[Fwd: Lithium vs. Lecithin]

[Fwd: Omega 3 and Bipolar]

The TCM Diagnosis and Treatment of Bipolar Disorder, Part One

Acupuncture Today
September, 2003, Vol. 04, Issue 09
The TCM Diagnosis and Treatment of Bipolar Disorder, Part One
By Yong Ping Jiang, DOM, PhD
The "Ask Dr. Jiang" column is designed to explore corners of Chinese medicine that may not be easily understood by American practitioners or are underrepresented in American clinical health literature.
Dear Dr. Jiang:
I haven't been able to find anything about manic depression / bipolar disorder in the modern Chinese reference books. Does Chinese medicine recognize this illness, and if so, what are its causes, and what are the guidelines for diagnosis and herbal treatment?Qi Healer
Chicago, Illinois
Dear Qi Healer:
This is a big question, so I'm going to have to answer it in two installments. You're quite right; it's difficult to find any mention of bipolar disorder in the Chinese medical literature, particularly in the older classics. While there are abundant references to mania (kuang) and depression (dian) as separate entities, it is hard to find a clear description of a disorder involving mood swings between the two. While chapter 22 of the Ling Shu is titled "Dian Kuang," this chapter is really about mania, not depression; its description of dian being more suggestive of epilepsy than a mood disorder. We are left with the impression that the authors of the Nei Jing were much more concerned with mania than with depression, perhaps because of its more destructive manifestations. It is perhaps because of this that they never felt the need to describe a combined syndrome of manic depression.
The Chinese description of mania refers to a patient with abnormally outgoing, aggressive and excited behavior; who is easily angered, with a tendency to talk loudly or shout. The body movements are restless and forceful, and in extreme cases, the patient may strike things or even expose themselves in public. This is pretty close to the Western descriptions of the manic stage of bipolar disorder. In the case of depression, the behavior is the opposite: quiet, withdrawn, a low voice, and being untalkative, easily frightened or saddened. In extreme cases, patients may close themselves away from all social contact or mutter to themselves incoherently. In the simplest sense, we can say that mania belongs to yang and depression belongs to yin.
In spite of their obvious differences, mania and depression are both disorders of the spirit mind (shen zhi), and so it is possible in some cases for the two conditions to share the same etiology. Both mania and depression can be caused by excess emotions, for example. This is an important concept I explained in the January 2003 issue. Sometimes emotional disorders are caused by emotions themselves. Even if the root cause of an emotional disorder is physical in nature, extreme emotions can make the condition worse. Chapter 8 of the Ling Shu, for example, states that mania can be caused by extreme anger; by excessive joy, which damages the "inferior mind" (po); and by sadness, which damages the "soul" (hun). Another potential cause of both mania and depression is disorder of the heart and liver, the two body organs most responsible for generating emotions.
Some etiologies, however, are exclusive to one or the other. Yang heat excess, for example, can give rise to mania by disturbing the shen. Chapter 74 of the Su Wen states, "All mania belongs to fire." This fire is often caused by other pathogens stagnating in the body, such as blood stasis or phlegm, or by extreme emotions such as anger, joy, or even sorrow - the latter emotion causing stagnation which leads to fire.
In Clinical Guide to Case Studies, Ye Tian Shi wrote in the Qing dynasty that long-term worry can cause the qi to stagnate, which allows the phlegm to accumulate and "cloud" (hun xiao) the shen, causing depression. According to Ye Tian Shi, therefore, depression is essentially a disorder of yang qi. We can take this a step farther and say that there are two types of yang qi disorder that can lead to depression: excess and deficiency. Depression of yang qi, which we nowadays refer to as liver qi stagnation, is the more excess cause, and the one most often described in Chinese textbooks. Liver stagnation can cause stagnation by itself, or it can combine with phlegm. But depression can also be caused by yang qi deficiency, which leads to an overly yin constitution and an exhausted individual that wants to withdraw from social contact. Yang qi deficiency can cause depression in and of itself, or it can lead to phlegm accumulation causing the clouding effect described above. These various etiologies are compiled in the table below.
CAUSES OF MANIA
Fire transformed from stagnation
CAUSES OF DEPRESSION
Yang qi deficiency (+ / - phlegm)
Yang qi stagnation ( + / - phlegm)
CAUSES OF BOTH MANIA AND DEPRESSION
Extreme emotions
Disorders of the liver and heart
It's fairly easy to see how depression might transform into mania. According to Chinese medicine, anything that stagnates can turn into heat; the process is something like the warmth generated in the center of a compost pile. If the disease process causing the depression is yang qi stagnation, the stagnation will eventually transform into heat and this will produce mania - but transformation to excess fire is less likely to happen if the disease process causing the depression is yang qi deficiency. This helps to explain why not all patients with depression develop bipolar disorders; very deficient patients will lack the yang qi necessary to cause transformation to excess fire. If a patient's depression is caused by yang qi deficiency, therefore, additional pathologies are needed to cause mania. If there is phlegm accumulation or food stagnation, for example, transformation to fire may still occur, or the mania can develop directly from extreme emotions as described above.
It's a little bit harder to explain how mania might transform into depression. In fact, the process has never been formally described in the Chinese medical literature. Allow me, therefore, to offer my own opinion: the extreme yang of the manic state exhausts the body and damages the qi and blood, leading to the relatively yin state of depression. During the manic phase, the patient is extremely active, rarely sleeps, and often goes without eating. It's only a matter of time before the yang qi "runs out" and the patient's spirit is forced back into the more yin state of depression. If the yang qi should become stagnant again, the whole process starts all over again. The result is what modern medicine calls bipolar disorder.
I believe this explains the etiology of bipolar disorder. In the next installment, I will explain its differential diagnosis and treatment.
Edited with the assistance of John Pirog, MSOM.

(sent via mobile Outlook)

FW: Interesting article on BPD

Alan Tang (sent via mobile Outlook)

---

From: Dr. Alan Tang <drtang@familycarewellness.com>
Sent: Sunday, October 25, 2009 5:18 PM
To: dralantang.hbm@blogger.com
Cc: dralantang@gmail.com
Subject: Interesting article on BPD

Zanarini, Frankenburg.  Omega 3 fatty acid treatmentwith women with borderline personality disorder:  a double blind, placebo-controlled pilot study.

