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Looming Mental Health Collapse – U.S: 5% Of World Pop, 2/3rds Of All Psych Meds, 1 in 10 on Anti-Depressants

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  • Mon, Feb 25, 2013 - 08:15pm

    #1

    Poet

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    Looming Mental Health Collapse – U.S: 5% Of World Pop, 2/3rds Of All Psych Meds, 1 in 10 on Anti-Depressants

One in 10 Americans takes anti-depressants (just one type of psychiatric medication). Others take other kinds. The U.S. population makes up 5% of the world population, yet are prescribed 2/3rds of all psychiatric drugs used worldwide.

People of all ages are affected, but the fastest growing group is young adults. Millennials are the most stressed demographic, according to "Stress in America", a study commissioned by the American Psychological Association.

According to 2002 and 2004 study data, inmates in federal, state, and local prisons and jails, 69.1%, 68.6%, and 45.5%, respectively, were placed on a psychiatric medication after admission into the system. At time of arrest, the numbers were 25.5%, 29.6%, and and 38.5%, respectively.

Sources:
http://www.npr.org/blogs/health/2011/10/20/141544135/look-around-1-in-10-americans-take-antidepressants
http://www.guardian.co.uk/commentisfree/cifamerica/2011/mar/15/psychology-healthcare
http://www.usatoday.com/story/news/nation/2013/02/06/stress-psychology-millennials-depression/1878295/
http://www.medscape.com/viewarticle/703701

So, what happens when medications become increasingly expensive, increasingly unavailable?

For people who may be depressed now (and more depressed as economic and social conditions worsen), holistic medicine, meditation, talk therapy/counseling, friend/family support, etc. may help. (Caution: St. John's Wort, an herb taken for depression also makes birth control less effective for women.) But what about psychosis and anger management and violence?

Recent Examples Of What I Am Concerned About:
Adam Lanza, the Newtown School shooter, was taking the antipsychotic Fanapt.
Ali Syed, who earlier this month went on a killing and carjacking rampage, was taking some kind of anti-psychotic.

How To Adapt And Cope?
I think things are going to get crazier, if you know what I mean. What can we do to adapt and cope? It's not just about ourselves and our children. (That's addressed here and elsewhere.). It's also about how deflect unwanted attention away from ourselves and our families and homes? To help friends and relatives who may have a hard time coping at exactly a time when medication becomes more expensive or difficult or impossible to obtain… Please share your thoughts.

Poet

 

  • Mon, Feb 25, 2013 - 08:31pm

    #2

    Aaron M

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    Symptoms, not the cause…

This approach is really alarming. 
What I read when I see studies and conclusions like this is:
1. Society is creating mentally unhealthy people with vast amounts of sensory deprivation, violent ideation and a truly insane pace of existence with little in the way of psycho-social harmony or satisfaction.

2. Society is unwilling to change the pace, scale back the violence, sex and ideation.

3. Money can be generated by maintaining this unhealthy lifestyle, and then selling snake oil to 'cure' the symptoms, while leaving the cause in tact to damage more generations of Americans.

4. Good business practice is unhealthy and unethical.

I hate to decry the business model of the U.S. because it's such an easy scapegoat for ideologically driven arguments, but this is one area where it's particularly devious. The health care that we receive is horrendously offset with the healthcare we're capable of providing. 

The main problem (isn't it always?) is that we can't provide quality to quantity
Now, I'm not a physician, but have a strong interest in medicine, and I must say that the ideal of altering neurochemistry on whim to satisfy complaints of symptoms that can be remedied by healthy, regular activity, and an gratifying social and family network seems painfully myopic and flawed.

The impacts of these drugs are well understood to be very harmful – especially to young men – and yet they continue to be prescribed without regard, as the long term health of the patient is thrown away for an easy, 'one size fits all' solution in pill form.

Sad.
Aaron

  • Mon, Feb 25, 2013 - 10:11pm

    #3
    AndyG

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    As a Physician who prescribes

As a Physician who prescribes these medications [in the UK] we have a similar but less significant trend in prescribing over here.

I think there's quite a few things going on. Including, but not exclusively:

1. Breakdown in relationships, family and community support structures

2. Uncertainty about jobs and the future

but an attitude I see more and more is people's expectations to always be 'happy'. I call it the 'McMedicine' syndrome. [TM pending!] Depression – remembering there are various types with some definitely benefitting from medication – is natures way of telling you something isn't right. It should cause you to stop and reflect if some change is necessary. It's the medicalisation [and medications = $ to companies] of normal human experience that is seen to need 'curing'.

