A few years ago I only knew a few people with a bipolar diagnosis who were living well without medication.
censorship by big pharma?
Access to good recovery training and explanations of the effects of the various medications have changed so much for so many. Increasingly I am meeting people who, like me, were diagnosed and told to stay on medication for life and then found that it was possible to responsibly come of the medication and stay well.
This week, I met a newly diagnosed person with a forward-thinking-psychiatrist who showed a list of medications, what they were said to do and the side-effects for each. They asked the patient which they thought would be best for slowing their thinking and making them sleep more during the night. The patient selected one and although they told me it was giving some horrible side-effects such as blurred vision, they were happy with their choice. They felt it better than one of the antipsychotics known to cause permanent brain damage.
Censorship? If the censorship laws being considered today go through, will this lead to more restrictive laws in the future that will stop us talking about bipolar recovery. Big business supports the medical model, which says that recovery is not possible. They say that we are sick people who cannot learn from our mistakes. They say that our emotions (that cause us to write about these things) have to be kept under control by medication.
The trend is for more people who have discovered they were not mentally ill after all to come on-line and talk about their horrendous experiences on drugs. This is beginning to threaten all the big drug companies and their share prices/value on the stock market. Yes, what we are doing is starting to unsettle and is likely to make the global economy more unstable. This is a shame.
It has to be said though. The only alternative is greater censorship and increased use of drugs to stop people talking.
People who study causes of mental distress know it is events/things that cause it.
Businesses who thrive on telling us that it is genetic illness have had louder voices. Maybe Blogs and Twitter are now allowing us to get the word out there.
Blogs and Twitter may not be good for the big drug companies but are definitely good for anyone who reads this page at wellnesswordworks and then avoids being diagnosed and medicated. Mostly it’s not more medication that people need.
Quality listening helps a lot more than most people realise.
People who study causes of mental distress know it is events/things that cause it.
Businesses who thrive on telling us that it is genetic illness have had louder voices. Maybe Blogs and Twitter are now allowing us to get the word out there.
Blogs and Twitter may not be good for the big drug companies but are definitely good for anyone who reads this page at wellnesswordworks and then avoids being diagnosed and medicated. Mostly it’s not more medication that people need.
Quality listening helps a lot more than most people realise.
Following on from the words Electroboy (Andy Behrman) wrote about Abilify here is the video he made when he stopped being a spokes person in favour of this antipsychotic.
This does not mean that this drug is any worse than any other. It just means everyone needs to be cautious about drugs and just because it is on prescription does not make it good for you or even necessarily ideal for anyone.
In favour of Abilify…
1) It slows down thinking so if fast thinking is causing you trouble then this will help to correct what can be seen as an anomaly. Doctors who monitor psychosis know that immediately after taking a tablet they are likely to see less psychosis for a while. Although the patient may find the fast thinking comes back if they suddenly stop taking it.
2) It will seem to help patients sleep. Probably any anti-psychotic will do this. It kind of goes with slowed down thinking. Many will say that the sleep quality when taking antipsychotic is not as good, but then if you have been getting into trouble by being awake while others are sleeping there could be an advantage. Maybe also look into visiting a sleep clinic or specialist for advice, as well, as there are a lot of things that help sleep without such powerful and often very unpleasant side-effects.
And the concerns about Abilify…
Elderly people with psychosis related to dementia (for example, an inability to perform daily activities as a result of increased memory loss), treated with antipsychotic medicines including ABILIFY, are at an increased risk of death compared to placebo. ABILIFY is not approved for the treatment of people with dementia-related psychosis (see Boxed WARNING).
Antidepressants may increase suicidal thoughts or behaviors in some children, teenagers, and young adults, especially within the first few months of treatment or when the dose is changed. Depression and other serious mental illnesses are themselves associated with an increase in the risk of suicide. Patients on antidepressants and their families or caregivers should watch for new or worsening depression symptoms, unusual changes in behavior, or thoughts of suicide. Such symptoms should be reported to the patient’s healthcare professional right away, especially if they are severe or occur suddenly. ABILIFY is not approved for use in pediatric patients with depression (see Boxed WARNING).
