dark mood before, but mention of that coiled all her helpless fury deep in her breast until its poison nauseated her. The ire in her defiant glower could have set his hair to ashes, but she remained silent. She would have liked nothing more than to cut out his mouth and use it to spit in his face. She hated with a passion how he, or any other among the Circle’s officers could so easily bring her to rein with so simple a threat. If there was one thing she didn’t need to be reminded of, it was her stake in this. The cost of failure - to her - was far worse than death. And it was a threat that would have her serving the Circle’s every whim for the rest of her life.
Neirus, after a show of waiting for her reply, seized the last word like a trophy as he triumphantly rose and walked past her out of the office. As he passed, she caught the subtle scent of flowers effusing from the dark lengths of his well-kempt hair. Whatever flower it was, he had ruined it for her for life.
Rekia relished in a small fantasy of turning the tables on Neirus with her knife until he screamed for his mother before finally releasing her vice-like grip on the chair and exhaling deeply. She would have done nearly anything to escape the Circle’s grip on her. Nearly. Unfortunately, the Circle knew the one thing she would not do.
And here she was.
Rekia turned to leave when something caught her eye. Neirus had left his keys. She wasn’t sure why that had caused her to hesitate. She wasn’t a thief, and she had no particular interest in anything that belonged to that man. Even so, she felt compelled to take them, if for no other reason then to foil him for being such an ass. She couldn’t help but smirk at how reminiscently childish it was as she picked them up and twirled them around her finger.

Pay Off or Pay Out: What Pharma Corps Will Do to Sell You Drugs

2008-04-14T10:26:00.000-07:00

Despite the dominant presence of pharmaceutical companies in psychiatry and their influence over clinical trials and research, the direction and focus of some current blogs I have explored reveal that there are others beside myself who are concerned with the current trend of drug treatment in the

United States

and the role these corporations are playing in it. The first post: “Drug Research: To Test or to Tout?” specifically addresses the issue of corporations such as Eli Lilly paying off state officials to get atypical antipsychotics put at the front of the market, causing doctors to prescribe patients drugs that cost far more and prove no more effective than their predecessors. These drugs, unlike ones before them, are also known to cause diabetes and severe weight gain. It follows the successes of Allen Jones, one of the current legal heads of the anti-pharmaceutical movement in psychiatry. The second post: “Pharma Pursues Its Wet Dream Legal Fantasy, Gets Paxil and Zoloft Suicide Lawsuits Denied” is a response to a current legal matter which has claimed Paxil and Zoloft victor of suicide lawsuits against their anti-depressant medications. Apparently, Zoloft and Paxil did not include increased risk of suicide on their lists of side effects despite several studies proving this to be true, and they are not being held accountable for risking the lives of consumers. However, the outcome of the case isn’t as important as the case itself. The fact that Zoloft and Paxil manufacturers attempted to hide such severe and fatal side effects from patients reveals the nature of the corporations producing them, and what they will do in order to increase sales. I have offered my own comments on both of these posts below, responding to the current issues with pharmaceutical companies and offering my own opinions and analysis.

Comment: "Drug Research: To Test or to Tout?"

First I would like to thank you for drawing the public eye to the questionable ethics of pharmaceutical corporations such as Eli Lilly. After having done extensive research on the effectiveness of atypical antipsychotics and their predecessors, it comes as no surprise to me that these new drugs are no more effective and pharmaceutical companies are doing everything they can to cash in on them anyway. Although this article does not address the greater issue of the severe negative effects of antipsychotics in general, giving consumers a reason to question their prescriptions and begin researching these drugs themselves is the ultimate goal, and this is definitely the type of provocative post that could cause such a phenomenon. It is important that patients realize that they can not rely solely on FDA approval as evidence that medications are safe and effective; that much of what the FDA approves is influenced by biased research conducted by these corporations, and that even those that the FDA attempts to restrain manage to spearhead through direct marketing to practicing physicians. In criticism, however, I would like to mention that many sources and studies are alluded to, but no direct references or links to references are given besides the link to the St. Petersburg Times. When confronting an issue of such a purely scientific nature with so much contention in the research field, linking to authoritative electronic resources is truly a necessity in order to drive home the point. Although a minor issue, I also believe this post could have been improved upon by use of graphics or visual media, as these elements are essential in harnessing a would-be reader’s attention. I only offer these suggestions because I truly believe in what your blog is doing. I am an avid reader of Atypical Antipsychotics and look forward to many more insightful posts in the future.

