We thought you might find a recent interview conducted by David DiSalvo of interest. We have broken it into two parts for easy reading. We’ll publish Part II next week. Also, sorry we haven’t blogged in a while; we were busy traveling in the Mediterranean.
Part I
Depression For Dummies, Overcoming Anxiety For Dummies, Obsessive-Compulsive Disorder For Dummies, Borderline Personality Disorder For Dummies–these are just a few of the titles penned by Dr. Laura Smith and Dr. Charles Elliott, a writing duo with a library of psychology and self-help books between them. Tackling challenging topics with an accessible style is their specialty, and has allowed many readers gain a better understanding of anxiety, depression, OCD, and borderline personality disorder, among other topics. They recently spent some time discussing the For Dummies series and a variety of psychology issues and questions with www.Neuronarrative.com
You’ve written several books on depression, anxiety, OCD and related topics, including some of the wildly popular For Dummies books. What led you to the Dummies format to address these topics?
Yes we have; in fact, we’ve just finished our sixth book in the series. As clinical psychologists, we’ve read dozens of self-help books. Most of them focus on how to deal with some specific mental disorder such as depression, obsessive compulsive disorder, or generalized anxiety disorder. Some of these books ignore empirical findings and present an interesting, but highly idiosyncratic and non-data based set of recommendations. Many of the better books in this genre are written by highly renowned researchers and do a great job of presenting the findings from a specific researcher’s approach to the disorder. However, in the past couple of decades, the mental health field has managed to develop a number of empirically based treatment strategies for most emotional disorders. We believe people can profit from knowing about a range of strategies so long as they rest on a research base.
In the For Dummies series, we saw an opportunity to provide consumers with an unusually comprehensive approach to each topic covered. Thus, in all of our books we discuss a variety of empirically supported treatment approaches, diagnostic issues and controversies, related disorders, etiology, prevalence, where and how to find professional help, and ideas for how friends and family can facilitate treatment. For example, in Obsessive Compulsive Disorder For Dummies we discussed the fact that twenty years ago, the only treatments for OCD were exposure and response prevention (ERP) and medication. We were able to review not only ERP, but new mindfulness based approaches, cognitive therapy specifically tailored to OCD, medications, and Deep Brain Stimulation (a very preliminary, but possibly promising strategy).
At the same time, we appreciate the For Dummies series for its nontechnical, no nonsense approach to presenting information. We really enjoy taking complex subjects and presenting them in a way that enables intelligent consumers to understand a topic that may be new to them. Finally, we were thrilled that the editors also encourage the use of humor and a panache of irreverence. We believe that readers enjoy a touch of levity when reading about such serious subjects.
Some fear that the proliferation of medical information, particularly on the internet, is causing widespread self-diagnosis panic. What’s your take on this?
We’re firm believers in the value of information. No doubt, some people panic when they discover on the Internet that they may have a couple of symptoms of some serious disorder yet later learn that they don’t really have the actual illness or disease. But we suspect that for all those who are unnecessarily rattled by what they read, many more discover that they suffer from problems that that they were unaware of, but that can be successfully treated-and generally with greater success than they would have had by not starting treatment until their doctor discovered something at a physical exam months or years down the road.
News concerning the development of psychiatric disorders in children, such as OCD, is on the rise. In your opinion, are parents getting better at identifying symptoms in their kids? And have doctors become more willing to consider the possibility that a child needs psychiatric help?
We do believe that both parents and doctors have greater awareness about these issues than ever before. That awareness is certainly one of the reasons we see disturbing trends in the rise of various mental health issues in kids today as compared to the past. At the same time, some evidence suggests that more than increased awareness lies behind the escalating numbers we’ve seen in the past fifty years or so. Several studies have suggested that the rate of anxiety and depression in kids today greatly exceeds levels we’ve seen in the past.
We’re also concerned that there has appeared to be an over reliance on medications for dealing with these issues. Potent medications are increasingly being prescribed to kids for disorders which were once considered rare in children such as bipolar disorder. We suspect some of these diagnoses are given instead of behavioral disorder diagnoses so that these medications may be employed.
