Mental Health and Incarceration by TheHappyTrader

Even if they're given the meds, they're much less likely to take them.

My reaction to getting out of the loony bin was to stop taking the zombie making drugs. That was a big mistake. I didn't understand that the drugs had permanently altered my brain chemistry, and that the result of not taking them was going to be radically worse than the condition I was sent in there for in the first place.

They need to go into a detox, and it should be set up by someone independent. One way is just to go straight to their mental health clinic. Their pretty good about getting people into detox. I can't really picture a chemical state that creates a criminal. I've basically been in every chemical state their is as a result of being a guinea pig, and I can't say that I ever had any criminal impulses. Nor did I even feel inclined to do violence. These things aren't chemical. They can be exaggerated by chemicals, but I'm beginning to understand that this stuff is psychology, a field I really know nothing about, and am just starting to learn. I used to not believe in psychology because I read so many bogus theories on it, but listening to Frem and CTS, as well as the stuff I've read on mental illness, I am really grasping what a profound influence psych has.

The ex-con can also get therapy at the mental health clinic. Ultimately, they're no longer a prisoner, they don't have to take the meds, but the withdrawal is going to be a nightmare.

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Sunday, February 6, 2011 8:34 PM

Beir bua agus beannacht

This is a huge problem. Often times, crime committed or not, the hospital will send you out with very little medicine and you're kind of on your own to find a prescriber etc. Some hospital social workers are better than others, they'll help you set things up so there's a plan for after the hospital etc.

But yeah, sometimes what you are saying does happen. In OR, we have a program called PSRB (I don't know what it stands for, sorry). If a person commits a crime and it is determined that the person has a mental illness the presence of which contributed to the situation, they go into PSRB instead of the regular prison system. This can include anything from state hospital to specific group home placement etc. while treatment is administered, depending on the crime and many other factors a person's participation in the program can last a little while or a long time. At some point though, unless the crime was really bad like murder etc. the person's time is finished and they're free to leave. Oh, and usually they are in unsupervised apartment housing, or with minimal staff interaction, before they are let go. That's how it works in my state. I know several people who are under the PSRB, I don't know any of their crimes, I don't think its my business to ask and they're all stable and regular right now, symptoms under good control, seem ordinary etc.

"A completely coherant River means writers don't deliver" KatTaya

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Sunday, February 6, 2011 9:10 PM

Psychiatric Security Review Board (I used the google)

Anyway, yes, when I got out of the looney bin, they took my meds from me, confiscated them, I went into shock withdrawal, and I was on a fatal dose. They don't tell you about fatal withdrawal, but it happens, and you can get up to a level where withdrawal is fatal.

Fortunately, there's witchcraft.

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Sunday, February 6, 2011 9:29 PM

Beir bua agus beannacht

WOW, I totally spaced that one, I've been told that before, I feel stupid, oh well.

I should mention here that people with mental health differences are far more likely to be victims of violent crimes than they are to commit them.

If one is going to stop taking a medicine it needs to be done slowly with apropriate pacing etc. doing it cold turkey can be really dangerous.

"A completely coherant River means writers don't deliver" KatTaya

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Monday, February 7, 2011 2:56 AM

Quote:
Originally posted by RionaEire:
WOW, I totally spaced that one, I've been told that before, I feel stupid, oh well.

Riona a chara,

Don't worry, hey, it beats posting some argument that happens to be wrong that anyone could have checked on wikipedia or something (we've all undoubtedly done that at some point)

Quote:
I should mention here that people with mental health differences are far more likely to be victims of violent crimes than they are to commit them.

Even if they weren't, it doesn't logically follow. I mean, people could say any particular ethnic or socioeconomic group is more likely to commit crimes and should therefore be drugged.

Quote:
If one is going to stop taking a medicine it needs to be done slowly with apropriate pacing etc. doing it cold turkey can be really dangerous.

Yes, no kidding. I wish I had known some of the tricks I know now, such as that ginseng can greatly reduce withdrawal stress. It inhibits cortisol, so it's much more potent towards this than some of the other treatments. What you definitely don't want is a transference (something like methadone, where you're no longer addicted to morphine or whatever, and you're addicted to the methadone you took to help quit the addiction.)

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Monday, February 7, 2011 6:30 AM

SIGNYM

I believe in solving problems, not sharing them.

As you may have noticed, DT is anti-drug. Any drug. Far better that a person be mentally tortured and commit suicide, like van Gogh.

One of the major complaints that schizophrenics have about their meds is that it makes them stop feeling anything. I wonder if this can be modulated by adjusting the dose? Similar problem with bipolars- they really miss the high which makes them feel imnipotent. Depressives have more motivation to take meds, bc the meds in many cases help ppl feel better, and so are more immediately rewarding.

I see a lot of homeless; they are often alcoholics or mentally ill. I know there is a big push for freedom, but most of us would feel more compassion if we saw a dog in similar situation.

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Monday, February 7, 2011 6:48 AM

CANTTAKESKY

Quote:
Originally posted by SignyM:
As you may have noticed, DT is anti-drug. Any drug.

This is not true. DT and I argue privately about certain drugs--he argues in favor, and I against. So clearly, he is in favor of drugs he believes are correct for the problem. In mental illness, a field in which he has personal experience, he happens to be against many of the drugs used.

Let's not exaggerate to the point of making false statements, shall we?

Wouldn't it be nicer to simply ask him, "DT, are you against all psychotropic medication in all circumstances? BTW, are you against all drugs? In which circumstances would you be in favor of drug use?" (Yanno, instead of making false assumptions and accusations.)

-------
Everything I say is just my opinion, not fact.

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Monday, February 7, 2011 8:00 AM

Thank you CTS

The issue is that much of psychopharmacology is guess work and experimentation. It doesn't fit my definition of science. Some drugs have well understood mechanisms of action, and the designers and researchers have been able to get from point a to point b. Other drugs have unknown MoAs and some even just kill braincells.

The way much of pharmacology works is based off of economics rather than science. To wit:

The most valuable commodity int he medical world is a synthetic novel compound. If it's natural, it cant be patented, if it's not novel, then it can't demand exclusivity. If it's new, exclusive and patented, its pretty much name your price. Ergo, a novel synthetic is a goldmine.

So, the next problem is if you *do* devise a novel synthetic, theres very little chance that it will be bioactive in any meaningful way, and even if it is, it may not be bioavailable, which means that you'll only be able to administer it by injection which isn't going to carry you very far in the world of psychiatry. Worse yet, even if it's bioavailabe and bioactive, chances are that it won't have any positive effect.