Comment: "Pharma Pursues its Wet Dream Legal Phantasy, Gets Paxil and Zoloft Suicide Lawsuits Denied"

Philip:I’d like to start by thanking you for attacking the growing issue of pharmaceutical companies in an argumentative fashion that demands attention. I too believe that the growing power of the already colossal Big Pharma within the legal and research spheres is a frightening problem. However, I would like to contest your comment that “We all know that pharma companies dream about little but money and will go to damn near any length to create a market, hide problems with their drugs from the public and regulators, and manipulate their way to the latest blockbuster.” It is my belief that an epidemic of patient ignorance is the only thing truly responsible for these drugs becoming “the latest blockbuster.” If people understood that their marketing, their labels, and the doctors who prescribe them are not to be trusted, I would hope that sales would be on the decrease instead of the rise. Just from my personal experience with individuals on anti-depressants and anti-psychotic medications, I can say that there are still too many people who trust their drugs more than they trust themselves to cope with a problem. I agree with your response to the third circuit court’s ruling and I have little doubt that the reason for this ruling is checks being written on both sides of the table – in fact I just commented on another blog that addressed this issue in particular. The bigger pharmaceutical corporations get, the less chance anyone has of tackling them through the court system. This is why I believe our primary goal should be raising the awareness of consumers about the ineffective and destructive nature of antipsychotic and anti-depressant drugs. Your indirect approach to this matter is quite effective. If people start asking why Big Pharma would hide the suicide risk on drug labels, maybe they’ll start asking why doctors are prescribing them, and why they don’t seem to be getting any better. I appreciate your post and hope to see more like it in the future.

No Easy Way Out: The Depressing Reality of Anti-Depressants

2008-04-07T01:10:00.000-07:00

The drawing to the rightis something I created in response to a disorder that I have experienced first hand: clinical depression. It is a work I created in expression of my fundamental belief that the power to overcome hardship and emotional trauma lies within nothing so much as the self. Depression is one of the most commonly treated psychiatric disorders in the United States, with anti-depressants being among the leading medications in sales within the pharmaceutical market. However, despite their popularity, the effectiveness of these drugs in the treatment of depression is not as miraculous as consumers would be led to believe. This is because no matter how well anti-depressants treat depression’s symptoms, they cannot treat the cause.

It is widely held that depression is caused by a chemical imbalance of the brain; that, because depression is caused by a chemical imbalance, it is something that a victim suffering from this illness has no control over. However, in spite of this common belief, there is little evidence to support it outside of research funded by the pharmaceutical companies which produce these drugs themselves. According to neuroscientist Elliot Valenstein “no biochemical or anatomical traits have been found to reliably distinguish the brains of the depressed, and attempts to prove the chemical deficiency hypothesis of depression have been in vain.” This would suggest that clinical depression is a very natural condition caused primarily by life experiences.

Whether or not antidepressants treat the cause, however, they will remain titans within the pharmaceutical market for the treatment of depression’s symptoms due to their heavily marketed effectiveness; for, as my previous posts have shown, the majority of psychiatrists and patients in the United States are already more concerned with alleviating the symptoms of mental illnesses rather than finding ways to cope with them. The majority of patients just want to feel better, whether their problems get solved or not. However, unlike anti-psychotics, an overwhelming amount of evidence suggests that antidepressants fail to treat even the symptoms of depression at a significantly higher rate than placebos. One of the largest studies ever done on anti-depressant drugs has concluded that they have “no clinically significant effect.” In this study, researchers conducted an analysis of the 47 published and unpublished clinical trials submitted to the Food and Drug Administration in the US made in support of the best known antidepressant drugs, including: Prozac, Seroxat and Efexor. The results proved the drugs ineffective in all but a very small portion of the most severely depressed.

It is of such importance for patients to be aware of what antidepressants do not do because of what they have been proven to be capable of. Long term doses of anti-depressants can actually lead to the patient becoming more depressed. This is because many of the side effects of antidepressants such as weight gain, sexual dysfunction and anxiety can cause a depressed state in people or make their depression more severe. Since depression is often if not always the result of life problems, adding more difficulties and stress on to those that drove the patient to take the medication in the first place can only cause the psychological state of the individual to worsen. Not only this, but according to Peter Breggin, M.D., the methods by which antidepressants reach–or attempt to reach–their desired effect inhibits the brain’s function and can lead to permanent, irreparable brain damage. There are also several published research studies which suggest that antidepressants increase a patient’s likelihood of attempting suicide–especially in the case of adolescents. These results can be especially problematic due to the deceiving nature of antidepressant withdrawal symptoms such as crying spells, irritability, anxiety and agitation. These symptoms can lead a patient to believe their depression has actually worsened and further medication is needed when such is not the case.

Although it is puzzling that antidepressant medications remain so widely trusted, believed in, and consumed in light of all the research that suggest their relative ineffectiveness, even more confounding is the use of off-label anti-psychotic drugs to treat depression. Currently twenty-one percent of anti-psychotics are prescribed for symptoms not indicated on the label and one of the few other disorders for which they are prescribed is depression. Considering several studies have shown, with little opposition, that anti-psychotics have absolutely no positive effect on depression, one need only read my prior posts on the negative effects of anti-psychotic pharmaceuticals to understand how grave an issue this is.

Why are antidepressants being prescribed when their effectiveness has such limited value and their side effects are so severe? Why are anti-psychotics being prescribed for something they do nothing about? For the same reasons that children younger than five are being prescribed them before they can say “I’m sad” and 67% of pharmaceutical companies negative research results remained unpublished (see chart). The majority of researchers involved in data collection are being sponsored by - or hold shares in - the very corporations producing the drugs, the doctors are getting paid to prescribe them, and the patients demand expensive placebos that make them feel better about the situations they don’t want to cope with.

