Mood Swings

Hi, Dr Ghaemi. You and I are interested in fixing what is broken. Or, to put it another way, in getting something that works to work better. Thus, if the battery to your watch needs replacing, you get a new battery.

But if you are an antipsychiatrist or a sensationalist media reporter or a therapist with an anti-meds agenda or a grandstanding politician, if the battery is broken you smash the entire watch with a hammer, then go smashing other people's watches under some kind of "anti-time" pretext.

Unfortunately, even well-meaning individuals can be fooled by misinformation from supposedly credible sources.

Dr Goodwin is certainly not part of what is broken. The facts, not reported in the media, conclusively demonstrate that "shill" is a libel.

I have done my best to educate the public in three blogs:

http://www.healthcentral.com/bipolar/c/15/49780/frederick-goodwin-ny

http://www.healthcentral.com/bipolar/c/15/50902/frederick-goodwin-ny

http://www.healthcentral.com/bipolar/c/15/51277/frederick-conclusion

I am looking forward to hearing more from you.

John McManamy
McMan's Depression and Bipolar Report
Living Well with Depression and Bipolar Disorder
Recipient, 2007 Mogens Schou Award for Public Service

You say postmodern nihilist like it's a bad thing. I understand the need to defend your friend and also protect an easy source of income from being regulated by the government. However, the New York Times is slightly more reputable then an obviously biased blogger (no offense intended).

There is a trend in our culture that suggests that someone with a "Dr." prefix is above being greedy. That Doctors are too advanced as humans to be influenced by money. Much like an athlete paid to advertise shoes, when a prestigious doctor gives a speech supporting a drug, he endorses the drug. As such, said doctor will receive further monetary compensation based on the success of that drug. Quid Pro Quo

Thank you for this column, Nassir, and your comments, John M.

I've about had it with the anti-science whackdoodles leading this debate. It may make for sensational headlines and self-medicating online "discourse."

But meanwhile, experts like Goodwin and, yes, Biederman et al, are doing the real work of helping people who have been neglected, misunderstood, or maltreated by too many other physicians who haven't bothered to keep up with neuroscience.

Enough with Grassley's witch-hunt and the NYTimes being his mouthpiece. Somebody needs to start investigating his (and his staffers') bias. Now that would be true reporting; haven't seen that one yet. And, so far, I seem to be the only person checking Grassley's campaign donors to see that Blue Cross/Blue Shield ranks #2. What's good for the goose is good for the grandstanding gander.

When I shared that factoid with Gardiner Harris, he didn't understand what that had to do with anything.

Gina Pera, journalist-advocate
Is It You, Me, or Adult A.D.D.? Stopping the Roller Coaster When Someone You Love Has Attention Deficit Disorder
http://www.ADHDRollerCoaster.org

"I've about had it with the anti-science whackdoodles leading this debate."

Love it.

One of my biggest fears is waking up and finding out we have reached the end of science and the end of psychiatry. This isn't an abstract issue to me. I've been manic, I've been suicidally depressed. Plus a bunch of add-ons such as anxiety. And I have an illness whose salient characteristic is cycles, so breathing easy and pretending I'm recovered is not an option with me. Psychiatry has been instrumental in keeping my cycles within a range that I can handle. And if the day comes that my cycles get the better of me, I am going to need psychiatry to help get my life back (again). But if the anti-science crowd has their way, then I'm toast.

I read somewhere that most people in the US do not believe in evolution. Scary, isn't it? We celebrate a culture of dumb, and antipsychiatry is part of that phenomenon.

Thanks, Gina, for the Grassley non-disclosure. Yes, it's relevant, precisely because Sen Grassley made disclosure an issue. The "gander" thing.

I'm raving on. Thanks for the opportunity to step out of my dispassionate medical journalist persona.

John McManamy
McMan's Depression and Bipolar Report
Living Well with Depression and Bipolar Disorder
Recipient, 2007 Mogens Schou Award for Public Service

in english law, years ago, a ruling was made that a judge could not be allowed to have a stake in a case that may come before them. this was to prevent any bias and also to allow judges to be seen as independent.

psychiatry and the pharmaceutical industry are really very well linked. i know you don't like simplistic arguments and that you would like another way of viewing things. i also note that you make the point that doctors have integrety and that capitalism is not necessarily evil. you also make the point that doctors can rely on their many years of training to make proper judgements and successful treatments are profit making.

it has to be accepted that training for doctors is heavily influenced by the pharmaceutical industry, so how effective is a doctor's critical evaluation? anyone that is critical of the pharmaceutical industry risks harsh treatment and being labelled as some sort of ill informed ludite. how can real critical evaluation take place in such a hostile environment?

doctors are not above being influenced by their paymasters and industry is not above protecting its interests. both psychiatry and the pharmaceutical industry have a stake in the same game and they both eat at the same table. it is not enough to have people declare their interests, some sort of proper seperation of the two main parties needs to happen.

I don't think anyone is disagreeing with you. In fact, I strongly agree with you. I was trained in British law principles (I have law degree from a New Zealand University and was a law journal editor). I have a good working knowledge of judicial impartiality and conflict-of-interest principles. I also picked up more working knowledge as a financial journalist.

I have no hesitation in saying that psychiatry has been badly corrupted by the drug industry. A quick PubMed search will yield no shortage of industry-designed, industry-written studies fronted by academic authors and published in respectable journals where the "spin" in the abstract completely contradicts the data, very much to the detriment of patients.

For a particularly egregious example, you might want to check out:
http://www.ncbi.nlm.nih.gov/pubmed/16449478?ordinalpos=3&itool=EntrezSys...

Here's part of what the abstract to that study said:

"CONCLUSIONS: Compared to placebo, olanzapine delays relapse into subsequent mood episodes in bipolar I disorder patients who responded to open-label acute treatment with olanzapine for a manic or mixed episode."

The abstract neglected to mention that 80 percent of the patients on olanzapine dropped out of the study.

Psychiatry, at least, can be fixed, probably only with outside pressure. The current financial melt-down illustrates the fallacy that industries and professions can be entrusted to regulate themselves.

Antipsychiatry, however, is neither interested in fixing things nor in contributing to a rational debate. Against all evidence to the contrary, they don't believe in psychiatric illness, they don't believe that kids can have psychiatric illness, they don't believe in treatment, and they don't believe in funding for research and treatment.

So Luddite is far too mild a term for them.

And - get this - they claim to speak for me (a patient). Seriously, I don't want to wake up to the day where they are running things. And seriously, neither do the tens of thousands of patients and family members I have listened to and addressed in talks and corresponded with.

So back to the point: We - you, me, others - need to take charge of the debate, not the anti-science, anti-intellectual fringe.

I appreciate this discussion. I would agree that there is no question about needing to clean up the relationship between the pharmaceutical industry and academic psychiatry. A defense of the truth about the research and integrity of individuals like Dr. Goodwin is a separate issue from the larger policy issue of needing to fix what is broken. It is wrong to unjustly criticize individuals because we are angry at the larger system. We can fix the system without commiting new personal injustices. As John McManamy points out, being a patient with one of these illnesses, the matter is hardly academic, and there has to be a motivation to want to fix things, rather than to cause more damage.