This led to what I call the random rat game, which isn't as common as it used to be, but still happens. It goes like this: take your novel synthetic, and administer it to a wide variety of rats with various problems. If any rats improve, take a second group of rats with that problem and do a double blind study.

This is a terrible way to do medicine because it misses all sorts of things, such as mechanism of action and what negative effects might be have on other rats.

Newer research tends to come from the biotech industry, and tries to specifically analyze the problem, and devise a solution. This is much better, but still has a problem: just because it *can* bind to a receptor or act as a metabolizing enzyme, of metabolized into something, doesn't mean it *does* ... Not to mention that it might bind to something else, metabolize into something else, and in fact, this is often the case that it *does* do just that. Buspirone for example metabolizes into an anti-psychotic damine inhibitor. If you are not psychotic, these can cause psychosis, zombie-like state or even catatonia. If you walk in with depression or OCD and walk out with one of these other conditions, your doctor has not done you a favor.

When the science is well done, the question becomes "do the benefits exceed the risks?"

In one case I argued here, Gardasil, I would say yes, but it took a lot of research to get to that point. Gardasil is a synthetic HPV-16 vaccine made by Merck (yeah, I know you know this) and I know a guy who runs a rival company with a rival drug. Because of this, I know a lot about the disease. HPV-16 (not "HPV" which is an MoA for a virus, not a virus itself, most HPVs are very common, but not deadly. HPV 16 and 18 are deadly) Its generally accepted to be implimented in cervical cancer, but actually we think it's implemented in epithelial cancer in general, and may cause as many as a million deaths a year. The risks associated with giving this to a non-infected individual are minimal. The risks among the infected are significant, so they should test first.

But when we go into psychopharmacology, I'd have to raise the bar a little. We are usually dealing with anywhere from bad science to non-science, or pseudo-science, and almost always not dealing with a life threatening situations. My most obvious exception would be seizure conditions. Seizures are deadly, and while many of the seizure drugs out there are also deadly, you may need to use the minimum measure. That means, for some cases, a gab a agonist will do the trick, for others, you might need to move to the adrenal inhibitor, which is a dangerous, but sometimes lifesaving step.

As for depression, there are plenty of very effective non medicinal solutions using diet, probiotics and supplements. Also, it's a fallacy to cite suicide as a risk, because we all know that statistically the risk of suicide among diagnosed depression is twice as high among those *taking* anti-depressants as not taking them. Sure, those not taking them might lack motivation, and may even commit suicide, but thats not a risk that you're *reducing* with the introduction of SSRIs, SNRIs or tricyclics.

And, not all of my judgments are raw and intuitive, this is a field I'm very familiar with. When I say something like "this is a matter where you're better off with witchcraft," I mean herbal MoAs for neurochemical agents are often far better understood, and usually far more appropriate to the problem. This is no accident. Most problems come from dietary or genetic deficiencies, which means that they can in some way be supplemented with an herbal, a food, or some bacteria which synthesizes that *natural* compound, but that it is by *definition* a natural compound which is missing in any flawed or unbalanced system, so going to a novel synthetic is a radical step. Not one I always oppose, but not likely to be my first choice for non-life-threatening conditions. (even to this I make exceptions, but they are based on hard science.)

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Monday, February 7, 2011 8:51 AM

THEHAPPYTRADER

I've also heard that the general lack of personal interaction with other people (as in face to face) has lead to a rise in cases of depression and the like. I'm wary of over diagnoses and I hate taking medicine of any kind myself (I usually try and just tough it out) but I would never make that decision for someone else.

The prison scenario applies mostly to schizophrenics and you're right that in addition to the money/insurance issue there is of course the possibility that they just won't take their meds if they had them. I know they're criminals and all and shouldn't get preferential treatment over those who did not break the law, but it just seems wrong that they're just on their own, no real way to get insurance and meds, and often wind up right back in jail.

Concerning psychiatric meds, I don't see them as evil as a whole, but more like some of the other topics like gun rights which are occasionally abused. The g/f used to take anxiety meds after a car accident in high school, but stopped about 2 years ago. She pretty much just quit cold turkey and has been fine until recently, when she is now stressed over the GRE and a health issue that could turn out to be next to nothing (very likely) or could possibly (but very unlikely) be the beginning of something really bad, like cancer bad. The other day she spoke of possibly getting back on the anxiety meds, but I don't really understand why. She's been happy and functional for 2 years off the meds and I'd think it's normal to be a mite stressed considering what's going on right now and those meds seem like a risky solution to a temporary problem.

Of course, I am not a psychiatrist and have never suffered from any mental issues I am aware of. I told her my opinion and she says she'd have to talk to some professional before being able to get meds anyway, and I can only hope that professional will honestly prescribe what's best for my girlfriend and not what's best for his/her bank account. I realize the info I've offered is no where near enough for a proper diagnoses, but I'm also curious as to what fellow RWEDers might think of that? This is a mite personal so I would prefer if we can keep insults to a minimal (but make so mistake, I want you to tell me I am wrong if you really believe that).

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Monday, February 7, 2011 9:30 AM

Happy, if you mean making eye contact, or not doing so, that can also be a symptom, if you mean hiding in your house, that can too, but definitely a non-active lifestyle and too much time on the computer, etc. Will lead to a marked increase in cortisol, which can cause depression as a side effect, it also causes anxiety, and of course, stress.

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Monday, February 7, 2011 10:48 AM

Gettin' old, but still a hippie at heart...

Coming back after a few days gone, as I said, so excuse if I’m redundant.

Yes, Byte, everything you said is valid. They did a Law & Order episode on this, and on several other issues around mental illness, which I thought were excellent. In this one, it was just as you said; the guy was kicked out of a halfway house with few meds and no follow-up, and the inability to continue his meds. It can be disasterous; not so much because of criminality, but because most of these people end up on the streets in terrible shape, with no help.

For someone with a mental illness, especially if they’re in an “episode”, to remember to go to a clinic, or even know there is one or how to get to it, is pretty difficult. Most people are given NO resources when they’re let out of a psych ward—it may be different for criminals, in fact I’m sure it is, but it’s a problem.