Am. J. Psychiatry 2003 Jan 160(1):167-9

MERCURY: Influences on Body Chemistry

Reproductive effects: infertility, miscarriage and prematurity. Mercury lowers progesterone levels, which is needed to allow the uterus to support pregnancy. Progesterone insufficiency can be associated with low libido (sex drive) and premenstrual syndrome (PMS). Low progesterone levels can lead to infertility. In fact, PMS and infertility are common among many young female dental workers due at least in part to their mercury exposure. Male dental workers also have a relatively high incidence of infertility. Mercury also leads to lower testosterone (male hormone) levels. Both progesterone and testosterone production are zinc dependent. Mercury interferes with zinc metabolism and thereby indirectly affects hormone production. Mineral Displacement: mercury (usually with a +2 charge) can grab the biological spaces that should be filled by another essential mineral. As a result, there may be plenty of the mineral found in the blood, urine, hair, etc. but due to the displacement at the active site, mercury interferes with the activity of the essential mineral. Symptoms that can be caused by a deficiency of minerals displaced by mercury include: Magnesium: irregular heartbeat, chocolate cravings, cramps, PMS, receding gums, elevated blood pressure, etc. Iron: anemia, fatigue, etc. Copper: anemia, thyroid dysfunction, impaired digestion, liver enzymes are all copper-dependent, easy bruising, etc. Zinc: anorexia nervosa, loss of taste and smell, loss of appetite, low libido, PMS, impaired growth, acne and other skin disorders, etc. Iodine: thyroid dysfunction, thickened bile, etc. Digestive effects: mercury acts as an antibacterial and has been used in some medicines (vaccines, eye drops, etc. as a preservative). Mercury could be an important cause of bowel yeast or parasite overgrowth due to killing off beneficial bacteria which normally repel parasites and aid in digestion. Yeast overgrowth with its attendant symptoms of fatigue, sweets cravings and vaginal infections is often traced to the antibiotic effect of dental mercury. Suspect this as a root cause when yeast is a continuing problem in spite of repeated treatment. The symptom (yeast overgrowth) will not likely go away until the root cause (mercury) is dealt with. The effect of dental mercury on normal gut flora is well documented. Thyroid problems: such as low body temperature often improve when mercury-containing amalgams are removed. Normal body temperature is about 98.6 F orally. Those with a temperature range of 96.2 to 97.6 degrees are often considered to have hypothyroid (low thyroid function). It has been observed that their temperature can rise to 98.2 in as little as one day after amalgam removal and to 98.6 soon afterward. It is plausible that a low body temperature, which can be a sign of low thyroid function, is another symptom caused by mercury. Of course it would be far better to correct the cause of the apparent thyroid malfunction by removing the fillings or other cause responsible for the low body temperature, rather than prescribing thyroid hormone. Brain and Learning: Birth defects involving the brain and learning ability, can be caused by mercury, as the metal can passes through both the placental barrier into the fetus and the blood-brain barrier. There is a sheep study documenting that the fetus actually accumulates and concentrates mercury from the mother! Accumulation in the brain leads to mental and nervous system effects such as brain fog, depression, vision difficulties, and others as listed above. Mental effects are among the most common due to mercury's strong affinity for the brain. Mercury inhibits the effects of certain neurotransmitters: Dopamine: controls pain, well-being Serotonin: relaxation, sleep, well-being Adrenaline: energy and stamina Noradrenaline, melatonin: sleep cycles Inhibition of these neurotransmitters by mercury can account in part for the feelings of depression and loss of motivation. Other mental/neurological symptoms include: General neurological symptoms Mental illness Demyelinization, which can lead to such diseases as multiple sclerosis (MS) Developmental problems Cerebral palsy ALS (Amyotrophic lateral sclerosis, or Lou Gehrig's disease) Alzheimer's disease Psychological problems, including loss of function and memory, anger and emotionality, and timidity There is an excellent on-line movie clip that you can see right on your computer. You may require a standard plug-in video program called QuickTime to run it but it is well worth viewing. Go to www.commons.ucalgary.ca/mercury Mercury effect on energy: Mercury binds to nitrogen and sulfur in proteins, oxygen from the lungs, sulfur from the liver's detoxification systems, and selenium from the colon. Lower levels of body tissue oxygen due to mercury's binding it may lead to: Fatigue caused by low blood sugar secondary to low blood oxygen Parasite infestation by setting up an anaerobic (less oxygen) environment, and by lowering the level of the good bacteria which fight off parasites An anaerobic environment also favors the development of yeast infections and cancer, since yeast is a fermenting spore and cancer is a fermenting cell rather than a normal respiratory (oxygen using) cell. Mercury binds with hemoglobin, which is located inside the red blood cell and carries oxygen for transport to tissues. Mercury bound to hemoglobin results in less oxygen carrying capacity of the red blood cell and therefore less oxygen will reach the tissues. The body senses the need for more oxygen and may attempt to compensate for this by increasing the production of hemoglobin. A normal or increased hemoglobin level combined with symptoms of lack of oxygen (fatigue, weakness, appearing pale, rapid heart rate, shortness of breath, etc) could indicate mercury toxicity. This can confuse the doctor since the patient seems like they are anemic but in fact the blood counts seem fine. Copper is also required to prevent anemia, and mercury can compete for copper's binding sites. In this case, a lowered hematocrit (red blood cell count) can be indicative of lowered blood copper levels. The terms hematocrit and hemoglobin, found routinely on blood test printouts, can be confusing. If blood is compared to a train carrying oxygen to where it is needed, hematocrit is a measure of the number of boxcars on the train (red blood cells), while hemoglobin is a measure of the carrying capacity of each boxcar, or red blood cell. When there is a low hematocrit (less boxcars), it is called anemia. The activity of other minerals on metabolism and energy production can be reduced by mercury's tendency to fight for site. A deficiency of the function of minerals can lead to fatigue and other symptoms: Cobalt, calcium, magnesium, potassium, and sodium are all required for energy. Zinc is needed for the manufacture of adrenaline. Cobalt, a component of vitamin B12 prevents pernicious anemia, which can cause fatigue. Mercury blocks magnesium and manganese transport required for memory, resulting in lowered ability to concentrate. These mineral deficiencies may be primarily due to dietary deficiencies. However, deficiencies may also be secondary. The mineral may be in the body but cannot get to where it is needed because mercury has blocked the way. This is like putting a too-large battery in a toy - it won't fit in the slot made for a smaller battery, both denying power to the toy and blocking the slot from receiving the correct size battery. For this reason, knowing the mercury load is critical to understanding the mineral balance in the body. Lab tests can only tell the levels available – they do not tell if the minerals are performing there function in the body. Symptoms and physical signs can often be helpful in clarifying the illusion that the “labs are all normal…” Increased toxicity: the mercuric ion (Hg+2) binds to sulfhydryl groups (-SH) in proteins and disulfide groups (-SS) in amino acids. These sulfur containing groups have an important detoxification function in the body by binding to a variety of chemicals, toxins, minerals, etc. Mercury binding to these sulfur groups may prevent them from detoxifying the chemicals. Mercury binding the bile lowers the ability of the body to absorb fat, leading to increased absorption of toxic oil-soluble chemicals such as solvents and pesticides like a dry sponge. Selenium is an antioxidant which binds in place of oxygen and which protects against free radical damage from chemicals which can lead to cancer. Mercury can bind to selenium, making it useless for this protective purpose. What else can mercury do? Mercurous ion (Hg+1) pushes out Na+1 (sodium), K+1 (potassium), and Li+1 (lithium). Sodium and potassium are part of the cellular sodium/potassium pump which causes muscle movement. Interference with sodium and potassium can lead to muscle weakness for this reason. Leg and muscle cramps may be due to potassium deficiency. Lithium is sometimes given as lithium carbonate to patients suffering from bipolar depression (manic depressive illness) since lack of lithium is one of the causes of the disease. Lack of lithium may itself be caused by mercury preventing lithium from working as it should in the brain. Mercury is like the 200 pound bully attacking a 7 pound baby; the small baby doesn't have much of a chance. 200 and 7 are the molecular weights of mercury (the bully) and lithium (the baby) respectively. If you have been diagnosed with bipolar depression, maybe what you need is less mercury, not more lithium pills. Mercury fights for binding sites in the kidney, another organ for which it has a special affinity. A mineral and electrolyte balance is needed in order for the kidney to perform its functions, and a poorly functioning kidney can lead to edema (fluid buildup in the body). These minerals are prevented from entering into their reactions when mercury is there to interfere. Suppression of potassium by mercury also affects the kidneys which takes you from making adrenaline to maintaining electrolyte balance, and the lowered adrenaline level can lead to lower energy. Detoxification systems such as metallothionein, cytochrome P-450, and bile are adversely affected by mercury. Metallothionein binds toxic metals in the body to prepare them for excretion. Mercury ties up this material so it cannot clear out other metals such as lead, cadmium, and aluminum. Mercury from amalgam binds to -SH (sulfhydryl) groups, which are used in almost every enzymatic process in the body. Mercury therefore has the potential to disturb all metabolic processes. Some people appear to be allergic to whatever food they eat. No matter what they eat, at least one thing in common is ingested - mercury (or nickel). Mercury released from amalgam during chewing may be the cause of most of the symptoms which seem to be caused by the food. If a mercury vapor test, described later in this chapter, is done, it may show a low to moderate level of mercury initially, but a sharply increased level after chewing gum. This is also what happens when food is chewed. Such a test result combined with apparent allergy to most food points to mercury as a probable culprit. Nickel, which may also be contributing to the problem, is in stainless steel dental posts and braces. (Paraphrased from the book "Surviving the Toxic Crisis" by William R. Kellas)

