British Prime Minister Gordon Brown was the target of the media’s latest attempt to discredit a politician with an alleged mental illness. Seems some blogger heard someone at a party who said that the PM avoids foods that  should not be eaten when taking certain antidepressants (I don’t know what food that is but I hope it’s not ice cream).

It didn’t take long after this hearsay to hit the blog-o-sphere for BBC interviewer Andrew Marr to take an interest. With no other evidence than the word of a single blogger, Marr went on live television in Britain last Sunday and asked Brown if he takes “prescription painkillers or pills to get through” – as in “do you take antidepressants?”

Ambush journalism wrapped around stigma. Lovely. I have been a journalist for nearly 30 years. A responsible journalist would have investigated this rumor before going on national television and ambushing a major world leader with such an ignorant, stilted question.

Brown quickly denied taking antidepressants. But what if he is? So what? Winston Churchill suffered terribly from depression, which he called his “black dog.” Historians believe Abraham Lincoln suffered from depression. Both did a fine job and neither had antidepressants to lighten their burden. Is depression more debilitating than polio, which put FDR in a wheelchair? Have we made no progress since 1972 when George McGovern selected Thomas Eagleton to be his running mate, only to drop him after Eagleton disclosed he had been treated for mental illness?

Why is it that seeking help for physical illnesses – diabetes, cancer, hypertension – considered wise but seeking help for mental illness scandalous? Will we ever move beyond this prejudice? Journalists, such as Marr, stoke the stigma when they ask inflammatory questions which imply that those of us with mental illness aren’t fit to handle responsibility greater than brushing our teeth.

We are fit and responsible. We also are smart enough to know when we need help and humble enough to ask for it, even in the face of overwhelming ignorance. Aren’t those characteristics we want in our leaders?

Last week our local sheriff – reacting to a demand to cut $3 million from his proposed $480 budget  - threatened to cut a successful substance-abuse treatment program before cutting deputies. In other words, if the sheriff doesn’t get what he wants he will put alcoholics and drug addicts back on the street before he takes deputies off the street.

This kind of political extortion is inhumane, illogical and demonstrates the sheriff’s ignorance of substance abuse and mental illness. According to the sheriff, ”I only have two options. Cut deputy sheriffs … or cut programs that I’m not mandated to do.”

Many, if not most, inmates with substance abuse problems also suffer from other mental illnesses. It’s called dual-diagnosis. Their addictions and companion illnesses – such as bipolar – have reached the stage where they are committing crimes to self-medicate, support their habits or because they have completely lost their ability to control their impulses.

Release these addicts and alcoholics without treatment and they WILL very likely commit more crimes and those crimes WILL very likely be more serious.  Just as mental illnesses are progressive, so is criminal behavior.

Unfortunately we cannot see the crimes that an addict/alcoholic inmate will not commit because they received treatment. A clean and sober addict/alcoholic probably won’t end up homeless, in an emergency room or back behind bars. They are better able to manage their companion mental illnesses, such as bipolar and depression, and are less likely to physically abuse and abandon their kids. Clean addicts and sober alcoholics are less likely to contract AIDS because they are less likely to have unsafe sex or prostitute themselves. Many actually get jobs, go to school and pay taxes.

Who can put a price tag on how much misery and how many dollars are saved by treating just one mentally ill inmate?

Putting more deputies on the street undoubtedly prevents crime from being committed at a particular location at a specific time. But the drug dealers will simply move to another corner and the addicts will follow. The addicts and alcoholics will continue to drink and drug, abuse and abandon their children, clog emergency rooms, spread sexually-transmitted diseases, commit crimes …

So, looks like we have ANOTHER doctor accused of prescribing drugs that killed a celeb. This time it’s Michael Jackson’s doctor. Apparently, Jackson’s doctor injected propofol – a powerful anesthetic- to Jackson the night he died. Tox reports are not in but investigators believe the drug caused his heart to stop. Two years ago it was Anna Nicole Smith and the psychiatrist who prescribed a smorgaasbord of benzos to her in the months before her death.