And yes, DT, withdrawal can be hell. We’re reminded over and over that, if we want to change meds or stop them, we HAVE to “titrate” down carefully. Even if we want to increase the dosage, titration is vital. These are heavy-duty medications, and the ways they alter our brain chemistry can be dramatic; to just stop them can lead to all kinds of problems, including death. I’m sorry you had such a bad experience; it seems kind of a toss-up whether psychiatry helps or hurts people these days.

As to withdrawal from psychiatric pharmaceuticals, however, I’m surprised you weren’t warned. The warning is BIG these days, and is emphasized strongly by many p-docs...maybe not all, unfortunately. But you’ll notice in the ads these days for mental-illness medication (may they rot in hell and those who produced them!) always say if you’re going off, consult your doctor.

Dunno if anyone’s mentioned this, but psychiatric meds are able to pass the “blood-brain barrier”, which almost all other medications cannot. Ergo, they can affect our brains much more than other medications. When you mess with the brain pharmacologically, the results can be horrific. It’s also why we suffer more side effects from our meds than people do from other medications. The potential for harm is enormous.

As to mental states creating criminals, oh, yes, it definitely can. FAR less than society believes, mostly because when they DO, it makes the news, and when someone does something really crazy, people LOOK for a mental-illness component. But I’ve known people who acted criminally out of manic episodes, I guarantee it happens. In a couple of the cases, these people are undiagnosed and had no idea they were in an episode. One “played slalom” across the Golden Gate Bridge, then did wheelies on the grass at Crissy Field. Another tried to take a tire iron to a pharmacist because he wouldn’t give her drugs to commit suicide. I’ve mentioned those before, because they are the most dramatic incidents I know, but yes, mania can produce criminal behavior.

Oh, Rion, I’m so glad to hear about that program. It’s something we’ve needed in this country for far too long. I don’t know if anyone else has quoted the figures here; if so, pardon my duplication. This frm 2000:

Quote:
In February the United States reached a benchmark of 2 million individuals in its prisons and jails. The US incarcerates the greatest number of people of any country in the world, and has become a worldwide example of prison abuse, especially in the use of the death penalty. In state after state growing numbers of juveniles are being tried and sentenced as adults.

The US Department of Justice has estimated that 283,800 mentally ill offenders were held in state and federal prisons and local jails at mid-year 1998. Additionally 547,800 mentally ill persons were on probation. Seven percent of federal inmates and 16 percent of those in state prisons or local jails or on probation said they either had a mental condition or stayed overnight in a mental hospital, unit or treatment program.

Rion, you’re absolutely right on that
Quote:
people with mental health differences are far more likely to be victims of violent crimes than they are to commit them
unfortunately. DT learned the hard way, but he was smart about it; far too many people get trouble because of ignorance, still. One of the laughs I get is the quit-smoking commercials. They list as “possible side effects” of the medication might be depression, agitation, anger, and suicidal impulses. I laugh because those are symptoms of QUITTING SMOKING, with meds or not! I know, legal disclaimer, but it’s still funny as hell. Whether you take a med or not, one or another (or more) of those are things MOST people experience when quitting...duh!

A Michigan Community Health Department survey indicates the number of mentally ill suffering in prison may be even higher than the Justice Department figures.

More at http://www.wsws.org/articles/2000/mar2000/pris-m06.shtml

You can only imagine what the numbers are by NOW. This is a long-standing problem and is only getting worse due to budget cuts and the economic crisis in this country. Something desperately needs to be done, and there are a few programs out there, but not nearly enough.

This from 2004:

Quote:
Outgoing APA President Marcia Goin, M.D., says she was motivated to work on the subject of mental illness in jails and prisons by personal visits to the Los Angeles County Jail, the largest psychiatric hospital in the country. There she witnessed firsthand the suffering of patients in what has come to be regarded as the largest psychiatric hospital in the country.

She outlined how the problem of mental illness in jails and prisons has historical roots that go back to deinstitutionalization, exacerbated today by severe budget cuts at the state and local levels.
“Following deinstitutionalization, the number of state hospital beds decreased from 339 per 100,000 population to fewer than 20,” Goin said.” Meanwhile, the number of mentally ill persons in jail has increased geometrically. Untreated and without access to long-term care, many mentally ill patients ended up with symptoms and behavior that led to their incarceration.”
Today, Goin said, hospital closures, reduced services in outpatient clinics, and crowded emergency rooms have contributed to the erosion of resources available for public psychiatry and the care of people with severe mental illness.
“Too often the body politic has been willing to abdicate responsibility for the health consequences of impoverishment and violence,” she said. Goin said the group modeled its work on the APA Business Initiative, focusing its efforts on the fiscal implications of the problem. The report, for instance, cites data showing cost savings associated with treatment versus confinement.

More at http://www.wsws.org/articles/2000/mar2000/pris-m06.shtml

Sig, yes and no:

Quote:
One of the major complaints that schizophrenics have about their meds is that it makes them stop feeling anything. I wonder if this can be modulated by adjusting the dose? Similar problem with bipolars- they really miss the high which makes them feel imnipotent. Depressives have more motivation to take meds, bc the meds in many cases help ppl feel better, and so are more immediately rewarding.

The “zombie effect” is shared by bipolars and unipolars (depressives) as much as it is by schizs. That old blood-brain barrier means that any psychiatric pharmaceuticals we take can make zombies out of us.

And yes, both dosage and medication can be modulated to make a vast difference. All psychiatric drugs affect each person differently. One of the jokes in the psychiatric community is that trying to find the right meds for bipolars, given how swiftly our moods change, is “like trying to hit a moving target”! It’s true, which is why those of us who are proactive learn to “jiggle our cocktail”...we have a “cocktail” of two or more medications because we need antidepressants to fight the down side, but mood stabilizers to keep it from going too high. A GOOD p-doc will work with us to learn how to jiggle the two to achieve the best result (LISTENING to us and working WITH us, that is). I learned to jiggle mine years ago, and it’s worked great.

The other problem is the WRONG meds. Given each affects each person differently, some meds do nothing for one person, work perfectly for another; the same differences can exist in side effects, efficacy and QUALITY OF LIFESTYLE. That’s why we tell everyone that if your med doesn’t do what you want, insist your p-doc try another, and another and another...titrating off one and on another CAREFULLY. It can be a long process, sometimes take years, and there can be two negative results. Some people can find NOTHING that works for them, or others, like my friend Choey, have such sensitive systems that there’s virtually no med they CAN take. Mental illness is incredibly complicated, and as far as I’m concerned, psychology HAS to accompany it to do any real, long-term good.

