The Mentally Ill Brain

with Kay Redfield Jamison, Elyn Saks, Eric Kandel, Helen Mayberg, Stephen Warren and Jeffrey Lieberman
in Science & Health part of Charlie Rose: The Brain Series
on Tuesday, June 22, 2010 * * * * *

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On Episode Nine of the Charlie Rose Brain Series, a discussion of mental illness with Kay Redfield Jamison of Johns Hopkins, Elyn Saks of University of Southern California, Jeffrey Lieberman of Columbia University, Helen Mayberg of Emory University, Stephen Warren of Emory University, and Eric Kandel of Columbia University

Watch previous episodes here

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Keywords:
health
schizophrenia
emotion
brain
sickness
mental illness
health care
Insurance

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    1. jpke  08/21/2012 03:47 PM Report

      Mr (Charlie)Rose,

      You've had a series on the brain, brain "science" and psychiatry with various guests discussing developments and "discoveries" in their field(s). How about doing a show (or even a series) on a growing number of groups and activists in the field of "mental health" and psychiatric reform? I (and a growing number of others) believe it would be of great public service to broadcast in the "mainstream" media the views and work of individuals such as Peter Breggin, MD(author,psychiatrist), Jim Gottstein (atty, mental health activist), Robert Whitaker(psychiatric researcher and author), David Healy MD (author, psychiatrist), Ann Blake-Tracy(International Coalition for Drug Awareness), and others.

      There is increasing, documented evidence on the harm done by the use of psychotropic drugs which should be made more "public".

      There are also mental health/ psychiatric consumer (and "insider expert") voices rising on issues related to: Informed consent, coercion, disclosure, misrepresentation, false claims, conflict of interest, corruption, ghostwriting, fraudulent practice, physical/mental abuse, and professional ethics and standards issues in the psychiatric and mental health field.

      Your response would be appreciated.

      Sincerely, Jim Keiser

      PS: I'm adding the following statements (by others) for your consideration and comment:

      RE. DIFFERENTIAL DIAGNOSIS: "The thing that bothers me the most about psychiatry (outside of the harm done by its so-called "treatments") is the fact that psychiatrists almost NEVER look for underlying medical disorders. They just use their "Bible," the DSM, which is merely a collection of symptoms that could be caused by MANY THINGS. By not using differential diagnosis, psychiatrists are failing to practice actual medicine. Joe Blow off the street, with no medical training, could come up with a diagnosis after listening to someone describe their symptoms once he has flipped through the pages of the DSM. If I can accomplish one thing (and I have no idea of how to do this), I would like to create a standard that forces psychiatrists to do a thorough battery of medical tests before any medications are prescribed or labels given."~unk

      ___________________________________

      STANDARD PRACTICE IN PSYCHIATRIC "DIAGNOSIS" AND TREATMENT (valid from my, and others' experiences):

      "...Most people would agree that people need to (be) told accurate information about the validity of a diagnosis; including whether or not it is Biological in nature; or if this is a belief based on nothing more than a yet to be validated Hypothesis. Saying that a psychiatric diagnosis is a disease/chemical imbalance/neuro-biological in nature is a story told to 'bust the stigma' and to get people to take their meds; not because it is based on fact.

      ...Fraud is a crime, and also a civil law violation. Defrauding people or entities of money or valuables is a common purpose of fraud, but there have also been fraudulent 'discoveries', e.g., in science, to gain prestige rather than immediate monetary gain. ...

      ...Most people would agree that people need to given accurate, unbiased information about the drugs prescribed to them and their children. Most of us would agree it would be wrong to tell people that they in fact have a disease/chemical imbalance or a neuro-biological condition requiring drugs to treat it; when no imbalance, disease, defect or neuro-biological condition has been identified. These claims are being made without any physical, neurological or medical examination taking place. A conversation with the person and gathering information from others about their personal opinions and subjective observation of the patient or 'client' is not an examination; and even a consensus of informed opinions does not make the weakest of 'evidence' scientific or valid; it does not make the psychiatric diagnosis a medical condition either. ...

      The fact is: no genetic condition, chemical imbalance, or neuro-biological pathology has been identified ever--in any human being alive or dead; that causes any mental illness, or psychiatric diagnosis. ...

