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View Diary: Was Bowe Bergdahl "going Galt"? (Cue Teapublican heads exploding.) (188 comments)

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  •  I disagree (4+ / 0-)
    I have problems with a lot of the medical jargon that is used to characterize the vast array of psychiatric disorders. I even avoid the term "mental illness", unless I'm referring to more overtly dysfunctional states like schizophrenia. And I can't for the life of me countenance the term "sick" for the troubling and occasionally bizarre comments that Bergdahl makes in this article
    .

    The problem is that at least some of what he said DOES SOUND like schizophrenia. He admitted to hearing voices and he wrote several pages of gibberish: "zipper/velcro/zipper/velcro"

    I have to say that it disturbs me that you as a mental health professional would ignore stuff like that.

    I do understand about your squeamishness about labels and stigmas but sometimes you need to call a spade a spade. A label is useful if it helps us to understand the situation. If he was mentally ill then this can exonerate him and also ensure that he gets the help he needs.

    You are correct to a certain extent that war is insane and those who live in an insane system and object to that cannot always be regarded as being insane themselves. The most sane person may be the one who bucks the status quo, the one who is brave enough to think for himself.

    However it sounds like that is not the whole story here and by framing it this way you can enable people who read this to deny if they have a mental illness or that someone they care about has a mental illness. The brooding poet/philosopher ideal that is romantisized in our culture is not always mentally well and many have commited suicide.

    I used to be the depressed poet a la Sylvia Plath style and have been told that I have some talent in that area but that is not a road I would want to travel again.

    I take the phrase "Bleeding Heart Liberal" as a compliment...

    by Pixie5 on Thu Jun 12, 2014 at 05:01:07 AM PDT

    [ Parent ]

    •  Please don't tell me about schizophrenia. (10+ / 0-)

      I've been a psychiatrist for 29 years. I would bet the rent money that he does not have schizophrenia.

      Battling psychiatric myths with sensible skepticism at www.makingsenseofpsychiatry.com

      by candid psychiatrist on Thu Jun 12, 2014 at 05:13:04 AM PDT

      [ Parent ]

      •  Because you have interviewed him??? (1+ / 0-)
        Recommended by:
        Heart of the Rockies

        I have some experience too, by working at a mental health social center for seven years and even living with an unmedicated schizophrenic.

        Please explain to me how hearing voices and writing senseless gibberish are not signs of mental illness.

        And explain to me why he was discharged from the Coast Guard for psychiatric reasons.

        I take the phrase "Bleeding Heart Liberal" as a compliment...

        by Pixie5 on Thu Jun 12, 2014 at 05:35:23 AM PDT

        [ Parent ]

        •  Hearing voices (2+ / 0-)
          Recommended by:
          Catte Nappe, Elizabeth 44

          I think we need more information.  I'm not sure that the "hearing voices" comment is a self-evaluation of an actual experience (rare if you have a severe mental illness), or a metaphor.  I could say, I hear voices in the wind to describe an experience of standing in a grove of trees on a windy day.  But, I wouldn't mean that I'm "hearing voices" that are telling me to do . . . whatever, and a symptom of a mental illness.  To say that this is a symptom of a mental illness, which it is, but without a full psychiatric examination, is premature.  We are making conclusions on third hand observations from media reporting.

          We all keep grasping for understanding or explanation of what happened.  He was a deserter.  He has a mental illness.  Or even he went Gault (my apology to the author of this diary, because it is a valuable insight).  Until we hear from official sources and from Bergdahl himself, it is all speculation.

        •  I'm concerned about his "blackness" comments (0+ / 0-)

          He speaks of blackness, darkness overcoming him or his fighting against it.  I find that concerning and would love to know more.  I really can't agree with the diary's description of Bergdahl.  That may be the way he was heading, but he sounds far too unformed yet.  I think he was struggling to find his way, but I don't think he had a good sense of what that way was.

      •  I get it now, after going to your website (1+ / 0-)
        Recommended by:
        Heart of the Rockies

        You are a anti-psychiatric medication psychiatrist.

        Let me tell you about a friend I have. In 1999 I met him at a facility run by Mental Health America. I was diagnosed with bipolar disorder. He had schizophrenia. He had a LONG history of going off his meds and becoming homeless. This last time someone gave him info to go to the homeless assistance program at MHA. He did not think he was mentally ill, but went anyway. The got him medical and financial help and place him in a board and care. He thought he was required to take the meds for him to stay there, so he took them. After a while he came out of his psychosis.

        He managed to get a job with Mental Health America to run a peer-run center. He hired me to help out. He moved up the ranks to higher management. During the MANY years I knew him there was not a trace of odd behavior on his part.

        Until he went off his meds, quit his job, went on a crazy spending spree and tried to find a long lost relative who did not want to be found by him and then ended up homeless on my doorstep.