So what you said about van Gogh is right on, tho’ you missed it by saying “omnipotence” alone. One of the main aspects of bipolarity is creativity; many, like van Gogh, would rather struggle with their disorder than be zombined into losing their creativity. It’s what keeps them alive and able to endure the bipolar episodes, despite that it allows the disorder to ruin their lives. I don’t know of too many who don’t want the meds because they lose the sense of “omnipotence”, tho’ with some that’s no doubt the case. Most of us don’t realize we’re manic when we feel that omnipotence, it comes on and when one is in that state, just as schizophrenics don’t realize what’s around them is unreal, we don’t think there’s anything wrong; when medications work, we look back and say “omigawd!”, but the next time it comes on, it’s just the same.

I got a real inside look at Bipolar I when Jo lived with us. When mania hit, she would have these grandiose schemes, which would disappear when she came out of the episode. She got to the point where a few times she’d ask me “does that sound feasible?” and I could tell her it sounded like mania...but even then, sometimes she wouldn’t believe me. Like I said, we had people come to the support group I ran who thought they were God or Jesus, or had allthe answers to the world’s problems. And I have a good friend in England who is in extra danger of a manic episode in Spring (not unusual for us). One Spring she was COMPLETELY convinced she was an angel and could help people...once the episode passed, she was terribly embarrassed, and after a couple of episodes, she began to anticipate the problem and be extra careful in Spring. I’m SO lucky I’m bipolar II, as we can’t go manic, but I’ve felt hypomania, and trust me, at the time it feels perfectly all right.

You're DEFINITELY right about the homeless who suffer from mental illness; it totally sickens me how people can close their eyes and walk by, when if they saw a dog limping or looking skinny and lost, they'd pick it up and find help for it.

Hippie Operative Nikovich Nikita Nicovna Talibani,
Contracted Agent of Veritas Oilspillus, code name “Nike”,
signing off

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Monday, February 7, 2011 11:40 AM

HERO

Quote:
Originally posted by TheHappyTrader:
...she mentioned criminals with mental illness who get the medication and therapy they need get released back into the free world with only 2 weeks worth of medicine.

In my experiance with these folks they are released with 2 weeks more or less and have follow up through the County Mental Health services. The problem is they do not follow up or they are inconsistant.

H

"Hero. I have come to respect you." "I am forced to agree with Hero here."- Chrisisall, 2009.
"I would rather not ignore your contributions." Niki2, 2010.

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Monday, February 7, 2011 11:42 AM

Gettin' old, but still a hippie at heart...

That got long, so I’ll continue here. I can't help it; mental illness is "home territory" for me, so if we get into it, I can't shut up.

DT, absolutely right on

Quote:
The issue is that much of psychopharmacology is guess work and experimentation. It doesn't fit my definition of science. Some drugs have well understood mechanisms of action, and the designers and researchers have been able to get from point a to point b. Other drugs have unknown MoAs and some even just kill braincells.

But even the “well understood” mechanisms differ with different people. I’ve watched it. I’ve seen the people I know have to go through drug after drug, with everything from no response to horrible side effects, and more. When they hit the right one FOR THEM, the transformation can be amazing, and it’s always so great to see. But even then, for bipolars, as I said, the most efficacious way for us is to learn to titrate our meds according to our mood, to “jiggle the cocktail”.

Did you know our first medications originated as treatment for other things? The term Bipolar Medications is somewhat of a misnomer. That is because most of the popular bipolar meds in use today were originally developed and prescribed for other mental illnesses - not for bipolar disorder.

For example, the first medication found effective for bipolarity was lithium—still a standard for many, tho’ the long-term effects on the body can be terrible. It was originally used for gout (don’t ask me why!), waaaay back in history, and then for epilepsy. In essence, medications for bipolarity in the early days were “found” by accident to be effective in treatment of bipolar disorder, but since nobody knew what CAUSED bipolarity, it was categorized as such partly because of how the meds affected the disorder! By the way, one of the components of 7-Up was originally lithium, like cocaine for Coca-Cola!

That lithium was effective for bipolarity was a clue to the origins of bipolarity, so in a way the medication led to the understanding that the disorder as caused by the brain, like epilepsy is. Nowadays, they’re closer to finding out the causes of mental disorders and are targeting drugs specifically for them, but in many ways we have luck to thank for finding out lithium was helpful.

Also, damned straight that

Quote:
Ergo, a novel synthetic is a goldmine

I’m not going to get started on THAT one. The other side of it is, however, that although the meds affect everyone differently, some of the synthetics DO work and are safer for the body than the old guys like lithium, depakote and the (shudder) MAOIs! The closer they get to targeting, the more effective the medications are, although certainly NO medication is perfect and in some cases people are medicated who should not be. And the debate still rages as to whether ANY of the psychiatric drugs work or not.

And yes, yes, yes:

Quote:
If you are not psychotic, these can cause psychosis, zombie-like state or even catatonia. If you walk in with depression or OCD and walk out with one of these other conditions, your doctor has not done you a favor.

Same is true of bipolarity, in that misdiagnosed as depression, SO many have been given antidepressants which spiked them into latent bipolarity, or CAUSED “medically-induced bipolarity”, which means once they’ve been spiked into a manic episode, they BECOME bipolar. I’m not sure they’ll ever understand it all completely.

As to Buspar itself, most the people I know never got any good from it. For those who DID, it’s a wonderful alternative to the benzos, which are highly addictive (valium, ativan, for example). Nowadays they use buspar mostly for anxiety disorder, but that’s a disorder which in my mind could be better treated with psychology than pharmaceuticals, and is sometimes a component of bipolarity, for which there are better meds.

On the other hand,

Quote:
because we all know that statistically the risk of suicide among diagnosed depression is twice as high among those *taking* anti-depressants as not taking them.

I don’t think “we all know” at all; for one thing, bipolars have one of the highest rates of suicide of anyone, and do so FAR more often when manic than when depressed, so how many people who were actually bipolar were given antidepressants only and ended up in a manic state? Also,

Quote:
Overall incidence of suicide attempt was highest among patients receiving antidepressant prescriptions from psychiatrists (1,124 per 100,000), lower among those starting psychotherapy (778 per 100,000), and lowest among those receiving antidepressant prescriptions in primary care (301 per 100,000). The pattern of attempts over time was the same in all three groups: highest in the month before starting treatment, next highest in the month after starting treatment, and declining thereafter. Results were unchanged after eliminating patients receiving overlapping treatment with medication and psychotherapy. Overall incidence of suicide attempt was higher in adolescents and young adults, but the time pattern was the same across all three treatments.

http://ajp.psychiatryonline.org/cgi/content/abstract/164/7/1029

For one thing, primary doctors who prescribe psychiatric medications for perceived depression usually prescribe lower-intensity meds (like Zoloft), whereas psychiatrists think they know it all and are more likely to start one on the stronger meds like Effexor—which can be a killer for a bipolar without a mood stabilizer! All in all, tho’ I would say depression has a much higher chance of recovery from therapy than medication.

