I recently wrote of an informative NBC News article of June 2, 2013 (see part 1 here). Investigative reporter Rebecca Ruiz laid out medical research evidence pointing toward non-genetic alterations in brain chemistry — that is, organic changes in the brain’s chemistry after birth.

Specifically, Ruiz’s article was centered around the behavioral concept of resiliency. She provided medical research and testimony, as well as case study, that early formative experiences may produce structural adaptations to genes

Amazing, that early experiences can have such an impact on the developing physical brain. But what about later in life? Short of the eventual physical decline of aging in the brain structure, are there other experiences which significantly alter the actual organic brain?

Drink and drugs immediately come to mind… But these affect functioning ability, no?

One of the charges leveled against psychiatry’s diagnostic categories is that they are often “politically motivated.” If that were true, the framers of the DSM-5 probably would have retained the so-called “bereavement exclusion” — a DSM-IV rule that instructed clinicians not to diagnose major depressive disorder (MDD) after the recent death of a loved one (bereavement) — even when the patient met the usual MDD criteria. An exception could be made only in certain cases; for example, if the patient were psychotic, suicidal, or severely impaired.

And yet, in the face of fierce criticism from many groups and organizations, the DSM-5 mood disorder experts stuck to the best available science and eliminated this exclusion rule.

The main reason is straightforward: most studies in the past 30 years have shown that depressive syndromes in the context of bereavement aren’t fundamentally different from depressive syndromes after other major losses — or from depression appearing “out of the blue.” (see Zisook et al, 2012, below). At the same time, the DSM-5 takes pains to parse the substantial differences between ordinary grief and major depressive disorder.

Unfortunately, the DSM-5’s decision continues to be misrepresented in the popular media.

Last week, the Associated Press reported on the deplorable state of Kenya’s only psychiatric hospital — where locking patients up and over-drugging them appear to be the norm. Things are so bad, recently 40 patients actually escaped from the hospital.

Mental health treatment continues to lag — sometimes quite severely — in under-developed countries throughout the world. Many countries in Africa continue to treat people with a mental illness as though they had leprosy or some other inexplicable, communicable disease.

Because so little is understood about mental illness by some of the peoples of these countries, family members are often outcast and given over to well-meaning — but severely understaffed and under-resourced — professionals. This is of little surprise when poverty is so rampant in countries like Kenya.

For as long as Viagra has been on the market for men (1998, if you’re keeping tabs), scientists have been hard at work trying to find a female equivalent. What will make women as horny as men on Viagra?

The answer has been elusive. That’s probably because sexuality isn’t just about blood flow to your sexual organs, but also the blood flow to your primary sexual organ — your brain. Research has suggested that for women, the brain is as important as any other body parts. And for researchers looking for a female sexuality pill, that presents a unique set of challenges.

The New York Times talks about researchers’ latest attempts at crafting such a pill, called Lybrido. It’s an in-depth story that explores women’s personal experiences — and frustrations — with their decreased sexual desire.

I was going to comment on health care expenditures with an article entitled, “How the High Cost of Health is My Fault.” In it, I would briefly outline my experience with mental illness and detail the cost of caring for it, which, at present, includes medication and doctor visits, totals at least $10,500 per year. Much of this cost is borne by an insurance company.

Then I was going to relate the story about how, in the summer of 2002, I chose to stop taking my medicine the way my doctor directed me to take it, and then I stopped taking my medicine at all.

This was a bad choice. As a result, my illness became an emergency.

Nine hours in the ICU, four days in a private room, and two more weeks of hospital care brought a bill that topped $95,000.

The cost of nine years of care was eaten up by just a few weeks of my irresponsibility. That was cost that the health care industry, including my insurance company, would not have had to bear if I had only taken my medicine as directed.

If you were hoping to get some medications prescribed for attention deficit hyperactivity disorder (ADHD) while in college or at university, you might be in for a rude surprise.

Colleges and university are cutting back on their involvement with ADHD, primarily due to abuse of the psychiatric medications — stimulants like Ritalin — prescribed to treat the disorder. Students — whether they are malingering the symptoms or actually have it — are prescribed a drug to treat ADHD (sometimes from different providers in different states), then sell a few (or all the) pills on the side. Profit!

