![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 20 to 44 of 57. Go back in thread:
Posted by hello321 on October 4, 2015, at 21:05:01
In reply to Re: Shooters and Psychiatry, posted by baseball55 on October 4, 2015, at 19:33:24
> And where exactly is the evidence that mass shooters take anti-depressants? Can you name one? It might make this convo more productive if you followed what is said during it.
>I don't think crime stats have anything to do with depression or anti-depressants, since depressed people or people recovering from depression rarely commit crimes in the first place.
Why do you think this? Any evidence?
> Changes in the crime rate since the 1960s are probably due to:
>
> *greater access and availability of guns (see the book Fist, Stick, Knife, Gun) which lead to more disputes escalating to murder.
> *The crack epidemic that caused huge spikes in violent crime in the 80s.
> *Some people argue that greater availability of birth control and abortion reduced the birth of unwanted children among single parents and caused crime rates to decline by the 90s, when those children would have reached prime crime-involvement years.
> *Aging of the population. Crime rates decline with age. Prime crime ages are 16-25.
> *More intense focus on street level policing and incarceration in the mid-80s.
> * Better reporting. For example, rape, in the 60s and 70s, was rarely reported or prosecuted. In the late 70s and early 80s, a lot of crime in high crime rate cities went unreported because the police just didn't bother investigating anything but murders.
> *reduction in gang activityTrue, these things you listed probably have had an effect on the crime rate.
> I don't know of one serious study of crime rates by criminologists or sociologists of crime that mentions antidepressants as either a cause or solution of violent crime.
Do you think serious studies need to be done then?
> Psych drugs are not responsible for everything, nor is mental illness.
No one said this
Posted by SLS on October 4, 2015, at 21:16:43
In reply to Re: Shooters and Psychiatry, posted by hello321 on October 4, 2015, at 17:09:49
>
> > > Interestingly, the rate has been going down steadily since the
> >
> > After reviewing the chart further, I don't understand how anyone would try to use it to make an argument that increased antidepressant use is associated with higher rates of violent crimes.
> >
> > 1. Within a few years of the release of Prozac, violent crimes have gone down steadily.
> >
> > 2. The media attention paid to Prozac and depression beginning in 1988 produced a large increase in antidepressant prescriptions. I believe it is at least 400%.
> >
> > http://www.health.harvard.edu/blog/astounding-increase-in-antidepressant-use-by-americans-201110203624
> >
> > Wouldn't one expect an increase in the rate of violent crimes by 400% if antidepressants were responsible for producing them? Instead, there is a significant reduction. How can this be?
> >
> > The statistic I haven't seen yet is the proportion of people that take antidepressants who go on to commit suicide or violent crimes. If you line up 100 people who take antidepressants, how many of them will suffer negative behavioral reactions? What if it is only 3*? The media attention paid to those 3 will be greatly exaggerated and make antidepressants seem like prolific killers. Perhaps negative reactions can be screened for more closely by doctors early in treatment. Weekly or biweekly evaluations might be indicated.
> >
> > * I have no idea what this number really is. Maybe someone can produce this statistic.
> >
> > More interesting statistics:
> >
> > http://www.cdc.gov/nchs/data/databriefs/db76.htm
> >
> >
> > - Scott
> I didn't post those numbers to prove any point. I just posted them for us to look.
>
> But the rate of violent crimes continued to increase even after Prozac quickly became a blockbuster soon after it was released.Prozac was released in December of 1988. However, it didn't become a blockbuster until the media made it into one. It didn't make the cover of Newsweek magazine until March 26, 1990. I don't think it reasonable that Prozac should increase prescription numbers by 400% in the two years following the magazine article. Violent crimes began to fall beginning in 1993 according the chart you posted. Maybe Prozac reduced violent crime. Fewer depressed and anxious people = reduced violent crime? It would make a wonderful explanation for what we see in the statistics you cited. But, then again, maybe not.
So now you have me confused. I forgot exactly what we were talking about.
- Scott
Posted by hello321 on October 4, 2015, at 22:03:37
In reply to Re: Shooters and Psychiatry, posted by SLS on October 4, 2015, at 21:16:43
> >
> > > > Interestingly, the rate has been going down steadily since the
> > >
> > > After reviewing the chart further, I don't understand how anyone would try to use it to make an argument that increased antidepressant use is associated with higher rates of violent crimes.
> > >
> > > 1. Within a few years of the release of Prozac, violent crimes have gone down steadily.
> > >
> > > 2. The media attention paid to Prozac and depression beginning in 1988 produced a large increase in antidepressant prescriptions. I believe it is at least 400%.
> > >
> > > http://www.health.harvard.edu/blog/astounding-increase-in-antidepressant-use-by-americans-201110203624
> > >
> > > Wouldn't one expect an increase in the rate of violent crimes by 400% if antidepressants were responsible for producing them? Instead, there is a significant reduction. How can this be?
> > >
> > > The statistic I haven't seen yet is the proportion of people that take antidepressants who go on to commit suicide or violent crimes. If you line up 100 people who take antidepressants, how many of them will suffer negative behavioral reactions? What if it is only 3*? The media attention paid to those 3 will be greatly exaggerated and make antidepressants seem like prolific killers. Perhaps negative reactions can be screened for more closely by doctors early in treatment. Weekly or biweekly evaluations might be indicated.
> > >
> >
> Prozac was released in December of 1988. However, it didn't become a blockbuster until the media made it into one. It didn't make the cover of Newsweek magazine until March 26, 1990. I don't think it reasonable that Prozac should increase prescription numbers by 400% in the two years following the magazine article. Violent crimes began to fall beginning in 1993 according the chart you posted. Maybe Prozac reduced violent crime. Fewer depressed and anxious people = reduced violent crime? It would make a wonderful explanation for what we see in the statistics you cited. But, then again, maybe not.
>
> So now you have me confused. I forgot exactly what we were talking about.