Contraindication: Patients should not use ABILIFY if they are allergic to aripiprazole or any of the ingredients in ABILIFY. Allergic reactions have ranged from rash, hives and itching to anaphylaxis, which may include difficulty breathing, tightness in the chest, and swelling of the mouth, face, lips, or tongue. Serious side effects may include:
• An increased risk of stroke and ministroke have been reported in clinical studies of elderly people with dementia-related psychosis
• Very high fever, rigid muscles, shaking, confusion, sweating, or increased heart rate and blood pressure. These may be signs of a condition called neuroleptic malignant syndrome (NMS), a rare but serious side effect which could be fatal
• Uncontrollable movements of face, tongue, or other parts of body, as these may be signs of a serious condition called tardive dyskinesia (TD). TD may become permanent and the risk of TD may increase with the length of treatment and the overall dose. While TD can develop after taking the medicine at low doses for short periods, this is much less common. There is no known treatment for TD, but it may go away partially or completely if the medicine is stopped
• If you have diabetes, or risk factors for diabetes (for example, obesity, family history of diabetes), or unexpected increases in thirst, urination, or hunger, your blood sugar should be monitored. Increases in blood sugar levels (hyperglycemia), in some cases serious and associated with coma or death, have been reported in patients taking ABILIFY and medicines like it
Lightheadedness or faintness caused by a sudden change in heart rate and blood pressure when rising quickly from a sitting or lying position (orthostatic hypotension) has been reported with ABILIFY.
Decreases in white blood cells (infection fighting cells) have been reported in some patients taking antipsychotic agents, including ABILIFY. Patients with a history of a significant decrease in white blood cell (WBC) count or who have experienced a low WBC count due to drug therapy should have their blood tested and monitored during the first few months of therapy.
ABILIFY and medicines like it can affect your judgment, thinking, or motor skills. You should not drive or operate hazardous machinery until you know how ABILIFY affects you.
Medicines like ABILIFY can impact your body’s ability to reduce body temperature; you should avoid overheating and dehydration.
ABILIFY and medicines like it have been associated with swallowing problems (dysphagia). If you had or have swallowing problems, you should tell your healthcare professional.
Tell your healthcare professional if you have a history of or are at risk for seizures, or are pregnant or intend to become pregnant. Also tell your healthcare professional about all prescription and non-prescription medicines you are taking or plan to take since there are some risks for drug interactions.
While taking ABILIFY, avoid:
• Drinking alcohol
• Breast-feeding an infant
Most common side effects (≥10%) from all clinical trials involving adults or pediatric patients include:
• ADULTS: Nausea, vomiting, constipation, headache, dizziness, an inner sense of restlessness or need to move (akathisia), anxiety, insomnia, and restlessness
• YOUNGER PEOPLE (6 to 17 years): Sleepiness, headache, vomiting, extrapyramidal disorder (for example, uncontrolled movement disorders or muscle disturbances such as restlessness, tremors and muscle stiffness), fatigue, increased appetite, insomnia, nausea, stuffy nose, and weight gain It is important to contact your healthcare professional if you experience prolonged, abnormal muscle spasms or contractions, which may be signs of a condition called dystonia.
For patients who must limit their sugar intake, ABILIFY Oral Solution contains sugar.
For patients with phenylketonuria or PKU, ABILIFY DISCMELT® (aripiprazole) contains phenylalanine.
If you have any questions about your health or medicines, talk to your healthcare professional.
– – – – – – – –
If you have concerns, talk to family and especially to those mental health professional who better understand lists of side effects – certainly do not only rely on what you read on the internet.
When Andy Behrman’s book (Electroboy 2003) was published, for many people around the world he became ELECTROBOY! I certainly found Electroboy easier to remember than Behrman.
Something Andy and I (in Stop Paddling/Start Sailing 2004) have in common is we both wrote about treatments we saw as acceptable, only to discover psychiatry is less scientific and more flawed than we ever could have imagined. For me, it was Zyprexa®/Olanzapine and Lithium gradually destroying me, whilst Andy came up against Abilify®/aripiprazole.
