Personal stigma

When we think of depression it is usually in the context of the negative views held by people, specifically other people, about mental illness. Yet perhaps one of the most corrosive forms of depression can be seen when our own views prevent us seeking help for our own poor health.

Thankfully this is improving but it remains a real barrier to patients receiving the care they need. In a Guardian article from 2006 one woman talks of her own experiences.

“I was nearly 20 before I understood that there was a name for what sometimes happened to me. Later, I learned that it has gone by many names – the black dog, the bell jar, the noonday demon, darkness visible, malignant sadness – but in my teens I’d just assumed that my fierce highs and days of disproportionate, isolating despair were part of every teenager’s repertoire – how else would Morrissey have sold so many records? These pitches in mood were something I didn’t speak about to anyone, because I was afraid of two things – either that it was nothing serious, and I would be told to pull myself together, or that it was serious, and I would be told that, yes, I was a mental case.

This is why work such as the “Time to Change” project has such importance in addressing the needs of people with mental illnesses.

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New video uploaded

A new teaching video has been uploaded to the various video sites we use and posted on this site on the schizophrenia page. The video illustrates several forms of catatonia including waxy flexibility, forced grasping, opposition, negativism and aversion.

http://www.vimeo.com/19840546

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Portrayal of people with mental health problems as violent

We’re all used to the portrayal of people with a current or previous history of mental health problems as violent. If you work in the field then it is a daily issue when visiting patients outrside mental health units as the stigma associated with mental illnesses is prevalent in our colleagues from other disciplines. The Guardian today has an interesting piece that discusses a piece or work by the Glasgow Media Group, entitled “Making a Drama out of a Crisis.” The report states that “Some of this study suggests that mental illness is still used as an easy source of violent tragedy or as something to poke fun at.”

According to the Guardian:

“[The report] examined three months of drama programmes on British terrestrial channels between 4pm and 11pm from 1 January this year. It found 74 episodes from 34 different programmes contained mental illness-related story lines.Of those story lines, there were 33 instances of violence towards others, including a character in Channel 4’s Shameless attacking her partner, and an escaped schizophrenic patient in Channel 5’s CSI:NY killing people to avenge his girlfriend’s murder.

There were also 48 instances of additional types of harm, including the Emmerdale character Sally Spode drugging and sleeping with a vicar to break up his family. Some 53 instances of self-harm were also recorded.”

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US prescribing practice

Top US psychiatric drug prescribing

Table of top psychiatric drugs prescribed in the US

There’s an interesting post reported on BoingBoing today about prescribing in the US. Of particular interest os to view this in conjunction with the evidence to support prescribing and to think about how drug companies market and target doctors. I’m particularly interested to note the use of duloxetine in fibromyalgia. Is this a case of a treatment seeking a disorder? There is after all considerable debate as to whether this is an actual disorder:

Fibromyalgia syndrome was an attempt to create, for the purposes of investigation, a relatively homogeneous clinical entity out of the clinical phenomena of musculoskeletal pain and tenderness. The attempt has foundered, arising out of circular argument and violation of its own criteria, thus creating an over-inclusive and ultimately meaningless label. The epistemological errors include the failure to distinguish a clinical feature from a disease process, the use of syndromic description without a unifying concept and failure to agree on the importance and biological nature of tenderness itself.

Cohen ML (1999) Is fibromyalgia a distinct clinical entity? The disapproving rheumatologist’s evidence Best Practice & Research Clinical Rheumatology 13(3), 421-425

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Manufacturing depression

Gary Greenberg

Gary Greenberg

In an article published in The Observer on Sunday Gary Greenberg is interviewed following publication of his new book “Manufacturing Depression”. In his book Greenberg discusses his history of depressive symptomatology and calls into question the wholesale prescription of anti-depressants ‘to deal with our reactions to life’s extreme events, or to “ordinary” human misery’. Now this could be viewed as yet another anti-psychiatry polemic but it isn’t. Greenberg doesn’t discount the use of antidepressants in appropriate cases, what he is concerned about is the commodification of suffering and human misery. His view is that big pharma has a commercial interest in ensuring that this is the case. As a psychotherapist himself it might be expected that his solution would be recourse to psychotherapy but he is unflinchingly critical of talking therapies too. Again he accepts there value in specific circumstances but concludes ultimately that “I used to think it was possible to overcome yourself in some way. Now I think what we can do is that we can move into our own stories, grapple with who we are and try to live with that.”

The Observer has three pieces online; the interview, an extract discussing his involvement with an antidepressant drug trial and a further extract detailing how he found love with his current wife through the use of ecstasy.

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Useful BBC resource

Following the first Global Mental Health Summit in Athens in September 2009 the BBC collected a number of interesting resources which remain available on their web site.

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Schizophrenia among British African Caribbean groups

Patrick Vernon, chief executive of the Afiya Trust

Patrick Vernon, chief executive of the Afiya Trust, is concerned about the lack of specifics in the government's New Horizons mental health strategy. Photograph: Anna Gordon

The Guardian today contains two [1; 2] articles which describe responses to an research examining the prevalence of schizophrenia in black and minority ethnic people in the UK. The response is because the original piece of research has had a reported impact on government health policy [3].

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