>
>
Lol I've gotten a bit confused about it too. I suppose the thread started out about what was causing all these mass shootings we hear about lately. And I posted one reason for it may actually be psychiatric meds.
Maybe prozac and other psych meds have worked to make some who take it less prone to violence. I think this is likely. But I also believe these meds can do the opposite.Also, here is a study done is Sweden that concluded depressed people undergoing outpatient psychiatric treatment are more likely to commit violent crimes. Well it didn't come to this conclusion exactly. Just that depressed people are more likely to commit violent crimes. Though all the folks in the study were diagnosed nd being treated for depression by psychiatric services.
"The study only included patients diagnosed and treated for depression by outpatient psychiatric services. People who required inpatient admissions and those treated by their GPs were excluded, so it may not be representative of people with different severities of depression."
Posted by PeterMartin on October 5, 2015, at 9:33:41
In reply to Re: Shooters and Psychiatry, posted by hello321 on October 4, 2015, at 22:03:37
John Oliver nailed it:
John Oliver slams GOP candidates for citing mental health in response to Oregon mass shooting:
https://www.youtube.com/watch?v=NGY6DqB1HX8
Posted by Tomatheus on October 5, 2015, at 12:40:28
In reply to Shooters and Psychiatry, posted by bleauberry on October 3, 2015, at 7:11:44
Psych Central's John Grohol, Psy.D., argued in a blog entry published today that scientific data do not support the idea that people with mental illness are an "important piece of the puzzle of violence in America."
Dr. Grohol wrote: "We need to stop pointing fingers and scapegoating the percentage of the population with mental illness. That kind of behavior is pure discrimination and bigotry. I expect policymakers and Congress people to respect all of their fellow citizens, including those with a mental illness - not call them out for special, discriminatory treatment."
Read the full blog entry below:
http://psychcentral.com/blog/archives/2015/10/05/congress-policymakers-stop-scapegoating-mental-illness-in-mass-shootings/Tomatheus
Posted by hello321 on October 5, 2015, at 14:56:12
In reply to Re: Shooters and Psychiatry, posted by Tomatheus on October 5, 2015, at 12:40:28
Some have a problem with pointing a finger at the chemicals used to treat mental illnesses as one factor behind violent crimes. Others are outraged by mentally folks being singled out. While others disapprove of the inanimate objects used to commit the crimes being blamed. I guess you can't make everyone happy.
Then others demand only knowledge gained from well designed studies be used to decide what action should be taken. While others are upset and claim discrimination if these numbers single out a certain group.
I suppose we can only expect progress to be very slow and meet many roadblocks along the way, if progress is ever even achieved.
It is true that fewer violent crimes are being committed by folks diagnosed and treated for depression. And that's great. But that's like pointing out that fewer crimes are being committed by African Americans in a city consisting of 80% Caucasians, if a higher percentage of African Americans have committed violent crimes in this city. Of course it is no good to judge anyone before you know them. And if a non-violent person is being singled out by anyone as a factor in the crime rate, that helps no one.
As I've said, my thoughts are that the brain altering prescriptions being prescribed to depressed people are, in some cases, causing or worsening their negative thought processes and making them more likely to become violent. The study I posted in my last post showed that a modest but still significantly higher percentage of people diagnosed and being treated for depression by a psychiatrist have been convicted of violent crimes. It talked about some shortcomings in the study that should be addressed by future studies. Though one good thing about the study was that it compared the time before the people studied sought psychiatric treatment (the unmedicated version of themselves) to the time when they were being treated with psychiatric medications. It appears to be a well done study that came up with numbers that could be helpful when deciding what steps should be taken to decrease the amount of violence occurring.
Posted by Tomatheus on October 5, 2015, at 16:16:26
In reply to Re: Shooters and Psychiatry, posted by hello321 on October 5, 2015, at 14:56:12
> It is true that fewer violent crimes are being committed by folks diagnosed and treated for depression. And that's great. But that's like pointing out that fewer crimes are being committed by African Americans in a city consisting of 80% Caucasians, if a higher percentage of African Americans have committed violent crimes in this city. Of course it is no good to judge anyone before you know them. And if a non-violent person is being singled out by anyone as a factor in the crime rate, that helps no one.
The data that Dr. Grohol presented in his blog didn't just indicate that fewer violent crimes are committed by individuals with mental illnesses because those with mental illnesses are in the minority. The data indicated that individuals with mental illness are less likely (than those without a mental illness) to be perpetrators of violence: "According to the Congressional Research Service ... the prevalence rate of mental illness in the U.S. in any given year is 18.5 percent. If only 3 to 5 percent are carrying out violent acts, that means a person with mental illness is one-third less likely to be a perpetrator of violence!"
Do you think that what Dr. Grohol presented was incorrect? And if you do think that what he presented was incorrect, could you explain why?
I don't think that mental illnesses and the medications used to treat them are never a factor in violent crimes. But I think that one of the points that Dr. Grohol and others are trying to make (which I agree with) is that mental illness isn't a big player when it comes to violence in the U.S. and that thinking that changing the mental health system will lead to significant reductions in violent crime is faulty thinking. In his original post to this thread, Bleauberry identified poorly managed psychiatric care and the targeting of individuals in gun-free zones as big players in mass shootings. But if Dr. Grohol is right, and most of the perpetrators of the recent mass shootings had no history of mental illness, then it seems that mental illness isn't really such a big player when it comes to the mass shootings and other violent crimes.
Again, I'm not saying that mental illness and the medications used to treat such illnesses don't ever contribute to violent crimes. It's definitely a problem that the treatment of mental illness is as unsuccessful and problematic as it is, and I think that if evidence-based ways of improving the treatment of mental illness come along that they ought to be implemented as quickly as possible. But I think that it would be erroneous to say that one of the biggest reasons why we have so many mass shootings today is because of problems associated with mental illnesses and the treatment of such illnesses.
Tomatheus
Posted by SLS on October 5, 2015, at 19:44:39
In reply to Re: Shooters and Psychiatry » hello321, posted by Tomatheus on October 5, 2015, at 16:16:26
Q: Are violent crimes committed by people because of the presence of major mental illness?