‘Another horrible side effect for me was the problems that I experienced with my cognitive skills, which actually reminded me so much of my experience after electroshock therapy. One day while at lunch, I gazed blankly at a friend and could not for the life of me remember her name although I had known her for more than a couple of years. I was often confused and agitated over simple things: a misplaced piece of paper, whether I had taken my dogs out for a walk or not and even focusing on a simple conversation. Abilify, my new “wonder drug” was failing me and I was embarrassed to tell anyone, even my wife…‘ Andy Behrman 2006
Why is almost everyone talking about a bipolar diagnosis as something that can never ever be eliminated?
Here is one controversial answer: Bipolar is big business.
'Bipolar ensures reliable profit'
It is said that 5.7 million adults have a bipolar disorder diagnosis in the USA[1]. I am going to guess that about 5 million of these people are taking an average of two tablets per day. So that is 10 million tablets. Even if those tablets only cost $1 each that is $3.65 billion per year just in the USA. As bipolar is said to affect every race and every country, the worldwide bill for medication must be enormous.
Any kind of therapy after a bipolar diagnosis is likely to be expensive. The clinic Kathryn Zeta Jones stayed in recently was said to charge $750/day [2]. Yes, that is an exception, but even ordinary beds on psychiatric wards cost the tax payer a lot of money.
In the UK it costs £1 billion/year for 9,220 NHS psychiatrists [3]. OK, they work on a lot more than just bipolar, but there is no doubt that bipolar is a fast growing sector for psychiatrists. In 1998 the average age of diagnosis in the UK was 39, now it is just 19. Younger diagnosis, with no hope of ever eliminating the diagnosis means more work for the health services and more medication needed over a lifetime.
The controversial idea here is nothing to do with anyone being evil or even particularly bad, it is just that there is money to be made and many jobs depending on the growth of the bipolar industry.
I cannot claim to be whiter than white here having been paid to deliver training that included phrases like, “Bipolar is a life-long illness” and “Medication is important”. Of course both phrases may be true, but how do we know that they apply to everyone all the time?
I am ready to be paid less, if that is what happens when fewer people are diagnosed and a few more people eliminate their bipolar diagnosis.
I communicated with Greg Montgomery quite a few times while writing the bipolar for nurses handbook.
He was famous as a football player.
I like his film especially the way he shares about life after diagnosis.
Is there a risk that we could be glamorizing a diagnosis rather than working towards annihilating it? Take a look at the video and let us know if you think.
that seems to have been dragged up, perhaps by someone somewhere hoping the public will see it as new and worth re-reading?
This idea alarmed and worried people at the time, but then seemed to be untrue having only involved a small number of people and possibly not taken into account a lot of lifestyle issues, such as drug intake that may have influenced the results more than the diagnosis. Here is one of the places it was discussed at the time. You will see some people were upset by being told their brain would shrink faster.
Professor Goodwin was reported as saying, “It supports the idea that cognitive function is impaired in bipolar patients in middle age” By saying this in this way, makes it sound as if this is a well documented fact. Where does this idea of impaired thinking come from? Those who so readily point out that Winston Churchill and Sir Isaac Newton were probably manic depressives do not seem to believe that mood disorders caused ‘cognitive impairment’ in the days before antipsychotics.
Through my work I meet hundreds of people with the bipolar diagnosis. In my experience those who take antipsychotics gradually have impaired thinking whilst those who do not take drugs continue to have ‘sharp thinking’. Now, clearly the people I meet are a particular sample and a lot of other things are going on in their lives. It is just that they talk to me about the drugs they take and over the years I have seen deterioration in brain function in those who take antipsychotics for long periods. Good brain functioning seems to return for those who can safely, gradually come off the drugs.
The results from this old study might still be useful, if enough data was collected to view them in a different way. What if records exist for how much of the various brain-wasting drugs were taken by each person prior to their first scan and in the four years between the two scans?
It is known that anti-psychotics cause brain shrinkage. How much drug was taken by the bipolar group and how much by the control group? Also alcohol is associated with changes in the brain. Research has shown many people with mood disorders drink more than average amounts of alcohol. Did the researchers record alcohol consumption?