      ...Failing to give people the very information which is necessary to protect their children and themselves is particularly heinous; despicable really, all things considered. ...

      ...For professionals to ignore their ethical duty to fully inform patients and parents of children about the nature of psychiatric diagnoses, about the potential for harm involved in taking psychiatric drugs is criminal; not just 'unethical.' It is, in reality fraud...

      ...This being the case, it is an unethical claim for any psychiatrist or mental health professional to make. It is dishonest, it is disrespectful and it is evidence of an utter lack of professional integrity. ...

      ...Many believe the drugs are treating a disease, because of the erroneous belief that doctors don't lie to patients. People take neurotoxic drugs believing that the drugs treat a brain disease they have. The drugs cause iatrogenic, or 'physician caused' diseases, neurological impairments, and can disable them; and even cause their untimely death. ...

      ...It is fraud. It is Standard Practice. It is criminal. "~from article in Systems of Care Yakima

    2. SharkswithfrikingLazers  01/07/2011 03:19 PM Report

      DEPRESSION:

      One of the TOP TEN Stories from UT Austin in 2010:

      http://www.utexas.edu/features/2010/10/18/sentences_depression/

      Load the mind with a six-digit number and then have the client reorder a sentence to predict depression--two sets of 25 scrambled sentences and three and a half minutes to unscramble each set.

      "Interestingly, and consistent with prior findings, only the subset of sentences that had been completed under cognitive load predicted a later diagnosis of depression," says Rude. "This supports the idea that a truer picture of the cognitive biases contributing to depression vulnerability emerges when respondents' ability to intentionally compose their answers is hindered."

      Looks like this study found a way to detect the formation of neural pathways of depression.

    3. memirose  10/17/2010 04:56 PM Report

      Very simply: These kinds of roundtable discussions are useless until we offer appropriate options and opportunity for ALL sufferers.

      People with money and health insurance have the luxury of "finding" proper treatment and support.

      I have been involved in the psychiatric "system" as a patient for over 20 years and constantly forced to save my own life and research what I can for myself. I AM LUCKY that I have intelligence and education to bolster me through the times when I am not over-prescibed benzodiazepenes or when my doctor has ignored certain research facts.

      I continually struggle with the stigma attached to mental illness because I am expected to find competent physicans and do physical exercise, meditate, and secure small jobs to FIX MYSELF.

      I am legally diagnosed with Bipolar 2, granted disability from the Federal Government, and expected to survive with no outside income on $694 a month. (And not experience stress?)

      The poor are simply statistical experiements for drug companies.

      I appreciate the mainstreaming of the information but even Jamison's Clinic states they don't work with many insurance companies. Do they take Medicaid and Medicare? Do any clinics of high esteem?

      Long live the rich.

    4. dieselisadog  09/08/2010 03:09 AM Report

      Fantastic episode!! Thank you so much for airing it.

      I suffer from depression (with suicidal ideations) myself and I appreciate Kay's accurate and articulate explanations of the disease. I also appreciate the panel's desire to remove the stigmatism associated with mental illness which makes people such as myself feel "broken" and reduces my desire to comply with treatment. Fortunately I am doing very well with the exact treatment everyone talked about - drugs (Wellbutrin) and physcotherapy (weekly counseling sessions and support groups).

      My father told me about this program and I cannot applaud his support of me enough. He works tirelessly to understand this disease and I wouldn't be where I am now without his love and support.

    5. beenthere  09/07/2010 11:57 PM Report

      To Caprino:My husband had bipolar disorder.He took cogentin to mitigate muscle tension. Ask your doc if this would help you. Good luck.

    6. Yosey  09/06/2010 08:34 PM Report

      Excellent program. I would be interested to hear about all possible treatments for depression - not only about drugs - but rather about holistic approach.

      More practical information about how to treat depression like one of the comments mentioned the Brain Bio Center in Princeton, NJ. Informative survey about similar centers would be greatly appreciated.

    7. amunjal  09/03/2010 01:40 AM Report

      Thanks for such informative program. We have so much knowledge about these mental disorders including the need for early intervention but what about those who do not get treatment because the law does not allow it. No one talked about the frustration of watching your loved one get sicker in front of your eyes and you can not do anything about it because the law wants a sick and irrational person to make rational decision about getting treatment. These are the patients with no insights into their ailments. What about their human rights when the law is letting them get sicker to the point of no recovery. The explanation- they are adults and no danger to themselves and others. Is it not danger to themselves if their sickness is progressing without treatment? What do you do about that?