10 Ways to Stay Informed: Sites Dedicated to Mental Health

2008-03-29T10:48:00.000-07:00

Continuing with my previous post “Mental Links: A Guide to the Authorities in Mental Health”, I have once again scoured the web for reliable and up-to-date resources to post for the assistance of others who wish for information on the topic of mental health. However, unlike my last post, these most recent links are more dedicated to information on pharmaceuticals and their misuse in the psychiatric field. As before, I have kept in mind the Webby Awards Criteria and the IMSA Criteria during my search and have offered here the top ten I have found to be most useful and authoritative.

DB’s Medical Rants, for one, is a blog covering a wide range of topics on health and pharmaceuticals. The blog, being posted by a very prestigious doctor, contains a great deal of authority and receives fresh posts on a daily basis, currently containing over 3000 posts. Unfortunately, “DB” does not make use of visual aids or graphics of any kind. “Atypical Antipsychotics”, another blog, shares this deficit. However, it makes up for this by being updated several times daily and providing recent information on harmful drugs in mental health and the negative effects of irresponsible prescriptions. Unlike these blogs, “The Last Psychiatrist” contains a humorous and entertaining twist to an otherwise grave topic, and manages to do so in a way that remains informative and insightful. Although the authority behind the author of “The Last Psychiatrist” is questionable, his sources are reliable. Stepping out of the blogosphere, I’d like to direct interested parties to “Psychiatric Services” and “Advances in Psychiatric Treatment”, two websites which feature online databases of medical journal PDFs in the psychiatric field; two sites most commendable on their levels of concrete and referenceable data and most lacking in their ease of direct navigation. If filtering through a massive selection of PDFs is too cumbersome, ScienceDaily or Pharmacy Choice might be better websites to visit. Both feature extensive and up-to-date news coverage on the latest in medical and pharmaceutical news but unfortunately lack the use of large, visually appealing graphics and multimedia. The Citizens Commission on Human Rights, being an organization dedicated to the investigation and exposure of human rights violations, is something all-together different. CCHR uses concrete evidence to reveal treatments harmful to patients, and offers healthy and beneficial alternatives. Following a similar field of interest is PsychRights, a law firm targeting these violations in the field of mental health. The site, although drab in its choice of colors and lacking visual quality, contains some very useful information relevant to the mistreatment of the mentally ill in psychiatry today. PsychSearch, a site which indexes case reports of such malpractice, is a very professional, model example of a page which makes proper use of colors and graphics while remaining easily navigable and with fast load times. As previously, all of these websites can be found in my linkroll posted on the right.

“Macha”: An Anti-Psychotic Community

2008-03-10T08:37:00.000-07:00

"Macha"

Macha had always been unapproachable
Not just by her classmates and peers
but her teachers, her parents
felt powerless to relate with her
she wasn't unfriendly
nor her demeanor unpleasant
She was, simply put, an enigma
impossible to define
impossible to predict
Her style was not normal
nor was it rebellious
Her choice of music was unnerving
Celtic lullabies to death metal
There was no label
nothing relatable
The school counselor was suspicious
any child who didn't get along
didn't communicate
anyone undefinable
unpredictable
wasn't necessarily dangerous
but definately had something wrong
Were the parents abusive?
No cigarette burns to tell
No bruises, no cuts
Nothing at all
She seemed happiest alone, though
and there was crime in that
there were rumors too
of other things
unusual things
that she spoke to empty chairs
giggled at the oddest times
"spaced out" a bit too much in class
smiled at phantoms
and spent three days
walking a dead cat.
How much of this was true
was certainly questionable
She denied everything
As did her best friend
whose pleading was hopeless
considering her lack of substance
When they were alone,
Macha would explain that others
couldn't perceive her
because she wasn't real
but her friend simply couldn't understand
She knew that Macha wasn't crazy.
And only crazy people saw things others didn't
After several tests, Macha was defined.
Predicted.
Labeled.
Schizophrenic.
A single word that meant nothing
yet explained it all
A few weeks in the hospital
and a regular dose of antipsychotics
coupled with antidepressants
to relieve unpleasant side effects
And she should be Perfectly
normal
in no time.

"Macha, Patient 47A"

The binding on her wrists were tight, because they knew she would fight it.
She had dislocated her thumb three times in the past week trying to escape
She went for the gag first every time. It was remarkable.
The binds were as padded as could be without being escapable,
yet somehow, she had managed to make her wrists bleed again
she would make anything she could bleed when she got the chance
they had had to clip her nails uncomfortably short
so she wouldn't attempt to scratch her captors to death
or failing at that, gouge her way into her own throat
Fortunately the medications kept her mouth dry
or they would have had to swab out her spit
to keep her from choking on it.
They had to keep something in her mouth at all times
lest she bite off her own tongue
She was a difficult one to manage
with eyes that glowered with ire and defiance.
It had started with refusal to take meds.
Then institutionalization,
Now this.
Most of the staff refused to be anywhere within her general vicinity.
one member had even offered a letter of resignation.
When it was apparent that her behavior would not cease
They locked in a medicated stupor
tranquilized at the slightest upset
A drugged, unwilling surrender.

Epilogue: Are Antipsychotics Anti-Psychotic?