A: Do antidepressants cause violent crime?
I'm not sure.
----------------------------------------------------------------
1. Bartholomew was born without any genes that would predispose him to mental illness.
2. Bartholomew had a childhood predominated by physical and emotional abuse, neglect, and exposure to domestic violence.
3. Bartholomew grew up feeling inferior because his family didn't have as much money as his peers did. He was teased and bullied. He swore that he would one day have money.
4. Now out of high school, Bartholomew continued to feel poor and inferior. He couldn't find a job. College was out of the question.
5. Bartholomew's mother noticed that her son's behavior had become erratic and that he was often quiet and uncommunicative. He was ruminating in his anger and indignation. She thinks that his quietness is depression, and convinces him to go to the family doctor. She would accompany him.
6. The doctor of internal medicine hears the word "depression". This is enough to convinces the doctor to prescribe Lexapro.
7. After six months, nothing changes.
8. 18 years previously, a law abiding citizen bought a hand gun legally.
9. This law abiding citizen had his house robbed while he was out at the cinema watching a mediocre remake of "King Kong". The gun was stolen along with a box of Fruit Loops.
10. The gun eventually found its way into Bartholomew's hands. He now felt empowered. He could use it to get the money and respect that he never had growing up. Society owed it to him.
11. Bartholomew was still angry. He decided to rob a convenience store. On impulse and filled with anxiety, he burst through the door and ran up to the counter waving his gun around and screaming for everyone to get down on the floor. He just happened to notice a box of Fruit Loops on the shelf. He was not distracted, though.
12. Bartholomew demands that the clerk give him all the money in the cash register. When the clerk raised his hands in the air to show Bartholomew that he was unarmed, Bartholomew panicked and shot him. Several patrons got up off the floor and began to run for the door. Bartholomew shot them all.
13. Realizing what he had done, Bartholomew felt trapped. He would surely be executed - or worse. There was no way out except by suicide. Suicide was not an unfamiliar thought. He used the gun one more time.
14. The coroner determined that Bartholomew's body contained Lexapro and Fruit Loops.
15. Upon investigation, Bartholomew's mother and doctor corroborated this finding and described that Bartholomew was taking Lexapro for depression.
16. In the media and on official public records, Bartholomew was taking an antidepressant for a mental illness and committed mass murder.
17. Bartholomew was not mentally ill.
18. Strange, though. Bartholomew didn't even like Fruit Loops.
----------------------------------------------------------------
Posted by baseball55 on October 5, 2015, at 20:41:17
In reply to Re: Shooters and Psychiatry » hello321, posted by Tomatheus on October 5, 2015, at 16:16:26
Reasonable and even-handed post, as always Thomatheus.
Posted by baseball55 on October 5, 2015, at 20:47:39
In reply to Re: Shooters and Psychiatry, posted by SLS on October 5, 2015, at 19:44:39
This is too cool, Scott. This is the complexity of mental illness, violence, anger, disempowerment. If you've never read it, there's this great book called Violence by Patrick Gilligan. Gilligan was the medical director of the Massachusetts state prison system and a psychiatrist at Bridgewater State Hospital for the criminally insane. It's a powerful book that looks at these complex interactions of shame, rage, violence and mental illness, based on years of interviews with frighteningly violent men in the Mass prison system.
>
> 1. Bartholomew was born without any genes that would predispose him to mental illness.
>
> 2. Bartholomew had a childhood predominated by physical and emotional abuse, neglect, and exposure to domestic violence.
>
> 3. Bartholomew grew up feeling inferior because his family didn't have as much money as his peers did. He was teased and bullied. He swore that he would one day have money.
>
> 4. Now out of high school, Bartholomew continued to feel poor and inferior. He couldn't find a job. College was out of the question.
>
> 5. Bartholomew's mother noticed that her son's behavior had become erratic and that he was often quiet and uncommunicative. He was ruminating in his anger and indignation. She thinks that his quietness is depression, and convinces him to go to the family doctor. She would accompany him.
>
> 6. The doctor of internal medicine hears the word "depression". This is enough to convinces the doctor to prescribe Lexapro.
>
> 7. After six months, nothing changes.
>
> 8. 18 years previously, a law abiding citizen bought a hand gun legally.
>
> 9. This law abiding citizen had his house robbed while he was out at the cinema watching a mediocre remake of "King Kong". The gun was stolen along with a box of Fruit Loops.
>
> 10. The gun eventually found its way into Bartholomew's hands. He now felt empowered. He could use it to get the money and respect that he never had growing up. Society owed it to him.
>
> 11. Bartholomew was still angry. He decided to rob a convenience store. On impulse and filled with anxiety, he burst through the door and ran up to the counter waving his gun around and screaming for everyone to get down on the floor. He just happened to notice a box of Fruit Loops on the shelf. He was not distracted, though.
>
> 12. Bartholomew demands that the clerk give him all the money in the cash register. When the clerk raised his hands in the air to show Bartholomew that he was unarmed, Bartholomew panicked and shot him. Several patrons got up off the floor and began to run for the door. Bartholomew shot them all.
>
> 13. Realizing what he had done, Bartholomew felt trapped. He would surely be executed - or worse. There was no way out except by suicide. Suicide was not an unfamiliar thought. He used the gun one more time.
>
> 14. The coroner determined that Bartholomew's body contained Lexapro and Fruit Loops.
>
> 15. Upon investigation, Bartholomew's mother and doctor corroborated this finding and described that Bartholomew was taking Lexapro for depression.
>
> 16. In the media and on official public records, Bartholomew was taking an antidepressant for a mental illness and committed mass murder.
>
> 17. Bartholomew was not mentally ill.
>
> 18. Strange, though. Bartholomew didn't even like Fruit Loops.