    8. amunjal  09/03/2010 01:40 AM Report

      Thanks for such informative program. We have so much knowledge about these mental disorders including the need for early intervention but what about those who do not get treatment because the law does not allow it. No one talked about the frustration of watching your loved one get sicker in front of your eyes and you can not do anything about it because the law wants a sick and irrational person to make rational decision about getting treatment. These are the patients with no insights into their ailments. What about their human rights when the law is letting them get sicker to the point of no recovery. The explanation- they are adults and no danger to themselves and others. Is it not danger to themselves if their sickness is progressing without treatment? What do you do about that?

    9. c824767  08/25/2010 06:12 PM Report

      http://www.ppao.gov.on.ca/inf-rst.html

      amazing information about restraints and your rights as a psychotic patient.

    10. c824767  08/25/2010 06:09 PM Report

      It may be said that Kandel is a goofball,

      but a nice one...

      however his idea that depression is more complicated than diabetes is riculous... diabetes leads to depression in more cases than not....

      google depression and diabetes and it is totally easy to see how they are related.

      http://www.dlife.com/diabetes/information/daily_living/depression_and_coping/index.html?s_kwcid=TC%7c 3015%7cdiabetes%2520and%2520depression%7c%7cS%7cb%7c2671873493&gclid=CKeg9NXR1aMCFUf75wodBn5YuA

      Several studies suggest that diabetes doubles the risk of depression compared to those without the disorder.

    11. c824767  08/25/2010 06:00 PM Report

      No one needs to feel pressure to contribute to society. society is not that great.

      however, it would be nice if everyone could live without becoming a threat to society... i.e. psychotic people can you contribute to society by taking your medication ? that is ALL that is required of you

    12. c824767  08/25/2010 05:57 PM Report

      ha ! obama, get us health care for our schizophrenics

    13. c824767  08/25/2010 05:53 PM Report

      Ok people with depression do not connect.

      one does not always have to make a connection...people are on the same planet what else really matters ?

      interesting though the area in the brain responsible for self connection ??? how does that work in animals who do not have as much of a sense of self ?

    14. c824767  08/25/2010 05:43 PM Report

      i think psychopaths and sociopaths do not experience grief

    15. c824767  08/25/2010 05:10 PM Report

      surely brain circuits are not like circuits in stereo equipment etc??? or are they ??????

      i feel soooooooooo for people who feel sad much of the time.

      to me depression is like when you are tired. you have to rest your body and brain. people have to give themselves a break.

      i think it is so important to find some good medication.

      it is pretty easy to be depressed when you look at the "state of the planet" ....

      people who are depressed might be the REAL HUMANS...

    16. oypol  07/30/2010 08:00 PM Report

      Having been a victim of the mental health community, I have realized all too late that there is no such thing as Brain Chemical Imbalance. I have come to understand that the medications themselves are what causes the "chemical imbalance" in those being treated. I believe Dr. Peter

      Breggin has the best interest of the patient at heart, rather than his own bottom line.

      Suffering migraines, led me to *anxiolytic* medications, and unknowingly into addiction. I was never made aware that Benzodiazepines were, in fact, tranquilizers. Had I known that, I would have never taken my first pill. Ever. I was led to believe benzos were a new class of drug - for treating anxiety.

      I was addicted, Iatrogenically Addicted, and spiraled down into a deep depression, and began to believe I was going insane. My doctor kept asking me if I was hallucinating. I said, "No." She actually looked disappointed and as though she did not believe me. Benzodiazepines are dangerous drugs when given long term, and cause a host of negative symptoms. Doctors tell patients they need them like a diabetic needs insulin. What? Does anyone NEED addictive substances for life? Would they tell an alcoholic they need Vodka for the rest of their lives? NO!

      So why the disconnect with the benzos? Docs know these meds are dangerous as they will substitute an anti-seizure medication when cutting a person off from the benzos. Benzos quit in a cold turkey fashion have caused some victims to suffer seizures, and some have even died.