My purpose in creating the fictional “Macha,” as well as my artistic renditions of the work, is to address the typically unquestioned authority of antipsychotic medication as the first and last solution to mental disorders such as schizophrenia. The use of such drugs as exclusive treatment is a current and growing trend in the United St ates, and it is my belief that this is primarily due to intolerance or misinformation. Although it may be true that medication is widely accepted in psychiatry as an adequate suppressant of symptoms and is often necessary for the treatment of the most severe and dangerous forms of illness, there is an insurmountable amount of evidence to suggest that it does so at the cost of cognitive improvement, recovery, little permanent benefit, and with devastating long-term side-effects. Therefore, it should only be considered as a temporary solution, and even then, only in the most ominous of circumstances.

I created Macha to be an example of what happens when medication is considered before alternative, less detrimental and more productive methods of treatment have been exhausted. As in Macha's case, there is a high probability that the popularity of medication is due to its instant gratification, a deficiency in information, lack of required effort, and the dearth of tolerance and patience for mental illness. Antipsychotic treatments, as they function currently, aren’t designed for patients so much as for the short-term suppression of the unnerving characteristics of psychosis. The alternative–facing the unsettling nature of this disease, understanding it, and supporting those who experience it– should be the goal of not only patients’ guardians, but their communities, and society as a whole.

There is such an overwhelming amount of evidence and research to suggest that medication is not only an unproductive treatment but a hindrance to recovery, that it is astounding how widely accepted, promoted, prescribed and suggested antipsychotic medication is today. It is so unbelievable, that even as an informed individual backed by a small army of researchers with conclusive evidence to support my current conclusions, I am forced to second guess myself out of sheer lack of acknowledgement. How can so much evidence be ignored by practitioners? Are educators ignoring pertinent data? Are the doctors? Is the prescription of pharmaceuticals more profitable and thus ultimately better received? Whatever the reason, the current status quo among professionals is disregarding this research, and conclusively condemning the majority of uninformed patients to detrimental, unproductive and oft times unnecessary forms of treatment. Since the majority of patients trust and rely on their doctors for information, the current state of affairs is grim indeed.

A common misconception is that medication is required for the recovery of individuals with mental disorders such as schizophrenia. However, schizophrenia reverses naturally in the majority of its victims, and the highest rate of recovery has been observed in non-industrial countries where antipsychotics are not used. A fifteen-year multifollow-up study published by The Journal of Nervous and Mental Disease supports this claim, documenting the extreme disparity in recovery between schizophrenic patients who took antipsychotic medication and those who remained without it. According to their study, at the end of the fifteen-year period, twelve out of sixty-four patients were in a period of recovery. Of the sixty-four, twenty were not on any form of medication and eight of those twenty (fourty percent) were in a state of recovery; two of the thirty-nine patients on antipsychotics (five-percent) were recovering; and two out of five patients on medications but not antipsychotics were recovering. This article is not alone in its conclusion. One need only begin to browse the vast number of references it cites for further evidence. For even more authoritative research backing this conclusion, browse this index of authoritative articles dedicated to the subject.

M.D. Matt Irwin offers an explanation for why this lack of recovery in patients might occur. According to his extensive research, the physiology of people who have been exposed to antipsychotics and other drugs naturally adapt through “alterations in receptor number and function.” This "creates a physiological dependency which reinforces psychological dependency." The current emphasis of psychiatrists on drug treatment might also cause issues of social, psychological and spiritual nature to go unaddressed. A combination of these factors could worsen the outcomes, especially since tolerance of severe adverse effects of antipsychotics among patients is low and many choose not to take them unless forced to do so.

Obviously, the difference in recovery between patients on and off antipsychotic medications is not marginal. Even so, it can not be denied that there are plenty of cases of schizophrenia that are too severe to simply “cope with” and “tough out”. In such situations, antipsychotics might be necessary for short to mid-term therapy but should never be used as a primary or sole form of treatment. This is why anyone with a mental disorder or the guardian of anyone with a mental disorder–be it schizophrenia or otherwise–absolutely must educate themselves on evidence-based, alternative methods of treatment–treatment which offers permanent recovery benefits whether or not the individual requires a term of medication. A method that has been proven effective in multiple cases is cognitive behavior therapy (CBT). This system uses mental techniques such as developing alternative explanations for symptoms, and altering thought processes to “reduce the severity of, or distress from, the symptom regardless of whether the patient accepts a diagnostic label.” One of the greatest advantages of cognitive behavior therapy is that it does not rely on the patient accepting his or her symptoms as a function of a mental illness in order to be effective. In fact, in the United States, American-based guidelines for treatment of schizophrenia such as those issued by the American Psychiatric Association and the schizophrenia patient outcomes research team recommend cognitive behavior therapy for treatment-resistant patients for this very reason. However, it is unfortunate that in the United States only the stubbornly defiant are receiving what the United Kingdom has already accepted as adequate, acceptable and readily available treatment. An article printed in the American Journal of Psychiatry titled “Cognitive Behavior Therapy for Schizophrenia” specifically addresses the lack of cognitive behavior therapy as a primary method of treatment in the United States in comparison to the UK and the severity of this issue due to its empirically researched and supported benefits.

