Far be it from me –

Guest Post By Roger Smith : Whitney Houston – How Much Can We Learn About The Dangers Of Mixing Sedative Drugs?

Whitney Houston’s death has been ruled to be an accidental drowning. Heart disease and chronic cocaine use also contributed. March 22, 2012

The above is the headline that has flashed around the world .   The message seems to be, “Look after your heart and avoid cocaine” Not many people are going to be looking at the details of the coroner’s report.

Did she die of a heart attack? “…plaque in her arteries… …common in drug users… …wasn’t clear whether Houston had a heart attack on the day she died.” – http://ibnlive.in.com/news/whitney-houston-died-from-drowning-coroner/241874-45.html

They seem pretty sure it was not a heart attack.  It seems she simply fell asleep in the bath.  It could happen to any of us. It is however, a rare thing for anyone who is not under the influence of sedatives.

What about prescription drugs?   What part might drugs available on prescription and used by Whitney Houston have contributed to her early demise?

“Several bottles of prescription medications were found in her hotel room, but coroner’s officials said there weren’t excessive quantities.” – same web page as above http://ibnlive.in.com/news/whitney-houston-died-from-drowning-coroner/241874-45.html

What does, “…weren’t excessive quantities.” mean and was cocaine the only drug affecting the singer at this time?

“Cocaine was found in her system as were traces of marijuana, Xanax, Flexeril, and Benadryl although they did not contribute to her tragic passing.” And “…several pills were found on the scene including Xanax, Ibuprofen, and Midol. However, investigators found no evidence of cocaine in the hotel room.” – http://www.pep.ph/news/33496/whitney-houston-dies-of-accidental-drowning-and-cocaine-use

Clearly marijuana (cannabis) can lead to some health problems, but what of the prescription drugs that presumably Houston had taken not so long before she died?

Xanax: It was detected in her body.  Also known as Alprazolam
“Alprazolam possesses anxiolytic, sedative, hypnotic, skeletal muscle relaxant, anticonvulsant, and amnestic properties.” http://en.wikipedia.org/wiki/Alprazolam
Side effects include: Drowsiness, dizziness, lightheadedness, fatigue, unsteadiness and impaired coordination.  It does not sound like a good thing to be taking before having a bath.

Flexeril: It was detected in her body. Also known as Cyclobenzaprine
Side effects: significantly increased rates of drowsiness (38% of patients)
Another thing probably not to take before having a bath.

Benadryl: It was detected in her body. Active ingredient Diphenhydramine
“…may also produce anticholinergic effects, antiemetic effects, and significant sedative side-effects.
In the United Kingdom, Benadryl products contain either the non-sedating antihistamine acrivastine (marketed as Benadryl Allergy Relief) or the non-sedating antihistamine cetirizine (marketed as Benadryl One a Day Relief).” http://en.wikipedia.org/wiki/Benadryl

Clearly the drug companies believe it is sedating else surely they would not be marketing less sedating varieties of Benadryl.

Is it possible that the different formats of Benadryl in different countries leads to the debate about whether it can be used to put children to sleep on plane flights:
“I’ve totally given Benadryl as a way to get the kids to go to sleep when they were littler… …I think I did it about a month ago even. I would do it on a flight if I thought it would make them less freaked out.” – /the_benhttp://www.salon.com/2012/03/21adryl_solution/singleton/

Ibuprofen: In hotel room.
This is a common drug used all over the world for pain relief and there is a lot of evidence to say that it is one of the safer drugs around when used correctly. There is this, “Infrequent adverse effects include: esophageal ulceration, heart failure…” on Wikipedia. As there is nothing about finding Ibuprofen in her body this does not seem to have anything to do with her death.

Midol: In hotel room.
According to: http://www.midol.com/pm.html
“Active ingredients (in each caplet)
Acetaminophen 500 mg = Pain reliever
Diphenhydramine citrate 38 mg = Nighttime sleep-aid”

Midol contains acetaminophen is known as paracetamol in many countries. It is not usually associated with extra drowsiness, although I certainly find I get off to sleep quicker and sleep longer even just taking one paracetamol 500mg tablet. This effect is probably related to pain relief – that is, when we feel less pain we find it easier to sleep.