Mercury and Mental Health

Bioplar Disorder: A possible dental connection

By Dr. Gerald H. Smith

I was inspired to write this article after watching Jane Pauley's appearance and promotion of her new book, Skywriting: A Life Out of the Blue, on the September 3rd , 2004 David Letterman show. After listening to Jane describe her symptoms of bipolar disorder, I suddenly realized that what she was describing was mercury or heavy metal poisoning. As a biological dentist and one who has experienced first hand the devastating effects of mercury poisoning, I quickly made the connection.

From my own research, mercury as well as other heavy metals (cadmium, aluminum, nickel, etc.) have an affinity for the nervous system as well as being transported via the lymphatic drainage system from the mouth to the rest of the body and particularly to the thyroid gland. Chewing food with teeth that have mercury fillings on the biting surfaces of the bicuspid and molars will cause a release of mercury vapor for a 90 minute period. This fact has been scientifically documented by Drs. Fritz L. Lorscheider and M.J. Vimy of the Department of Medicine and Medical Physiology University of Calgary. It has been estimated that between 3 - 17 micrograms of mercury per day come from undisturbed mercury fillings. This number elevates to as much as 45.49 micrograms/cm2 per day with brushing twice a day. If a person had 12 mercury fillings their exposure would be 29 micrograms per cubic meter of mercury. The Environmental Protection Agency (EPA) says that 30 micrograms per cubic meter per day is the maximum allowable intake from all sources that the average weight person can tolerate before clinical symptoms of mercury poisoning start to show up. When factoring in the EPA's estimate of 10 micrograms of mercury coming from daily intake of food, air and breathing the toxic level of mercury exposure is exceeded! Because mercury is a powerful neurotoxin it plays a major role in causing numerous medical problems and is a major influence in causing cancer. My new book, Reversing Cancer, describes in depth mercury's role in this plague that is now upon us. (156 new cases of cancer are being diagnosed every hour!)

Bipolar disorder causes dramatic mood swing (overly "high" and/or irritable to sad and hopeless), and then back again, often with periods of normal mood in between. Severe changes in energy and behavior go along with these changes in mood. The periods of highs and lows are called episodes of mania and depression. One potential underlying mechanism for which mercury poisoning can replicate the symptoms of bipolar disorder is the migration of mercury to the brain and the thyroid gland. The medical literature describes the mercury poisoning profile with the term "erethism." Erethism consists of subtle or dramatic changes in behavior and pe rsonality, such as depression, irritability, despondency, fearfulness, easily provoked anger, restlessness, indecision, timidity, and a tendency toward easy embarrassment. Companion symptoms are drowsiness, headache, fatigue, dizziness and insomnia with an exaggerated response to stimulation. These represent the neurotoxic symptoms of chronic brain involvement.

Migration of mercury to the thyroid has the potential for causing an under-active or hypothyroid state. Hypothyroidism is associated with severe fatigue and low energy, mental fog, inability to remember, headache, dizziness, poor concentration, low stress tolerance, depression, anxiety, mood swings, insomnia and difficulty in weight control. In addition, numerous other symptoms are associated with a low thyroid: cold hands and feet, dry skin in the winter, infertility, low sex drive, constipation, short windedness, diffuse muscle spasm, excess sleeping, lowered immune system, poor digestion, high cholesterol level that does not respond to medication, heart palpitations and the same symptoms of fibromyalgia.

Below are two lists: signs and symptoms of mania and signs and symptoms of depression.

Signs and symptoms of mania (or a manic episode) include:

• Increased energy, activity, and restlessness
• Excessively "high," overly good, euphoric mood
• Extreme irritability
• Racing thoughts and talking very fast, jumping from one idea to another
• Distractibility, can't concentrate well
• Little sleep needed
• Unrealistic beliefs in one's abilities and powers
• Poor judgment
• Spending sprees
• A lasting period of behavior that is different from usual
• Increased sexual drive
• Abuse of drugs, particularly cocaine, alcohol, and sleeping medications
• Provocative, intrusive, or aggressive behavior
• Denial that anything is wrong

A manic episode is diagnosed if elevated mood occurs with 3 or more of the other symptoms most of the day, nearly every day, for 1 week or longer. If the mood is irritable, 4 additional symptoms must be present.

Signs and symptoms of depression (or a depressive episode) include:

• Lasting sad, anxious, or empty mood
• Feelings of hopelessness or pessimism
• Feelings of guilt, worthlessness, or helplessness
• Loss of interest or pleasure in activities once enjoyed, including sex
• Decreased energy, a feeling of fatigue or of being "slowed down"
• Difficulty concentrating, remembering, making decisions
• Restlessness or irritability
• Sleeping too much, or can't sleep
• Change in appetite and/or unintended weight loss or gain
• Chronic pain or other persistent bodily symptoms that are not caused by physical illness or injury
• Thoughts of death or suicide, or suicide attempts

A depressive episode is diagnosed if 5 or more of these symptoms last most of the day, nearly every day, for a period of 2 weeks or longer.

As a biological dentist, I have clinically witnessed many patients whose blood tests showed normal levels of thyroid hormone but who had many of the symptoms of an under active thyroid. An interesting observation is the fact that with nutritional therapy to chelate out the mercury, many of the above symptoms disappeared. The following letter was unsolicited and sent to me by a patient with whom I nutritionally consulted. This individual was diagnosed with bipolar disorder for 29 years. His father was a dentist and he had a mouth full of mercury fillings. This patient's friend was a dentist who attended one of my seminars and upon returning informed his friend of the above information. After removal and nutritional therapy miraculous results were obtained.

Copper Toxicity and Mental Health

Copper Excess (Toxicity):

Psychological Implications for Children, Adolescents, and Adults

Richard Malter, Ph.D.