No two people agree wholeheartedly about mood-disorder medications, and while I recognize you are well-versed on the topic, I’m pretty well versed myself, as much from experience, observation, and a lot of experience with others with mood disorders and how things have affected THEM. While I agree wholeheartedly that

Quote:
it is by *definition* a natural compound which is missing in any flawed or unbalanced system, so going to a novel synthetic is a radical step

I think an awful lot of people are programmed to “take a pill”, and less willing to change diet or attempt herbal medications, so a “pill” would be more accepted. What we try to do is encourage people TO try other things, to self-educate as MUCH as they can, to learn coping strategies and symptom-management skills, rather than depending just on medication. A lot find that if they do all these things, they don’t need medication, or can utilize it in smaller dosages...and these days, some medications which are derived from synthetics can be less damaging to the body, if the right one can be found.

Just my thoughts on medication.

Trader, bang on

Quote:
I've also heard that the general lack of personal interaction with other people (as in face to face) has lead to a rise in cases of depression and the like. I'm wary of over diagnoses and I hate taking medicine of any kind myself (I usually try and just tough it out) but I would never make that decision for someone else.

I never took ANY medication regularly in my life until I was diagnosed bipolar. First I was diagnosed with a thyroid problem (which is very, very common among bipolars) and on meds for that; later the bipolarity was recognized, and I’ve been happy enough with my “cocktail” not to try to go off it. I have few side effects (lamictal affected my balance, but I found a lower dose quite workable), so I’m not comparable to those who had severe ones. What has turned out to be the MOST effective, by the way, is people who have a “team” comprised of their doctor, psychiatrist, therapist AND family members...I read a study years ago from a university which had amazing results...unfortunately it wasn’t more widely used, dammit.

The problem with lack of interaction is that unipolars don’t WANT to be around others, and many of us bipolars don’t either, even when not in a depressive episode. So while it can DEFINITELY be helpful, it’s hard to make ourselves “get out there”, and when depressed, triple harder. Believe me, when I had my first (and thank gawd only) major depressive crash, you couldn’t get me out of BED, much less be around other people. Admittedly it was when I forced (and I mean absolutely FORCED) myself to join a support group that things got better, but I had to wait for them to get a bit better before I COULD. Mostly I ride it out these days too...I haven’t had hypomania for years, and I admit I miss the hell out of it, but I can spot a depressive disorder and I may jiggle my cocktail some (tho’ I can’t jiggle much, since I’m on a low dose of lamictal; if I up the effexor much, I get DYSphoria, which few realize is just as common as Euphoria).

As to your girlfriend, I understand how she feels. And yes, what we call “situational anxiety” is perfectly normal for anyone. But I know when Choey has severe anxiety (which is the main component of her bipolarity, now that she understands the disorder and is great at controlling it), she takes her anxiety meds. As long as one titrates correctly and doesn’t depend on them, in other words gets off them as your girlfriend did, they can be very efficacious. I think you’re absolutely right about her consulting a professional, but there are as many bad p-docs out there as good; if she has a med that worked well for her before, I’d go back to my PRIMARY PHYSICIAN for an rx, and then seek therapy. I’ve worked with my primary for many years; she trusts me to know what works for me and prescribes for me; I’ve had bad enough experiences with p-docs (like one good one, FIVE bad ones) that I wouldn’t trust one. They’re not the people to do therapy with anyway; they are med oriented and are LOUSEY at empathy and “working together”. That just my two cents’ worth.

I can tell you one thing for certain, however. Our byword is "stress is our worst enemy". It can "trigger" an episode more easily than just about anything else, so wanting to go back on anxiety meds, at least until things calm down, can be a very good idea. Given she's been on them before and they've helped, I'd trust her judgment.

Hippie Operative Nikovich Nikita Nicovna Talibani,
Contracted Agent of Veritas Oilspillus, code name “Nike”,
signing off

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Monday, February 7, 2011 12:50 PM

THEHAPPYTRADER

Quote:
Originally posted by dreamtrove:
Happy, if you mean making eye contact, or not doing so, that can also be a symptom, if you mean hiding in your house, that can too, but definitely a non-active lifestyle and too much time on the computer, etc. Will lead to a marked increase in cortisol, which can cause depression as a side effect, it also causes anxiety, and of course, stress.

It's not just shut ins either, in the workplace folks are often shut off in their cubicles, often only interacting with a human when they are 'in trouble' or receiving more assignments (makes human contact seem negative). Also dogs are being diagnosed and medicated for depression. With mom and dad at work and the kids at school, the dogs spend a long time by themselves and become lonely and depressed.

There was an interesting piece on this on NPR that also mentioned the rise in the popularity of cooking shows while people cooked in their own Kitchens less and less.

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Monday, February 7, 2011 3:27 PM

Gettin' old, but still a hippie at heart...

Hsppy, I agree...and the other part of it is that, what with computers, cell phones, etc., we make less contact with people. Even when we're WITH people, or surrounded by people. At the dog park, I see people standing alone or walking, on their cell phones, paying no attention to their dogs or the rest of us, who usually gather around and yak. In cars, I see one person sitting in the passenger's seat while the driver has a phone to his ear. You see it everywhere, and this no doubt contributes to the lack of personal contact, yes?

Hippie Operative Nikovich Nikita Nicovna Talibani,
Contracted Agent of Veritas Oilspillus, code name “Nike”,
signing off

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Monday, February 7, 2011 3:38 PM

Beir bua agus beannacht

Sygnam, they key is finding the right medicine and the right dosage as Niki2 says. What you want is to get rid of the symptoms that are troubling for the patient while maintaining creativity and things that the patient wants or benefits from. Sometimes that takes some trial and error. Unfortunately trial and error is part and parcel of this field because everyone's body is different and so we all react a little differently to the medicines.

