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The Brain on Antipsychotic Drugs: What Happens?

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(August 18, 2014) Antipsychotics like clozapine and mood stabilizers like lithium are a part of recovery for people with severe mental illness, and they also cut violent crime, according to a study published in the Lancet (“Antipsychotics cut violent crime, study finds.” May 8).

antipsychoticsAntipsychotic drugs are an important part of the picture in most people’s journey to recovery from serious mental illness. They are also a complex piece of an approach to address the biology of these illnesses. The Treatment Advocacy Center’s backgrounder, "Do antipsychotic drugs change brain structure? ” updated in April 2014, demystifies the way these drugs act on the brain.

As the backgrounder explains, “changes in brain structure are caused both by the disease process of schizophrenia and bipolar disorder and by the antipsychotic drugs used to treat these diseases.”  Moreover, that these drugs produce changes to the structure of the brain should not surprise anyone. The backgrounder describes the following structural brain changes the drugs cause:
  • Decreased brain volume with associated increased volume of the ventricles;
  • Increase in size of the striatum; and
  • Increased density of glial cells in the prefrontal cortex.

It is important to apply an informed perspective to understanding treatment for serious mental illnesses like schizophrenia and bipolar disorder. One area of controversy remains the safety and impact of antipsychotic drugs – and with justification. However, not all criticisms are created equally, and as we know, antipsychotic drugs both require careful monitoring by physicians and have the potential to help change lives for the better for those experiencing psychosis.

The backgrounder can be an important tool towards informing community members, politicians, and media about antipsychotic medications, along with education about the many devastating consequences of non-treatment of serious mental illness.

For access to more of our backgrounders, which summarize information about severe mental illness, policies and programs related to its treatment, and the consequences of lack of treatment, visit the “Reports, Studies, Backgrounders” page on our website.

 

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If I Could Turn Back Time – personally speaking

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(August 15, 2014) I am a member of our community who lives with anxiety, sadness, fear, exhaustion, frustration, grief and society blames me for not doing enough for my son. When I drive my son to the hospital there is no one there to answer my questions or offer emotional support and when I come home, there is no consoling or casseroles waiting from friends. There will be no fundraisers to help with hospital bills.

ninamcdanielpart1I grieve and reminisce for the son I once raised by love and support the new child before me now. If my son had a heart attack, cancer or was in a car accident, my life would be different. My name is Nina McDaniel and I am the proud mother and advocate to my 32-year-old son, Michael, who has schizoaffective disorder.

Michael was a hard worker from a young age. Even though Michael was awkward and enjoyed being alone, he always showed a huge heart and always helped others in need. His smile warms your heart and his affection is contagious.

His downward spiral began in July 2007. He began wearing sunglasses all the time, even to bed. He also became paranoid over secret messages on the radio, helicopters flying overhead and thought his sister and her husband were part of a conspiracy.

We filed our first petition for commitment also in July 2007. This commitment resulted in only three days in the psychiatric unit. We filed another petition for commitment in August that resulted in five days of treatment in a psychiatric unit. That time he was rapidly losing weight by starving himself. Even though we were trying to save Michael’s life, this began the endless cycling through the mental health system in order to attain help.

Things only got worse. In 2008, we rushed Michael to the emergency room after he tried to end his life by consuming a large amount of alcohol. The hospital just dismissed him as an alcoholic.

At one point we received a call from our daughter, who cried, “Michael swallowed a handful of my medicine, come quick!” We called the crisis unit, but nothing was done because Michael refused to voluntarily speak with them. Under the law, he still had the right to refuse treatment and remain psychotic.

After one terrifying episode that included verbal threats and a potential weapon, I was able to get Michael committed for 20 days. After the 20 days we decided as a family that we could not bring Michael home, he needed to remain in the mental health system. But that is not what happened. The hospital declined my request to have Michael placed in an intensive program. It ultimately became clear that if we did not take him home, the alternative would have been a homeless shelter and we were not going to leave him homeless.

My beautiful son deserves to receive help in his life and a chance for happiness. But instead, we feel like second class citizens, neglected by friends, neighbors and law makers who slash funding and block access to care.

Nina McDaniel
Mother of Michael
Part II of Nina and Michael’s story will run next week.