Clinical Psychologist

Nutrition Counselor

2295 W. Trail Blazer Drive

Cottonwood , Arizona 86326

(928) 649-9343 Fax: (928) 649-1971

www.malterinstitute.org

e-mail: rickmind@cableone.net

© April, 1984; June, 2001

Copper Excess (Toxicity): Psychological Implications

for Children, Adolescents, and Adults

INTRODUCTION

There is increasing evidence that significant environmental changes in biochemical factors are contributing to a wide range of psychological problems in children, adolescents, and adults. These problems include: ADD, hyperactivity, distractibility, and memory problems, learning disabilities, depression, anxiety and panic disorder, bipolar disorder, obsessive-compulsive disorder, anorexia, violent aggression, and suicidal tendencies. In fact, there is good reason to believe that there are increasing incident rates of these problems today that are best accounted for by nutritional/biochemical factors. In order to grasp the magnitude of the nutritional/ biochemical problems we are facing today requires a shift in perspective and a new paradigm. The old paradigms and psychological models have become obsolete and are much too limited in perspective.

During the past 20 years, data from hair tissue mineral analyses of children, adolescents, and adults (especially women) point to copper excess (or in extreme cases, copper toxicity) as a major factor associated with many of these psychological problems. The manifestations of these problems are different in preschool and elementary school children, in adolescents, and in adults. One of the major syndromes with which copper excess is associated in younger children is with Attention Deficit Disorder (ADD). Copper excess may be related to ADD with hyperactivity and also without hyperactivity.

The impact of copper excess seems to be much more severe in preadolescent and adolescent girls than in boys. As girls reach puberty, the increase in estrogen levels tends to exacerbate the effects of copper excess because estrogen raises the level of copper in the body’s cells and tissues. When this occurs, there is likely to be an increased risk for behavior and emotional disorders: mood swings, depression and suicidal tendencies, anxiety and panic disorder, irritability and aggression, running away, promiscuity, and eating disorders. Memory, learning, and concentration problems may also increase. Copper excess can be a significant factor contributing to a dramatic increase in the numbers of teen age girls and young women being psychiatrically hospitalized and medicated for “bi-polar” disorder. I consider this diagnosis to be really a “pseudo”-bipolar disorder because the role of excess copper as a contributing underlying factor is rarely if ever identified or considered in the diagnosis and treatment. The eating of foods high in copper content is likely to exacerbate these conditions.

Copper excess also is frequently seen in adults, especially in women. Again, estrogen is a strong contributing factor because of high correlation between copper and estrogen. In addition to the normal increase of estrogen in the menstrual cycle, estrogen also tends to increase in the third trimester of pregnancy, thus contributing to post-partum depression and other psychological problems in some women. Furthermore, women (and adolescent girls) who use the "pill" for contraception increase the amount of estrogen in their system. This is strongly associated with an increased tendency to experience depression, panic disorder, and obsessive-compulsive disorder.

There are a number of environmental factors which further exacerbate the problem of copper excess. For the past forty or forty-five years, the use of copper pipes in household plumbing has contributed substantially to ingestion of increased amounts of copper, especially in the presence of "softened" water. Also, zinc deficient diets may lead to copper excess. Food processing and the deficiency of zinc in our soils are contributing directly or indirectly to the risk of copper excess.

There is some clinical evidence which suggests that copper excess in children with ADD and certain types of behavior disorders may begin in utero. Heavy copper excess in a mother may be strongly associated with copper excess in one or more of her children depending on how much stress she experienced during her pregnancy. The in utero transfer of significant amounts of excess copper to the fetus may also account for the dramatic increase in the number of babies being born with jaundice today. The excess copper is stored primarily in the liver and in the brain. The liver storage can be contributing to the increasing incident rates of jaundice in new-born babies. The brain storage can be contributing to the increasing incident rates of learning and attention deficit disorder.

Clinically, the hair tissue mineral analysis is the best available laboratory test for assessing copper excess or toxicity. However, there are some important technical and dynamic aspects to the identification of copper excess as a possible contributing factor to psychological problems. In some individuals, the first hair tissue mineral analysis may clearly show a high copper level regardless of what is seen in the rest of the mineral profile. In other individuals, what appears to be a near normal level of copper may actually be a very high level in relationship to zinc; that is, the zinc/copper ratio is significantly below normal. These are the two principle ways in which copper excess may manifest itself in the first hair mineral analysis.

In some cases, copper excess may be latent and not be seen so clearly in the first hair mineral analysis. This is because the high amounts of copper may be stored and locked in tissues so that the hair is not picking up the excess amounts. This may be due to the presence of other heavy metals which mask the excess copper. Lead, mercury, cadmium, and/or aluminum may show more readily in the first hair mineral analysis. However, after the individual goes on a nutritional program, the excess copper may be released from tissue storage and will be clearly seen in a subsequent hair mineral analysis.

At the present time, because copper excess is expressed in different ways as a part of a complex dynamic system of interacting nutrient minerals and heavy toxic metals, the review of individual cases is the best method for observing the role of copper excess in a variety of conditions. This is especially true when the copper is masked or hidden in the first hair mineral analysis. The role of latent copper is often missed in most studies using a cross-sectional rather than a longitudinal method of data collection. The nature of the copper excess phenomenon often requires repeated measures over time in order to clearly see the role of copper in many psychological problems.

CASE STUDIES

ADD with Behavioral Hyperactivity

This case illustration is that of a 9 year-old boy referred by his mother. The presenting problems included: "no concentration, can't remember, can't relate to friends, accidents, bumping into things, temper tantrums, chronic depression." Psychological testing indicated that he excelled in verbal concepts and in spatial relations; but, visual-motor and auditory sequential memory problems were evident. On the Davids behavior rating scale, his mother rated him 36/36, which is the most hyperactive rating. White spots were observed on his finger nails. White spots often are associated with a zinc deficiency. Since a low zinc/copper ratio also is indicative of copper excess, white spots are often an indicator of copper excess.

The first hair mineral analysis showed that this boy was a very "fast oxidizer" with a significant sodium/potassium "inversion". This combination -- a fast oxidizer with a sodium/potassium inversion-- is the most common hair mineral analysis profile of hyperactive children. In addition, excessive amounts of lead, cadmium, and aluminum were reported in the first mineral analysis of this boy. However, copper was latent; it was .80 mg/%, a level far below normal (2.5 mg/%).

The second hair mineral analysis was done three months later and showed a major shift in the boy's profile. He had gone into "slow oxidation" with a significant improvement in the hyperactivity ratio of sodium/potassium. Lead, cadmium, and aluminum were still present. However, the copper level had increased from .80 to 24.0! Also, even in the presence of a doubling of the zinc level from 6.0 to 12.0, the zinc/copper ratio dropped from a near normal level of 7.5 (8.0 is the lab's normal zinc/copper ratio) to .50; this is indicative of extreme copper excess. The sharp increase in the hair copper most often indicates the elimination of copper from tissue storage. During this copper "dumping", the hair temporally picks up the increased amount of copper.

During this period of time, the boy's mother reported that she and others who knew the boy observed improvements in his behavioral control, increased calmness, and his ability to anticipate the consequences of his behavior.

Four months later, a third hair mineral analysis showed that his mineral pattern was becoming more balanced and stable with a greatly reduced tendency towards hyperactivity. Excess lead and aluminum had been eliminated along with a very large amount of copper that had dropped from 24.0 to 3.4. The zinc/copper ratio had improved from .50 to 2.95 (still indicative of copper excess, but not quite as severe).