Niki2, you make lots of good points. As for PSRB in some ways its a good program, its definitely better than putting people in jail without addressing treatment and improvement. I do believe that if someone commits a horrid crime they do need to be kept away from the general population for a time, maybe forever. But treatment (if its a mental illness) should be included in the situation. A lot of people I know who are on the PSRB whine about it, complain, but I think they'd prefer it to just going to plain old jail. No program is perfect.

Dreamtrove, how do you know how to address me? You probably saw it in the profile. Anyways I believe that since suicide is so much higher in the population of people with mental illness it can be considered a life threatening situation in certain cases. I know that it can happen on medicines or off, but either way it is a risk. You need to do what helps your body and brain best, so if naturopathic things are helpful to you then that is great. I'm glad you specified that you meant herbs because I was confused.

Happy Trader. It is probably best for your girlfriend to go talk to a professional and then she can make a decision based on how she feels, what the professional says, etc. I think if I were her I might wait to see if things get better on their own as the situations resolve themselves, but if she really is struggling she should talk to a professional and then she can make a decision from there. It is natural after all that our anxiety does go up when handling stress.

My friend at work with schizophrenia tried chantex, the smoking medicine to quit, she landed in the hospital for a week, didn't try that abgain.

I want people to feel as safe and content as possible, that can look different, and be achieved differently, for different people when it comes to mental health and brain differences.

"A completely coherant River means writers don't deliver" KatTaya

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Monday, February 7, 2011 5:20 PM

Riona a chara

Your tag line, it's Irish Gaelic, a language I've tried to learn. I've spend time in Ireland and had planned to move there, one of my ancestral homes (mother's side). I was really quite taken with Connemara, which Ironically is where my mom's people were fleeing, as the Irish were being rounded up, though they themselves were of County Donegal. Anyway, it's something that I heard in Connemara, where some people still speak it as a first language, and much of the entertainment available is in it. (or was ten years ago) But also, I tried to pick up the language online. It's so hard to learn a language that way, it's like a phrase book. Do you speak it?

As for herbalism, myself, I wouldn't do it for religious reasons, but rather scientific ones. I've studied the field in much depth. If the risk with treatment is greater than without, than it's not exactly a cure, is it? The sad thing is that I feel fairly sure I can cure this one without any serious doubt, and yet we live in a society where curing things is not valued, and so far my experience has been that if something is effective, natural, and becomes widely known, it will be banned.

I used to do something very similar to what Frem does, I ran an underground railroad stop for runaways. That was, until they caught me at it. I actually got in no trouble for it, but the cops let me know in no uncertain terms that I was not to continue. (Another strange part of our culture: Nothing about what I was doing was illegal, yet it is considered forbidden to help.)

The more I think about it, the more I would want to do it differently. But it's not just my personal experience, many of them had mental issues, some very severe. I found depression was actually the easiest one to treat. I feel fairly confident I could take any chemical imbalance and correct it without drugs, but I'm not sure that I should. I only want to correct those that either are life threatening, or that people *want* to change. If someone is okay being a paranoid schizophrenic, than they should remain so.

My new interest is psychology, which is not something I have a background in, but it is the other half of the puzzle.

Ps. I should let you know for the record that I had a rather traumatic 3 years of my life as a guinea pig where I was experimented on by 20 doctors with a large number of drugs. It didn't leave me with a great respect for the medical community's approach. Not just for me, but the other patients there. I was shocked to learn how many widely varying mental conditions were being treated with the exact same prescription. I also was able to find out what was slated for my future treatment plan, which in short order would have involved shock therapy and a lobotomy (I'm not making this up.) So, I sued for my release, moved to Hungary and started studying Neurochemistry (Okay, I had a head start with my background in biochem) But eventually I was able to cure myself. I've been studying the subject ever since.

Now I take ideas from wherever I find them, and do intensive research into the underlying mechanisms. Most I find fail the tests of safety and efficacy, but every now and again, I find some.

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Monday, February 7, 2011 8:20 PM

Beir bua agus beannacht

I'm glad herbalism and natural things have worked to put your symptoms into remission/cure/I don't know you so I won't label it definitively.

Irish is the hottest coolest language ever, I can only speak a little, having run into the same problemas you with online learning, plus I'm dreadful at languages. But if there was such a thing as a language syrum and if I drank it I'd know which ever language the syrum indicated on the bottle I totally would. Or if some wonderful Irishman from Conamara moved in next door ... Mmmmmmmm. :) Then I'd really be getting somewhere.

"A completely coherant River means writers don't deliver" KatTaya

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Tuesday, February 8, 2011 2:41 AM

HARDWARE

A few years back when I worked in a psychiatric hospital I worked on a long term ward with 3 men who were Not Guilty by Reason of Insanity for murder. 2 of them were very high profile cases. One guy sniped at a highway and shot people in passing cars. Another walked down a street in a college town shooting people with a rifle. The last man was in the hospital and beat another patients brains out on the floor.

The highway shooter had been in the hospital for about 5 years at that point. He had never been on psycho active medications. The general opinion of the staff was that he had worked the legal system to avoid jail.

The college shooter had a history of schizophrenia. His family knew he was off his meds but had done nothing to intervene. After the shootings they sued his doctor. The doctor won, as the shooter had skipped appointments and the doctor had no way of knowing that he was de-compensating. But the doctor still had to pick up the tab for his legal defense against a malpractice claim.

Without a doubt the 3rd guy was batshit crazy, dangerous and aggressive. He had previously taken 5 guys to subdue while on a rampage. While I was present He attacked a doctor and turned his face into hamburger. There were only 2 staff capable of intervening. We were insufficient to the task of restraining this guy. But he let us walk him away. Fortunately an alert LPN in the med room called a PIT Major and everybody came from every building around. All 3 of us involved were injured.

Because of the 2 shooters and a couple of other incidents North Carolina's legislature was considering removing NGRI from their legal system and replacing it with Guilty, But Insane. The proposed process would be incarceration in a psychiatric hospital and upon release, you would begin your prison term. I'm okay with this idea. I'm also okay with euthanasia for the insane. Don't ask me to care for you when you can't, at risk to my life and limb. I've got a permanent injury because of the incident with the doctor.

The sad fact I learned at that hospital is that nobody will pay a great deal of money to take care of anything that has a pulse.

The more I get to know people the more I like my dogs.

