This Week in Mentalists (33)

It’s Saturday, so let’s do our weekly round-up of the mental health blogosphere.

Let’s start with a new addition to my blogroll. Coloured Mind and Scattered Thoughts is a 17 year old with bipolar disorder. She criticises the lack of out-of-hours coverage for child and adolescent mental health services.

I know for adults they have a crisis telephone line and a dedicated crisis assessment and treatment team that is 24/7, but for those under the age of eighteen there is nothing. I picked a random NHS trust (not my local one) and they state ”we do not provide a crisis or out of hours service however young people requiring urgent medical attention should attend their nearest A & E department. NHS Direct is also available on 0845 4647, non-urgent messages can be left on our answerphone which will be picked up the next working day”. In 2007 30% of CAMHS teams were unable to provide weekend support and 9% could not provide on call support.

Meanwhile Experimental Chimp is searching for the “real me”.

We tell ourselves stories and we never know how true they are. Is the fact I’m feeling great at the moment a pathological symptom, or a sign of recovery? Although I know that the question “Is this the real me?” is meaningless (what does it mean by ‘real’ anyway), that doesn’t stop me wondering. I’m confident, sociable and filled with energy. I don’t need much sleep and don’t get hungry. I am the very picture of a happy hypomaniac.

So if I tell myself I’m hypomanic at the moment, I confirm that these feelings are part of the disease. This is not the real me. According to my therapist, I switch between depressed and hypomanic states when either becomes unsustainable, when the coping strategies that either represent fail. She asked me where I want to be emotionally. I think somewhere around here would be good, but without the unreasonableness and selfishness that hypomania seems to evolve into. This is the real me, but only a part of me. I am not my coping strategies.

Random Acts of Reality deals with some abysmal carers to a woman with mental health problems.

“What can you tell me about the patient’s normal condition?”, I continued.

“I don’t really know her”, she said. When I pressed her on how long our patient had been at the home she told me it was only “four or five months”.

Shaking my head in disbelief that in a small house like this the carers took so little interest in the people living there that they knew nothing about them after four months I asked what medicines she takes.

“Two little white pills in the morning, and two purple ones at night”.

I let the carer know that my psychic powers weren’t that good and she’d have to be more specific than that. She couldn’t.

The patient was unkempt, appeared to have someone else’s underwear on and her hair hadn’t been washed in some time. The ‘carer’ didn’t know anything about her and refused to have anyone come to the hospital with the patient. By now the patient was starting to wander around the back of the ambulance and I wanted to get her to hospital.

The Shrink tells us why he became a psychiatrist.

In old age psychiatry I get to work with older adults, which I prefer. They’re often a disadvantaged group with few folk improving their lot. There’s an affable and courteous nature to consultations that’s very agreeable. There’s a stoicism that arises from having coped with everything life’s thrown at you for 60, 70, 80 years or whatever, so dealing with the problems of the here and now can be childs play compared to some of the past adversity that folk have had to manage. Almost always, there’s a lot that can be done to improve things. There’s usually physical comorbidity to improve upon. There’s usually a drug regimen that can be rationalised and improved. Sometimes mental health problems can be improved upon, invariably even if we can’t change/fix the condition we can help folk cope with them better.

Mental Patient About Town has been reading RD Laing.

I have finished reading The Divided Self. I didn’t find it an excellent read or engaging as people had suggested. In fact I found it quite tedious, with only the final third being in any way enjoyable - and part of that pleasure was laughing at it. The case studies - so carefully constructed - read like the work of an imagination overreaching itself. I just didn’t find the arguments convincing. I don’t think biological psychiatry has all the answers - I’m just as likely to scoff at the vague references to “chemical imbalances” - but I think it goes some way towards providing an explanation. It’s heading in the right direction.

Seaneen gives her own take on the antipsychiatry debate.

Oh, yeah, and if you want to be in my bad books forever, do come here and tell me three things:

1) Pull yourself together, I did, it’s just a label, think positively, your diagnosis doesn’t mean anything, etc etc

2) DIET and EXERCISE? Oh, and YOGA and REIKI and other bollocks? It worked FOR ME. You don’t need ANY OTHER TREATMENT AT ALL. In fact if the above doesn’t work for you, YOU’RE WEAK, AND BEING CONTROLLED BY THE BIG PHARMA!

3) Your illness is an EXCUSE for you not to live a NORMAL LIFE because obviously due to your EXCUSE you must not ever tell anyone that you LOVE them or PLAY WITH YOUR KITTENS or ANYTHING since you spend ALL DAY just being MANIC DEPRESSIVE.

4) How dare you use the words SUFFERING and MENTAL ILLNESS. It is “MENTAL DISTRESS” and saying that people SUFFER from it makes it sound BAD.

For those people, I can use other words, like “fuck” and “off”.

Serotonin is ambivalent about beginning CBT.

I received the ‘Mind Over Mood’ book today & have read about 20 pages.My ASW wanted me to read the first 60 to get me up to speed on the Thought Charts.Seems like a good CBT workbook - but have to admit am having a few nagging doubts about whether it could work for me.This is not me being necessarily pessimistic, actually not really sure what it is.Maybe I’m so stuck not being able to move on.

The Cockroach Catcher comments on the increasingly controversial topic of childhood bipolar disorder.

Well, a few years ago I was at an American Psychiatric Association conference, where a strong case was made for diagnosing children with Bipolar and giving them the modern anti-psychotic drug. I was impressed then.

Later I was more impressed that a single person seemed to have been able to push through a whole new agenda for the diagnosis of Bipolar disorder in children and their treatment.

ADHD was the old black. Bipolar became the new black.

Cockroach Catcher isn’t at all impressed by this new trend.

Looking back at my career as child psychiatrist for over 30 years, I can count six bipolar cases, one at age 11, three between 13 and 16 and two over 16. All of them responded extremely well to Lithium.

The New Republic highlights the fragmented (and sometimes non-existent) nature of services to people with autism.

In the UK, social care services are delivered by a number of different organizations within the local area. These are typically: Child and Adolescence, Elderly, Learning Disabilities and Mental Health.

Learning disabilities do ‘do autism’ but only if your IQ is less than 70. If your IQ is 150, not matter how badly you’re disabled by autism, they’re not interested.

As for the Mental Health people, well, autism isn’t a mental illness so they’re not interested. But they will happily stand back and wait until you’re suicidal or psychotic and then section you (That’s cart you off to the funny farm, to you Americans).

Then, when you’re better, they kick you out to start all over again.