Early on in my training I was given Ivan Illich's book [1975] Limits to Medicine. To quote Wikipedia:  Illich subjected contemporary Western medicine to detailed attack. He argued that the medicalization in recent decades of so many of life's vicissitudes—birth and death, for example—frequently caused more harm than good and rendered many people in effect lifelong patients. He marshalled a body of statistics to show what he considered the shocking extent of post-operative side-effects and drug-induced illness in advanced industrial society.

Primum non nocere – "first, do no harm", from the Hippocratic Corpus. However, to 'do nothing' seems not to be acceptable to many patient's theses days. 'Do something doctor!' is the plea. Add in defensive medicine to the profit motive [Doctors and big Pharmacy] and the scene is set for over perscribing.

Question – What is the most sensitive organ in your body?

Answer – your Brain. Bear this in mind when you put chemicals in your body.

Having lived for a few years in Africa, and comparing cultures, they have a richness we so often surrender on other altars. I visited with some University students [age 19/20] and had them ask their Africa peers this questions:

Q. If you had no money, and needed to borrow some, how many people could you turn to who would instantly lend some to you?

How would you answer that question?

Africa student = around 90 people

UK student = 3

It is true African's [generalising for a continent aside – the part I was in anyway] are more 'time rich but cash poor'. Their 'treasure' and investment is in people. They live with scarcity all the time, and day to day. They maintain relationships in ways we are having to re learn here in the West. We have lost it. They still have it. In one sense I hope a 'slow descent' will enable our communities to become more 'healthy' in so many ways. Those who manage to do so with thrive in proper human like ways.

  • Mon, Feb 25, 2013 - 10:17pm

    #4
    robie robinson

    robie robinson

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    Wow

AndyG, wonderful post.

  • Mon, Feb 25, 2013 - 10:26pm

    #5

    Aaron M

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    Agree

Andy, 

Thank you for that… what a contribution.

Aaron

  • Mon, Feb 25, 2013 - 10:49pm

    #6

    Greg Snedeker

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    Anatomy of an Epidemic

Richard Whitaker's book "Anatomy o an Epidemic" is an eye opening look at the meteoric rise in neuroleptic prescriptions in the past 2 decades. Are there any doctors out there that might comment on his findings? It's scary!

  • Tue, Feb 26, 2013 - 12:23am

    #7

    Poet

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    A Sample List…

The following list is taken from the Save Project web page:

http://www.thesaveproject.com/

  • Thirteen year-old Chris Fetters killed his favorite aunt while taking Prozac.
  • Twelve year-old Christopher Pittman murdered both his grandparents while taking Zoloft.
  • Thirteen year-old Mathew Miller hung himself in his bedroom closet after taking Zoloft for 6 days.
  • Fifteen year-old Jarred Viktor stabbed his grandmother 61 times after 5 days on Paxil.
  • Luke Woodham aged 16 (Prozac) killed his mother and then killed two students, wounding six others.
  • Boy in Pocatello, ID (Zoloft) in 1998 who in seizure activity from Zoloft had a stand off at the school.
  • Michael Carneal (Ritalin) a 14-year-old opened fire on students at a high school prayer meeting in West Paducah, Kentucky. Three teenagers were killed, five others were wounded, one of whom was paralyzed.
  • Andrew Golden, aged 11, (Ritalin) and Mitchell Johnson, aged 14, (Ritalin) shot 15 people killing four students, one teacher, and wounding 10 others.
  • TJ Solomon, aged 15, (Ritalin) high school student in Conyers, Georgia opened fire on and wounded six of his class mates.
  • Rod Mathews, aged 14, (Ritalin) beat a classmate to death with a bat.James Wilson, aged 19, (Psychiatric Drugs – various) Breenwood, South Carolina, took a .22 caliber revolver into an elementary school killing two young girls, and wounding seven other children and two teachers.
  • Elizabeth Bush aged 13 (Paxil) was responsible for a school shooting in Pennsylvania
  • Jason Hoffman (Effexor and Celexa) – school shooting in El Cajon, CaliforniaAnother boy in Pocatello, ID (Zoloft) had a stand off at the school.
  • Jarred Viktor aged 15 (Paxil), after five days on Paxil he stabbed his grandmother 61 times.Chris Shanahan aged 15 (Paxil) in Rigby, ID who out of the blue killed a woman.
  • Eric Harris aged 17 (Zoloft then Luvox) and Dylan Klebold aged 18 in Colombine school shooting in Littleton, Colorado, killed 12 students and 1 teacher, and injured 23 others, before killing themselves.
  • Jeff Franklin (Prozac and Ritalin), Huntsville, AL, killed his parents as they came home from work using a sledge hammer, hatchet, butcher knife and mechanic's file, then attacked his younger brothers and sister.
  • Neal Furrow, (Prozac) in LA Jewish school shooting reported to have been court-ordered to be on Prozac along with several other medications.
  • Cory Baadesgaard (Paxil then 300 mgs Effexor) in Matawa, WA school shooting. This was not long after being taken off Paxil cold turkey and changed over to Effexor.
  • Shawn Cooper of Notus, aged 15 (SSRI and Ritalin) took a 12 gauge shot gun to school and started firing, injuring one student and holding the school hostage for about 20 mins.
  • Jeff Weise, 16, (PROZAC) Minnesota School Shootings March 2005, killed his Grandfather and Grandmother, then went on a rampage at the school killing a teacher, a security officer, 5 students (and wounding 7 others, 2 critically), before exchanging gunfire with police and then shooting himself.
  • Christopher Pittman, aged 12, (Paxil then Zoloft). Known amongst family as 'pop-pops shadow', he had always been very close to his grandfather. Shortly after being prescribed Zoloft he shot both his grandparents dead and burned the house down.