>
> ----------------------------------------------------------------
>
Posted by hello321 on October 5, 2015, at 21:19:02
In reply to Re: Shooters and Psychiatry » hello321, posted by Tomatheus on October 5, 2015, at 16:16:26
"If only 3 to 5 percent are carrying out violent acts, that means a person with mental illness is one-third less likely to be a perpetrator of violence!"
If this guy is saying that 3 to 5 percent of the 18.5 percent of mentally ill in america are committing violent crimes, and that this adds up to a mentally ill person being 1/3 less likely to commit a violent crime. Then if one were to look at the numbers, they'd see this is simply a false statement.
Posted by Tomatheus on October 5, 2015, at 21:57:11
In reply to Re: Shooters and Psychiatry, posted by SLS on October 5, 2015, at 19:44:39
> Q: Are violent crimes committed by people because of the presence of major mental illness?
>
> A: Do antidepressants cause violent crime?
>
> I'm not sure.Scott,
I think that as Baseball55 pointed out and as you illustrated with the scenario about Bartholomew that you posted, whether mental illness and/or psychiatric medications cause violent crime is clearly a complex issue. Certainly, when examining the extent to which mental illness and/or psychiatric medications might be a factor in a violent crime, all of the available details need to be closely examined, including factors other than mental illness and the treatment thereof that might have influenced the perpetrator to commit the crime. While there may be cases in which a perpetrator's mental illness seemed to be a driving force in the carrying out of a violent crime, there are probably also a lot of cases where the perpetrator might have received a diagnosis of a mental illness (and also, presumably, some form of treatment) where it isn't quite clear what role the illness and/or the treatment might have played. And to make matters even murkier, psychiatric diagnoses can be questioned. Did the Bartholomew character that you wrote about have a mental illness? You wrote that he didn't, even though it seemed that he likely received a diagnosis of some form of depression from his family doctor. Along with trying to figure out the extent to which a mental illness might play a role in the carrying out of a violent crime, trying to validate the diagnosis is another issue.
Tomatheus
Posted by Tomatheus on October 5, 2015, at 22:00:51
In reply to Re: Shooters and Psychiatry » Tomatheus, posted by baseball55 on October 5, 2015, at 20:41:17
Thank you for the compliment, Baseball55. I appreciate it.
Tomatheus
Posted by Tomatheus on October 5, 2015, at 22:10:21
In reply to Re: Shooters and Psychiatry, posted by hello321 on October 5, 2015, at 21:19:02
> "If only 3 to 5 percent are carrying out violent acts, that means a person with mental illness is one-third less likely to be a perpetrator of violence!"
>
> If this guy is saying that 3 to 5 percent of the 18.5 percent of mentally ill in america are committing violent crimes, and that this adds up to a mentally ill person being 1/3 less likely to commit a violent crime. Then if one were to look at the numbers, they'd see this is simply a false statement.I suppose that we'd need to look at the numbers to know for sure. Who knows, perhaps you might be right.
Tomatheus
Posted by hello321 on October 5, 2015, at 23:28:33
In reply to Re: Shooters and Psychiatry, posted by SLS on October 5, 2015, at 19:44:39
> 1. Bartholomew was born without any genes that would predispose him to mental illness.
>
> 2. Bartholomew had a childhood predominated by physical and emotional abuse, neglect, and exposure to domestic violence.
>
> 3. Bartholomew grew up feeling inferior because his family didn't have as much money as his peers did. He was teased and bullied. He swore that he would one day have money.
>
> 4. Now out of high school, Bartholomew continued to feel poor and inferior. He couldn't find a job. College was out of the question.
>
> 5. Bartholomew's mother noticed that her son's behavior had become erratic and that he was often quiet and uncommunicative. He was ruminating in his anger and indignation. She thinks that his quietness is depression, and convinces him to go to the family doctor. She would accompany him.
>
> 6. The doctor of internal medicine hears the word "depression". This is enough to convinces the doctor to prescribe Lexapro.
>
> 7. After six months, nothing changes.
>
> 8. 18 years previously, a law abiding citizen bought a hand gun legally.
>
> 9. This law abiding citizen had his house robbed while he was out at the cinema watching a mediocre remake of "King Kong". The gun was stolen along with a box of Fruit Loops.
>
> 10. The gun eventually found its way into Bartholomew's hands. He now felt empowered. He could use it to get the money and respect that he never had growing up. Society owed it to him.
>
> 11. Bartholomew was still angry. He decided to rob a convenience store. On impulse and filled with anxiety, he burst through the door and ran up to the counter waving his gun around and screaming for everyone to get down on the floor. He just happened to notice a box of Fruit Loops on the shelf. He was not distracted, though.
>
> 12. Bartholomew demands that the clerk give him all the money in the cash register. When the clerk raised his hands in the air to show Bartholomew that he was unarmed, Bartholomew panicked and shot him. Several patrons got up off the floor and began to run for the door. Bartholomew shot them all.
>
> 13. Realizing what he had done, Bartholomew felt trapped. He would surely be executed - or worse. There was no way out except by suicide. Suicide was not an unfamiliar thought. He used the gun one more time.
>
> 14. The coroner determined that Bartholomew's body contained Lexapro and Fruit Loops.
>
> 15. Upon investigation, Bartholomew's mother and doctor corroborated this finding and described that Bartholomew was taking Lexapro for depression.
>
> 16. In the media and on official public records, Bartholomew was taking an antidepressant for a mental illness and committed mass murder.
>
> 17. Bartholomew was not mentally ill.
>
> 18. Strange, though. Bartholomew didn't even like Fruit Loops.
>
>Scott, I find this confusing. There is no precise way to diagnose major depressive disorder. But it is mentioned in psychiatric literature and occasionally talked about on this board that chronic stress can result in one developing Major Depressive Disorder. That looks to be what Bartholomew experienced. Chronicle negative circumstances led to him developing lasting symptoms of what is recognized as clinical depression with today's limited ability to diagnose it as effectively as we can diagnose high blood pressure. True, many different situations can cause a person to rob and murder someone. But a situation like what you described is what just about any psychiatrist would diagnose as depression, isn't it? If not, then should only a chronic, negative mood accompanied by low energy along with other depression symptoms that are caused by efficiently diagnosed physical medical conditions be diagnosed as clinical depression? Am I missing something?