...and he that has no sword, let him sell his garment, and buy one. Luke 22:36

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Tuesday, February 8, 2011 3:06 AM

Riona

I met plenty of lads in Connemara, they shared their drink with me, but it wasn't a language serum, it was only guinness. ;)

I have actually a couple of language experts in my family (we're cunning linguists ;) ) But seriously, my sister is a neuro cognitive something language expert, she spent many years teaching teachers to teach ESL, and also teach immigrants and eskimoes. She speaks a lot of languages, and knows how to learn them. I'll bet we could construct something. I'll ask her about it.

My whole family are writers. My cousin is also a linguist, she translates ancient mayan texts. It took much urging from me, but she's finally getting all over 2012. She didn't want to do it because it wasn't "scholarly" but now she has some stuff to say about it, and she's the technical consultant for some movie or other that's coming out about it. I know I should know more, but we've been pre-occupied with other matters more urgent.

I have a slight advantage as not having english be my first language, my brain develops differently, but I have a disadvantage, due to being an experimental guinea pig, I now have some memory loss. Still, I'm sure we could hack it, and maybe find some irish *girl* ;) :p

None of the Irish lads I know actually know Irish. I did meet some girls in Connemara who spoke it, but mostly it was the older people. (girls tend to pick it up from watching soaps. It's kinda funny, because if you make something in Irish, it's subsidized, so people do it, but then most people watch it with subtitles. It's sad. Also sad is the encroachment of the English, who are buying up Leinster as a retirement community, and worse, the Euro.)

As for the mental stuff, I have no fear anymore, at the risk of sounding cocky, I know I can cure any mental chemical imbalance. Very very few mental problems involve physical damage, but a lot involve psychological missteps, and so I've been wanting to learn more psychology. That's mainly why I'm still here ;)

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Tuesday, February 8, 2011 10:38 AM

Gettin' old, but still a hippie at heart...

Quote:
I do believe that if someone commits a horrid crime they do need to be kept away from the general population for a time, maybe forever

Rion, some won’t like my answer, but I’m afraid I believe if someone commits a truly horrid crime, they shouldn’t rejoin the general population, unfair as that might sound. There’s no way of guaranteeing they will stay on their meds or get further help, so there’s no guarantee they won’t do something horrible again. Obviously I’d rather see them in a better setting than jail (!!), but I don’t think killer, for example, should ever be turned loose. You can’t “cure” the true mood disorders (unipolar, bipolar schizophrenia and Bipolar Affective Disorder, which is kind of a mix of the two). A criminal can be rehabilitated, however difficult it is and small as the chances may be, but you can never guarantee someone with mental illness won’t go off their meds or snap under stress. Even the most perfect med can be overridden by stress and cause the person to “act out”. All the other mental illnesses are “behavior disorders” and CAN be cured---actually much more effectively by therapy than meds, which are a stop-gap for them, so that’s a different matter. But those with severe mental illness? I don’t believe they should ever be among the general population once they have done something like the woman I mentioned who took a tire iron to her pharmacist. She was stable the entire time I knew her, and we were friends, but there’s no guarantee.

Boy, Rion, you sure know your stuff! It’s always nice to meet someone who understands so much of the complexities and especially someone who is pro-active! Means a LOT to me. Once in the dog park I overheard some people talking and one woman wondered why the mentally ill didn’t just take their pills. I spoke up and gave them a short lecture on some of the MANY reasons people go non-compliant on their meds. The woman who asked moved away from me and I could see her opinion of me was altered by knowing I was bipolar, but everyone else in the group asked questions and were astonished to learn all about the meds, the potentially awful side effects, how our brains, when meds work, can convince us “it’ll never happen again”, and how hard it can be to find the right med. Me, I consider those who have suffered horrid side effects who go on trying to be very brave. I could tell you guys some horror stories, and an awful lot of people wouldn’t keep on trying after experiencing some of them!

None of you who are knowledgeable (DT, Rion, etc.) have mentioned Omega 3 yet. It’s a “wonder drug” in its way and has been very helpful for many. The only problem is, bipolars have to take MAJOR doses of it each day, and it’s expensive that way. Early on in that support group I was in, we were hearing a lot about Sam-E and St. Johns Wort. The people who tried them in the group went manic or had other bad experiences with it. Herbal meds that become popular can be just as dangerous as “medications”. Two of our members who were diagnosed unipolar went hypomanic on them and, just like “medically induced mania”, they were re-diagnosed bipolar. There are pros and cons to herbals just as there are for pharmaceuticals, but Omega-3 is the only “natural” medication I’ve ever heard of that never caused problems. We have to take it at least three months for it to be effective, and it was for me. I began feeling better and had forgotten how long it was that I started it---looked back, and damned if it wasn’t just about three months. I wish I could have afforded to stay on it, but insurance, of course, doesn’t cover non-pharmaceuticals.

DT, statements like

Quote:
I feel fairly confident I could take any chemical imbalance and correct it without drugs, but I'm not sure that I should. I only want to correct those that either are life threatening, or that people *want* to change.

and

Quote:
I know I can cure any mental chemical imbalance.

make you a potentially very dangerous person. I understand the desire, and have no doubt you would be successful in some cases, but to put yourself up as an authority could endanger people. I hope you never try. Yes, p-docs can hurt people, and the pharmaceutical companies do it wrong, but for just that reason, any layman who is “confident” they could “cure” mood disorders is even moreso.

On the other hand,[quote I was shocked to learn how many widely varying mental conditions were being treated with the exact same prescription.

Damned straight. It’s terribly wrong. I know several people who’ve had ECT, and one whose memory was BADLY damaged from multiple treatments. Unfortunately, he was severely unipolar and turned to it every time it got really bad because it helped---for a time. I always hated it when he got to the point that nothing else seemed to work and he’d start going there. The subject of ECT is one I should stay off of; tho’ they’ve made major strides in making it less harmful, I just do not believe in it in any way.

I, too, don’t know what your situation is or what you were dx’d with, but I’ve never known anyone who was “cured” of one of the mood disorders. Remission, yes; functionality, yes; but actually “cured”, no. Bipolarity CAN go away with old age, or mitigate, but that’s about it.

Hardware, your attitude scares me. I don’t like this one at all:

Quote:
The proposed process would be incarceration in a psychiatric hospital and upon release, you would begin your prison term.

The reason being that when one of us with a mental illness is in an episode, WE don’t choose what we do. It’s something we remind one another all the time, because the guilt that accompanies our actions can be horrible. So while I don’t want a murderer or something turned loose on the general population, neither to do they belong in jail, and making someone serve a jail term for something that was neither their choice nor their intent does no good for anyone. On the other hand

Quote:
I'm okay with this idea. I'm also okay with euthanasia for the insane.

sickens me; it typifies the attitude of still too many people. It’s the same as the death penalty to me; abortion is wrong, but killing people because they’re judged to be bad is okay. Now I know where you’re coming from, I won’t forget it.