 

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How Suicide Risk Rises with Serious Mental Illness

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(August 14, 2014) The suicide of actor and comedian Robin Williams has brought renewed attention to the unspeakably sad and often baffling topic of suicide, a lethal act of violence against oneself. 

manic episodeToo often overlooked in discussions of mental illness and violence is the fact that the most likely victim of a violent act associated with psychiatric disease is the individual him/herself. Homicide currently takes the lives of about 15,000 people a year in the U.S., an estimated 1,500 of whose deaths are associated with untreated mental illness. In 2011, suicide took almost 40,000 lives, and NIMH Director Tom Insel has said every one of those losses is associated with mental illness.

The Treatment Advocacy Center’s recently updated backgrounder, “How many people with schizophrenia and bipolar disorder commit suicide?” looks specifically at suicide associated with schizophrenia and bipolar disorder, the disease from which Williams suffered. The top two risk factors listed are depressive symptoms and substance abuse, both of which he had suffered.

The suicide of a prominent member of society makes big headlines, but smaller headlines every day paint a grim picture of a cause of death that is preventable with appropriate and effective treatment. At Saline Memorial Hospital in Benton, Arkansas, for example, the hospital’s ambulance service answered 147 mental-health emergency calls reporting suicidal thoughts, intentions or attempts in just the first 151 days of 2014 (“Suicide, mental illness touch many in Saline County,” July 20).

Treatment Advocacy Center backgrounders are useful tools for raising awareness about mental illness and treatment issues. For a complete list of backgrounders, visit the “Reports, Studies, Backgrounders” page of our website. To see the Treatment Advocacy Center’s original research, visit our TACReports.org site.

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Robin Williams: ‘If Only You Could Grasp … It Was Not Him’

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(August 13, 2014) Comedian Robin Williams, who died of asphyxiation after hanging himself this week, has already been removed from Everyday Health’s list of 10 famous people with bipolar disorder.

robin-williamsFrom his “Mork and Mindy” days in the late ‘70s, Williams brought laughter to whole continents of people. For individuals and families living with bipolar disorder, he brought the inspiration of seeing someone who shared the disease achieve such heights.

In a reflection on the sad end to Williams’ life, blogger Elad Nehorai has made an eloquent plea for understanding Williams' death was not self-inflicted but disease-inflicted.

“Williams did not make that choice,” writes Nehorai, who says he has been suicidal himself (“Robin Williams didn’t kill himself,” PopChassid, Aug. 12). "If only you could grasp it. It was not him. It was his illness.

“It can be so hard to understand for the mentally healthy. Just as I cannot possibly comprehend what it means for someone to have AIDS or cancer, I think it can be truly hard for people to wrap their minds around the idea that for some people, a choice cannot be a choice....

“Robin Williams did not kill himself. His disease, whatever it was, killed him.”

Williams' humor and his inspiration will be sorely missed. 

Read the entire blog on PopChassid.

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Are People with Untreated Serious Mental Illness Dangerous?

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(August 12, 2014) An executive walking near a shopping mall in the posh California suburb of La Jolla was allegedly stabbed 40 times by a man whose father said is suffering from bipolar disorder the family can do nothing to help because the suspect is an adult ("Father says he tried to warn authorities about son," CBS8 San Diego, Aug. 8).

odie-miller"What I want people to know is that my son has mental illness," father Odie Miller Sr., said. His son, Odie Jr., is "bright, talented, creative and personable," according to the father. "That's on his medication - without his medication - his life becomes unmanageable."

The victim is recovering at home. Miller Jr., 20, has been charged with attempted murder.

The association between violence and serious mental illness is hotly debated in mental health circles but not in the academic or scientific worlds. There, it is almost universally acknowledged that – while most people with severe mental illness are never violent – untreated mental illness is a risk factor for committing violent acts.

"Are people with serious mental illness who are not being treated dangerous?" is one of 15 recently updated Treatment Advocacy Center backgrounders that address important issues in mental health. The paper summarizes research into the association between untreated mental illness and violence and provides references to relevant studies.

When when timely and effective intervention is not available, terrible variety of consequences befall at-risk individuals like Odie Miller Jr., their families and their communities. To raise awareness of the devastating consequences of not treating serious mental illness, including the potential for violence, share "Are people with serious mental illness who are not being treated dangerous? with your local community members, politicians and media.

For more information about mental illness treatment issues, visit the "Reports, Studies, Backgrounders" page on our website and our TACReports.org site dedicated to the Treatment Advocacy Center's original research.

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