Now universities are becoming wise to the epidemic nature of the problem, as some studies have suggested up to a third of college students are illicitly taking ADHD stimulants.

This might help curb the abuse problem, but will it also make it harder for people with actual ADHD to receive treatment?

Admit it: You like reading articles that contain lists. You know the ones I mean. The ones that contain those snippets that’ll explain how you can change your life if you follow a five-step plan to being a better person. The five steps to being wealthy; five beauty tips of the stars; five things that will help you beat procrastination, depression or anxiety. Come on, I know you like them — because I do too!

There’s something strangely comforting in looking at these lists and hoping that our life problems can be boiled down into five simple steps. I read them hoping for the answers, because I too want the secret to life, the universe, and everything.

However, I think the reality is this: As much as some lists offer interesting ideas, the majority mislead people about change. They offer false hope instead of facts. They generally encourage people to think their lives can be simpler if only they do those five secret things that may have worked for another person.

Come on, really? Life is so complex and the reasons why we feel and do what we do also are complex.

At first the weight gain from my new antidepressant didn’t bother me. All I cared about was that this medicine was working. I felt myself coming into my body again; I could experience emotions and enjoy the present; I wanted to do things again.

One of those things was eat ice cream. A lot. So I gained a few pounds. It was time to buy new pants anyway. The only important thing was that my medicine was working and I was feeling good. I felt like participating in my life again. Feeling good and eating ice cream were natural.

But then I broke the couch.

While I believe mindfulness meditation has been the keystone to my recovery, I still think of it as an adjunct therapy. I couldn’t manage mental illness as well as I do now if I did not meditate. But I acknowledge that the medication my doctor prescribes and the therapy visits I have with him are crucial as well. Only through the consistent application of all three therapies am I well.

Mindfulness meditation is currently all the rage, and it works. But I am wary of its proponents who claim it can treat (or even cure) mental illness by itself.

Meditation is a powerful tool when used to decrease stress and increase well-being. But if we are to maintain that mental illnesses are biochemical malfunctions of the brain and nervous system, then we must allow room in treatment for medicine. Therapy also has a long history of positive impact on the lives of those challenged by psychiatric disease. Meditation, when added to more traditional and well-tested methods of treatment, can help a patient successfully manage a challenging life. I, and so many others like me, am proof of that.

“Insanity is doing the same thing over and over again but expecting different results.”
~ Rita Mae Brown

Ya have to admire psychologists who endlessly lobby state legislatures for the right to extend prescription privileges to their profession (with a little additional training). They won’t take repeated defeat as a sign that perhaps their efforts are… insane?

Illinois is the latest state to hand psychologists seeking prescription privileges a defeat, with NAMI Illinois siding on the side of not supporting the bills in front of the Illinois legislature. After intense lobbying by both sides of this issue, they concluded, “NAMI Illinois opposes SB 2187 and HB 3074 in its current form to expand prescriptions privileges to psychologists.”

When will psychologists learn?

In this age of advanced modern medicine, it is a depressing fact that not all people suffering with a depressive illness respond to antidepressants.

The mental health charity Mind UK recently highlighted their concern that there is a serious need for a range of therapies to be made available to depression sufferers.

According to the best psychological working practices, medication is now considered to be only one option for effectively treating the illness.

Talk therapies — otherwise known as psychotherapy — such as cognitive behavioral therapy (CBT) have proven effective at alleviating melancholic symptoms in hundreds of research studies conducted around the world. In Australia, the Australian Psychological Society has identified a serious need for psychotherapeutic interventions in the lives of people with depression.

Shame really should be on the list of deadly diseases. It may not actually murder a physical body, but it has the capacity to barrage the soul to the point of psychological imprisonment. It attacks our sense of self-worth and destroys our ability to be fully alive.

If it were actually effective, I would wholeheartedly join you in your strike against shame, holding signs to keep it out of the psyche and saying, “Shame on you, shame.” But from my experience, it usually just grows into an angry beast. It haunts us day and night until we do something about it.

Pushing away the shame isn’t the answer. So what is?

Sharing the shame with a trusted person is what will heal us.