Midol contains diphenhydramine is the same active ingredient as in Benadryl – see above. This brings us back to a question of whether this chemical could make it more likely for someone to fall asleep in a bath?
According to the sales web site at http://www.benadryl.co.uk/symptoms-and-advice
“At the recommended dosage, BENADRYL® products do not cause drowsiness in the majority of sufferers.” – It is interesting that one drug company says it does not cause sleepiness while another is marketing it as a “Nighttime sleep-aid”!

It seems very likely that anyone taking two medications both containing this compound would be likely more likely to fall asleep in a bath as they may well exceed the recommended dosage.

– – – –

Overall, it seems there were a lot of drugs being used by Whitney Houston that could have each contributed a little towards her falling asleep in the bath. From this point of view I feel that a headline that focuses attention on heart disease (that certainly was not the main cause of death) and chronic cocaine use (which does not seem to have been significant in the drowning) seems mis-leading.

It is leading us away from the truth, which is that deaths from mixing prescription drugs are becoming more common.

In researching this subject I happened to find this article where the author is thinking along similar lines:
http://www.healthzone.ca/health/article/1139522–how-anti-anxiety-meds-are-killing-celebrities

Here are just three examples from the article by SORAYA ROBERTS…

Anna Nicole Smith, who died on Feb. 8, 2007 (Age 38) who had taken a mix of drugs including Benadryl
Heath Ledger, who died on January 22, 2008 (Age 28) who had taken a mix of drugs including Xanax
DJ AM (a.k.a. Adam Goldstein), who died on Aug. 28, 2009 (Age 36) who had taken a mix of drugs including Benadryl and Xanax
I do not wish to single out Diphenhydramine and Alprazolam as drugs that are any more dangerous than others. What I hope to do is to alert more people to the fact that too many quite young people are dying through taking prescription drugs without realising the dangers of mixing them.

A final coroner’s report into Whitney Houston’s death is expected to be ready for release within two weeks.

Roger Smith

http://www.rethinkingbipolar.com

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Childhood Trauma As A Risk Factor for Psychosis

It is well documented that children who experience difficulties in childhood are at increased risk for various negative mental health outcomes. In the last decade many population based studies have suggested that childhood trauma is a risk factor for psychosis. The link is now well accepted. What do we mean by childhood trauma? Emotional abuse, physical abuse, general abuse, sexual abuse and physical neglect.

Possible pathways are the relationships between negative perception of the self and negative affect, and biological mechanisms such as dysregulated cortisol (a stress hormone) and increased sensitivity to stress. Psychotic patients with a history of childhood trauma tend to have post traumatic stress disorder, high levels of depression and anxiety and are responsible for more suicide attempts.

Children who have been abused are more likely to seek abusive partners as adults as they unconsciously repeat pattens of the past. They are likely to have very low self esteem and be non assertive.

Statistics show that 1 in 4 of us will experience mental health problems; our children are at risk – nearly 12 million of them. That’s why it’s vital that the government provides adequate mental health services for children. Currently only half of all local authorities provide mental health services for children and this is due to government cuts. Recently the government pledged £22m for children’s mental health services but frankly this is a drop in the ocean. If we fail our children and do not protect their mental health we are looking at a ticking time bomb.

The greatest gift you can give to a child is to listen. Not medicate, label and ignore, but listen to what they have to tell you.

The government has to review its spending on children’s mental health or the consequences will be catastrophic.

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Guest Post by Fiona O’Fee, FAB Research

More Trans Fat Consumption Linked to Greater Aggression – 13 March 2012

 

Researchers at the University of California, San Diego School of Medicine, have shown – by each of a range of measures, in men and women of all ages, in Caucasians and minorities – that consumption of dietary trans fatty acids (dTFAs) is associated with irritability and aggression. Read the full news item and FAB Research comment here.

The study of nearly 1,000 men and women provides the first evidence linking dTFAs with adverse behaviours that impacted others, ranging from impatience to overt aggression. The research, led by Beatrice Golomb, MD, PhD, associate professor in the UC San Diego Department of Medicine, has been published online by PLoS ONE.