Obviously, I am NOT a doctor. But I don’t need a medical degree to know that both these celebs has serious mental illnesses. You only had to watch one episode of Anna Nicole Smith’s reality television show to see that she was an addict. One look at Michael Jackson and you could tell he had – at the very least – some body-image issues (Body Dysmorphic Disorder).

Mental illnesses are like potato chips: Many of us have more than one. In the medical world they call it “co-morbidity.” In other words, you have more than one illness going on. Some research shows that at least 30 percent of addicts and alcoholics have at least one companion mental illness. Knowing this, wouldn’t you screen your patient for substance abuse if they came to your office looking like Michael Jackson or Anna Nicole Smith?

Where is the line between common-sense and criminal negligence? These doctors aren’t stupid. I truly believe that Anna Nicole’s doctor knew that Anna Nicole was a addict. Despite that knowledge, the doctor made a conscious decision to prescribe benzos to Ms. Anna Nicole Addict. Same with Michael. What kind of doctor injects Diprivan to help you sleep at night? Maybe to help you sleep DURING SURGERY but not to go nighty-night.

I believe these doctors were seduced by celebrity and money. But what about the doctors treating folks like you and me? Did your doctor screen you for substance abuse before writing you a ‘script for Xanax or Klonopin? Likewise, if you are in treatment for substance abuse, did your doctor screen your for depression and bipolar?

Let’s put it this way: It’s common practice for a doctor treating a diabetic to screen …

We have yet another study finding that the number of adults taking anti-depressants, anti-psychotics and Alzheimer’s drugs is rising. Pardon my sarcasm, but DUH!

This one was recently reported in the journal Health Affairs. This study found a 73 percent increase in the use of these drugs between 1996 and 2006. Experts said it shows that more doctors have become familiar with the drugs and are more comfortable prescribing them. Well, I don’t know about that. But I do know this: Critics argue that the numbers prove that Americans are overmedicated.

Undoubtedly, some are. What we don’t hear is that this decade saw the introduction of some of the most successful drugs for treating mental illness and Alzheimer’s: Lexapro 2002; Wellbutrin XL 2002; Lamictal for bipolar 2003; Celexa goes generic 2003; Cymbalta 2004; Aricept and Exelon for Alzheimer’s 2006.

No one mentions the hit-or-miss factor: Because no one knows how these drugs work, it can take months of trying different drug combinations before a doctor finds the right one or the right dose. How many of us have half empty prescription bill bottles for drugs that did not work?

And what about the Medicare Modernization Act of 2003 which greatly expanded prescription drug coverage for the elderly? Could that account for some of the increase?

Obviously I am biased. I have been on antidepressants and a mood stabilizer since 2006. They not only saved my life, they made it much, much better. We often hear horror stories about overmedicated kids and zombie grandmothers. But we rarely hear the success stories because there is so much stigma about using these drugs.

I am not going to use these numbers to say we are overmedicated. I am not going to use these numbers to prove anything. Numbers always look impressive. But they can be twisted like a strand of DNA. They are just numbers. Period.

Wait! News flash! I see another story in the paper this morning about a study that says that antidepressant use among young people has fallen – since the drugs began carrying a “black box” warning. The study also found a DECREASE in the number of depression diagnosis! Holy cow! …

I went to meeting of our local Criminal Justice Commission last week. The commission created a task force called the Criminal Justice, Mental Health and Substance Abuse Planning Council. After months of research the council held a “summit” to prioritize their goals. The consultant admitted – out loud – that he had to be educated about dual diagnosis before he started his research. There were charts, cost estimates and a free breakfast.  They came up with a fancy bureaucratic-babble name that I have already forgotten. 

I wanted to scream. I know these people mean well but they are designing programs that probably won’t work. Why? Because they do not know what they do not know. Most alcoholics and addicts charged with a crime have another mental illness. Most mentally ill people charged with a crime are also addicts or alcoholics. The number one reason for relapse among recovering alcoholics and addicts in the criminal justice system is untreated depression, biplolar or other mental illnesses. The number reason that the mentally ill in the criminal justice system cannot be stabilized is because they are abusing drugs and/or alcohol.