True, this guy had what are described as symptoms of depression that look to have been induced by life circumstances. But even when one perceives a situation like this as nearly hopeless. And they develop lasting feelings of worthlessness and become withdrawn, this doesn't have to happen. With the right brain function, one is more capable of being positive through experiences like his. They become less bothered by things in life and are just more able to see life from a better perspective. Because of this, they are more likely to make better decisions.
This is what can happen if a certain antidepressant we works well for someone. I've experienced this myself. Cyproheptadine (not exactly an antidepressant) brought me from not being able to leave my house because of severe feelings of inferiority and anxiety, to being able to go anywhere, anytime I wanted without putting a second thought into it. I also would notice what I thought of severe flaws in my appearance that made me feel terribly self-conscious. Cyproheptadine made those flaws unnoticeable to me. It became like they never existed. And basically I felt like my world became bigger and I became able to see the bigger picture thanks to cyproheptadine. I became less irritable and more positive about every aspect of life. Relationships became better as well. I could go on and on about how amazing this med was for me.
But first and foremost, I'd say Bartholemews situation became the way it did because of the perspective he viewed things from. Why did he view it the way be did? If not with any of today's treatments, maybe one day through medical advances, a treatment might come out that could turn a guy like Bartholomew into a more positive person that wouldn't consider such extreme actions like robbing a store for money, in hopes of being made happier by the money. Maybe even just seeing a therapist could have helped him to see life in a better way.
But then again, maybe if he had tried the wrong treatment, he might have ended up feeling even more negative and hopeless than he already did. He could have even been made unable to see any amount of money creating a bright future, and wouldn't even feel like robbing a store could make anything better, even if he had gotten away with it.
http://news.berkeley.edu/2014/02/11/chronic-stress-predisposes-brain-to-mental-illness/
Posted by SLS on October 6, 2015, at 0:53:21
In reply to Re: Shooters and Psychiatry » SLS, posted by Tomatheus on October 5, 2015, at 21:57:11
Sometimes, violent people try antidepressants in the hopes that they will relieve them of their inner pain and struggles. They don't. They are not truly depressed. When they are arrested for a violent crime, they report taking an antidepressant. What shall be the possible conclusions?
- Scott
Posted by SLS on October 6, 2015, at 9:35:32
In reply to Re: Shooters and Psychiatry » SLS, posted by hello321 on October 5, 2015, at 23:28:33
> > 1. Bartholomew was born without any genes that would predispose him to mental illness.
> >
> > 2. Bartholomew had a childhood predominated by physical and emotional abuse, neglect, and exposure to domestic violence.
> >
> > 3. Bartholomew grew up feeling inferior because his family didn't have as much money as his peers did. He was teased and bullied. He swore that he would one day have money.
> >
> > 4. Now out of high school, Bartholomew continued to feel poor and inferior. He couldn't find a job. College was out of the question.
> >
> > 5. Bartholomew's mother noticed that her son's behavior had become erratic and that he was often quiet and uncommunicative. He was ruminating in his anger and indignation. She thinks that his quietness is depression, and convinces him to go to the family doctor. She would accompany him.
> >
> > 6. The doctor of internal medicine hears the word "depression". This is enough to convinces the doctor to prescribe Lexapro.
> >
> > 7. After six months, nothing changes.
> >
> > 8. 18 years previously, a law abiding citizen bought a hand gun legally.
> >
> > 9. This law abiding citizen had his house robbed while he was out at the cinema watching a mediocre remake of "King Kong". The gun was stolen along with a box of Fruit Loops.
> >
> > 10. The gun eventually found its way into Bartholomew's hands. He now felt empowered. He could use it to get the money and respect that he never had growing up. Society owed it to him.
> >
> > 11. Bartholomew was still angry. He decided to rob a convenience store. On impulse and filled with anxiety, he burst through the door and ran up to the counter waving his gun around and screaming for everyone to get down on the floor. He just happened to notice a box of Fruit Loops on the shelf. He was not distracted, though.
> >
> > 12. Bartholomew demands that the clerk give him all the money in the cash register. When the clerk raised his hands in the air to show Bartholomew that he was unarmed, Bartholomew panicked and shot him. Several patrons got up off the floor and began to run for the door. Bartholomew shot them all.
> >
> > 13. Realizing what he had done, Bartholomew felt trapped. He would surely be executed - or worse. There was no way out except by suicide. Suicide was not an unfamiliar thought. He used the gun one more time.
> >
> > 14. The coroner determined that Bartholomew's body contained Lexapro and Fruit Loops.
> >
> > 15. Upon investigation, Bartholomew's mother and doctor corroborated this finding and described that Bartholomew was taking Lexapro for depression.
> >
> > 16. In the media and on official public records, Bartholomew was taking an antidepressant for a mental illness and committed mass murder.
> >
> > 17. Bartholomew was not mentally ill.
> >
> > 18. Strange, though. Bartholomew didn't even like Fruit Loops.
> >
> >
>
> Scott, I find this confusing.It really isn't so confusing if you take the story at face value. In this scenario, Bartholomew does not have a predisposition to mental illness as a reaction to psychosocial stress #1. He is, what scientists call, "resilient".
> There is no precise way to diagnose major depressive disorder.
They can get pretty close. What is your point? Bartholomew is not depressed. Nature has determined this. #1
> But it is mentioned in psychiatric literature and occasionally talked about on this board that chronic stress can result in one developing Major Depressive Disorder.
I talk about this a lot. It is not news.
> That looks to be what Bartholomew experienced.