The research article by Beatrice Golomb is freely available online at PLoS One here:

Golomb et al 2012 – Trans Fat Consumption and Aggression

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Guest Post by Lynn C Tolson – “Change”


Change is a concept that refers to making or becoming different than what came before. Change is an activity that requires deliberate steps toward transformation. We have to be conscious about changes that lead to a different way of being.

I’d been allowing bits and pieces of myself to be swept away. I wanted to trek through the wasteland that was my life toward more fertile ground. I wanted to take charge of my life, to be accountable to myself and responsible toward others. I wanted to change everything, as if change is an all or nothing event.
Once I thought that the only way to change my life was to cease living it. Fortunately, I had conversations with my counselor about change. These discussions started with the observation of myself as a victim. I learned that I perceived myself as a victim and I was led into circumstances that continued the victim role. Why was that? In my case, especially as it pertained to my relationships with men, I’d been around abusive men my whole life. The inner resources to defend my self were eroded by the myth that men are a force to fear. I learned that men and women are equal in the emotional and spiritual levels. I also had to learn that I deserved relationships that made me feel good, that were based on healthy common interests, and that true partners bring out the best in us. Change meant transforming from a vulnerable target to an empowered woman.
This knowledge helped me to disengage from abusive relationships. But this change does not occur in a linear fashion. The activity that accompanies change happens in fits and starts, by trial and error, with failure and success. What remains constant is the determination to make a change, as well as the discipline to develop the strength and skills required to be different than before.

 

My counselor suggested that I change my way of living by changing my way of thinking. “You can replace negative self-talk with optimistic thoughts. It is possible to change a negative perspective on life into a positive life force if you keep a sense of proportion.” Survivors of trauma are often drawn into drama by reacting without thinking. I learned that not every minor inconvenience leads to a major catastrophe. Rather, the whole of life is more about how I shaped it, day by day, by making good decisions and better choices.
My counselor encouraged change but I was paralyzed with ambivalence. My desire to change was in conflict with the fear of change, and I resisted change even as I risked change. If only change could occur overnight, by osmosis, or at least if I could leave well enough alone. I pleaded with the universe to cooperate:Now travel, Time, no more delays, Propel me now to future days.To days of good, new days unfold. Now faster, Time, before I am old.
I asked my counselor, “Why do I continually make mistakes?” Her answer was, “Your experiences were not mere mistakes, but life lessons. Human experiences pertain not just to suffering but also to personal development and soul growth.” That helped me to ease up on myself for perceived mistakes.For example, I couldn’t count on myself. I could not make up my mind or I would change my mind, or anyone could change it for me. I changed plans, habitually procrastinated, and invented excuses: a headache, a stomachache, it was too early or it was too far, or the weather was too terrible for whatever it was that I was avoiding. It was all too much because I’d been through too much.
My counselor taught me the concrete steps to making a change:

  • Be aware of the behavior needing change
  • Examine the reasons for developing the behavior in the first place
  • Have compassion for the choices made under the circumstances
  • Find new and healthy ways to meet the needs
  • Get support! Ask for help!
  • Set goals in small timeframes: one day, one week, one month
  • Break down the larger goals into smaller ones
  • Give yourself rewards along the way.
  • Try not to minimize triumphs but appreciate the steps toward self-improvement.

“What if I fail?” I asked my counselor. I realized that I failed to try anything that I could not do perfectly and all I could do perfectly was clean house. I thought about trying other things but never got around to it. I made a mental note: “To think and think and think about a thing and never to accomplish it at all.”
She responded by saying, “Use failures as a learning experience and try again. It’s a waste of time to wait to do everything perfectly. In order to grow, it’s necessary to attempt new skills. Let go of the limiting controls of perfectionism! To make mistakes is to be human and everyone makes mistakes.”
I began to change by using discipline to keep commitments, finish projects, and manage emotions. While I was incorporating healthy changes into my life, I was in transition, no longer the person I was and not the person I was yet to be. I had to call upon my courage reserves to navigate the hurdles and overcome an obstacle course of adverse circumstances. It would take courage to clear the past to find clarity for the future. Meanwhile, I kept the commitment to changing my life from constant chaos to inner peace.
You can’t change everything at once, and some changes are noticeable only in retrospect. I can look back and knowfeel, and believe how much I have changed since embarking on a healing journey. Have confidence in your ability to change! Confidence is based on previous accomplishments; build confidence by acknowledging the cumulative ways you have changed.
The power to change is already within you, ready to be discovered. Find new methods to deal with old routines. It is up to you to make the conscious choices that bring a better future.

