Monday, 25 August 2014

It All Started with Antidepressants

It all started with antidepressants about ten years ago. Oh, I wasn’t the one taking them, but several close friends and family were. And the funny thing I noticed was that not only did the antidepressants not seem to be helping, but they seemed to make things worse! The users claimed they helped and said they felt better, but I observed yawning and tiredness nearing exhaustion in one, self-harming behaviour in another, and a complete inability to cope with normal, everyday stresses in a third. And then, within two weeks of a dose being doubled, two consecutive suicide attempts. Alarm bells went off.

It got worse when one of these people decided to quit taking the antidepressants. Following advice to decrease slowly, pills were quartered. The first drop (1/8th of the prescribed dose) resulted in increased anxiety, unexpected mood changes, irritation and anger over inconsequential events, and physically, nausea and vomiting. This passed in a couple of weeks. A month or so later, and another quarter of a pill drop. The same result, only withdrawal symptoms were more marked. The third ¼ pill drop a month after that brought on intense, irrational anger coupled with thoughts of suicide. He remarked (and I wrote this down), “Why should I be so angry she wants to spend some ridiculous amount of money on that? It’s a stupid thing to want to do, but why should that make me want to kill myself? This is bizarre!”

And this wasn’t the “suicidally depressed” response you imagine, where someone is so down and out they see no possible future. This was a volatile suicidality coupled with anger that appeared seemingly out of nowhere, materializing in less than a day, sparked by a minor and relatively impersonal event, and clearly linked to the lowered dose of the antidepressant. Even in the midst of feeling suicidal, he recognized the absurdity of the feeling even while acknowledging its intensity. In a few days, the suicidal inclination had passed, but it was seriously scary while it occurred.

And so began my research and mini-crusade on antidepressants. When asked if we’d be willing to share our experience with researcher Rachel Liebert, then a student at the University of Auckland, Simon (not his real name) and I agreed. I was so impressed with Rachel’s project—which culminated in her thesis Medicate Me Into Madness—that I was inspired to return to university and do something similar. (The above link to Rachel's thesis is not direct, but you can apparently access her thesis through a New Zealand library.)

My master’s thesis, CollateralDamage: A Mixed Methods Study to Investigate the Use and Withdrawal ofAntidepressants Within a Naturalistic Population, was published in 2010. Several people who read it, including my advisor, encouraged me to develop and publish the first portion of the thesis, on the history of antidepressant use and development, as a book or part of a book for a more popular (less academic) audience.

My new book
Reframing Mental Illness is the result of that suggestion. In it, I have gone beyond the antidepressant story to look at treatment of/for the mentally ill in general, and how that has developed historically. For many folks, the realization that psychiatric drugs are developed and marketed not so much to solve people’s problems as they are to grow a market and increase sales and profits for corporate shareholders is an eye-opener. (For more on this, see my post Mental Health Drugs are Big Business.)

And it’s not as if anti-depressants and anti-psychotics and ADHD meds like Ritalin--which may or may not work--are harmless placebos either, although side effects may not be a problem for everyone. The astonishing thing is, though, we as a society have bought the story of brain-chemicals-gone-amuck to explain our mental dis-eases and dis-comforts with no scientific evidence whatsoever to back up the theory (although the pharmaceutical companies trot it out regularly).

The second part of the book considers alternative viewpoints (frames) for understanding mental dis-ease (and that’s dis - ease as in “without ease”) and suggests a whole range of useful approaches to resolve the many problems we tend to throw in the mental basket. From practical techniques borrowed from  EFT (Emotional Freedom Technique), hypnosis, and NLP (Neuro-Linguistic Programming) to understanding body energy, quantum energy fields, priming, emotional intelligence and our three brains (head, heart, and gut), this is a book designed to get you wondering about why we are so quick to throw up our hands crying “victim!” and hand our mental health care decisions to our doctors who, while well-meaning, are mostly likely to pull out the prescription pad and send us home with a bottle of pills because its cheap and quick.

This is my first book, and I’m pretty pleased with it. I’ve published through Amazon with CreateSpace and Kindle, which means I didn’t need to find a publisher, I’ve had full control over design, layout and editing, and I earn a somewhat higher royalty rate on sales than I might do with a traditional publisher. CreateSpace and Kindle make it amazingly easy to publish.  The downside is it is also up to me to do my own promotion for the book. So this post is a bit of a promotion.