        I took him in which was a mistake. I should have sent him back to the homeless assistance program. He claimed that he was fine and that he had cured himself with diet. I could not make him take his meds. I had to deal with my house being wrecked and his gaining so much weight that he could not control his bowels. He used my sofa as a urinal, peeing UNDER the cushion and was completely surprised when I told him about it.

        He was delusional and at one point told me that he had never said he did not need medication, even though he had told me that for months. He just said he had run out. So I made him promise to take it. Later on he could not remember the incident and told me he was not going to take any medication. When once I showed him a book of poetry by Rumi he got scared and said that he would have to hide like Simon Rushdie.

        And yet even HE was not as bad as some of the cases I had seen on the job.

        He finally went through the homeless assistance program again and now he is well and working again for Mental Health America.

        After going through my own mental health problems where I inevitably had a breakdown every time I went off meds and also seeing it happen to others as well, I get a little upset when people minimize mental health issues.

        I take the phrase "Bleeding Heart Liberal" as a compliment...

        by Pixie5 on Thu Jun 12, 2014 at 06:19:02 AM PDT

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        •  Bullshit. (11+ / 0-)

          I prescribe medications for a living. Every patient I see is on medication, or otherwise they would be seeing a psychotherapist from another discipline. I simply think that psychiatric diagnoses are for the most part trumped up pseudoscience, and that academic psychiatry is in the pocket of the pharmaceutical industry. It's not a rare opinion among the profession--I'm just more comfortable with the ambiguities of my work, and more open about my opinions.

          Battling psychiatric myths with sensible skepticism at www.makingsenseofpsychiatry.com

          by candid psychiatrist on Thu Jun 12, 2014 at 08:47:15 AM PDT

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          •  Pardon my initial insensitivity to your response. (13+ / 0-)

            I'm hurried, and overreacted to your characterization of my beliefs. My best friend in high school had schizophrenia, which I thoroughly believe is a medical disorder. However it's a degenerative disorder, very malignant--and if Bergdahl had schizophrenia, it's highly likely he would be dead under his circumstances of the past few years.

            I don't minimize mental health issues at all. I just have a more holistic view of the brain-mind, and feel that the contemporary psychiatry embraces the medical model of psychiatric disease for reasons other than scientific truth. It's Big Pharma, it's the respect of other doctors, and it's psychiatry's historic desire to come up with convenient answers for things that are unanswerable.

            Battling psychiatric myths with sensible skepticism at www.makingsenseofpsychiatry.com

            by candid psychiatrist on Thu Jun 12, 2014 at 08:53:52 AM PDT

            [ Parent ]

          •  There are psychiatrists who don't prescribe meds (1+ / 0-)
            Recommended by:
            Subterranean

            but natural stuff (orthomoleculer MD's for example). And there are a few out there that still do therapy.

            I simply think that psychiatric diagnoses are for the most part trumped up pseudoscience, and that academic psychiatry is in the pocket of the pharmaceutical industry
            .

            That is really all I need to know about you. You can't treat  a disease without a diagnostic framework. And the only thing I see wrong with the way things are is that some doctors, usually GP's, over-prescribe psych meds such as antidepressents without first determining whether the depression is endogenous or exogenous and whether it might fall into another framework such as bipolar or schizoaffective disorder. Antidepressants work no better than a placebo for situational depression, but work well with true clinical depression. I do not think that GP's should be allowed to prescribe psych meds, only qualified psychiatrists.

            I am curious why you would prescribe meds at all, if you do not trust the pharmaceutical companies?

            I take the phrase "Bleeding Heart Liberal" as a compliment...

            by Pixie5 on Thu Jun 12, 2014 at 09:15:41 AM PDT

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            •  I wrote this before your last response (0+ / 0-)

              so it is a bit harsh. I still would be interested in a response.

              I take the phrase "Bleeding Heart Liberal" as a compliment...

              by Pixie5 on Thu Jun 12, 2014 at 09:25:19 AM PDT

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            •  Glad to answer that question. (10+ / 0-)

              But first, would you please quit making declarative statements like "that's all I need to know about you"? Do you think Major Depression is a disease? Because, medically speaking, a disease is a pathological entity that has a consistent presentation, and a known cause--like, say, "streptococcal pneumonia". It's infection of the lung caused by Streptococcus pneumoniae, a bacteria.

              Major Depression, on the other hand, is a collection of associated signs and symptoms, WITHOUT a known causative agent. No neurochemical deficit has been scientifically verified whatsoever, nor can it be done with contemporary technology. (Response to medications doesn't verify a neurochemical deficit, as is amply explained on my website and in my Youtube video.) Such an entity is referred to in other medical specialties as a syndrome, not a disease. And look at the checklist of symptoms--a disorder that is verified by increased OR decreased sleep, increased OR decreased appetite, psychomotor retardation OR agitation. Does that sound like a convincing "disease" to you.