Quote:
Don't ask me to care for you when you can't, at risk to my life and limb

Taken to extremes, that can be said of people with any debilitating injury, because even caring for a paraplegic can endanger others.

If you feared injury, you shouldn’t have been working there. There, that’s MY judgment.

Hippie Operative Nikovich Nikita Nicovna Talibani,
Contracted Agent of Veritas Oilspillus, code name “Nike”,
signing off

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Tuesday, February 8, 2011 1:30 PM

Niki

Omega threes don't hurt, but they're not really primarily a psychoactive compound. People can have problems if they have a deficiency, which is common now that natural oils have been replaced with lots of mass produced omega 6s, but a wonder drug would be a misclassification.

Chemistry is only one piece of the puzzle, but it's one I understand quite well. I've helped many people, and I sometimes need to state this because, frankly, I find the Pharma-manipulations here being proposed very scary, and I have tried to impress on certain other people here that neurochemistry *is* in fact a well understood field of science, and am somewhat frustrated that people will continue to defer to the pseudo-science of psychopharmacology over well established science, and if I overstate the case, I'm sorry, but the opposing cases in favor of clinical treatments and drugs has been overstated to the absurd.

For you, I will try to be dangerous

Unfortunately, it's closer to the truth that I'm unconvincing, and people are deferring to a malicious system because its advocates are more persuasive than those of what I would consider to be a) science, and b) common sense.

Taking someone who has some sort of irregular behavior and putting them on a synthetic analogue that has myriad as of yet unknown effects, and is generally disruptive to the system, causes problems like the one that Byte brought up which sparked this recent debate.

So, yes, there are things I can't fix yet, I'm working on this. I can fix the simple chemical imbalances that cause the mainstay of what are considered "psychiatric problems" but I think it's their choice, and I advocate the minimal measure necessary to get them where they want to be.

The issues I'm trying to deal with chemically are those related to receptor loss, which someone just brought up here, I forget who, because I do have some memory loss, which itself is a receptor loss. My current theory revolves around receptor resistance training, but I don't really have all the tools for it.

Riona.

Sorry about this, you walked into the middle of an ongoing war ;)
People here have some differences on the issue, and this is a place that can get very contentious. Welcome to RWED

ETA: I'm fairly alarmed at the number of suggestions that have been posted about forcible medication, tracking, imprisonment and euthanasia for people with psychological differences from a perceived norm, which may not even be healthy, normal or perhaps even exist, and could even come at the whim of legislators or overseers, but regardless, I find these sorts of ideas worrisome.

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Tuesday, February 8, 2011 3:14 PM

HARDWARE

Quote:
Originally posted by Niki2:

Hardware, your attitude scares me. I don’t like this one at all:
Quote:
The proposed process would be incarceration in a psychiatric hospital and upon release, you would begin your prison term.
The reason being that when one of us with a mental illness is in an episode, WE don’t choose what we do. It’s something we remind one another all the time, because the guilt that accompanies our actions can be horrible. So while I don’t want a murderer or something turned loose on the general population, neither to do they belong in jail, and making someone serve a jail term for something that was neither their choice nor their intent does no good for anyone. On the other hand
Quote:
I'm okay with this idea. I'm also okay with euthanasia for the insane.
sickens me; it typifies the attitude of still too many people. It’s the same as the death penalty to me; abortion is wrong, but killing people because they’re judged to be bad is okay. Now I know where you’re coming from, I won’t forget it.
Quote:
Don't ask me to care for you when you can't, at risk to my life and limb
Taken to extremes, that can be said of people with any debilitating injury, because even caring for a paraplegic can endanger others.

If you feared injury, you shouldn’t have been working there. There, that’s MY judgment.

So, your attitude is; "I'm incapable of taking care of myself. But I shouldn't be held accountable for the injuries I inflict or the damage I cause." Either you are competent under the law or you are not. If you are competent you must be held accountable for your actions. If you are incompetent in the eyes of the law then you get no say in how you are treated.

Until you've taken care of the insane in a clinical setting, don't presume to judge me for my opinion based on FACT and actual incidents I observed and was involved in. Exactly when did you work at a psychiatric hospital?

Nobody is talking about putting the insane in jail. That would be unfair to the prisoners. However, after the insane have been normalized they should be made to pay society for their crimes. A developmentally delayed individual (formerly called mentally retarded), must pay for their crimes. Are you saying that they insane are not even up to the level of responsibility of the retarded? You do know how crazy that sounds, right?

After sustaining a permanent injury I reevaluated my position at the hospital and left to a happier and more lucrative career. But I took all those lessons I learned there with me. The insane are dangerous, unpredictable and not to be trusted.

The more I get to know people the more I like my dogs.

...and he that has no sword, let him sell his garment, and buy one. Luke 22:36

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Tuesday, February 8, 2011 3:59 PM

Beir bua agus beannacht

DT, yes that sounds overly cocky, I think your restated position sounds slightly better. I'm so pissed that I already wrote all this up an hour ago but it disappeared.

Hardware: I don't agree with your youthenasia plan, but I understand that you've had experiences that I haven't had and experiences shape our perceptions. We'll have to agree to disagree. I myself will not be reproducing because of my horrid genetics (I have physical disabilities along with mental health challenges). Plus I know I don't have the stammina to handle babies and little ones 24/7. I love kids, I love my little brother and nephews and all the little ones I've had the privelidge of watching grow up. but I know this is the right choice for me and the world.

Niki, thanks for the compliments. Yes herbals can be dangerous too if they aren't suited to one's body or misreact with one's body. They can also be helpful, as other medicines can be. It is silly that insurance doesn't cover natural remodies, I think it should. I agree with you that in some cases and with some crimes people should never be let out into society, if people have murdered once they could very well do it again and we need to look after society by keeping criminals in check. I enjoy talking to you too Niki, we agree on a lot of things related to mental health. But we don't agree on everything in the world so don't be surprised if we ever disagree. I love your tag line, that is really funny and I smile whenever I read it.

Hardware, jail is already full of people with mental illnesses.

I think that's most of what I had written earlier.

"A completely coherant River means writers don't deliver" KatTaya

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Tuesday, February 8, 2011 7:04 PM