If you are interested to read the full story, with a look at why we use psychiatric drugs (20% of us do), what they are really, how they are regulated, what problems they cause, and why/how they are pushed, and then have a chance to examine mental dis – ease from alternative perspectives that open up a range of options for “treatment” (and I use that term loosely because it implies “illness”, which may not be a useful frame)—read the book.

Click here to zap to Reframing Mental Illness at Amazon. I’ve kept the price as reasonable as I can, US$11.99 for the paperback version, and just $5.99 for the Kindle (electronic) version. If you don’t have a Kindle, you can download a Kindle reader for your PC or a free Kindle app for other electronic devices at Amazon, and of course the book is available worldwide through Amazon.

Lastly, once you’ve read it, if you could post a review at Amazon, that would be awesome! Your reviews help to “up” my profile on their site. Thank you!

For more information on antidepressant withdrawal, see my posts Antidepressant Withdrawal, How Long Does it Take to Get Off Antidepressants, and Ten Tips for Making Antidepressant Withdrawal Easier

Friday, 22 August 2014

Dirty Politics in New Zealand. Yeah, Nah.

"People today—it seems they are good, or sometimes evil, mostly by inertia, not by choice. They act as their surroundings prepare them to act… A hundred men, convinced by society that ‘everyone does it this way’ will go along with the most crude and despicable of acts." (From Brandon Sanderson’s The Alloy of Law)

The election campaigns in New Zealand are ramping up with the 20 September voting day in sight. Much fuss has been made about Nicky Hagar’s just-released book Dirty Politics which reveals the incumbent National government’s links to knavish right-wing bloggers, an apparent fistful of incriminating emails, accusations of dodgy leaks and hacked opposition party computers.

I haven’t read the book, and I don’t intend to, but it raises an interesting issue about the folks we have running our country. When the microphones are shoved into his face by eager reporters wanting his take on the latest revelations, Prime Minister John Key is quick to tell the press that New Zealanders are more interested in issues than scandals, and that may be true to a point. But I think issues of honesty, integrity, and being up front with the public from the country’s leaders surely rate as high as national cycleways, class sizes, and rugby referees. 

See John Key: Ask Me Anything

Key, often referred to with a bit of a grin as “Teflon John,” or less complimentary as “Slippery John,” has a rather charming way of letting the mud and muck that often mire down those in a political arena simply slide off, but he’s finding that harder to do these days. Perhaps, like an old Teflon fry pan, he’s picking up a few too many scratches.

In the midst of this National political scandal-fest, the following post popped up on my Facebook page a day or so ago, and it not only made me chuckle, but it made the point.

This coming election, I will be voting Green. I confess I don’t like all of their policies (and I DO wish they’d take a stand against 1080 poison, but I appreciate it is a controversial topic that may not earn them enough brownie points to make it a wise issue to pursue at election time). But I admire the way they present themselves as voices of reason, responsibility, intelligence, and integrity at a time when these qualities seem to be sadly lacking in our politicians.

In the midst of all the politics, I stumbled upon the line quoted at the top of the page—I’m currently reading Alloy of Law, a crackin’ good book, by the way, but for it to make sense, you probably should read Sanderson’s superb Mistborn trilogy first—and I was struck by both the words, and seeing the same theme echoed in this fantasy novel.

In a way, politicians reflect the ethos of the folks they hang out with, just as other social groups conform to their group social norms. Although it’s apparently easy for John Key to justify National shenanigans by saying “this is normal”, it’s nice to see the Greens (and Labour) saying, um, wait a minute, maybe that’s your normal. It’s not ours.

Maybe it’s time we let integrity, morality, ethics—goodness, if you well—become political issues we DO care about.

Tuesday, 5 August 2014

Inequality, Poverty, Social Problems, and Politics

It’s been a week since psychologist Nigel Latta presented a documentary on New Zealand television called The New Haves and Have Nots.  Latta pointed out that the gap between the poor and the wealthy seems to be ever-increasing, and the numbers are disturbing.

Back in 2007, Statistics New Zealand called the distribution of wealth in New Zealand “unbalanced”, noting in a paper on wealth disparity that while the top 5% of New Zealanders held almost 38% of the country’s wealth, the bottom 50% accounted for just 5%. Bizarrely, it seems difficult to nail any official data more recent than that, although this map gives some idea of what it looks like visually. (Please, don’t take the map literally and assume the north of the country is “rich” and the southernmost tip of the country is “poor” as some respondents have apparently done—this is just a metaphorical representation.)