The medicine for depression and bipolar and other mental illnesses are antidepressants, mood stabilizers, anti-psychotics and other medications (preferably NOT benzodiazepines.) The medicine for alcoholism and addiction is a 12-step program – the most successful abstinence program ever.  Who in the criminal justice system knows what a 12-step program is? Who knows how a 12-step program works? Who knows the 12-steps? If judges, prosecutors, attorneys and probation officers could answer these questions they would know what questions to ask to determine if someone is really clean and sober and working a program.

Learning about 12-step programs is simple, easy and costs almost nothing. Get “the” book and read the first 168 pages. Then make sure the addict or alcoholic in court gets “the” book, reads the first 168 pages and works a program. As for medication, it is stupid and cruel to release a mentally ill inmate with a prescription for a week’s worth of medication, as they do here.

Jails, unlike prisons, are for defendants who cannot post bail or are serving …

Say you are an alcoholic and/or addict and dual diagnosed (or triple diagnosed like me). You want to get clean and sober. You have heard that successful sobriety hinges on the one addict/alcoholic helping another. You seek help from a clean and sober addict/alcoholic – a mentor who will share his/her experience, strength and hope. A mentor who will guide you and make suggestions. Sounds like a good idea, right?

Well, it can kill you if your mentor tells you that you must stop taking anti-depressants, mood stabilizers or anti-psychotics because they are are “mood altering” drugs. Some recovering addicts/alcoholics refuse to mentor others who take these “mood altering” drugs. Some even say you are not clean and sober if you take these medications. 

This attitude is insane, ignorant, irresponsible, arrogant, dangerous, self-righteous and stigmatizes mental illness even more. Where do  people clean and sober for years – often with nothing more than a high school degree – get off thinking that they know more than a psychiatrist? Sure, there are ignorant psychiatrists who prescribe benzodiazepines, such as Xanax to a self-proclaimed addict/alcoholic. There are probably just as many addicts/alcoholics to do not tell their phsychiatrist that they are addicts/alcoholics so they can get a script for benzos. 

Studies have shown that 30-50 percent of addicts/alcoholics also suffer from a companion mental illness. I believe the number one cause of relapse among the dual-diagnosed is untreated depression and bipolar. ALL illnesses must be treated for us to become healthy and stay clean and sober. 

I slipped into a clinical depression seven years into my sobriety. I was one of those recovering alcoholics who thought that if I just worked harder and helped other alcoholics more I would feel better. It did not work. I finally surrendered after a friend in recovery told me that she had taken anti-depressants for years. I have taken anti-depressants and a mood stabilizer for years. I AM clean and sober.

These self-righteous recovering alcoholics and addicts need to wise up and shut up. In my opinion, it is okay – even helpful – to ask recovering alcoholics/addicts if they have been honest with their doctor …

Welcome to Rant-O-Rama, an occasional blog about stuff that really ticks me off in the mental health world. Please feel free to share your own rants. Believe me, it feels really good.

I was watching the nightly news on Saturday and, once again, I heard some talking head use the phrase “schizophrenic” to describe a situation as though it had multiple personalities. First, I do not like the colloquial use of a horrible disease as a metaphor. Second, I do not like the colloquial use of a horrible disease as a metaphor when it totally misrepresents the horrible disease!

Schizophrenia and dissociative identity disorder (aka multiple personality disorder) ARE NOT THE SAME! DID is a condition in which at least two distinct identities routinely take over a person’s behavior and interact with the environment in their own distinct way. (I wont’ even touch the debate as to whether DID should be a valid medical diagnosis.) When you think DID, think Sybil, Dr. Jekyl and Mr. Hyde, or the movies Fight Club or Bourne Identity or the series Captain Underpants.

Schizophrenia, on the other hand, IS a psychiatric diagnosis characterized by psychosis, in which sufferers ( and I do mean SUFFER) experience hallucinations or delusional beliefs. Although schizophrenia literally means “split mind” it is not DID. This is the illness that afflicted the Nobel Prize winning mathematician John Nash. 

This may sound petty. But to me it represents the ignorance that surrounds mental illness. I do not believe – nor do I want to believe – that people would do this deliberately. I do know that when I point this out to people who misuse “schizophrenic” that they don’t seem too upset about it. Maybe that is why it grinds me to much.

What do you think?