November 16th, 2010 by Dinah Miller, M.D. in Better Health Network, Book Reviews
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I’ll cut to the chase: I loved this book. Five stars. Two thumbs up.
When I read books, especially psychiatry books that I write about on Shrink Rap, I often read more carefully and sometimes more critically. I was so immersed in reading “Just Like Someone Without Mental Illness Only More So” that I didn’t stop to think, I just went on the journey.
Mark Vonnegut is a pediatrician and the son of my favorite author when I was in junior high school. His memoir is a poignant and candid account of his struggles with, well, life in general, and life with a psychotic illness in particular. Schizophrenia, bipolar disorder — who knows? (I’ll vote for bipolar disorder.) Some illness where he had three episodes in his twenties, then another episode 14 years later.
Thorazine and lithium and megavitamins and psych wards. Xanax and alcohol and how humiliating it is to be psychotic on a stretcher in the ER hallway of the hospital where he works. Divorce and remarriage. First and second families. Childhood as the son of a financially struggling, not-yet-famous eccentric writer, and adulthood as the son of an icon. Vonnegut is a hippy, a mainstream doctor, a middle-aged softball player, then finally a guy who accidentally poisons himself with wild mushrooms. Read more »
*This blog post was originally published at Shrink Rap*
November 14th, 2010 by DrCharles in Better Health Network, Health Policy, News, Opinion
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When the Republicans took back the House of Representatives [recently], John Boehner, the presumptive new Speaker and current Senator from Ohio, unleashed a “sob heard round the world.” As The New York Times quotes:
“I’ve spent my whole life chasing the American dream,” (Boehner) said, beginning to cry. He swallowed and tried again. But describing all the bad jobs he had once led to near sobbing when he got to the line, “I poured my heart and soul into running a small business.”
Boehner has cried in public many other times, the recent election night being only the largest stage to date. The tears also flow at his annual golf tournament, or while watching a child pledge allegiance to the flag, listening to a Republican colleague speak about his Vietnam War experiences, the unveiling of a statue of Ronald Reagan, while accepting various awards, during a rendition of “America the Beautiful,” etc. Could these tears be signs of major depression? Should melancholy be a disqualification for leadership? Were Clinton’s tears any better? Read more »
*This blog post was originally published at The Examining Room of Dr. Charles*
November 3rd, 2010 by Steven Roy Daviss, M.D. in Better Health Network, Health Policy, Opinion
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Back in the 1970s, Kansas passed a law that could prevent people with mental illness from voting. The law was never used, but advocates were successful in getting an amendment passed that revoked that law.
This law was passed at a time when stigma against mental illness was much higher than now. I’m guessing it was presumed that folks with a mental illness could not reason enough to exercise an informed vote, which is not true, of course. If 1outta5 have a psychiatric illness, including anxiety, depression, and substance abuse, then there could have been a huge swath of disenfranchised voters.
And there already exists, to a degree, a basic cognitive test for voting: Navigating the whole ballot process. In Maryland, ours was electronic and no harder to use than an iPad, but I could still imaging some with severe dementia unable to navigate the system. But there should never be a cognitive bar one must pass to vote. The challenge would be where to draw the line.
*This blog post was originally published at Shrink Rap*
October 6th, 2010 by Dinah Miller, M.D. in Better Health Network, Health Tips, Opinion
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“I have bipolar disorder. Can I be a doctor?” One of our readers asked this. It’s one of those questions to which there is no real answer.
Being a doctor takes a long time, it requires reliability, diligence, and a willingness to learn things you may not want to learn (organic chem anyone?) and do things you may not want to do. It requires endurance and passion. You need to be tolerant of many things: Arrogant supervisors, irritable colleagues, sick people who may not be charming and who may, in their distress, be downright nasty. You have to tolerate a militaristic order and be willing to work with a system that may be very difficult, wrong, and demand your obedience in ways that may be uncomfortable. (Oh, I am so happy to no longer be a medical student or a resident in training.)
So can you do it with bipolar disorder? Can you do it with diabetes? Can you do it with attention deficit problems? Can you do it if you’re disorganized or ugly? Read more »
*This blog post was originally published at Shrink Rap*
September 24th, 2010 by Dinah Miller, M.D. in Better Health Network, News, Opinion, Research
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In psychiatry, we’ve had a hard time drawing precise links between brain pathology and psychiatric disorders. We can do it for groups of people: “Disease X” is associated with changes in brain structure of “Brain Area Y” or metabolic changes in “Brain Area Z.” But it’s groups, not individuals, and it’s an association, not a cause-and-effect, or a definite. We still can’t use this information for diagnosis, and there are still patients with any given psychiatric diagnoses who will have brains where “Area Y” is the same size as those without the disorder. We’re learning.
From what I read in this New York Times article, Owen Thomas was a bright, talented young man with no history of psychiatric disorder and no history of known concussion. In April, he committed suicide — a tragedy beyond words.
Sometime people commit suicide and everyone is left to wonder: There was no depression, no obvious precipitant, no note left behind, and every one is left to wonder why. The guilt toll on the survivors is enormous, as is the grief for their families and communities. In this case, according to the Philadelphia Inquirer, the young man was apparently struggling with the stress of difficult school work and concerns about his team and employment.
Owen’s family donated his brain to Boston University’s Center for the Study of Traumatic Encephalopathy. They discovered that Owen’s brain showed damage similar to that seen in older NFL players — he had a condition called chronic traumatic encephalopathy. Read more »
*This blog post was originally published at Shrink Rap*