              Many contemporary psychiatrists simply prescribe pills, regardless of contributing stressors. If I think a patient's depression stems from a miserable marriage, I dare to share with them that concern, and explore the issue. Not many psychiatrists will trouble themselves to do so.

              Scientifically speaking, the DSM is a crock of shit. We treat SYMPTOMS, not diseases.

              Battling psychiatric myths with sensible skepticism at www.makingsenseofpsychiatry.com

              by candid psychiatrist on Thu Jun 12, 2014 at 09:35:30 AM PDT

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          •  Candid- Thomas Szaz (0+ / 0-)

            And a cynical former Legal Aide in NJ opened my eyes to that.

            You actually sound a lot like Szaz's (sp?) viewpoints. Which were a huge outlier.

            But everything in my psych and the law class was straight from the institutions in NJ he worked at.

            And the greatest themes I remember were that you could walk down any wing and see that every patient was showing signs of Tardive diskenysia (sp?).

            Yet early on every medical journal put the likelihood at well below 5% for 1st gen psycho drugs.

            Then suddenly the patent runs out, generics made. Everyone then agrees these new drugs are better and the numbers before were wrong and really were giving permanent impairment to many. So yeah they had to pony up the money for the "new + better" but the same (with patent).

            If you're wondering the class was about the concepts of involuntary institutionalization (wherein docs are actually statistically terrible at predicting violence), in consideration of CON LAW where stats show that offenders will offend again yet we let the go and this constitutional grey area where we have people we deem not the same fed drugs that permanently impair them . . . etc.

            •  I don't believe that mental illness is a myth (3+ / 0-)
              Recommended by:
              mjjt, Ice Blue, Elizabeth 44

              Thomas Szasz would probably despise what I think and do. I don't believe that mental illness is a myth. I believe that the rubric of psychiatric disorders is nowadays an ever-expanding list of labels that encompasses: all manner of passionate emotional states, some pathological, and some not; all manner of human psychic eccentricities, some pathological, some not; and some serious mental illnesses.

              I think that contemporary psychiatry treats problems that are real--but in most cases they don't really know what it is that they're treating, because the brain-mind is devastatingly complex AND diverse.

              Battling psychiatric myths with sensible skepticism at www.makingsenseofpsychiatry.com

              by candid psychiatrist on Thu Jun 12, 2014 at 11:38:40 AM PDT

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            •  And people tolerated (0+ / 0-)

              the tardive dyskensia because the unmedicated alternative was a thousand times worse.

              Schizophrenia is a terrible disease.  Once the terror of the disease is appreciated, the 1st gen drug side effects seem relatively minimal.

              "When I was an alien, cultures weren't opinions" ~ Kurt Cobain, Territorial Pissings

              by Subterranean on Thu Jun 12, 2014 at 11:56:23 AM PDT

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              •  The problem with 1st gen drugs was compliance (0+ / 0-)

                The side effects (EPS, akathesia) made the patients feel horrible. Zyprexa has horrible metabolic side effects, but patients tolerated it very well. It's been a tremendous frustration as a practitioner.

                Battling psychiatric myths with sensible skepticism at www.makingsenseofpsychiatry.com

                by candid psychiatrist on Thu Jun 12, 2014 at 12:06:09 PM PDT

                [ Parent ]

          •  So you dispense drugs (0+ / 0-)

            But you're not beholden to the pharmaceutical industry, because you don't agree with academics.

            What a rogue you are!

            "When I was an alien, cultures weren't opinions" ~ Kurt Cobain, Territorial Pissings

            by Subterranean on Thu Jun 12, 2014 at 11:50:02 AM PDT

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            •  I don't consider myself a rogue. (0+ / 0-)

              I prescribe medications because I'm a physician, and because that's what I'm paid to do. I do primarily outpatient work, so the vast majority of my patients come to me requesting medication treatment, with no coercion whatsoever. They tell me that they benefit from the medications, they go to the pharmacy and get their medications filled, and take them on a daily basis. I'm not about to tell them that the medications don't help them. However, I am wary about the use of medications to address dysphoria that appears to be situational, or due to maladaptive personality factors. I go to the trouble to explain that medications are of little to no benefit in such circumstances, and try to redirect them to a therapist and/or address these issues myself.

              I don't think that psychiatric medications are any better or worse that other medications, all of which have the potential for negative effects. I don't do work for pharmaceutical companies anymore, although I did in the past until my ethical concerns became more crystallized. I think that pharmaceutical companies are created to make money, by creating products that are useful to health care consumers and providers, and in that manner are no more evil than a company that, say, makes tires. They have to maintain product safety, and fairly represent their product, but are not ethically responsible for their medical application.