Jim’s mother reported continued behavioral improvements. She also rated his behaviors again on the Davids scale. The new rating score was 25/36 as compared with 36/36, indicating a substantial decrease in hyperactivity. This case clearly illustrates the dynamics of latent copper excess that is only seen over time in two or more hair mineral analyses. It also illustrates how copper can be eliminated in stages from tissue storage.

Adolescent Behavior and Emotional Problems

This case illustrates the role of copper excess in exacerbating behavior and emotional problems in a very bright 13 year-old girl. One year prior to this tissue mineral analysis, the girl began running away from home. She continued to perform well in school, but home problems got worse and worse. She had always been a very difficult child to discipline, but her behavior became more unmanageable for her mother during the past year. The girl was admitted to a general hospital for a neurological and psychological evaluation. All medical tests administered were negative (a hair tissue mineral analysis was not performed.) The psychological evaluation indicated that the girl had a very high IQ, but there were emotional problems and therapy was needed.

The mother believed that there was a problem with the girl's body chemistry which got worse with the onset of puberty. The child had a history of reacting to milk with a runny nose, and she had a tendency to break out in a rash when she ate chocolate. She had dark circles under her eyes and the pediatrician suspected that she had allergies. However, she was never tested for them. The girl complained of being tired, and she tended to sleep a great deal.

After running away again, the girl was admitted to a psychiatric hospital where she stayed for four months. Immediately after being released from this hospital, she ran away again. Her hair mineral analysis showed that, as a slow oxidizer, she had very low energy reserves for coping with stress, Therefore, she tended to avoid stress by running away. The slow oxidation also accounts for her tendency to be chronically tired and to sleep a great deal. The slow oxidation with high copper is associated with depression and suicidal tendencies. She showed suicidal tendencies and was then placed in a state-supported psychiatric hospital. Today, many teen age girls with this high copper mineral pattern are being “diagnosed” with bi-polar disorder. I consider this to be a pseud-bi-polar disorder because the key underlying factor is a copper excess in a slow oxidizer mineral pattern.

Estrogen Replacement Therapy

This case illustrates the relationship between estrogen, copper excess, and slow oxidation. A 49 year-old post-menopausal female was placed on estrogen one and-a-half years prior to the hair analysis described here. She reported being active and energetic prior to the start of the estrogen therapy. She now reports that she feels chronically fatigued and exhausted, has dry skin, has gotten chronic infections, is much more distractible, and has a problem with easily gaining weight. She reports that her mind has been "racing" during the past few months.

The hair mineral analysis chart shows that this woman has a very high copper level (14.8) with a very low zinc level (4.0). The resulting zinc/copper ratio of .27 is indicative of an extreme degree of copper excess. In addition, she is an extremely slow oxidizer with a tissue calcium level of 900! The normal calcium level is 40 mg/%. The high copper results in a lowering of potassium and an increase in tissue calcium. A high calcium/potassium ratio is one of the characteristic ratios of a "slow oxidizer".

The psychological effect of very slow oxidation with a very high copper level is that the person's mind is hyperactive and racing while the person's body feels chronically exhausted and fatigued. The person has all sorts of ideas racing through the mind, but is too tired to act on any one of them. Such an individual easily becomes confused and frustrated. The low energy level of some depressed individuals is associated with very slow oxidation.

THE EXTENT OF COPPER EXCESS

There are a number of factors which suggest that copper excess may have already reached epidemic proportions. Many trends and developments which seem to be unrelated on the surface may have copper excess as an underlying common factor. A recent study reports a doubling of the rate of birth defects in the past 25 years. There appear to be increases in the numbers of children with learning and behavior disorders. The numbers of women with depression, anorexia, and suicidal tendencies seem to be on the increase. Hyperactivity rates among children seem to be increasing. The numbers of exhausted and fatigued young women are increasing. Behavior and emotional problems among adolescent girls are on the increase.

How are the contributing factors coming together to produce the trends which may be strongly related to copper excess? A number of these factors have been mentioned above. These include the extensive use of copper plumbing in homes during the past 25 to 35 years. Depending on the acidity of the water, copper may be leached into drinking and cooking water. Zinc deficient soils produce foods with inadequate zinc supplies to antagonize copper. Stress tends to deplete zinc which allows copper to become more toxic in a person's system. The use of the "pill" on such a massive scale increases the amount of estrogen in a female's system. This results in an increase in tissue copper levels, often resulting in copper excess and "slow oxidation". Pregnant copper toxic women give birth to copper toxic babies who may have birth defects, learning disabilities, and hyperactivity. A copper toxic female child will experience an exacerbation of her copper excess when she enters puberty. Behavior and emotional problems will frequently result. These may involve eating disorders, running away, depression, suicidal tendencies, mood swings, and violent episodes.

Because there is such a strong correlation between estrogen and copper, excess copper in the tissues of a pregnant female may strongly affect her fetus. The problem of copper excess can be passed on from one generation to another. As it is passed on, the problems are likely to become worse. It is suggested here that the problem of copper excess may be characterized by a cumulative effect. That is, as copper excess is passed from one generation to the next, the new generation begins life with a higher load of copper most likely transferred in utero. The quantity increases with continuous exposure to copper-loaded water and other sources of copper in the environment.

Copper excess predisposes one to psychological problems (Pfeiffer, 1975). However, the way in which these problems manifest themselves depends on other factors such as family dynamics, personality structure, physical health, neurological integrity, abilities, developmental history, etc. That is, "copper excess" is a general toxic condition found in many individuals, but the specific psychological and/or physiological problems manifested are unique to each individual. Therefore, the major underlying biochemical "common denominator" of a wide range of psychological and physiological disorders is "copper excess". It is strongly recommended that the most effective treatment for any of these associated disorders must include a treatment for the "copper excess" (general condition) as well as for the specific psychological and/or physiological problem which is manifested in the presenting symptoms and problem (specific condition). The diagnosis and treatment of anorexia nervosa would be a good illustration of this principle. An even more important application of these concepts would be in the direction of preventing anorexia nervosa by the early identification of copper excess in children in the intermediate and junior high grades. By implementing appropriate nutritional programs, the copper excess in individual children can be significantly reduced or eliminated, thereby substantially eliminating a major contributing factor in the development of this disorder. Clinically, we know that the excess tissue copper levels can be significantly reduced with diet, exercise, and proper nutritional supplementation.

Until the extent of the problem of copper excess is recognized and effectively treated, we are likely to see higher incidence rates of related psychological problems. These problems are likely to involve expensive treatments which, at best, will only reduce the symptoms without getting at a major underlying contributing factor. On the positive side, there is nutritional/ biochemical knowledge and, also, the laboratory technology available which permit us to identify the copper excess condition and to effectively reduce its psychological and physical impact. A nutritional program will enable us to build a more solid underlying biochemicalfoundation on which to build other treatment and intervention programs. The resulting synergistic effect would very likely speed up treatment of many psychological problems related to copper excess and drastically reduce diagnostic and treatment cost. Treatments would also be much more effective and longer lasting in psychological improvement.

References

Adams, P. et. al. "Effect of vitamin B-6 upon depression associated with oral contraception." The Lancet, April 28, 1973, pp. 897-904.