We take a more conservative approach to medications, especially for kids, because of a dearth of long term safety and efficacy studies. In fact, some studies have shown that many of these medications significantly increase risks of diabetes and sometimes set off suicidal thinking. Therefore, our usual recommendation is that treatments should first target the child’s problematic behaviors or moods as well as involve parents, the family, and the school environment. Cognitive behavioral interventions have been found to be especially effective and often obviate the need for medications. When they don’t, medications can be considered, but as judiciously as possible.
Continue reading Part II of the interview…
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From Psych Central's Drs. Laura L. Smith & Charles H. Elliott:
A Recent Interview of Us by David DiSalvo, Part 2 | Anxiety and OCD Exposed (June 30, 2009)
Thank you both for writing.
As far as I am concerned, give the consumer a little more credit. (in general!)
The media and most of TV seems to be speaking to the dumbest of dumbest of the ignorant, and we have seen the harm done.
But when I ask a question on-line of a physician about what he thinks about an issue, the response I get back is that I should see my doctor, and that only my doctor knows best, and that advice cannot be provided on the Internet and is no substitute for private medical care.
This is usually followed by a note to call 911 in an emergency. (as if I would write to you instead and that this piece of advice is an exception, and OK to give, as it meets me on ‘my level’)
Of course, anywhere in the world, people will be people and it matters not if this is on the Internet or in ‘real life.’
But it is also true that my doctor does not always know best, and if it comes down to the last person who will know best, that will be myself. This is not to mean that I know everything, but to mean that I go out to look for information and I do know the difference between useful and no useful, or good and bad advice. Usually, a portion of the advice is helpful and sometimes, the worst articles and worst people giving me advice, I learn the most from them. This was also true for my therapist. I learned most from his mistakes.
I have been around these sites for a long time, and I am really impressed with the audience in general, and also advice and opinions from lay-people.
Just a few thoughts that I wanted to share.
Thanks
Katrin
One more thing. my son had Tourette’s syndrome, and we were referred to a child psychiatrist. This was when he was about 7. The doctor decided that my son also had some OCD features, and that he was somewhat depressed, and she placed my son on Luvox. (aside from other medications)
To make a long story short, and the psychiatrist thought I was a little slow in accepting the obvious, I did have to admit that there was no longer a doubt about this new development. my son was bipolar.
I am a nurse, and for one entire year we went through every single one of the bipolar medicines. lets just say, and I am very serious about my words, that if it weren’t for me, my son would be dead from the so many serious side effects he experienced, especially from some of the drugs. And they usually came on only after about 7-10 days, and when the medicine started working.
For about 7-8 years, our family’s life was a nightmare. my son went to 6 different middle schools and then we finally found a great school, a tiny one.
But here is my point to the story. One day CSD, or DHD, or whatever they are called, came to visit my house, because my son had acted sexually inappropriately.
The case worker was a great surprise in that he really listened and in that he really ‘got it’ from what I told him. he asked me to sign a release to talk nto the psychiatrist who in turn, and without any other explanation, ordered me to stop my son’s Luvox.
And that was the very end of my son’s mental illness and manic depression or bipolar stuff. Gone. The Luvox had caused this.
Luvox is an antidepressant which is also supposed to be helpful with OCD symptoms.
@Katrin: You make some really good points about the fact that everyone needs to be actively involved in their own health care. You must be an active consumer, question, and research as much as you can. Sometimes professionals are wrong. When you think your treatment provider may be wrong, it’s important to both seek a second opinion as well as research the issue. One of the great things about the Internet is that research is something everyone can do more easily than in the past.
@Katrin: You make some really good points about the fact that everyone needs to be actively involved in their own health care. You must be an active consumer, question, and research as much as you can. Sometimes professionals are wrong. When you think your treatment provider may be wrong, it’s important to both seek a second opinion as well as research the issue. One of the great things about the Internet is that research is something everyone can do more easily than in the past.
BTW I love your blog!
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