              Providers are of course responsible, but are given guidance regarding their use from practice standards and research that is generated by academic medical centers. Such research has been generously funded by pharmaceutical companies. I don't blame pharmaceutical companies for promoting their products in this manner--but I do blame academic psychiatrists for taking this money, and especially for compromising psychiatric science because of this undue influence. I believe (idealistically) that academic centers are the stewards of science (i.e., truth), and it is their duty to maintain high standards of fidelity to the scientific process. The biological model of psychiatry that currently prevails, and justifies the obsession with medications as a solution for all psychiatric problems, is a simplistic pseudoscientific myth, buttressed with a ton of data--but no rigorous application of the scientific method for analysis of that data. In short, I see pharmaceutical companies as a bunch of johns--and I see the academic psychiatrists who collude with them as a bunch of whores.

              I share these impressions with my patients, telling them that the TV ads for psychiatric medications are no more realistic than commercials for Axxe, or any other product. I accept the ambiguities of my work, and frankly love doing it. And I don't pretend to be any more than what I am.

              Battling psychiatric myths with sensible skepticism at www.makingsenseofpsychiatry.com

              by candid psychiatrist on Fri Jun 13, 2014 at 09:30:37 AM PDT

              [ Parent ]

          •  You sound rather Jungian. (0+ / 0-)

            “You think You're frightening me with Your hell, don't You? You think Your hell is worse than mine.” --Dorothy Parker

            by Ice Blue on Thu Jun 12, 2014 at 05:48:21 PM PDT

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            •  Not really (0+ / 0-)

              What analytic orientation I have and use is primarily self psychology, i.e. Kohut. I'm a Buddhist, and also I used to play punk music--so I'm not afraid to be honest!

              Battling psychiatric myths with sensible skepticism at www.makingsenseofpsychiatry.com

              by candid psychiatrist on Fri Jun 13, 2014 at 09:32:43 AM PDT

              [ Parent ]

      •  Agree with Pixie, (2+ / 0-)
        The problem is that at least some of what he said DOES SOUND like schizophrenia. He admitted to hearing voices and he wrote several pages of gibberish: "zipper/velcro/zipper/velcro"
        I'm not a psychiatrist but a family member has schizophrenia, and I've volunteered at mental hospitals and worked with schizophrenics.  I've also taken psychology courses through the 400 level in college (not the same as a degree, but surely worth something).

        Hearing voices
        Writing repetitive word patterns without meaning.
        Social detachment and isolation.
        Irrational, impulsive behavior.

        I'm not asking for a diagnosis, I'm asking why you can rule out psychosis given those symptoms.  Because my experience with schizophrenia suggests that those symptoms scream out for further investigation.  Frankly, I wouldn't trust any medical professional who concluded schizophrenia is impossible given those symptoms.

        "When I was an alien, cultures weren't opinions" ~ Kurt Cobain, Territorial Pissings

        by Subterranean on Thu Jun 12, 2014 at 11:45:30 AM PDT

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        •  I don't think schizophrenia is impossible. (0+ / 0-)

          But having worked extensively with schizophrenia, I'd have to say that Bergdahl would likely be dead by now if that's what he had--by self-harm, or by his captors while acting-out. The guy has survived, with no current evidence of gross decompensation. If that's what he has, then it will be very obvious soon.

          Reporting voices is common as dirt in my business. Most of my patients who report voices do not have schizophrenia.

          Battling psychiatric myths with sensible skepticism at www.makingsenseofpsychiatry.com

          by candid psychiatrist on Fri Jun 13, 2014 at 09:37:06 AM PDT

          [ Parent ]

    •  This is debatable (6+ / 0-)
      He admitted to hearing voices
      As I read that I did not see the classic "hearing voices" of mental illness, I saw what could as readily be interpreted as the common metaphor of "listening to your inner voice".

      “Texas is a so-called red state, but you’ve got 10 million Democrats here in Texas. And …, there are a whole lot of people here in Texas who need us, and who need us to fight for them.” President Obama

      by Catte Nappe on Thu Jun 12, 2014 at 07:42:43 AM PDT

      [ Parent ]

    •  He Wrote Gibberish? (1+ / 0-)
      Recommended by:
      TrueBlueMajority

      Well, then, that would seem to support the "Ayn Rand disciple" theory....

      On the Internet, nobody knows if you're a dog... but everybody knows if you're a jackass.

      by stevemb on Thu Jun 12, 2014 at 07:56:28 AM PDT

      [ Parent ]

    •  Btw, I'm all about calling a spade a spade. (4+ / 0-)

      How about this--the DSM-whatever is a necessary evil.

      Battling psychiatric myths with sensible skepticism at www.makingsenseofpsychiatry.com

      by candid psychiatrist on Thu Jun 12, 2014 at 08:59:24 AM PDT

      [ Parent ]

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