Exactly. That's what it looks like, that's why a doctor prescribed for him the antidepressant, Lexapro. #5; #6 However, he is not depressed. #1 He is angry, ruminative, and withdrawn. #5
> Chronicle negative circumstances led to him developing lasting symptoms of what is recognized as clinical depression
No. Bartholemew is not depressed. #1
My question to you is: If you line up 100 people who are exposed to the same psychosocial stresses, how many will get depressed? The remainder will be resilient. Depression seems to be a product of an interaction between nature and nurture. What is the percentage of people who will get depressed from the environment Bartholomew found himself? Do you know? I don't. However, my guess is that fewer people will suffer a persistent psychobiologically driven case of MDD or BD depression than will remain resilient.
> True, many different situations can cause a person to rob and murder someone.
Yes.
> Am I missing something?
Yes. Please see above.
> True, this guy had what are described as symptoms of depression that look to have been induced by life circumstances.
What symptoms?
> But even when one perceives a situation like this as nearly hopeless. And they develop lasting feelings of worthlessness and become withdrawn, this doesn't have to happen. With the right brain function, one is more capable of being positive through experiences like his. They become less bothered by things in life and are just more able to see life from a better perspective. Because of this, they are more likely to make better decisions.
We are in agreement here.
> This is what can happen if a certain antidepressant we works well for someone.
For Bartholomew, antidepressants did not change his situation because he is not depressed. #7 What should have happened is that the family doctor should have made a follow up appointment during the first few weeks, and then monthly for awhile. After 6 months, the doctor should have sent Bartholomew to a psychiatrist. A psychiatrist would assess his psyche along with screening for major mental illness. A good psyshiatrist would have seen the need for psychotherapy. Psychotherapy would have had a more positive effect than antidepressants.
> I've experienced this myself. Cyproheptadine (not exactly an antidepressant) brought me from not being able to leave my house because of severe feelings of inferiority and anxiety, to being able to go anywhere, anytime I wanted without putting a second thought into it. I also would notice what I thought of severe flaws in my appearance that made me feel terribly self-conscious. Cyproheptadine made those flaws unnoticeable to me. It became like they never existed. And basically I felt like my world became bigger and I became able to see the bigger picture thanks to cyproheptadine. I became less irritable and more positive about every aspect of life. Relationships became better as well. I could go on and on about how amazing this med was for me.
I'll have to keep cyproheptadine in mind. Does it sedate you? How many times a day to you need to take it? How long did it take to work? I will be EXTREMELY pissed at myself if cyprohelptadine worked. On my last visit with Baron Shopsin, MD in 1986, he told me to try cyproheptadine. It was a weird idea, and I didn't follow up on it.
Did you try any of the following? How did you respond to them?
amitriptyine or nortriptyline
Remeron
atypical antipsychoticsLike cyproheptadine, these drugs all have the property of serotonin 5-HT2a antagonism.
- Scott
Posted by Tomatheus on October 6, 2015, at 15:09:00
In reply to Re: Shooters and Psychiatry, posted by SLS on October 6, 2015, at 0:53:21
> Sometimes, violent people try antidepressants in the hopes that they will relieve them of their inner pain and struggles. They don't. They are not truly depressed. When they are arrested for a violent crime, they report taking an antidepressant. What shall be the possible conclusions?
>Well, one could conclude that the antidepressant had something to do with the violent crime, or one could conclude that it had nothing to do with the violent crime. As far as whether a depressive illness might be involved, I think that I'd have to ask how the person ended up getting an antidepressant medication in his or her possession. If the medication was prescribed by a doctor who properly diagnosed the person with a depressive disorder, then I'd have to argue that the person was actually depressed (although you'd probably argue that the person wasn't properly diagnosed if he or she had violent tendencies without being what you'd call "truly depressed").
I don't doubt the idea that there are individuals out there taking antidepressants, even though the individuals don't have a depressive disorder or any of the conditions for which antidepressants are indicated. Perhaps there are some individuals with, say, antisocial personality disorder, who take antidepressants for their antisocial personality characteristics, even though they don't meet the criteria for any depressive disorder and are hence not "truly depressed." But as I was saying before, I think that all of the facts need to be examined when looking at whether a violent crime might be tied to a mental illness and/or the medications used to treat mental illnesses. Did the person have a history of violence? If a medication was involved, did others notice personality changes after the perpetrator started taking the medication? Even if a medication wasn't involved, did the perpetrator act in ways that were out of character in the days and weeks leading up to the incident? Was the perpetrator acting on delusions that the perpetrator might not have ordinarily accepted as true if he or she didn't have a mental illness? These are some of the first questions that I would ask if I were trying to evaluate the extent to which mental illness and/or psychiatric medications might have played a role in the carrying out of a violent crime. The answers to these questions might not always be straightforward, but I think that questions like these should be asked when looking at cases of violent crime where mental illness and/of psychiatric medications are thought to possibly be implicated.
Tomatheus
Posted by hello321 on October 6, 2015, at 16:53:01
In reply to Re: Shooters and Psychiatry, posted by SLS on October 6, 2015, at 9:35:32
> >
> > Scott, I find this confusing.
>
> It really isn't so confusing if you take the story at face value. In this scenario, Bartholomew does not have a predisposition to mental illness as a reaction to psychosocial stress #1. He is, what scientists call, "resilient".The guy grew up under very stressful circumstances. This is recognized to result in depression in some cases, particularly if someone isn't resilient to the stress. He became unable to deal with this stress in a healthy way and it had major effects on his thoughts and emotions. You see this because he grew up feeling inferior because of his situation and experiences. And he became withdrawn and began to behave erratically. You also see this because he eventually resorted to such a dangerous decision that could have obviously (and did) resulted in worsened circumstances. All of his reaction to the stress he experienced suggest he isn't all that resilient. I can only see someone like Bartholomew resorting to this either if they saw no way out of a terrible situation in life that they can't emotionally tolerate. Or if they just wanted/needed the money, recognized it could end badly, with death being a possibility, and figured death would still be better than continuing his life if he didn't succeed in his goal.... the guy is feeling so much emotional stress that he resorts to such an extreme decision. But I'm still expected to take at face value the idea of him being resilient to the kind of depression his life experiences could easily result in. He felt inferior to the people around him (sign of depression). Became withdrawn and began behaving erratically (more classic signs of depression) and basically ended up saying F it and resorted to a very dangerous decision that could result in his death. The guy might have been resilient to depression being induced by lesser circumstances. But what he went through made him a very depressrd pperson. To take idea that depression played no role in him attempting to rob a store would be unwise. It is like concluding the cause of death in someone who had their head cut off was when their body hit the ground after their head was removed. And then insisting this conclusion be taken at face value.
