Why does the Treatment Advocacy Center (TAC) misrepresent psychological research?

For instance, in its post on its website titled, “STUDY: Manic Symptoms Linked to Specific Criminal Acts,” the unattributed and undated article suggests that a new study was released that demonstrated a causal link between manic symptoms, and well, specific criminal acts.

But when I read the study, and compared it with what was in the article on the TAC website, I saw a complete misunderstanding (or misrepresentation, whether intentional or not) of the new study.

It now makes me question the validity of any information published by the Treatment Advocacy Center on their website, because it appears their bias — to drive home the mistaken idea that mental illness = increased risk of violence — affects their ability to even deliver research news objectively.

I love it when you get hit over the head with your own words.

Today I read a meaningful email by someone who had read my book. She said it was the passage on page 120 to 121 that provided the epiphany moment she needed to seek help for her mood disorder.

I was curious to see what was on these pages, so I got a copy out and read this…

Consider these alarming statistics:

* By 2020, behavioral health disorders will surpass all physical diseases as a major cause of disability worldwide.

* Of the more than 6 million people served by state mental health authorities across the nation, only 21 percent are employed.

* More than half of adolescents in the United States who fail to complete high school have a diagnosable psychiatric disorder.

* Between 2009 and 2011 states cumulatively cut more than $1.8 billion from their budgets for services for children and adults living with mental illness.

* In 2009, there were an estimated 45.1 million adults aged 18 or older in the United States with any mental illness in the past year. This represents 19.9 percent of all adults in the U.S.

*Serious mental illnesses cost society $193.2 billion in lost earnings per year.

* The annual total estimated societal cost of substance abuse in the U.S. is $510 billion.

* In 2008, an estimated 9.8 million adults aged 18 and older in the U.S. has a serious mental illness.

With our economy still in the toilet, states and federal government threaten to cut even more dollars in mental health funding, which would result in less or no access to mental health treatment and services for countless Americans. Ultimately the cuts steal the one thing that keeps those of us struggling with chronic mood disorders alive: hope.

Today is National Depression Screening Day, so it’s time for your annual depression checkup. Are you depressed? Or are you skirting the threshold of depression, feeling low on energy and taking little pleasure out of life?

You don’t need to make an appointment or go see someone in person in order to find out the answer to these questions. Since 1995, Psych Central has offered an online interactive depression test that gives you an instant result. While nobody can diagnose a mental disorder online, it can give you a quick sense of whether it’s something to be concerned about and make an appointment with a mental health professional to examine further.

The quick depression test is just 8 questions and is an accurate screening measure for depression. It takes most people less than a minute to complete. The longer 18-question depression quiz is the oldest one online and is a more thorough screen for depressive symptoms. It’s a little more accurate, and most people complete it in under 3 minutes.

EMPowerplus is a nutritional supplement that consists of 14 vitamins, 16 minerals, 3 amino acids, and 3 antioxidants. According to its makers, TrueHope Nutritional Support, EMPowerplus “works by giving the brain the right balance of vitamins and trace minerals on a regular basis.”

It backs up that statement with a link to 11 research studies which it says demonstrates the effectiveness of this supplement to help people with attention hyperactivity disorder (ADHD), bipolar disorder, and depression.

It’s been selling the supplement for over a decade now from Canada, to hundreds of thousands of people. Many people swear by it. Others have questioned whether it is really any better than placebo.

So does it work? Let’s find out…

Coming as a surprise to more than a few mental health professionals, a new study out today suggests that bipolar disorder is often missed in patients who present only with major depression. The study examined 5,635 adults seen at community and hospital psychiatry departments in a number of different countries.

The discrepancy was reported because of the use of “bipolarity specifier criteria” that are broader than the DSM-IV criteria, the standard for diagnosis of mental disorders by mental health professionals.

Using the broader bipolar criteria developed by the researchers found an additional 31 percent of patients who could have been diagnosed with bipolar disorder.

So what’s really going on here? Are professionals really “missing” bipolar disorder? Or have the researchers stacked the deck in this study simply to suggest it is so?

Dear Mrs. ——–

You have asked me about the cause of your mood disorder, and whether it is due to a “chemical imbalance”. The only honest answer I can give you is, “I don’t know”—but I’ll try to explain what psychiatrists do and don’t know about the causes of so-called mental illness, and why the term “chemical imbalance” is simplistic and a bit misleading.

By the way, I don’t like the term “mental disorder”, because it makes it seem as if there’s a huge distinction between the mind and the body—and most psychiatrists don’t see it that way. I wrote about this recently, and used the term “brain-mind” to describe the unity of mind and body.1 So, for lack of a better term, I’ll just refer to “psychiatric illnesses.”