      The negative symptoms from these drugs should be labeled as such. Calling them "side effects" minimizes and sugar coats the impact. These aren't side effects. These are DIRECT EFFECTS that a patient would not be experiencing, were it not for the chemical they are ingesting. These negative and direct effects are sometimes enough to destroy a person's life completely.

      Benzos screw up a person's judgment and render them incapable of making decisions that impact their lives. Having once possessed an IQ in the 140's, and retested at around 110 while in the hospital when being withdrawn from 40mgs Diazepam, I could not believe how impaired I had become, as it was very gradual and insidious. These drugs are debilitating and have no place in long term care.

    17. Natural  07/30/2010 12:53 PM Report

      Although I greatly appreciated the honest and courageous sharing of Ms. Saks and Ms. Jamison, I was disappointed with the purely mainstream treatment model discussed by the others on the panel. Ms. Mayberg stated that "chemistry has led biology -- and hypotheses have been formed." This is where mainstream medicine, dependent on medication, restraint, and shock, has missed the mark in the treatment of the mentally ill.

      Ms. Mayberg, and the others from Emory University, might do well to explore the work of one of their former colleagues, Carl C. Pfeiffer, PhD, MD, who taught pharmacology at Emory. It was through this work that he discovered the pathways used by nutrients and how they affect brain function, to which he later dedicated his life work. He founded the Brain Bio Center in Princeton, New Jersey, and helped many people find healing through complementary orthomolecular medicine.

      Dr. Pfeiffer, along with Drs. Linus Pauling and Abram Hoffer, found that high doses of certain nutrients helped correct imbalances that caused symptoms of mental illness. Over thirty illnesses/conditions were discovered that could cause what we call "mental" illness. Where medications were still needed, lower dosages could be given, and side-effects reduced. Overall health and quality of life is improved through these orthomolecular treatments.

      Anyone with a mental illness diagnosis should find a qualified physician and get a good biomedical evaluation. This should not be done on one's own, as it can be dangerous to reduce medication without proper treatment and care. I am glad that Ms. Saks and Ms. Jamison have responded well to traditional treatments, but many do not, and all people with "mental" illness should be tested for biological disorders that could be causing their symptoms.

      Thank you for an informative program.

    18. Mindfreak  07/18/2010 07:02 PM Report

      I'm a retired physicist and have much enjoyed the Charlie Rose Brain Series -- except that, right from the beginning, little mention was made of the Mind and, in fact, the distinction between Brain and Mind was not drawn. I see with great expectation that an episode is planned for November on "The New Science of Mind": bravo! There are many active researchers in this area; for example, Walter J. Freeman, Jr., of the UC Berkeley, who wrote a very readable book "How Brains Make Up THeir Minds".

      In Episode 9, Prof. Mayberg gave a first encouraging sign by pointing out the influence of body parts other than just the Brain on the overall result. In general, the Mind cannot be localized: it might well be the result of the nonloinear statistical dynamics of our very large ensmble of neurons, plus their insulating shields, plus the gray matter, plus the lymphic system -- and/or a verylarge network, whose complexity canot be fathomed by ONE of its nodes lighting up in an fMRI.- This budding understanding may well be THE most exciting scientific advance of the next decade or two!

      Antonio Damasio was in a previous Episode, but did not mention how much he has contributed to enlightening the Brain/Mind dichotomy in his book "Looking for Spinoza: ... the Feeling Brain" (confusing in the title what he well distinguished in the text)! Other great contributors to the round table would be Steven Strogatz (Cornell, "Sync"), Jefferey Satinover (Harvard, "The Quantum Brain"), Christian Gerloff (Hamburg, Germany, who has a coworker at NIH) - and Paul Churchland (UCSD, "Phisosophy of Mind").

    19. Caprino  07/14/2010 08:11 AM Report

      First I have to say that this was an extraordinary good episode. I loved it to the point that i almost cried. It looked like the guest enjoyed it very much as well.

      I have bipolar disorder, and this episode sums up pretty much all the information I painstakingly have gathered over the last couple of years. I wish I saw this episode when i was diagnosed 2,5 years ago.

      I will use this episode as an educational and inspirational video together with the support groups we try to gather in our local community.