      and etc…

Poet

  • Tue, Feb 26, 2013 - 01:22am

    #8
    Peak Prosperity Admin

    Peak Prosperity Admin

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    I suppose I cannot be fully

I suppose I cannot be fully objective on this issue as I work in the field but I do know some of the data. Truly, everyone's comments here are heartfelt and thoughtful. Aaron, I appreciate your perspective and as well as the others as they address the societal influences on individuals which is something mental health professionals cannot address so easily.

As I have said before, in addition to medication abuse, alcohol use is still known to increase risk of suicide and homicide in all age groups (per the
CDC) and should not be ignored in any discussion of violence.

http://www.cdc.gov/alcohol/fact-sheets/underage-drinking.htm
http://www.cdc.gov/alcohol/faqs.htm

Antidepressant and amphetamine use in youth can lead to manic episodes and worsening of psychosis in individuals predisposed to these problems.  A good child psychiatrist knows this. But there are very few child psychiatrists.  Most of these meds are prescribed by primary care doctors who cannot do therapy. That is not an indictment but a byproduct of pharmaceutical marketing to OB/GYN, surgeons, primary care doctors, pediatricians and internists coupled with a shortage in mental health professionals outside of big urban areas. This leads to some inappropriate prescribing as much as my treating someone's hypertension will lead to more mistakes, it is just not my area.

However-I have never seen medications restrain someone who was intent on harming themselves or others-I mean completely intent on harm. Medications don't stop a predator for very long.Even physical restraints won't keep someone down if they are inventive.

So we have a population of people who are isolated, stressed, on psych meds that are inadequately monitored by well meaning doctors who are overworked (most psych meds in the country are NOT prescribed by psychiatrists). The family unit and society supports are disintegrating. Parents are overworked, absent or having their own problems. No question the suicide rates and substance abuse rates are increasing.

What a great time to cut mental health funding.

St. John's Wort is studied in the US literature and found to be effective for mild-moderate depression but it is an MAOI and can interact with other medications. Sam-E also can be helpful. Nurses and PA and NP specialists may be available to monitor peopleon medication. Exercise is helpful. Meditation is helpful.

 

However, if someone is psychotic, with predatory impulses and paranoid delusions (like heaven forbid a Jeffrey Dahmer) http://en.wikipedia.org/wiki/Jeffrey_Dahmer what do you do???  Who wouldn't recommend medications? and incarceration.  Whitaker makes some good points but some people are truly dangerous and psychotic and need help. I still believe there is a place for psych meds.

As things deteriorate I think the NP's, PA's and nurses are going to be called upon, along with herbalists and alternative providers, to help out. And the cheapest medications will become the ones everyone will have to take if needed. I apologize for my unusually long winded post.

  • Tue, Feb 26, 2013 - 01:28am

    #9
    Peak Prosperity Admin

    Peak Prosperity Admin

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    clarification

By bringing up the extreme and provocative case of the psychotic cannablistic antisocial Jeffrey Dahmer in no way did I mean to imply that patients with psychotic disorders are routinely violent. Statistics show (IMHO)most are quite isolated and not at all violent. My apologies for a seemingly biased example.

Violence is associated with personality disorders, substance abuse and the manic phase of manic depression but I apologize I do not have time to provide sources. However, you can google it and find the information pretty easily by using keywords "psychiatric correlates violence" I suspect.

Regards, I have to drive home now

Denise

  • Tue, Feb 26, 2013 - 02:42am

    #10
    Peak Prosperity Admin

    Peak Prosperity Admin

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    an herbal guide

was on sale at the last Massachusett General Psychopharmacology Course, seems pretty good regarding effects, side effects and interactions:

I think cannabis use has to be looked at very carefully to see if it is friend or foe, speaking of herbs. It is a different drug from back in the day.

Enough of me, again apologies for my rants. I hope to compose my thoughts as time goes on. Violent behavior is a topic I deal with every day in my work and I still don't have many answers. Hopefully others will.

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