 

http://beyondthetears.blogspot.com/

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In My Eyes

According to my local Primary Care Trust,  psychiatrists cannot be expected to know about the side effects of the medication they prescribe.  What?   Yes,  it’s a given that medication has side effects.  I wonder how many people know that lens opacity/cataracts is a side effect of some anti depressants, anti psychotics, and steroids?

 

I was 48 when I was diagnosed with cataracts.  When I saw the ophthalmologist he said my cataracts were not the usual ones he saw and asked if I’d ever taken the drug Chlorpromazine.  I’d taken large quantities of Chlorpromazine ten years previously,  while sectioned under the l983 Mental Health Act.   The ophthalmologist said the Chlorpromazine had caused my cataracts.

 

I have had  surgery on both my eyes and had artificial lens implants fitted.  But, had I been informed of the risks perhaps I’d have had other choices available to me, who knows.  I took anti depressants and anti psychotics between l993-2000 and it’s been suggested to me that I should take the medication all the time……but what about the side effects I said.  Well you can take medication for those was the answer.  But what about my eyes I said.  I’m still waiting for an answer to that question.

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Guest Post by Stuart A. Wooding: Pride, Prejudice, Families, Mental Health and Suicide

Pride, Prejudice, Families, Mental Health and Suicide

 

I’m going to discuss myself and a close friend. We have both attempted suicide during spells on psychiatric wards. We are the lucky ones. Several dozen friends made in psychiatry didn’t fail and are now tragically dead. Our hospital has a high block of which friends have jumped to their death and a nearby tube line is often closed due to a body under the train, not to mention drug overdoses and self-harm.We didn’t fail due to a lack of seriousness but owing to our incompetence. The loss of life by comrades made and ‘forged’ on a psychiatric ward prepared my mind-set for my own attempt and has rendered me indifferent to ‘discomfort’ but compassionate towards suffering. Suicide belongs to know particular social class and this first hand realisation has rendered me indifferent to an individual’s particular class or circumstances.

Both of our attempts can be traced to Pride, Prejudice and Shame in our respective families with respect to mental health. We, as many other mental health patients, were ostracised and disowned by our parents upon diagnosis. He was literally disowned and divorced and ended up as a heavy drinker, the user of prostitutes and is ‘guilty’ of several suicide attempts. He is going to remain anonymous. His case is tragic as he is a gentle, kind, educated individual who has a long international professional work record. My rejection by my family firstly left me astonished, then angry and finally desperate. It took two decades to come to terms with the desperation and right in the middle I attempted to hang myself. At the time I ‘calculated’ that it was the only solution to isolation and desperation.

My family have skeletons in the cupboard (schizophrenia and chronic dyslexia) which were carefully closeted away but explain the long unexplained periods during which my father was away from homewhen I was a child. I only discovered as an adult, after a review of my medical records that he had been in psychiatry. Perhaps the existence of such skeletons in conjunction with their desire to front as a respectful middle class family, rose from working class roots, conforming to societally acceptable middle class norms lead to their brutality in my regard. Things got so extreme that my father hit me with such violence with his walking stick over my back from behind that it broke in two. I had to go to my GP for medication and he offered to report my father to the police but in my naïveté I declined.

My father attempted to have me placed under a Guardianship order which would have included me, in his design, being designated to a ‘structural’ home for life with him responsible for my affairs. He was naïve. He needed but couldn’t get psychiatric consent. It was at this turn of events that he became literally violent in my regard but, I did retain control of my finances. Much to his shame my friend still has his monies rationed by his daughter. This is clearly humiliating and results in unhappiness.