There has always been a certain degree of discrimination from the “haves” towards the poor who are not working. No one wants to feel like they are labouring away while helping to support some lazy clod sitting at home watching tv and drinking beer, but according to Latta the problem isn’t so much unemployed benefit-bludgers as it is the working poor.

It used to be (back in the 1950s and 1960s) that a single-income earner could support a family. Today, it seems that even in families where both parents work, if they’re only making a minimum wage and/or aren’t both full time, it’s nearly impossible to stretch that weekly budget to include even such modest pleasures as the occasional movie or trip to the zoo or family camping holiday. First you need to pay the rent, the power bill, the phone or cell phone bill,  the internet bill (if you have a computer), food, school fees, and car WOF and registration and petrol (assuming you have a car), or transport costs if you don’t. And then there might be one-off costs for things like clothing, shoes, medical bills, a second-hand fridge when the old one dies… There’s often not enough left over at the end of the week, fortnight, or month for a cup of coffee.

Overall social outcomes in highly unequal societies are mostly negative, according to the often-quoted but somewhat controversial book The Spirit Level by Richard Wilkinson and Kate Pickett, published in 2009. Wilkinson’s TED talk on the subject highlighted how factors like health and mental health, crime, addiction, infant mortality rates, and life expectancy are all affected by the psycho-social stress caused by income gaps and status anxiety.  If you watch the talk, you'll see in the graphs how NZ stacks up with other countries, and a New Zealand Herald article examined the New Zealand situation in reference to claims made in the book.

Latta has come under some flak for his doco. DomPost columnist Jane Clifton accused him of being “a know-all riding a hobby horse”, and expressed her disgust that a psychologist should step out of his area of expertise to comment on a social issue[i]. A small flurry of letters to the editor followed this diatribe, some defending Latta for covering the story and accusing Clifton of stepping out of line, while others gave Clifton’s denigration a thumbs up. This is an election year, after all, and raising a polarizing topic such as this could be seen as a political move.

The issue hovers elsewhere in the media too. In a recent article in the Sunday Star Times, Tim Pullar-Strecker looked at the New Zealand tax system. While our income tax rate for our wealthy citizens is one of the lowest in the OECD[ii] community of 34 countries, there is no tax-free threshold for low-income earners as exists in other countries, and we are the only OECD country that slaps a GST tax (currently 15%) on all goods and services including food. Indeed, Kiwis even pay GST on other taxes (e.g., petrol tax, rates)!

Although it sounds like the rich, at least, benefit from the current system, research suggests financial equality is good for growth. According to an International Monetary Fund (IMF) study published earlier this year, “countries with high levels of inequality suffered lower growth than nations that distributed incomes more evenly.” That said, New Zealand had been dubbed “the rock star economy of 2014,” a belief that continues to be touted by the National Government keen to strut their this-prosperous-recovery-happened-under-our-watch” motif leading into the election.

It IS an election year. If you are a Kiwi, and this is an important issue for you, vote. Just a quick squizz at the three major party policies on this topic reveals...

National, the party currently in power and most likely to stay there, doesn’t seem to have any real policy on this matter. The closest they come on their website is where they identify four priorities they specifically say are “for families”: 1) manage the government’s finances; 2) build a more competitive economy; 3) deliver better public services; 4) rebuild Christchurch.  Personally, I'm not convinced these are specifically “for families,” but this is National's viewpoint.

Labour acknowledges an inequality problem and generalizes three vague objectives to mitigate the problem: 1) well-paid jobs, 2) lower power bills; and 3) more affordable housing, but they offer no specific details.

The Greens, on the other hand, offer ten very specific solutions under four general categories: 1) taxation; 2) energy; 3) income support; and 4) housing. 

There is plenty of food for thought here. I DO think New Zealand has some significant social issues that would be well served by a closing of the inequality gap. Perhaps there is a groundswell  growing; I think many folks would like to see at least some of these problems addressed. Although most of us can do little individually to affect changes in our society, and being a democracy that's probably a good thing, one thing we can do that can make a difference--albeit a small one--is vote. 

[i] I don’t want to digress from the topic, but as someone trained in psychology, I wonder if that means I’m not allowed to think or have opinions on issues other than what goes on in people’s heads. Curious, I googled “What is a psychologist?”  and the first entry that came up, from the Rhode Island Psychological Association, began “Psychologists help to ensure the health and well-being of all people: individuals, families, groups, and society as a whole.” So I think he's right on target.
[ii] Organization for Economic Co-operation and Development