A study I haven't enjoyed reading showing loss of grey matter in children with a diagnosis of schizophrenia.

MAPPING ADOLESCENT BRAIN CHANGE REVEALS DYNAMIC WAVE OF ACCELERATED GRAY
MATTER LOSS IN VERY EARLY-ONSET SCHIZOPHRENIA
http://www.loni.ucla.edu/~thompson/MEDIA/PNAS/Schizo_article_PNAS_pdf.pdf
<http://www.loni.ucla.edu/%7Ethompson/MEDIA/PNAS/Schizo_article_PNAS_pdf.pdf>

At a mental health event a few weeks ago an advocate spoke to a doctor
telling parents their child's brain would deteriorate through
schizophrenia unless medicated using antipsychotics. I thought this was
bullshit like the "chemical imbalance in the brain" line. I may be
wrong. From this study which uses a small sample of patients, controls
and medicated controls with psychotic but not affective disorders other
than schizophrenia, it shows that a child's brain will deteriorate and
this is caused by the 'disease' process. I'm still not ready to give up
on the idea that psychosis may have other significance than brain
malfunction but its a powerful piece of evidence that it is a disease in
the classic sense of mental illness.

I'm not capable of assessing for quality. The small numbers would be
something I'd ordinarily take exception to but the authors suggest the
results are consistent. The loss in grey matter is also observed in
children without a diagnosis of schizophrenia or not taking medication
however it is significantly larger in children with a diagnosis. Clearly
the change from child to adult is associated with a loss in grey matter
but to a lesser degree than those who recieve a diagnosis of schizophrenia.

To the advocate I'd say that this paper is a research paper. The
diagnostic criteria used is DSM-IIIR which is not used in practice and
in the UK, so the results may not be applicable unless the same level of
rigour is used to identify schizophrenia. The paper also goes on to say
that schizophrenia is not only biological in cause and there are
environmental aspects. For the Psychosis Not Otherwise Specfied control
group the loss in grey matter was "subtle but significant" and none of
the group recieved a diagnosis of schizophrenia at follow up so getting
the diagnosis right is vital before giving a diagnosis of schizophrenia.

The thought I have is that many things could be looked at under the lens
of an fMRI scanner and many observations made about the way the brain is
somehow different. I'd be interested to see if there's been scans done
on people who have recovered from schizophrenia or have survived it
without medication. The latter group would be a useful control to see
the effect of medication on developmental neurobiology.

Information about the brain degeneration aspect of schizophrenia is
explained in a simpler form below but the study, though very complex for
anyone (like me) who knows little about neuroscience, is worth a read..
http://www.schizophrenia.com/research/schiz.brain.htm

An extraordinary result about untreated depression.

I came across this while reading a blog post from a superb blog.
http://www.madinamerica.com/madinamerica.com/Home/D6B7C500-5324-423B-BA01-C57B306C0F2D.html

From
http://www.madinamerica.com/madinamerica.com/Home/D6B7C500-5324-423B-BA01-C57B306C0F2D_files/The%20naturalistic%20course%20of%20major%20depression%20n%20the%20absence%20of%20somatic%20therapy.PDF
"
Our analysis of the subgroup of depressed subjects who
went without somatic therapy throughout the entire course of
their depressive illness yielded a median episode duration of
13 weeks-nearly identical to what Coryell et al. (1995)
reported in a separate cohort of subjects who did not receive
somatic treatment. Subseqent to the the first 3 months of illness,
the spontaneous remission rate appears to decrease dramatically,
though a substantial number continue to recover so that
by the end of I year, only 15% of the subjects who had not
received any antidepressant medication treatment were still
depressed.
"
Which leads the authors to say
"
If as many as 85% of depressed individuals who go
without somatic treatment spontaneously recover within 1
year, it would be extremely difficult for any intervention to
demonstrate a superior result to this.
"

Its not a high quality study though the analysis seems sound and its not
the only study to show a similar result including a meta-analysis by one
of the study authors.

There's another useful paper the blogger's has online.
http://www.madinamerica.com/madinamerica.com/Depression_files/Characteristics%20and%20significance%20of%20untreated%20major%20depressive%20disorder.PDF

Depression ramble

This ramble is on a lot of things. Its in part about language and
conceptualising depression and mental illness outside their medical
sense, and perhaps in their real sense. Its about treatment for
depression and another way of looking at things.
----
Depression is an affective disorder in psychiatric terms. Its also
unhappiness and misery in normal language.