It would be interesting to hear from the 2007 team and see the data they collected and how they came to the conclusion that a diagnosis was causing brains to shrink rather than any environmental factors.
If it turns out that the un-diagnosed group was taking similar drugs prior to the study and during the study then my thoughts are about diet, as people with the bipolar diagnoses can tend to give up hope and turn to less nutritious high calorie low vitamin content foods that may be associated with changes in brain structure. If not diet, stress hormone (perhaps cortisol) levels may be seen to vary between the groups as we know mental health diagnosis increases stigma and that could in turn increase stress levels.
Do any readers know of brain scan research that has looked at a fuller range of possibilities rather than starting out to prove that a diagnosis can directly shrink brains?
I do not doubt that those of us who were diagnosed have ended up with brain shrinkage. I am just keen to know which factors are causing the loss of brain cells… is it the antipsychotics, the illegal drugs, the alcohol, poor nutrition, higher stress levels or any number of other possibilities such as poor sleep or smoking more?
Let us have more research that includes brain scans – just that a future team could include me, as an experienced researcher with chemistry and pharmaceutical background having had the bipolar diagnosis. This would of course require the rest of the team to accept that the diagnosis has not already shrunk my brain too much. I can say upfront that the amount of medication I took is likely to have destroyed 10% of my brain. There again it is not how much brain we all have – it is how we use it that matters.
Chronic fatigue syndrome is ‘major’ cause of school absence: research
There is something very wrong with this headline from this morning’s The Telegraph, that has gone on to be reported in much the same way on TV and radio news.
This type of headline where a diagnosis is given as a cause simply promotes illness, the need to see doctors/psychiatrists and the use of medication.
Yes, diagnoses do cause problems for people. If you are diagnosed with schizophrenia or bipolar disorder you may find the stigma associated with the diagnosis is longer lasting than any distress you have had before.
This is not what this type of headline is about. These articles typically say about under-diagnosis. This one says, “Chronic fatigue syndrome (CFS) may be ten times more common than previously thought and be one of the major reasons children are absent from school“. [Have you noticed how often mental disorders ‘may be ten times more common’?]
I want to point out that CFS is not the cause or even the reason for the behavioural problems. Something else is causing the children to be at risk of diagnosis. The article is about children who have not been diagnosed. Clearly these children are tired and there could be many reasons for that other than a diagnosable syndrome. There is something going on in their environment that is causing this behaviour and that is what needs to be addressed.
Readers need to ask where these ideas of diagnosis = cause come from. Is this type of headline ever from truly independent researchers who have nothing at all to gain from the diagnosis? Can we be sure that there has been no influence from people whose jobs depend in some way on increasing diagnosis?
How is this linked to ‘Rethinking Bipolar’? The claims with bipolar are going further. It has been said that 1% of the population have been diagnosed since the bipolar diagnosis was created in 1980 and amazingly it is now claimed that up to 20% of the population are now experiencing bipolar symptoms. There is nothing like saying that huge numbers are experiencing something to make it more acceptable and helping it to spread!
The idea of a disorder called bipolar is largely based on people having faulty brains.
Brain scans of people starting to display extremes of mood hardly ever show faulty brains. They in fact seem to be reacting to what has happened to them.
When traumatized, drinking a lot of alcohol or taking street drugs brain chemistry changes. This change is temporary. Some people take a lot longer than others to naturally get over disturbing experiences. When given good support, good nutrition and reassurance that their reactions are what has always happened to people under pressure, then their brain chemistry gradually returns to be much the same as anyone else.
Text books about the brain tend to be too complex and go out of date. I have attended talks by experts and, even as a qualified chemist, struggled to keep up. What is needed is to have the facts interpreted and explained by a lay person with an extraordinary enthusiasm for sharing knowledge that up to now has only been available to a few doctors and pharmaceutical businesses.
Attending a talk by Robert Whitaker I met Catherine Clark who is one of those people with the energy and enthusiasm to share in a way we can all understand… See Catherine Clark’s > Story of the Brain
Training and observing ourselves can help us to not be so readily passive or aggressive. It can help with adult-adult transactions where both sides can put their ideas forward and reach a constructive agreement.