Brenner, A. "The effects of megadoses of selected B-complex vitamins on children with hyperkinesis: controlled studies with long-term follow-up." J. of Learning Disabilities, May, 1982, 15, pp. 258-264.

Malter, R. "Implications of a bio-nutritional approach to the diagnosis, treatment, and cost of learning disabilities." Paper presented at the Association for Children with Learning Disabilities International Conference, Washington, D.C., 1983.

Malter, R. "Trace mineral profiles of hyperactive children." Unpublished research paper. Northwest Suburban Child Development Clinic, Inc., Arlington Heights, Illinois, 1984.

Pfeiffer, C. Mental and Elemental Nutrients: A Physician's Guide to Nutrition and Health Care. New Canaan: Keats, 1975.

Rimland, B. & Larson, G. "Hair mineral analysis and behavior: an analysis of 51 studies." J. of Learning Disabilities, May, 1983, 16, 279-285.

Walsh, W. Study of hair mineral analysis related to violent behavior as reported in Science News, August 20, 1983.

Barkoff, J.R. "Urticaria secondary to a copper intrauterine device." International J. of Dermatology, 1976, 15, pp. 594-95.

Crook, W.G. et. al. "Systematic manifestations due to allergy: Report of 50 patients and a review of the literature on the subject (sometimes referred to as allergic toxemia and the allergic tension-fatigue syndrome)", 1961, Pediat., 27, pp. 790-799.

Crook, W.G. The Yeast Connection. Jackson, Tenn: Professional Books,1984.

Shelley, W.B. et. al. "Cholinergic Urticaria: Acetylcholine-receptor-dependent immediate hypersensitivity reaction to copper." The Lancet, April 16, 1983, pp. 843-846.

Chinese Medicine Theory and treatment

http://www.chinesemedicinetools.com/depression-mania-bipolar-kuang-dian

True hope

http://www.truehope.com/truehope_bipolar_disorder_court.aspx

what causes mental illness?

what causes mental illness?
Ask any psychiatrist or doctor what causes mental illness and they will tell you the same thing – no one knows exactly. There does appear to be a strong genetic factor in illnesses such as bipolar disorder, clinical depression and schizophrenia. Even though the gene location was recently discovered, the way the illnesses happen is still a mystery. Yet some intriguing possibilities are now coming to light.

chemical imbalances in the brain
The most common explanation for mental disorders is a chemical imbalance in the brain, but how and why these imbalances happen is not yet known. Since a complex web of nutrients, such as zinc, vitamin B6 and B12, are the building blocks that the brain needs to make the right amounts of important chemicals such as neurotransmitters, it makes sense that a lack of these nutrients could cause the chemical imbalances of mental illness.

a genetic need for more nutrients
As early as the 1960s, Dr. Linus Pauling, winner of two Nobel Prizes, speculated that some people have a genetically-based need for more vitamins and minerals than other people. He wondered if mental illness could be the result of failing to meet these extra requirements. Research is now showing that Dr. Pauling may have been right. Dr. Bruce Ames, at the University of California, Berkley, has shown that genetic mutations often result in an increased need for nutrients. He also found that taking extra amounts of these nutrients could correct the deficiencies. If a person with a genetic need for more nutrients does not get them or cannot absorb them, it makes sense that this person would, over time, become deficient.

lack of nutrients affect brain growth factors
Brain growth factors are necessary for keeping the neuron branches healthy and connected, so that proper signals can be sent. Many nutrients have been shown to increase brain growth factor levels. And a lack of these same nutrients leads to brain cell shrinkage and brain cell death. It's not a stretch to imagine that this could play a significant role in mental illnesses.

Bipolar

http://www.alternativementalhealth.com/articles/bipolar.htm

http://www.byepolar.com/

http://www.byepolar.com/

Can you live with, and move beyond, a relationship with a borderline parent?

Your childhood was full of tantrums--impulsivity, mood swings, neediness, fear of abandonment, and extreme sensitivity to rejection. And this isn't you we're talking about; it's your mom.
If you grew up the constant target of finicky and derisive comments, or the emotional caretaker for one of your parents, you know all too well the pain of having a father or (usually) mother with Borderline Personality Disorder. BPD doesn't just affect the one who receives the diagnosis; it often leaves a wake of turmoil through entire families as the emotional and relational disturbances ripple outward.
When a role model treats you as an extension of herself--there to meet her needs--the trauma can be long lasting. It takes a very strong person to overcome the effects, let alone maintain a constructive relationship with the parent. But there's hope. Here are several guidelines for dealing with a borderline parent, and for moving on with your own life.
Know the Type
Mothers with BPD outnumber fathers, and Christine Lawson, author of Understanding the Borderline Mother, has a taxonomy of the troubled parent: "The Queen is controlling, the Witch is sadistic, the Hermit is fearful, and the Waif is helpless," she says. And each requires a different approach. Don't let the Queen get the upper hand; be wary even of accepting gifts because it engenders expectations. Don't internalize the Hermit's fears or become limited by them. Don't allow yourself to be alone with the Witch; maintain distance for your own emotional and physical safety. And with the Waif, don't get pulled into her crises and sense of victimization; "pay attention to your own tendencies to want to rescue her, which just feeds the dynamic," Lawson says.
Build Fences
Borderline parents often can't separate their own needs from the needs of others. And sometimes they can't meet their own emotional needs, so they look to their children to fill it. When the child doesn't do the job, the parent can get angry, making resistance difficult. "Adult children need to define for themselves their limits and boundaries," says Kimberlee Roth, author of Surviving a Borderline Parent. "Let's say a parent regularly calls late at night to vent. Whatever your needs, communicate them in a calm, non-accusatory way: 'Mom, I'd like to listen but I can't do it late at night. How about if we talk in the morning instead?'" As a last resort, use Caller ID or voicemail.
Be Firm But Sensitive
Personal validation, which is important in any situation, is essential with a borderline parent. Express your awareness of her emotions even as you set boundaries. "You might feel like a broken record," Roth says, "but it's important to keep repeating your acknowledgment of the parent's needs without diminishing your own."
Trust Yourself
In writing her book, Roth encountered many children of borderline parents who said they felt crazy growing up. "They experienced a lot of inconsistencies--an action or statement that earned praise one day would touch off a three-day, stony silent treatment the next--as well as sudden outbursts and overreactions." So they never learn to trust their own judgment or feelings. The most important element to recovery, she says, is to accept that you're not crazy and that "it wasn't me."
Trust Others
People who've survived a borderline parent most frequently suffer from "feelings of worthlessness, fear of abandonment, and fear of people in general," according to Randi Kreger, co-author of the bestselling Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder. Because these adult children received "such mixed messages--you're a great person one day and you're horrible the next--there's a certain mistrust of people because you're always afraid they're going to hurt you." Kreger advises that they find friends and partners unlike the parent: consistent people who can provide unconditional love. And stop looking for sleights; hair-trigger defense systems that developed in the presence of abusive parents often lead people to see ill intentions where they don't exist and end up preemptively sabotaging relationships.
Defend Your Boundaries
Children of borderline parents are often forced to act as the parent themselves--"it's like a child raising a child," Kreger says--and this role can play itself out in other relationships. They grow up very quickly in many ways and act as caretaker for everyone, sometimes at the expense of taking care of themselves. "Having that undue sense of responsibility can leave them feeling very alone in the world," Lawson says. And they allow others to tread their boundaries just as the parent did. So once you learn to set limits for your parent, set them for other people and learn to put yourself first.
None of these steps will come easy. An abusive or inconsistent parent can leave a deep wound. "Trying to manage it can be a lifelong process," Kreger says. But she insists that with a good therapist, and support from a community of other people who have gone through the same thing, "there is real possibility to get better, and I know many people who have."
Psychology Today Online, 9 Jul 2007
Last Reviewed 13 Apr 2009
Article ID: 4370