      I take the medication Lamictal witch I have responded very good to. I have experienced no side effects that I know of yet. I also go to something called Norwegian Psychomotoric Physiotherapy(http://www.uib.no/isf/people/doc/hovedfag/sjursen.htm). Witch has saved my life by treating muscle tension and at the same time functioning as psychoanalysis.

      What I miss in the talk was focus on muscle tension and twitching muscles. I have found no good information about this, and no doctor I have been in contact with have been able to direct me to good information.

      Severe muscle tension and uncontrollable muscle contractions is a problem for me, and many of the people I know who has mood disorders. I have also been on internet forums for people with bipolar disorder and i see that this is a problem for many people with both bipolar 1 and 2.

      I have been to neurologists, but according to them I am very healthy and they find no sign of neurological problems at all. In spite of this, I hope that muscle tension and uncontrollable muscle contractions will be discussed in the last episode of the brain series.

      If people reading this comment section have good information about muscle tension and uncontrollable muscle contractions in connection with mood disorders, I will appreciate if you share that information here. Thank you.

    20. Online10  06/29/2010 02:02 PM Report

      Charlie, I have "sent" your videos of this series to many colleagues, and I thank you, and your wondrous team. My life has been one neuro "accident" or impact after another, including long-term child abuse. As much as I've studied professionally, more learning always helps - until two TBIs (errant drivers - MVAs) over a 5 year period were added on top of serious infections that affect the neuromuscular system, and left me with partial paralysis. No one 'touches' what TBIs do to us - no one but those in your group.

      On this series, the importance of psychoanalysis was brought up, and I must concur. Many of us who had neuromuscular diseases/disorders cannot take a lot of the medications now being used for pain, and/or impacts on the brain/mind, etc. due to their impact on the respiratory girdle. Thus, analysis coupled with increasing inforamtion about the wondrous brain is paramount. We are our brains.

      In closing, once due to PTSD after a truamatic hospital experience that could have been prevented, I had depression - it was horrid - but my experience in analysis moved me through it, in a short time. My heart goes out to those with depression. With the TBI impact and that bout of depression I would do anything to help this cause. Please give my heartfelt thanks to the team, and ask them to contact the states' departments of aging and disability, because each state MUST beef up their understanding of the brain, including TBIs. Their work is the path to joy, peace, and empowerment in our future.

    21. profbob23615  06/26/2010 11:18 PM Report

      I am a 70-year old male who has suffered from depression for over 50 years. I have particularly enjoyed your series of programs on the brain, but the recent episode on mental illnes was of particular interest. It was very informative and even with my long history of depression provided some new information. I have recommended the program to my family doctor, other treatment providers, and friends.

      Thanks so very much!

    22. tonybrown  06/25/2010 12:27 AM Report

      During the program, Kandel's statements "psychotherapy works on the

      brain. It’s a biological treatment," reminded me why I have followed this insightful scientist since my very first year of medical school. Thank you Dr. Kandel for continuing to affect my life and thanks to you Mr. Rose for facilitating the same.

    23. robbinsmail  06/24/2010 06:20 PM Report

      Amazing discussion on mental illness, encouraging news of future treatments and point-on regarding the lack of funding and undertreatment.

    24. GeneFox  06/24/2010 12:50 PM Report

      My wife and I find your series to be exceptionally welcome.

    25. gerlandson  06/24/2010 01:13 AM Report

      I appreciate your discussion with Jamison and Saks. I am a mental health professional that manages Bi-Polar. I know from my own journey that there is much more beyond medication that needs to be explored in the recovery process. I would like to hear even more about further significant components in managing mental illness like nutrition, meditation, healthy relationships, creative outlets, and peer support. I know from my work at a self-help center that understanding mental illness is indeed complex as your guests all affirmed. Medication support is key for many of us but it is just one piece of a multi-faceted approach to recovery. I am glad cognitive therapy was discussed but there are many other tools in addition to cognitive therapy that may be helpful. May the discussion continue and the stigma disappear!

    26. gracie  06/24/2010 12:10 AM Report

      The program last night was outstanding and informative even to me, a person with treatment resistant depression all my life. I particularly related and learned from the distinction between grief and the intolerable pain, as I call it, of depression. Seeing the beauty of a flower and not being able to take it in; knowing that I love my husband and not being able to feel it--and then the pain gets beyond definition or description and so horrible that physical pain would be a relief.