One example of such an examination is an piece studying cognitive behavioral therapy in schizophrenics with command auditory hallucinations, which found that patients undergoing this form of therapy had fewer episodes, complied to auditory hallucinations less, and generally acted in less ways to appease them. Although the hallucinations did not cease, they became less of a hindrance and burden on the lives of patients. Conductors of another, similar study discovered that after one year, patients who had undergone cognitive behavioral therapy, starting at the time of hospitalization and while acutely psychotic, benefited greatly over those who did not receive this therapy. They noted that the benefits extended to both the positive and negative symptoms of schizophrenia as well as overall social interaction.

Even though the severity of schizophrenic symptoms may require temporary treatment with antipsychotics, this represents a minority of cases. Those who wish to undergo such treatment, and guardians who are considering putting their children on antipsychotics should be fully aware of the long-term consequences, increased relapse rates, drug withdrawal symptoms, decreased probability of recovery and side-effects. They should also be relieved of any disillusions that these pharmaceuticals are a completely safe and effective form of treatment, because there is plenty of evidence to suggest otherwise. The greatest offense a guardian, or the community responsible for an individual’s care can commit, is medicating a person with a mental disorder out of sheer convenience. Antipsychotics are quick, easy and deceptively effective at suppressing symptoms, but their aid ends there. In and of themselves they are not, and should not be considered a healthy, productive form of treatment.

Mental Links: A Guide to the Authorities on Mental Health

2008-03-03T10:03:00.000-08:00

My endeavor in writing this blog is to not only spark a discussion within the web about literature and mental health, but also to be a conduct toward valid and accurate information about these subjects. Towards that end, I felt it necessary to search the web and provide a number of sources that individuals can turn to for their own research on mental health. I kept in mind the Webby Awards Criteria while evaluating the usefulness and utility of these sites, but most of all, with most of my resources being based in the academic field of mental health, I strove to make sure the information on the sites held enough authority to be referenced. The American Psychiatric Association is one such website. It serves as a member driven locale and a networking hub for psychiatrists and members of the association. It’s news feed is current and informative, and many useful links to education and career based resources in psychiatry can be found here. Unfortunately, the American Psychiatric Association lacks the visual appeal and navigational ease of the American Psychological Association, which is the Washington DC based organization which represents psychology in the United States. It has a very strong infrastructure and uses intriguing, relevant and interesting graphics to the utmost effectiveness. This site’s navigational tool system makes the navigation of a seemingly overwhelming amount of content easy on the user, something that Psychnet-Uk lacks. This is unfortunate, because although Psychnet-Uk lacks the visual appeal and ease of perusal of the American Psychological Association, it is an invaluable web directory of everything mental health. A directory which will inevitably lead you to Mayoclinic: a not-for-profit medical organization committed to the diagnosis and treatment of virtually all varieties of complex illness. Mayoclinic is not only a resource of high authority, it’s an experience. Navigation through any range of diseases, drugs, treatments and more can be pulled up immediately through their easy-to-use site map. They have podcasts and blogs which are updated daily coupled with captivating visual media such as slideshows and videos, all informative and on topics relative to health. Another incredible data resource is the National Alliance on Mental Illness. This site’s “Inform Yourself” section has the authority of a legion of professionals, yet communicates the complexities of mental disorders and medication in a way that is not only enlightening, but easy to understand and directed towards the general public. These sections also suggest relevant and authority-driven medical journals for further information. For a similarly informative and easily comprehensible experience on schizophrenia and depression in particular I would recommend exploring NARSAD, a charity for their research. NARSAD keeps its web-based data concise, and offers a general overview of these conditions while offering ways for the general public to help through charity. Unfortunately, NARSAD lacks in that its news feed hasn’t been updated in several months. A weakness that the National Institute of Mental health does not fall prone to. Less is more for the NIMH website. Although there are few graphics, the site retains its visual appeal and the abundance of insightful data in the “Mental Health Topics” section is executed in a way that keeps pages dynamic and the user interacting with the site. Its news section is a current resource which not only covers information relative to the National Institute, but also to press releases and current news in the field of mental health. Although the site is fairly easy to browse, no site in this linkroll compares to the ease of the Navigation found at the National Mental Health Association. The perusal of mental health related information at this site can be searched for alphabetically “by issue”, “by audience”, or by “disorders and treatments”. Everything is organized in scroll boxes, keeping page scrolling to a minimum and facilitating the research process. Even though the National Mental Health Association’s site is well-engineered, it has less than engaging visuals, something WebMD has in abundance. For a health-related resource, WebMD is the ultimate visual experience. Its images are eye-catching, provocative, and displayed in a dynamic slide-show format which keeps the page fresh. It’s “latest headlines” section makes it easy to keep up to date on current WebMD news and you can navigate nearly their entire site effortlessly from the homepage without needing to dig deep into site-maps. It even has a list of top 12 health topics for easy navigation. Recognized by several professionals and reviewers as a credible and in-depth resource, WebMD holds the most professional, well-developed and well-designed site in my link roll. Due to my emphasis in this blog being upon Mental health in literature, I thought it necessary to add at least one link to a writing resource I find invaluable: Writing.com. Writing.com offers information on everything about writing, from self-publishing to copyrights. It’s focus, however, is not as a resource of information, but rather as a member driven, interactive atmosphere. The site’s main function is as a forum in which writers can post their work on the site and get quality feedback from interested readers. Aesthetically, however, Writing.com is lacking. The home page is unwelcoming to new guests, featuring little in the way of captivating material, with little to garner the attention of the guest aside from the registration form, which is untactfully placed front and center. If you can overlook this one minor flaw, however, and dig deeper into the site, I believe you will be pleasantly surprised. If you wish to access any of these resources quickly and easily for your own personal use, feel free to use the linkroll found on the right of my blog page.