The bipolar child is a purely American phenomenon

Psychology Today

"The bipolar child is a purely American phenomenon": An interview with
Philip Dawdy
By Christopher Lane, Ph.D. on April 7, 2009 - 12:17pm in Side Effects
Philip Dawdy, a prize-winning investigative journalist, has for
several years written a powerful, well-researched, and well-regarded
weblog, Furious Seasons, which focuses on American psychiatry, mental
health, and the way we think about treatment options. Given his
intensive work on the issues, I wanted to ask him several burning
questions about ADHD, bipolar disorder, and other controversies in
American psychiatry.
You've written extensively about the psychiatric diagnosis of teens
and preschoolers. How do you account for the astonishing rise in the
number of diagnoses we're seeing in these age groups, especially with
regard to ADHD and bipolar disorder?
To me, you can lay all of this squarely at the feet of the pharma
companies, which had a slew of newish drugs come online in the 80s and
90s and wanted them taken by as many humans as possibleâC"consequences
for the patients be damnedâC"and a crew of child psychiatrists at
Harvard/MGH who see deeply-flawed, ill-for-life children where other
psychiatrists might see personality disorders and issues that will
burn out over time. The pharma companies and the Harvard crew worked
hand-in-hand to bring America a generation of ADHD kids and bipolar
children, and their profound influence can be seen in the millions of
children and teens who now carry lifetime diagnoses and take gobs of
psychotropic drugs each day, often to their detriment.
That may sound extreme to some people, but it's worth noting that the
rest of the world has not embraced these diagnostic and treatment
paradigmsâC"except Britain, where there was an initial embrace of ADHD
and stimulants, but where there's now a significant backlash.
Meanwhile, in France and Italy ADHD is rarely diagnosed and it's
difficult to see where French and Italian culture have suffered as a
result. As for bipolar disorder in kids (meaning pre-teens and
younger), it's simply not an issue in the rest of the world. The
bipolar child is a purely American phenomenon, as big a metaphor of
our times as credit swaps, subprime loans, and government bailouts.
Why do you think so many more teenage and younger boys than girls are
being diagnosed with ADHD, and what does that say about our culture,
education system, parental expectations, and so on?
The data I'm familiar with pegs the boy-to-girl ADHD ratio at 3 to 1,
which is pretty dramatic. I suspect that boys get pegged with the
diagnosis more than girls do for two reasons: One, boys have always
been far more energetic and physically exuberant than girls, a point
going back through history, perhaps because they are developing their
hunter-gatherer beings. And, two, the hyperactivity piece of ADHD is
quite easy to spot and probably leads to greater pressure for kids to
be diagnosed because hyperactive boys can be disruptive, especially in
school environments.
As out there as this may sound, I think we are as a culture cheating
boys of their inherent natures and I have real questions about how
that affects their psychosocial development long-term and what it will
all mean for manhood a couple of generations down the road (I'm
concerned about comparable issues with girls as well). What's more, I
think the educational system places too much emphasis on having quiet,
compliant kidsâC"far more so than in the past. When I was a kid in the
1970s, boys were pretty much allowed to engage in all kinds of
wildness at recess in elementary school and after school, but from
what I hear that's being discouraged today. Why the change I couldn't
say, but I do know that there's been a real push in our culture to
silence outward signs of male aggressiveness, both in kids and adults.
As for parents, I think they are under a lot of self-imposed pressure
to have perfect kids with high grades who get into top universities or
they've somehow failed as parents. The ADHD drugs and the diagnosis
itself have been foisted on them as a way to have their kids better
liked among school peers and to achieve higher grades and perform
better on the many, many standardized tests kids must take these days.
What's interesting to me is that parents and our culture may well have
been sold a bill of goods here, as the recently released MTA study (a
long-term tracking study of kids through teens with ADHD, both on and
off-meds) showed that long-term treatment with stimulants didn't
appreciably improve GPAs and other test scores.
What influence do you think patent cycles exert over such diagnostic
trends? I'm thinking especially of the move to "bundle" depression
with bipolar disorder when the patents for so many SSRI
antidepressants ran out.
I think there is some influence here, even though diagnostic trends
should ideally be driven by unbiased science, independent of the needs
of pharma companies. What I've noticed over time is that, as you
suggest, there's been a great rush to get a drug approved for as many
indications as possible as it nears the end of its on-patent life,
likely because the drug companies can then market said drug directly
to the public. Certainly, that's part of what went on with Paxil and
social anxiety disorder in the late-1990s and, right now, I'm noticing
an epic push by Eli Lilly and AstraZeneca to have their atypical
antipsychotics (Zyprexa and Seroquel, respectively) approved for a
wide range of indications (including ones like depression) before the
drugs go off-patent in a few years.
Perhaps the most egregious example of a pharma company trying to
influence diagnostic trends came in 2002 when Eli Lilly launched a
massive sales campaign to convince PCPs that patients walking into
their offices complaining of depression actually had bipolar disorder
type 2 instead, and that Zyprexa was the perfect fix for that. The
results were utterly disastrous for patients, what with all the weight
gain and diabetes they experienced as a result. Interestingly, female
patients were the primary target of the campaign.
Do you think the black-box warnings that the FDA issued against
pediatric antidepressant use were effective as a deterrent?
I'm not sure they were much of a deterrent since there's been 14
percent growth in antidepressant prescriptions since 2004, according
to IMS Health. But to the degree that the black box on suicidality
gave patients and doctors important information that had long been
hidden from them by both the pharma companies and some researchers, I
think the warnings were a boon. It has at least forced people to think
long and hard about what drugs they are taking, and to pay closer
attention to side effects and any strange emotions that might arise
upon first taking the drug or changing a dosage.
Why do you think Bipolar II disorder is controversial as a diagnosis?
I may be the only writer in America who thinks BP2 is controversial
and I can hardly think of any doctors who do. For me, it's a
questionable classification and something of a cop-out by the DSM
writers for a couple of reasons: One, BP2 isn't bipolar disorder,
properly understood. There's no mania, there's no hospitalization for
mania, and there's no one running naked down the street. The most
prominent features of BP2 are depression (and that covers the vast
majority of a person's time who is diagnosed with BP2) and bursts of
energy, broadly understood. To me, that sounds a whole lot more like
depression and agitation than it does manic-depression.
Two, the minute someone gets hit with a bipolar disorder diagnosis of
any subtype, then they are faced with a profoundly bad set of social
assumptions; they get stigmatized by friends and family; and they lose
their jobs. I know of multiple cases along these lines, including one
of a sheriff's deputy in King County, Washington who was fired from
her job as soon as the brass learned she had BP2, even though she had
a stellar track record as a cop and had done nothing wrong on the job.
That hardly seems fair when we're talking about a disorder that
doesn't involve hallucinations or psychosis and has none of the
off-the-charts impulsivity of true manic-depression. While it's nice
of researchers and mental-health advocates to claim that we've got to
end this kind of stigma, in the real world that would take generations
and by then people with BP2 today will have reached the ends of their
natural lives.
Why BP2 wasn't called something else is beyond me, but the diagnosis
has sure caused a lot of unfair social damage.
Much of the rationale for medicating teens and preschoolers has to do
with arguments about early intervention. You've written that you find
such claims questionable and their underlying philosophies flawed.
Explain why.
Let me restrict this to psychosis. What you are referring to is the
prevention paradigm, or the use of psychotropics as prophylactics, all
of it trading off kindling theories of mental illnesses and disorders.
They are interesting theories, but in the real world they've not
turned out to be successful. Simply put, there is very little
long-term or short-term research to prove their validity. For example,
the PRIME study at YaleâC"which sought to identify kids at risk of
psychosis and then gave them Zyprexa to prevent psychosis from ever
arisingâC"was an epic failure and certainly raised questions about the
ethics of giving kids dangerous drugs for disorders that they, at
least in some of the cases, didn't even have.
The trouble is that the prevention paradigm is deeply seductive. If
true, psychiatry would be like cardiology where high cholesterol is
considered a risk factor for heart disease and people with high
cholesterol are given statins to prevent heart attacks. But psychosis
isn't so simple andâC"from what I've seen to dateâC"researchers have
not been able to predict with a high degree of accuracy who will
develop psychosis. That's why I find the whole thing suspect. Perhaps
I'll be warmer to researchers' claims here when they can predict
psychosis with great accuracy and replicate their findings in many
studies across different population subtypes.
As you noted on your site, the St. Petersburg Times recently reported
that in 2007 23 infants less than one-year-old were given
antipsychotics. Given all the media attention to the death of Rebecca
Riley, aged 4, from an overdose of antipsychotics (and a diagnosis of
bipolar disorder at age 2), how is it possible for psychiatrists to
continue prescribing to infants in such numbers without more
oversight?
Doctors have great powers to prescribe drugs off-label for whatever
they see fit and, to a degree, that's fine. What's gone on with
antipsychotics prescribed to infants and toddlers is simply
inexplicable to me. The drugs are known to cause huge problems in
adults, so why the heck would a doctor give them to little kids,
especially infants? It boggles my small mind.
There probably is no acceptable way to introduce oversight into this
situationâC"outside of insurance provider overviewâC"without trampling
all over doctors' traditional freedom to prescribe off-label. I'm no
fan of bans or restrictions, but this does strike me as a situation
where there needs to be a serious rethinking of what we are
doingâC"and maybe there should be a ban on the use of these drugs in
kids under, say, 6 years of age.
That said, perhaps the most effective short term fix is for parents
themselves to get educated about the problems with these drugs and to
demand a second opinion when a doctor tries to prescribe them to their
child.
Your web site Furious Seasons, which has earned you awards, includes
extensive documentation about Zyprexa. What will readers of your site
learn about the drug and its side effects?
Hopefully, they'll learn that this is a drug that causes rapid weight
gain, hyperglycemia, diabetes, lipid problems and the like in a high
percentage of patients, and that it's a drug the use of which demands
great caution. They'll also learn that Eli Lilly actively lied to
doctors and patients about problems with the drug and that the company
has had to settle almost $3 billion in lawsuits and has pleaded guilty
to a criminal misdemeanor charge in federal court for off-label
marketing of the drug for use in dementia.
One classic example: in April 2002, Japanese regulators forced Lilly
to warn doctors in Japan abut hyperglycemia and diabetes problems with
the drug, but at the time same time the company claimed in internal
documents that this did nothing to affect the safety of the drug in
the US market. Two months later, Lilly rolled out its extensive
Zyprexa marketing campaign to PCPs, which I referred to above. That is
some of the worst corporate behavior I have ever seen in my 15 years
as a reporter.
Some months ago, the government's Clinical Trials web site signaled
that the antipsychotic Seroquel was being tested for people with
public-speaking anxiety. What can and should the FDA be doing to stop
such clear signs of "mission creep" over pharmaceuticals?
I don't think the FDA has any interest in stopping this kind of
behavior, and it likely doesn't even have the regulatory authority to
do so. For instance, in the last two years the agency has approved
antipsychotics for use in pediatric bipolar disorder and in treatment
resistant depression. Neither diagnosis exists in the current edition
of the DSM, but the agency seems just fine with this situation. It
even went to great lengths to justify the diagnosis of pediatric
"mania" bandied about by some researchersâC"which amounted to little
more than agitationâC"to the point where the FDA's chief of psychiatry
products, Thomas Laughren, was actively involved in a conference where
researchers and pharma companies joined to design clinical trials of
this kiddie mania.
Likely the best solution here is for Congress to pass legislation
requiring the FDA to only approve psychiatric medications for
disorders that appear in the then-current edition of the DSM. I cannot
think of a more effective way to stop Big Pharma's making up of
disorders which they then repurpose their drugs to "treat."
Final questions: How do you keep up with all the news in pharmacology,
and what are your standard sources of information?
My sources are a mix of traditional media coverage of the field
(although that's sadly declining as newspapers fade away), as well as
original research in journals, plus items that get sent my way by my
many dedicated readers. On top of that, I've been an investigative
reporter (mostly of government and law enforcement) for a decade and I
know where to snoop. Suffice to say, I read a ton of journal articles
and reportage. It's gotten to the point where I've not read a novel or
nonfiction book outside of the mental health world in about three
years.
Philip Dawdy is the author and editor of the award-winning weblog
Furious Seasons. Christopher Lane is the author of Shyness: How Normal
Behavior Became a Sickness.