>> > That looks to be what Bartholomew experienced.
>
> Exactly. That's what it looks like, that's why a doctor prescribed for him the antidepressant, Lexapro. #5; #6 However, he is not depressed. #1 He is angry, ruminative, and withdrawn. #5
>
> > Chronic negative circumstances led to him developing lasting symptoms of what is recognized as clinical depression
>
> No. Bartholemew is not depressed. #1
>Scott, the guy experienced depressing events in his life and reacted in a way a depressed person would. But he's not depressed? He even took an antidepressant in hopes it would help... help what?
His social withdrawal, feelings of inferiority, and his rumination his thoughts of anger and indignation. The antidepressant was prescribed and he took it on his own free will in an attempt to help emotional problems causing significant distress in his life.> My question to you is: If you line up 100 people who are exposed to the same psychosocial stresses, how many will get depressed? The remainder will be resilient. Depression seems to be a product of an interaction between nature and nurture. What is the percentage of people who will get depressed from the environment Bartholomew found himself? Do you know? I don't. However, my guess is that fewer people will suffer a persistent psychobiologically driven case of MDD or BD depression than will remain resilient.
>
I don't know.>
> > Am I missing something?
>
> Y
> > True, this guy had what are described as symptoms>
>
> > But even when one perceives a situation like this as nearly hopeless. And they develop lasting feelings of worthlessness and become withdrawn, this doesn't have to happen. With the right brain function, one is more capable of being positive through experiences like his. They become less bothered by things in life and are just more able to see life from a better perspective. Because of this, they are more likely to make better decisions.
>
> We are in agreement here.But sadly, for what ever reason, Bartholomew Bartholomew developed a very unhealthy mindset and experienced many negative emotions that stayed with him. But it's not depression?
>
> > This is what can happen if a certain antidepressant works well for someone.
>
> For Bartholomew, antidepressants did not change his situation because he is not depressed. #7 What should have happened is that the family doctor should have made a follow up appointment during the first few weeks, and then monthly for awhile. After 6 months, the doctor should have sent Bartholomew to a psychiatrist. A psychiatrist would assess his psyche along with screening for major mental illness. A good psyshiatrist would have seen the need for psychotherapy. Psychotherapy would have had a more positive effect than antidepressants.Maybe so. But I will reiterate, one does not react to depressing experiences in such depressing ways that lead up to such an extreme decision unless they have been made depressed. If the suggesting that He simply was not depressed should wisely be taken at face value. Then any suggestion that any time someone commits a crime while taking an antidepressant, that the antidepressant played a causative role in the crime should be taken at face value. That would be just as wise.
> > I've experienced this myself. Cyproheptadine (not exactly an antidepressant) brought me from not being able to leave my house because of severe feelings of inferiority and anxiety, to being able to go anywhere, anytime I wanted without putting a second thought into it. I also would notice what I thought of severe flaws in my appearance that made me feel terribly self-conscious. Cyproheptadine made those flaws unnoticeable to me. It became like they never existed. And basically I felt like my world became bigger and I became able to see the bigger picture thanks to cyproheptadine. I became less irritable and more positive about every aspect of life. Relationships became better as well. I could go on and on about how amazing this med was for me.
>
> I'll have to keep cyproheptadine in mind. Does it sedate you? How many times a day to you need to take it? How long did it take to work? I will be EXTREMELY pissed at myself if cyprohelptadine worked. On my last visit with Baron Shopsin, MD in 1986, he told me to try cyproheptadine. It was a weird idea, and I didn't follow up on it.
>
> Did you try any of the following? How did you respond to them?
>
> amitriptyine or nortriptyline
> Remeron
> atypical antipsychotics
>
> Like cyproheptadine, these drugs all have the property of serotonin 5-HT2a antagonism.
>
>
> - ScottI took it twice a day. It began working on day 1 with a very modest effect that built up over time. My experience is complicated, though. I've mentioned it throughout the time I've used psychobabble. But I've been thinking it's inverse agonist at the 5ht2c receptor is how I mainly benefited from it.
Posted by hello321 on October 6, 2015, at 17:21:54
In reply to Re: Shooters and Psychiatry » SLS, posted by Tomatheus on October 6, 2015, at 15:09:00
Here are the numbers for violent crime committed each year since 1960. I only looked at recent years and compared the numbers with the percent of mentally ill people that are believed to be committing violent crimes. I did this last night and I believe, at least with the numbers for 2014, I even used the lowest percent of 3% given for the ratio of violent to non violent mentally ill people. The numbers I came up with are at home, and I'm not home at the moment. But I have a general memory of the numbers for 2014. If I remember correctly, there were about 59 million mentally ill people in America for 2014, if 3% of them committed 1 violent crime in that year, that added up to over 2 million crimes. Then if only 3% of the population not deemed to be mentally ill committed 1 crime that year, that added up to a number that, when added to the amount of crimes committed by the mentally ill, then these numbers added together would have resulted in more crimes than are listed in the statistics. I can't remember how many more exactly, but it was significant.
But basically, it shows there is no way a mentally ill person is 1/3, or even any less likely to commit a violent crime. If the lowest number given, 3% of mentally ill people committed a crime, the numbers showed they are still more likely to commit a violent crime than a non mentally ill person to commit a violent crime.