Over-Medicated, Under-Treated: The Reality of Antipsychotic Pharmaceuticals

2008-02-20T10:36:00.000-08:00

Having only entered the external blog realm within the past week, I wasn’t sure what to expect when I began the search for authoritative, informative blogs on the subject of mental disorders. I began my exploration of the mental-health blogosphere with an emphasis on medication and schizophrenia and was taken aback by the severe lack of current informative news relative to the field. Fishing through the overwhelming number of Britney Spears related posts, I was eventually forced to negate her from the search entirely only to be overwhelmed with news articles on schizophrenic-related crimes dealing with individuals who apparently refused to take their medication. There were only two actual crimes in question, but tens of blogs found it necessary to cover them and all seemed focused on the mental disorder as the prime suspect. What I find so alarming about the initial results of my search isn’t Britney’s apparent downfall or the number of crimes accounted for, but the domination of this negative, nonconstructive and harmful media in the field of schizophrenic mental health.
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One of the first, truly informative blog posts I came across was “Injectable Longer Lasting Zyprexa May Be Approved”, an article on a new, injectable form of Zyprexa – an antipsychotic drug which is currently being considered by the FDA for child and adolescent as well as adult treatment. It’s an unforgiving drug with enough unpleasant side effects to keep anyone with a decent amount of sense away from it. Unfortunately, as an injection, it will probably see most of its use in forced medication, for people who will not take the Zyprexa pills willingly. After reading this article through a couple times, I came to an appalling revelation. Who would forcibly medicate a child with Zyprexa? Almost any concerned and uneducated parent. Considering the maelstrom of misinformation and negative media I encountered within my first few hours of blog-searching, it’s difficult to believe that anyone with average exposure to the media wouldn’t immediately draw connections between schizophrenia, crime, and the need to medicate - a connection which is completely false. Yes, the disorder needs to be addressed, but there are several alternative methods of treatment which have proven effective in several cases and should be exhausted before medication is even considered.

As Dr. Peter Breggin illustrates in his post “Brain Disabling Treatments in Psychiatry: Drugs, Electroshock and the Psychopharmaceutical Complex”, there is no “wonder” in anti-psychotic drugs. Medication for mental disorders do not “cure”, but merely hinder cognitive ability to “suppress” symptoms. They are misleading both in their initial effects and in their withdrawal symptoms. While on the drug, the patient will inevitably be perceived as doing better, when in fact, not only are the side-effects destroying the victim’s body, but the brain is doing worse. When off the drugs, the withdrawal symptoms can cause misleading psychotic episodes which could lead parents to believe their child is actually worse than before and seek more, possibly stronger medication. Instead of passing anti-psychotic drugs to force on unwilling patients in an effort to suppress symptoms, we should be researching alternative, healthy methods of helping victims of this disorder cope with their illness without destroying their minds, their bodies and inevitably their lives. However, before this can ever become a reality, the proliferation of nonconstructive, misleading information in the media about the disease and its treatments needs to be addressed.

I have offered my comments on the injectable Zyprexa drug as well as Dr. Breggin’s views on medication for mental disorder below:

“Injectable Longer Lasting Zyprexa May Be Approved”
Through the tone of your post, I can at once gather a sense of apprehension concerning the release of this new, injectable form of the Zyprexa and I am appreciative that you are revealing medications such as this for what they are rather than allowing them to remain naively considered “wonder drugs”. Your article is truly informative, and reveals several things about the Zyprexa drug that I was not aware of upon entering the post. I knew that Zyprexa could have devastating side effects, such as heavy weight gain, diabetes and sedation, but I was unaware that Zyprexa had actually made an effort to restrain information about these side effects to patients prescribed this medication. I find this to be revealing of Eli Lilly’s intentions in the pharmaceutical industry and something which patients or their guardians should be aware of before considering the drug. I also find it amazing that doctors prescribe this drug off-the label for anxiety and depression considering its side-effects. I suppose they never take into consideration that considerable weight gain and diabetes can cause even greater anxiety and depression than the disorder itself, not to mention that drugs such as these often fail to address feelings of hopelessness despite their effectiveness at ridding other symptoms. What I find most alarming about your post is that this drug is being considered for use on children and adolescents. Unlike adult patients, who can often at least have some control over their forms of treatment, children are completely dependent on their parents’ decisions; and I believe that many parents would decide to have a “fat, stable child” as opposed to an “unwell, skinny one” without ever consulting the child. And unfortunately, Zyprexa’s misleading marketing campaigns coupled with the vast amounts of negative media related to schizophrenics in general will have parents deciding on it before exhausting alternative forms of treatment that could potentially lead to a completely healthy, stable child. The 250% increase of antipsychotics in Florida children alone, not to mention its use off-the-label, reveals that this is already happening. I believe that posts such as yours are a step in the right direction. The first stride towards healthier treatment for schizophrenics is awareness about the reality of antipsychotics such as Zyprexa.