--

Yours in good health, happiness, and gratitude,

Dr. Alan C. W. Tang, DC FIAMA
Family Care Wellness & Rehab
805 Plainfield Rd, Darien, IL 60561
(630) 789-8080 http://www.FamilyCareWellness.com
Don't just manage symptoms, *FIX* the problem
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N-Acetyl Cysteine

• NAC has been shown to reduce the symptoms of both schizophrenia^[15] and bipolar disorder^[16] in two placebo controlled trials.

^ Berk M, Copolov D, Dean O, Lu K, Jeavons S, Schapkaitz I, Anderson-Hunt M, Judd F, Katz F, Katz P, Ording-Jespersen S, Little J, Conus P, Cuenod M, Do KQ, Bush AI (September 2008). "N-acetyl cysteine as a glutathione precursor for schizophrenia--a double-blind, randomized, placebo-controlled trial". Biol. Psychiatry 64 (5): 361–8. doi:10.1016/j.biopsych.2008.03.004. PMID 18436195. http://linkinghub.elsevier.com/retrieve/pii/S0006-3223(08)00270-9.

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T4S-4SBRTPW-1&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=0525028f4260826b34dc2ef39c05bb98

^ Berk M, Copolov DL, Dean O, et al (September 2008). "N-acetyl cysteine for depressive symptoms in bipolar disorder--a double-blind randomized placebo-controlled trial". Biol. Psychiatry 64 (6): 468–75. doi:10.1016/j.biopsych.2008.04.022. PMID 18534556.