Now, this notion of the “chemical imbalance” has been much in the news lately, and a lot of misinformation has been written about it—including by some doctors who ought to know better 2. In the article I referenced, I argued that “…the “chemical imbalance” notion was always a kind of urban legend—never a theory seriously propounded by well-informed psychiatrists.”1 Some readers felt I was trying to “re-write history”, and I can understand their reaction—but I stand by my statement.

Last month, Andrew Brown writing for the UK’s Guardian, noted when Professor David Nutt kept referring to depression as a “brain disease” on a popular UK television program.

We commend Andrew Brown for his calling out Professor Nutt in trying to dumb down the portrayal of mental disorders to simply “brain diseases.” Mental disorders remain complex disorders that involve all aspect of a person’s functioning and life — their brain and biology, their psychological makeup and personality, and their social interactions and relationships with others. The cause isn’t just one of these things in the vast majority of people who have a mental illness — the cause is all of these things, in differing proportions.

I’ve written about this in the past and in fact, I tag it as one of the top 10 myths of mental illness — because it still is. Even well-meaning family physicians and psychiatrists still refer to the false chemical imbalance theory as though it were fact. A theory, by the way, that has never enjoyed strong research support.

Take a minute and answer this question: Is anyone really normal today?

I mean, even those who claim they are normal may, in fact, be the most neurotic among us, swimming with a nice pair of scuba fins down the river of Denial. Having my psychiatric file published online and in print for public viewing, I get to hear my share of dirty secrets—weird obsessions, family dysfunction, or disguised addiction—that are kept concealed from everyone but a self-professed neurotic and maybe a shrink.

“Why are there so many disorders today?” Those seven words, or a variation of them, surface a few times a week. And my take on this query is so complex that, to avoid sounding like my grad school professors making an erudite case that fails to communicate anything to average folks like me, I often shrug my shoulders and move on to a conversation about dessert. Now that I can talk about all day.

Here’s the abridged edition of my guess as to why we mark up more pages of the DSM-IV today than, say, a century ago (even though the DSM-IV had yet to be born).

If there is no struggle, there is no progress.
~ Frederick Douglass

Let’s get this out in the open: I am bipolar II. That means the mania is really low-key and infrequent and the depression, at least in my case, for most of my life, has been pretty much nonstop.

There are degrees of depression, of course. Mine gets severe relatively quickly and stays that way a relatively long time. Yes, I have been an inpatient at psychiatric hospitals. Yes, I have self-harmed. Yes, I have been on every psychotropic medication known to man, and failed most of them. The two that I’m on right now combine for one really annoying side effect.

I have even, since about New Year’s, been undergoing a course of electroconvulsive therapy (ECT). My memory is shot, along with many other things, but the suggestion to do it came up in month 6 of an unrelenting depressive episode. Nothing else was working.

Despite all this, I’ve managed to push through as best I can. I’ve found work, and a work schedule, that works for me, as well as a compassionate employer.

For many mental illnesses relapse is part and parcel. Bipolar disorder is one of these. What’s especially unnerving for people is that relapse can seem random, as though you go to bed feeling one way and wake up another, feeling hints of mania or depression.

Why relapse occurs is largely unknown. But we do know certain facts based on research findings, according to Joseph R. Calabrese, M.D., director of the Mood Disorders Program at the Case Western Reserve University School of Medicine, in this excellent article in bp Magazine on relapse:

“Those who are diagnosed with bipolar II are more likely to relapse than those with bipolar I. Their episodes of depression, mania or hypomania are often shorter than the episodes experienced by those with bipolar I but tend to return more often, according to Calabrese. It’s also far more common to relapse into depression than into mania or hypomania. Calabrese estimates that in bipolar II, there is a 40-to-1 ratio of depression to mania; the ratio of depression to mania drops to 3-to-1 in bipolar I.”

Even though relapse may be the rule, you do have some control in shrinking its severity and impact.

The following post is by Hilary Smith, author of “Welcome to the Jungle: Everything You Ever Wanted to Know About Bipolar But Were Too Freaked Out to Ask” (Conari Press, 2010) as well as a cool blog to go with it, Welcome to the Jungle.

We’ve all heard about “mood foods” that can promote wellness for people with bipolar and depression–fish oil for brain health, oatmeal for stable blood sugar, chocolate for, well, chocolateness. But it’s also important to think about how we eat. How we eat can have just as big an impact on our mood as what we eat, yet it often gets neglected in conversations about bipolar and food. Here are some tips for maintaining a healthy mood through mindful eating practices.