 

I had resided and free-lanced in Italy for over ten years before returning to the UK, at my parent’s request, for treatment. I’m naturally gregarious and had a rich Italian social life. In the UK I had no friends and this in combination with my family’s attitude and my isolation in psychiatry meant that I was completely isolated and dependent on state benefits. The latter situation not only resulted in poverty but also fundamentally injured my self-esteem and pride. In fact I refused state benefits for several years and existed on capital. This rapidly depleted as I resorted to staying in hotels rather than acceptingsocial housing. I felt a failure. Failed jobless Japanese business men do it and commit suicide but it’s put down to shame and not seen as the result of a psychiatric disorder

My friend has a long history of well remunerated professional employments in Africa and North America. He was also ‘dragged’ back to the UK for treatment. He, like me, complicated his own situation by periods of self-denial resulting in downward spirals of illness, combined, like me, with bouts of heavy drinking. He, like me, was cut off from his own off-spring by his family and psychiatry. In both of our cases repairing the damage done has required extreme patience and perseverance. Neither of us has drunk for many years and we are both medication compliant.

When I attempted suicide it seemed the only option. I was cool, calm and collected and actually under observation on a psychiatric ward during the weeks prior to the attempt. I ‘rationally’ decided that hanging represented the best option and went about smuggling into the hospital sufficient rope. I then waited until the staff was occupied with tasks not related to my observation and left for the designated spot – a sparsely used park with a high swing onto which I hung. My attempt failed. My reaction at having failed was joy. My in-expert knot slipped under my body weight. It happened at spring time and I fell unconscious to the ground onto concrete. The tactile sensation of warm rain on my face slowly awoke me and filled me with the joy of life and the desire for it.

I went to my parents’ house for refreshment and love but they shut the door on me when they saw the burn marks around my neck. I was forced to return to hospital where I was subjected to all of the indignities of suicide control. It was horrendous. I was body and locker searched and injected with drugs that knocked me out for days. Even my razors were denied me. There then followed what is technically called 24 hour close observation. In short I wasn’t even allowed to sleep without a nurse in the dormitory observing me- an indignity enough to drive one to suicide. I should have paid a visit to the Samaritans.

My friend still exhibits intellectual sharpness but is ‘disquieted’ and passive. He is quite a lot older than me and has always been an employee. I’m a natural entrepreneur and am back at work with a now healthy relationship with my daughter and grandchildren. We are both lucky in the sense that we failed when many others are dead. However, whilst my work has been concomitant with an ever expanding social life in my case, his life consists of bribing friendship in drop-ins by being the ‘sucker’ who is always good for a free cigarette and small not returned ‘loans’. He is taken advantage of.

Both of my parents lost one of their parents when they were young. They raised four siblings in a family framework riddled with insecurity. We were a dysfunctional family headed by a schizophrenic father. I’m the eldest and have the diagnosis of affective bipolar disorder. The others suffer dyslexia and other psychological problems about which they are firmly secretive. I have a sister who never calls and I’m still denied knowledge of my brother’s home telephone number. I fell ill at the age of 46 and my family exhibited only stigma, shame and prejudice in my regard.

I’m now working as a Managing Director of my own company – Stuart Wooding Associates Ltd – after a period of freelancing in the mental health arena. I have also begun to repair the damage my parents and psychiatry did to my relationship with my daughter and grandchildren. So I enjoy my ‘own’ happy family. The road there has been riddled with pain, hurt and confidence building. My father, at the age of 91, passed away two years ago. In the latter years of his life I was his Carer as he suffered advanced dementia after two strokes. Paradoxically the stigma he had subjected me to enabled me to look after him as he was in a state of self-denial and self-stigmatization and my mother used to cast his problems in terms of insanity – literally taking the ‘micky’ to his face. In the end, life ‘defeated’ him.  I remember him with affection, as before his death we did reconcile but, as an incontinent baby. Sadly I don’t miss him as the affection is tainted with too many bad memories.

My mother has developed her own dementia and at the age of 86 is still in a state of self- denial. For a couple of years I was her Carer. She was very demanding, both practically and in terms of affection. She now lives several hundred miles away and is looked after by the sister who does talk to me. My mother, however, remains full of the need for affection and we speak every day. I do it as much as a safeguard against trouble mongering as out of affection. I’m delighted to report that I’m now well on the road to recovery and will be, in fact, discharged from secondary to primary services this year. The basis of my business is all that which I have learnt about psychiatry and psychiatric survivors and users the hard way.