Some training simply gives the ‘assertiveness is always good’ message. People who have been taught ‘assertiveness is always good’ and have practiced this for many years tend to be happy with their achievements through assertiveness. By clearly stating their case and repeating as many times as necessary in a clear calm voice, a less assertive person will usually back down. However, forcing others to back down is unlikely to have been the purpose of the assertiveness training.
A key point many people miss is: communication is never about just one person. It is of little importance whether we feel our communication style is assertive or not. The important matter is whether the person we are communicating with is experiencing assertiveness or aggression from us.
What observers of your conversation think or might describe afterward as what they saw and heard in the communication styles may or may not be useful. It is only the person who is backing down who really knows how they are feeling as they give up trying to be assertive and fall back to a passive state.
When we know we are right it is easy to start being assertive. When the other person has a point of view and puts this across assertively we have a choice as to whether to listen carefully and respond or to simply repeat what we said in much the same way. With either or both people not listening to the other, there is not going to be a ‘win-win’ outcome. One person has to back down. One person has to stop being assertive and no matter what the last thing is that they say or even the way they say it, they will have a feeling of having backed down. This is assuming no one becomes openly aggressive.
In this situation the person who continued to feel they were communicating assertively will most likely feel they got their way. However they have become the bully, whilst being unaware that the other person had experienced aggression from them. It is possible that if both communicators are good at appearing assertive, an observer will not have noticed any aggression or passive behaviour at all.
On encountering assertive bullies I would end up confused as they would keep repeating their point of view and not listening to mine. Body language plays an important part in assertiveness and they would be able to use this together with a fixed stare at my eyes. This staring they would say was appropriate eye contact. All was done in a way that would not seem aggressive, just extremely assertive, but it would feel extremely aggressive to me.
According to Covey* when two people have different but equally valid opinions it is best to seek a win-win solution, then he points out that win-lose or lose-win are not second best as with those options one person comes off worse. He sees the other option as ‘no deal’ and that is the only way to avoid assertive bullies pressuring us into agreeing to do something we feel is wrong.
On recognising the assertive bullies among health professionals I started to choose the no deal option. Having not coerced me face to face, they would sometimes attempt writing assertively. It is in these writings their bullying becomes more obvious. One thing to watch out for is how often they write, “you”. In speech we know that hearing a phrase that starts with “You will…” can sound aggressive. It can sound aggressive in a letter or email too.
This last paragraph has eleven words starting with “you” – see if you feel any over-assertiveness as you read it >> If you feel you are consistently assertive, now could be a good time to ask yourself how you are achieving this. Are you still able to listen carefully and are you able to compromise or even back down from a potential argument? If you are in doubt have a look at how often you are using the word ‘you’ when you are hoping someone will comply with your wishes.
* The Seven Habits of Highly Effective People by Stephen R Covey
Prior to setting up my business I worked for a large multi-national for 17 years. The business encouraged employees to attend assertive communication training to more easily recognize passive, assertive and aggressive communication.
The message was clear that being passive or aggressive in a situation where assertiveness is needed would lead to poor communication and that would be bad for business. It made sense to improve communication skills through training.
I went on to study assertiveness as part of my stress advisor training and found that communication styles are more dependent on mood than many people appreciate. It is well documented that in depression people tend to be passive. When anxious or over-active more aggression is likely to be seen. The thinking at the time was that assertive behaviour was always best and steadier moods would allow assertive communication.
When employed in bipolar recovery training our package included help with developing assertive communication. The general message given was:
It is good to be assertive
As a general message this is okay. It is simple and memorable.
There are dangers in this simple message.
1) Passive is not always bad. Humans use passive communication in a similar way to many other animals. When we are threatened or do not have the energy to argue a passive response will often get us through a difficult situation.
2) Aggressive communication is rarely good but sometimes a short sharp response to inappropriate behaviour can be very effective. I found from an early age that when done in the right way bullies always avoided the kids they knew could deliver a short sharp aggressive response. Bullies go for easy targets.