“Brain Disabling Treatments in Psychiatry: Drugs, Electroshock and the Psychopharmaceutical Complex”
In the sea of misinformation about the nature of mental disorders and their treatments, I found your blog post to be a breath of fresh air. Given the rise in popularity of antipsychotic drugs such as Zyprexa both on and off the label, a truly informative post such as yours, which reveals the true nature of antipsychotic drugs, is long overdue. The brain disabling function of antipsychotic medications as a means to suppress symptoms is certainly something that a patient or guardian should be aware of before accepting these drugs over alternative forms of treatment. I also somehow doubt that the withdrawal symptoms of these medications are being addressed, and that most patients are even aware of them. Considering the emulation of psychotic episodes that these withdrawal symptoms have, I don’t find it hard to believe that patients would be perceived as worse when off the medication when their condition might actually be improving. Bearing in mind that many mental disorders often improve over time, this could definitely have severe consequences for the unwitting patient. Although I understand that this is a mere summation of points expounded upon in greater detail in your book, I think it would be beneficial both to your post and to the community, to elaborate on some of the alternative methods of treatment that patients with mental disorders could consider besides medication. Currently it seems that pharmaceutical treatment has complete domination as the end-all be-all legitimate form of treatment for patients with mental disorder, and this absolutely should not be the case. But until other effective forms of treatment start to take a foothold both on the information highway and in the media, awareness levels will remain too low for medication to ever be challenged.

Elissa: A Case of Schizophrenia

2008-02-11T02:35:00.000-08:00

The first time she saw it, she was mortified.
A freakishly self-mutilating clown
tearing at its face as it laughed
It giggled like a girl
but that was the only girlish thing about it
Looking at it, watching it, she felt her flesh crawl
the hair at the back of her neck stood on end
this thing wasn’t right
No one else seemed to notice but her
It was obvious they were conspiring.
They paid this clown to scare her.
On the playground they were always laughing
the other kids
but there was never anything funny
She was the joke.
She knew it.
They never looked at her.
They didn’t have to.
There was nothing else to laugh at
Giggling, giggling
Just like the clown
They giggled just like it
All around her, giggling
Mutilating laughter.
The clown stepped closer
she wanted to run
her feet were frozen solid
tried to slap it away
with arms that defiantly hung
limp at her sides
closer
closer

She couldn’t see
Tasted like vomit
Where was she?
Tried to open her eye-lids
but she could only roll
her eyes up into her skull
She couldn’t remember how to open her eyes
It felt like hours passed
before the sickeningly bright light spilled in
Rolled her tongue in her mouth.
Spat out bitter, acidic flecks.
"Are you Okay?"
"Are you Okay?"
"Give her some room. I think she passed out."
"Probably the sun, she should be fine now."
The world swam with faces
colors, lights
Sounds…people talking, asking questions
"I’m Okay." She heard herself say. "Is it gone?"
"Is what gone?"
"The clown."
Confused voices. "What…clown?"
She felt breath on the side of her face
warm, rancid breath
it smelled like vomit.
She rolled her head to the left
That clown.
She wanted to scream but she couldn't
she couldn't force her voice out of her throat
her mouth worked at the words she wanted to say
no voice came
She looked the other way
Still there.
Again.
Still there.
She couldn't move the rest of her body
Couldn't hold her head straight
the clown was making a point.
And then she heard it
A voice like nails
clawing furiously at a chalkboard
There were no words but she understood the meaning
Don't be afraid. I'm on your team.
Elissa blacked out for the second time that day.

It was a dark place.
She wasn't sure where she was
Her chest tensed as she strained her eyes
trying to force her eyes to adjust
Her eyes darted about but it looked the same everywhere
Was it there?
Despite her fear, she felt comfortable, soft
Familiar
As her eyes adjusted she recognized
the blades of her overhead fan
the unique shape and color of her ceiling
Her room
The tense feeling that had gripped her
immediately vanished
She was safe here
Her neck muscles loosened
sinking her head back down into her pillow.
As the minutes passed, she felt them again
those eyes staring back at her
her nails dug deep into her palms
trying to hold back her panic
I changed sides, I’m on your team now.
The clown squealed in its raspy, wordless voice
Why? She asked shakily
She didn’t want to talk to it
She also didn’t want to make it angry
Because I’m just like you.
No you’re not.
Everyone hired me to fuck with your head.
You shouldn’t say bad words like that!
Fuck fuck fuck fuck fuck fuck fuck fuck
Stop it!
They want you put in the crazy plaaaace
Why!? Why does everyone hate me!?
‘Cause you’re lunie ‘lissa, lunie ‘lissa
No I’m not! I’m not lunie ‘lissa! Elissa cried
They want you all locked up so they can stab you with needles til’ you die.
Elissa stared at him in shock.
She couldn't believe it. Who?
Everyone.
Everyone?
Everyone.
At the playground?
In the world.
Everyone in the world?
In the world.
Even mama?
Even mama.
You’re a liar.
Even mama.
I’m not listening to you anymore! You’re still on their team!
even mama even mama even mama
He started yelling it over and over. Elissa screamed.
The clown giggled his girlish giggle when her mother came inside
What’s wrong honey? I heard screaming.
Mama was out of breath.
Get it away get it away! get it away from me! Elissa screamed
Get what away? Honey, there’s nothing here.
The clown hissed Even mama
Elissa’s eyes were wide
the shock of betrayal clawed at her heart
You want me to go away too mama? Even you?
Elissa baby what are you talking about? Come on, you can sleep in mama’s room tonight. You’ll be safe from the boogey man in there.
There was no boogey man. Everyone knew that.
This was proof.
Only a crazy person would believe in the boogey man
Mama was in on it too.
Elissa froze. She understood everything now.
They hired the clown to make her crazy
pretending it wasn’t real
But Elissa was smart
If she pretended the clown wasn’t real
when they were around
they would be the ones who went crazy