Posted by Tomatheus on October 6, 2015, at 18:14:54
In reply to Re: Shooters and Psychiatry » Tomatheus, posted by hello321 on October 6, 2015, at 17:21:54
Well, perhaps Dr. Grohol was incorrect in what he said about people with mental illness being less likely to be perpetrators of violence. As I've said, I do think that mental illness can sometimes play a role in the carrying out of violent acts, and a quote in Dr. Grohol's blog entry seemed to state essentially the same thing. However, the quote also pointed out that there are other factors (some of which the media and policymakers have placed little emphasis on) that are much more likely to contribute to violent behaviors than mental illness. Here's the quote (from a Vox.com interview): "[W]hile mental illness can be a contributor to some violent behaviors, other factors - such as substance abuse, poverty, history of violence, and access to guns - are much stronger predictors of violence and shootings."
Tomatheus
Posted by hello321 on October 6, 2015, at 19:48:07
In reply to Re: Shooters and Psychiatry » hello321, posted by Tomatheus on October 6, 2015, at 18:14:54
Oops, I meant to post this webpage link in my last post:http://www.disastercenter.com/crime/uscrime.htm
I posted it earlier in this thread, but figured I'd post it again.
Also, considering that guys quote, it is a vicious cycle between substance abuse and poverty and mental illness. Those 2 factors can increase the likelihood of someone developing a mental illness. And mental illness can also increase the chances someone will live in poverty or develop a problem with substance abuse. With a result of these situations being that these people have a higher chance of being involved in violent crime.
But I believe even the wealthy are regularly committing crimes. though with their crimes more likely falling into the category of crimes against humanity. An example being when a drug company covers up information about severe adverse effects their products can have on those who take their product. Or an auto company ignoring/hiding defects in their vehicles that result in the injury or death of many. But often they simply pay a fine when they are found out, and just go on about their business. Yet the amount of harm their actions/inaction often cause end up making any mass shooting look like a tiny speck in the statistics.
Posted by baseball55 on October 6, 2015, at 20:41:47
In reply to Re: Shooters and Psychiatry » Tomatheus, posted by hello321 on October 6, 2015, at 19:48:07
Studies show consistently that people with power or high status, even when that power or high status are given arbitrarily in psych experiments (think the Stanford Prison Experiment), are less compassionate and significantly less generous. Some studies find that people with power and wealth exhibit the characteristics of anti-socal personality disorder. The sociopathic nature of economic crimes is enabled by the cutthroat corporate culture where profits are valued above all and the tendency of high-level executives to "just follow orders" and take no individual responsibility for the human consequences of their actions.
I agree that corporate crime (or sometimes it's not crime, because corporations lobby Congress to not deem things "crimes") probably cause more death and misery than gun violence. In the US, we don't think of corporations as outright killing people, but those same corporations in developing countries will hire security forces to kill union organizers and community organizers who oppose the social and environmental impacts of mining or drilling.
As Marx wrote, capitalism entered this world drenched in blood.
> But I believe even the wealthy are regularly committing crimes. though with their crimes more likely falling into the category of crimes against humanity. An example being when a drug company covers up information about severe adverse effects their products can have on those who take their product. Or an auto company ignoring/hiding defects in their vehicles that result in the injury or death of many. But often they simply pay a fine when they are found out, and just go on about their business. Yet the amount of harm their actions/inaction often cause end up making any mass shooting look like a tiny speck in the statistics.
>
Posted by alexandra_k on October 6, 2015, at 20:50:50
In reply to Re: Shooters and Psychiatry, posted by baseball55 on October 6, 2015, at 20:41:47
> Studies show consistently that people with power or high status, even when that power or high status are given arbitrarily in psych experiments (think the Stanford Prison Experiment), are less compassionate and significantly less generous. Some studies find that people with power and wealth exhibit the characteristics of anti-socal personality disorder. The sociopathic nature of economic crimes is enabled by the cutthroat corporate culture where profits are valued above all and the tendency of high-level executives to "just follow orders" and take no individual responsibility for the human consequences of their actions.
With those studies... I do understand that 'most' people abused their power. But some of them didn't. Some of the Milgram experiment people didn't just follow orders, either.
I don't understand why we don't all actively promote those people (aka the good people) as leaders. Instead of promoting those who we think will further our interests (who will only turn on us when their interests come apart from our own).
Posted by baseball55 on October 6, 2015, at 21:04:14
In reply to Re: Shooters and Psychiatry » Tomatheus, posted by hello321 on October 6, 2015, at 19:48:07
To me, the point of Scott's story is that mental illness is incredibly complex. Psychiatrist Glen Gabbard, in his textbooks for psychiatric residents, writes that mental illness is a bio-psycho-social problem. The experience of mental illness, despite people meeting certain DSM criteria, is highly individual. When people suffer symptoms of depression or anxiety or psychosis, there are broad similarities, but the content of their ruminations and delusions is strongly affected by their psychological and social experiences.
Using myself as an example, I grew up in an abused and neglected. I was resilient and achieved a lot. In my 40s, I became depressed, but a lot of my depression was driven by the circumscribed nature of the life I had created to overcome despair about my youth. I believe there is a strong biological COMPONENT to my depression, but that the biology doesn't explain the intensity of the SI I experience when depressed. Many people are very depressed or anxious and never have overpowering SI. I, on the other had, have been hospitalized 10 times, following two suicide attempts and voluntarily committing myself to be safe from suicide. I believe the SI comes from a weak grip on life due to my history and from a tendency, due to my history to fall into despair that I will never be cared for.
I got help. But most people whose ruminations are about violence toward others do not get help. They may go to a doctor about getting on a drug to deal with their out-of-control feelings, but they don't do therapy and commit to trying to change. Instead, they ruminate on violent acts. I doubt this has much to do with meds and more to do with their psycho-social history which determines the nature of their ruminations.
This complexity and individuality is why I again recommend Patrick Gilligan's book, Violence. The case studies draw a complex picture of violent men (all the subjects are men, as are all the "shooters" and most perpetrators of violent crime).
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