      My disappointment for your viewers was that no one mentioned the cutting edge rTMS treatments (repetitive transcranial magnetic stimulation) of a specific area of the brain. These treatments are FDA approved --though my insurance company does not cover them -- and they are still very expensive. But they work! For me and others like me. Where not even ECT worked. They are available around the country. I believe they are also used to treat manic depression. The side effects are either nonexistant or very insignificant compared with most drugs and ECT. I would urge you to educate your public about these relatively new (1 1/2 years) treatments which should be covered by insurance but may be an option for some even without that.

      My apologies if I simply missed the episode in which these teatments were discussed. Thank you for your rare combination of interest and talent. Katherine Hamilton

    27. tdp  06/23/2010 10:59 PM Report

      Dear Mr. Rose,

      Your shows have always been great - but this series on The Brain is incredibly profound. You have outdone yourself. This is a brilliant way to inform the public about the research and information that is typically "hidden" from the mainstream.

      Dr. Kandel is amazing in the breadth of his knowledge and his understanding of each panelist's frame of reference. The panelists are not only brilliant minds but courageous souls because of their willingness to be so open about their own personal struggles.

      My only suggestion is to please keep the series going beyond the original plan. What a wonderfully entertaining education. Thank you.

      Terry Del Percio

    28. Meshimo  06/23/2010 03:14 PM Report

      Our physical senses were designed to give the kind of balance that this topic explores. We are an environmental being and we derive our point of reference from the stimulations in and around us as presented by elements of creation and nature.

      These neuron circuits (via the senses) are the gateways through which the emotional, mental and spiritual balances are made possible. If you deny the stimuli or block the outlet necessary to prod and incent a desirable behavioral outcome, then the human psyche will involuntarily respond in an undesirable manner. The expression is seen as abnormal or imbalanced.

      Examples will include a 24hr caging in an air conditioned environment with windowless buildings.

    29. REMant  06/23/2010 02:08 PM Report

      I think you can say that manic-depressiveness reflects an absence of rational control. It is more prevalent in less rational people, historically, comparatively, and developmentally. One can link mania to benefit, or happiness, and depression to cost or pain, the determination of which are common definitions of rationality. So-called talk therapy is better termed self-examination therapy, because its object is to get the patient to make himself more objective. Freud was on the right track all along, but Americans avoid thinking about the past, mainly because it involves shame. While schizophrenia and paranoia are more extreme examples of irrationality where the patient lacks autonomy or free will, yet is excessively proud, jealous or defensive, in obsession the concern is temptation and it is an illness borne of conditioning, neither rational nor jealous, but envious and greedy, concerned with approval, with feelings of shame and regret. It gives rise to compulsions without reason or enjoyment, grounded in self-denial. Obviously there are genetic components, so that it would be hard to tell whether the behavior is determined or the behavior determines, and one can go around in circles just as much as the theologians regarding predestination. It is to be expected that what is seen behaviorally will be found biologically. It does not necessarily mean a biological cure can be found, or if not, that nothing can be done.

    30. keithrobnel  06/23/2010 01:18 PM Report

      I'm fighting major depression and severe anxiety disorders.

      Everyone at the table is directly on-target. I gained a little more knowledge. They squeezed-out a great amount of info into an hour.

    31. Kathline  06/23/2010 01:04 PM Report

      Really enjoyed episode 9 of the brain series. One of my children has schizophrenia, and I am always searching for answers.

    32. ShalomFreedman  06/23/2010 01:01 PM Report

      Charlie Rose is to be congratulated for this program.

      Also, Eric Kandel.

      I know the work of Kay Redfield who wrote one of the greatest autobiographical works ,"An Unquiet Mind". Her remarks here on the difference between Grief in which we are still alive, and Depression in which we are dead inside were informative. So were the remarks of all the other panelists. The discussion was conducted with great intelligence.Kandel knows the work of the people he has assembled, and his questions enable them to explain their ideas and research in the best possible way.

      I hope this program will be helpful to many many people. And I hope too it will reduce to some degree the stigma people suffer as additional burden for having one of these illnesses.

    33. phonemwin  06/23/2010 08:35 AM Report

      Brain Series is very good