Epilogue: Making Elissa Convincing

While replicating the schizophrenic condition in a fictional character with unerring precision might be considered a task far from reasonable, with adequate research as a foundation it is possible to develop a convincing sketch of the condition within such a character, as I sought to do with Elissa.

Elissa is an undifferentiated schizophrenic. However, in writing Elissa’s story, or a similar case, one is immediately faced with an overwhelming obstacle. Assuming the writer is not incredibly familiar with schizophrenia, he has little true to the condition to offer the reader as evidence. Even if the writer contains some general knowledge on the subject, if all the misconceptions he might possess are not removed and/or replaced, the knowledgeable reader will quickly become “wise to his game”. This was my position when I first began writing “Elissa”. I knew nothing true of schizophrenia, and as a result, my initial character had nothing in the way of schizophrenia to offer the reader. If I had created Elissa without first delving into the subject, anyone who read my work with knowledge of the disorder would have been left thoroughly unconvinced that Elissa was “real”; and when writing a character driven story, if the main character fails to be adequately convincing, the story will almost always fail as a result.

It is necessary to take all information about a subject, in this case schizophrenia, into account when developing a character that will interact with or contain these traits. As I began to research the nature of the schizophrenic disorder, quite a few peculiarities that I was not aware of sparked my interest. A schizophrenic may or may not suffer from all of his or her symptoms continuously. When creating Elissa, this was something to consider. Would her symptoms be continuous, episodic, or a combination of the two? Which led to more questions: what symptoms would she be capable of suffering from realistically, and what is the nature of these symptoms?

The symptoms of schizophrenics can differ greatly. These differences lead to various "types" of schizophrenia: paranoid, disorganized, catatonic, residual and undifferentiated. In the case of undifferentiated schizophrenia, episodes might contain symptoms from various or even all of the other types. After carefully reviewing all of the possible symptoms that Elissa might suffer from, I decided that a combination of the symptoms regularly associated with catatonia and paranoia described her best, making her diagnosis “undifferentiated schizophrenic”.

Elissa does not suffer from all of the symptoms of catatonia, paranoia, or schizophrenia as a whole. This is because after consulting several first-hand accounts of individuals with the schizophrenic disorder, it became apparent that symptoms vary greatly but rarely if ever include all known symptoms. It would also be incredibly difficult to create a functioning main character that suffered from so lengthy a list. While this is true, there is also a minimum number of symptoms for an accurate diagnosis. To make Elissa’s condition as convincing and accurate to the schizophrenic disorder as possible, I placed her in the middle of the minimum and what I determined from my research to be a realistic maximum.

Next, unfortunately for Elissa, came application. During Elissa’s schizophrenic episodes, she consistently suffers from visual hallucinations of a frightening, clown-like figure coupled with auditory hallucinations similar to those of nails on a chalkboard. Another curious element to her illness that isn’t uncommon to paranoid schizophrenics is that she suffers from delusions of reference. That is, she sometimes believes that events, objects, the behaviors of others, and other stimuli have a particular and unusual significance to herself. There are two definite instances in which Elissa suffers from this. She believes that because children are laughing, and she doesn’t know what they are laughing about, they must be laughing at her. She also perceives special meaning from the sound of nails on chalkboard. Although this is an auditory hallucination, she is still deriving special meaning from it which simply is not there. Elissa also suffers from two other symptoms of paranoid schizophrenia which, in her case, go hand in hand: delusions of grandeur and irrational fear. Elissa believes that, for whatever reason, it is on the agenda of “the entire world” to drive her insane through a clown that “they” hired, after which “they” will proceed to lock her up and stab her with needles until she dies. The symptom which makes Elissa’s “type” of schizophrenia undifferentiated rather than paranoid is her body’s motor functions are prone to shut down – a symptom of catatonia. During her initial episode, she is unable to lift her arms and then loses consciousness completely. After she regains consciousness, she begins moving her head in a repetitive manner – another common trait of catatonic schizophrenics. Aside from this, she speaks irrationally, suffers from social withdrawal, and is beginning to experience deterioration in her personal relationship with her mother. These are secondary traits caused from the primary symptoms, but nonetheless they are characteristics taken into account when making a diagnosis so they are important to be aware of when considering the actions of the character in question.

“Elissa” is a depiction of what it might be like for an undifferentiated schizophrenic child suffering from symptoms of catatonia and paranoia in the early and most frightening stages of the disorder. However convincing Elissa’s symptoms might appear, they are the result of research on both scientific studies and victims’ personal experiences with the disorder.