My friend and I share a lot but are also quite different. We share just how brutal life can be on a psychiatric ward. The indignity, pain and shame of being man-handled by nursing staff and spending long periods in the isolation room with only the most primitive of provisions for toiletries. We both verified the sole destroying boredom of life on a psychiatric ward with the continual scrounging of cigarettes, now exacerbated by the smoking ban, and the theft of personal effects. We both verified that many nurses are indifferent to the well-being of their clients and are quite capable of ‘doctoring’ their nursing notes, in the isolation of the nursing office, rendering the once weekly ten minute meeting with one’s psychiatrist ridiculous and only a source of further frustration and anger. It took us both time but we did both learn to ‘parrot’ that which the psychiatrist wished to hear.

On the road to recovery my mother is my most significant obstacle. She plays an insidious game of continually asking, in the ‘same’ sentence “are you busy” and “are you alright?” In fact, our family is patriarchal and she is not sincere, resenting the challenge my well-being represents. She almost wants me to fail so she can re-play the role of Rescuer which in her mind only amounts to financial payouts.  My brother and sisters are evermore friendly in my regard and this only increases her dilemma and malignant impulses.

I was assigned the mental health label in 1991. As noted, my parents immediately ostracised me as in their mental construct I brought only shame. As mentioned, they even attempted to sever the relationship between me and my daughter.  In my isolation, I lost my own identity – spiritual, political, intellectual, social and economic. It wasn’t until 2006, when I was assigned a Care Coordinator who encouraged me to work on my strengths that I had the courage to re-seek my identity. I shall be forever in her debt.

I’ll never be symptom free but I now know how to control them and have now re-established my identity. I’m a Humanist, a Social Democrat and have been trained how to think at Cambridge University. I make no distinction based on race, creed or gender. My economic success is such that I passed the inheritance left me by father directly to my daughter. In this vein, I want, much to her bewilderment andconfusion, nothing from my mother as she gives nothing without gain and bribery. What are at stake are both my identity and my re-found healthy relationships and role with my brother, sisters, daughter and grandchildren – not to mention my well-being, independence and my business.

 

I have no desire to ‘destroy’ my mother as I realise that her lost role provokes unhappiness, loneliness and illness. In fact, whilst I telephone her every day I also welcome the now several hundred mile distance between us. I do resent the fact that I only discovered that my father’s absences from home when I was a child were due to his treatment for schizophrenia. A fact recorded on my medical notes but still denied by my mother. No doubt it explains why my mother’s mocked my father’s dementia. My mother is the victim of her own upbringing in which any departure from that which society accepts as the norm is to be hidden, denied and lied about even if the risk is isolation and suicide.

I hope that I have clearly shown how the treatment by our respective families, combined with some of the worst aspects of psychiatric detention, resulted in a state of hopelessness in which suicide seemed the only viable option. I would now like to finish by underlining that the ‘system’ is a system of pot luck in which I have been more fortunate than my friend. The system is dependent on the good well and honourable intentions, or less, of the individuals who compose it. As mentioned I had the good fortune of a Care Coordinator – an Occupational Therapist – who not only recognised my potentialities but also set about kindling them encouraging me to re-discover myself. My friend has not had this good fortune and is largely left to his own devices, drifting aimlessly through life. I have had my current Care Coordinator for about five years. Prior to this I had a laid back Social Worker and prior to this a bully boy nurse.

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Far be it from me -

Government is not delivering on mental health

The government’s mental health strategy set out five key issues affecting mental health, but current policy across departments is failing to address them.

depressed male
The government has outlined five key issues affecting mental health but has failed to protect them from cuts. Photograph: Matty/Alamy

A year ago the government’s mental health strategy, No Health Without Mental Health, was published, with the aim of ensuring all departments and agencies worked together to reduce the annual £105bn cost to the UK of psychological ill health.

When the National Mental Health Development Unit was scrapped the month after the strategy was published, that work was given to mental health charities including Mind, Rethink and the NSUN network for mental health.

As part of attempting to design a practical implementation plan for the strategy…

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