3) A small number of people interpret ‘assertive = good’ as ‘the more assertive the better’. The danger here is that there is a thin line between extremely assertive and powerfully aggressive. When people who strongly believe in and practice assertiveness skills cross this line bullying is probably inevitable.
“Bullying is a conscious, willful, deliberate, hostile and repeated behaviour by one or more people, which is intended to harm others” – www.bullying.org
In the case of Helen Green versus Deutsche Bank the employee was awarded £800,000 damages, as the court agreed with her that she had been bullied at work. The bank was also ordered to pay more than £350,000 in legal costs. These large sums are exceptional but illustrate one way that an unchecked workplace stressor can lead to litigation that might have wrecked a smaller business.
Sometimes we will witness and recognise bullying at work and our duty is obviously to point out that it is unacceptable. Doing so will save a lot of pain and might even save you or your company ending up in court. At Deutsche Bank it seems hardly anyone knew about any bullying and perhaps predictably the alleged bullies and their managers said they were not aware of the bullying.
We probably all recognized bullying while we were at school, but in the workplace it is rarely so obvious. There rarely seem to be witnesses, while employees who are terrorized, stressed and traumatized feel there is no point in speaking up. This can go on for years until the employee starts to suffer mental illness and may like Helen Green no longer feel able to work.
To eliminate (or perhaps more realistically minimise) bullying requires us first to be able to see it happening and to do this we have to be able to see the world from the victim’s point of view. The chance is that the victim will have been picked partly because they are stressed or suffering variable moods and the bullying will be making this worse. When stressed or suffering variable moods we are more likely to misjudge the motives of others. This means that the victim who is getting more and more stressed is likely to be seeing more bullying activity than anyone else. It also brings into question the definition at the top of this page. If you believe like me that there are very few truly evil people in the world then it is likely most “bullies” believe they are just ‘messing about’ and ‘having a laugh’ without realising the pain they are causing. Even the worst bullies probably did not start out with “conscious, willful, deliberate, hostile” attacks.
For many people it takes a paradigm shift to see workplace bullying as starting out from seemingly harmless leg-pulling, jokes, name-calling and so on, but only by realising behaviours most people tolerate can be intolerable for the very stressed employees, can we avoid more court cases and people struggling to ever get back to work.
I was thinking about how bullying has been identified as a factor in the onset of psychosis and bipolar disorder. Then I remembered two articles I wrote about bullying in 2006 and thought these were worth republishing. These are about bullying sometimes being subtle and unseen and where the line might be between… well see what you think to this first one of the two…
Cruel to be Kind – Roger Smith 2006
“Singing involves giving pleasure: you can’t.” – Simon Cowell
“You dress better than you sing and you got dressed in the dark.” – Simon Cowell
This morning an email arrived from a friend that included a question about a straight talking judge on TV talent shows.
“So what do you think of Simon Cowell?”
During the day I found myself coming back to this question about Simon Cowell. I am aware that most TV audiences either love him or hate him because of his brutally honest comments. Fortunately, Simon has years of experience, is respected around the world and is mega-rich, so he can easily afford to speak his mind. But it leaves me wondering if maybe the world would be a better place if more of us dared to be more honest.
“Cruel to be kind in the right measure
Cruel to be kind it’s a very good sign
Cruel to be kind means that I love you”
I just do not see Simon as, Mr Nasty. There are times when people need to be told the truth about themselves and sometimes such a message only seems to get through when delivered in a brutally honest way. I see Simon as cruel to be kind. Like in the song this must be a good thing providing it is, “in the right measure”.
In the work place, school or even at home this cruel-to-be-kind behaviour can be mistaken for bullying. There is a massive difference though as the bullies are either not seeing, or not caring about the hurt they are causing. Bullies also tend to be unaware of that their cruelty leads to stress that in turn can lead to poor work performance, absenteeism, depression and even suicide. There is a very serious side to the divide between not-bullying and bullying. It is this that will be discussed in the next issue.
then you will probably remember this idea that is ‘excerpted’ at 
Roger Smith (in the UK)
Rethinking Bipolar 