Sometimes unhappiness happens for a reason. Sometimes it doesn't. The
difference is usually not clear and often not the the reason. 2 weeks is
psychiatric minimum for the cluster of symptoms it uses to define
depression though it caveats grief as a natural process and applies a
much longer time for unhappiness associated with death (2 years in DSM
if I remember right). Bereavement and the pain associated with it
defined as acceptable misery whereas any other form of misery is dealt
with by medication.

On the one hand treatment with antidepressants is compassionate. Its
society providing drugs that get people high and away from their
problems, and its a lot cheaper than alcohol and drugs. Antidepressants
also offer hope to those trapped in the deepest of miseries, or what was
traditionally defined as melancholia in Kraeplin's day. They are a much
better than an electrically-induced seizure, or electro-convulsive
therapy as doctors call it. Thankfully the majority of people don't get
to that stage.

Its easier than attempting to understand why an individual may be
unhappy or miserable. Its easier for the individual if the negative
feeling, or the emotional and behavioural disorder to use the
psychiatric language, is about a change process because that process can
be averted or the pain taken away by all sorts of drugs. It may be
easier for society to hand out drugs to deal with the unhappiness of the
masses rather than see that perhaps society isn't working. It may be
considered better by governments focused on productivity as the value of
an individual that a person stays working and the drugs mean they're
capable of doing that whereas the change process may mean they could
temporarily be in a state where they could not work or should not work.

The reflection and the soul searching that can be associated with
unhappiness, the depth of thought and the seeking of answers that can be
associated with unhappiness may be important to an individual's journey
through life however society is not designed to understand that people
need that time without the mental illness system, however the system
often moves to medication people far too quickly and mistreats something
that may have significance to the individual outside psychiatric
measures of mood.

A society where 10-15% of people are worred and unhappy at some point in
the year, or anxious and depressed, is a distressing figure in itself.
One option is to drug those people up and another is to offer them
treatments to change the way they think and behave. It is perhaps
something in the vision of modern government but far from a reality that
the other option is to change society such that people are less unhappy
and worried. The systems that have developed within society are causing
the suffering in individuals but to see that may be hard for politicians.

It will be likely be the next century where the 1 in 4 or 1 in 6 figure
is seen as a measure of the failure of society and a government willing
to understand that large changes are needed to correct the illness in
society that's causing the distress.

The Work Capability Assesssment

The government's new drive is for getting people off Employment and
Support Allowance and back into work.

A fundamental shift in the UK state welfare system for sickness is the
change to the test for recieving medical benefits from what people can't
do to what people can do. I am unaware of the results of the change
however I assume it has been done to get people off the higher rate of
incapacity and onto the lower job seekers rate.

The higher rate of incapacity benefit isn't much. Its around £100 a
week. Its much more than the even smaller amount for job seekers which
is around £60 a week for a single person however there's a large drop in
real terms between poverty and extreme poverty. Its a situation that's
causing a lot of anxiety amongst people currently in receipt of medical
benefits.

I don't know enough about the test to criticise it however I suspect its
going to mean a lot of people who aren't ready to work will end up being
forced into poorly paid jobs with little control, job satisfaction and
challenge. There are many people who have a lot to offer or had until a
life crisis. Many people will be forced into menial, low paid jobs that
will be a detriment to their mental and physical health or face an even
worse impact from poverty when they had a high capability before
whatever life crisis resulted in a diagnosis of mental illness.

Its a loss to society as well. Employers value many things in the modern
age and there are many highly talented people who's careers have been
crippled through mental illness and the real problems that causes for a
person's career. Many don't 'flourish' as they should and while
remaining on benefits of any kind is not flourishing for many people the
pathway to reaching their potential should be the goal of the change in
the benefits system. Instead what is likely to happen is that people are
pushed into jobs where they do not flourish and are unhappy. Their
potential to contribute to GDP is lost if smart, talented people end up
working in call centres or stacking shelves in a supermarket.

Timescales for returning to benefits are important for those people
coming off benefits because the short few months between finding paid
work and the cessation of benefits could mean many people end up unwell
again and having to re-enter the system or work when they're not fit to
work. This means there will be a direct negative impact to many people's
mental health if they are not appropriately assessed and supported
throughout their return to work.

A friend of a friend who may have an exceptionally unusual experience of
consciousness recently brought this to my attention as a problem being
faced by many people in England. She wants to work and she is very
intelligent and capable, but severely disabled through the general
unacceptance of the symptoms of mental disorders in the workplace. Many
people like her will face the anguish of stigma and exclusion, sometimes
subtle and sometimes explicit, through this simple change that has not
been supported by a new system to support employers and encourage the
employment of the mentally ill as well as the employment antistigma
program required to change the real world problems people face in the
work place.

Suicide in Japan

By the time you've finished reading this something awful will have
happened in Japan. Its really quite a horrible figure. Japan has the
highest suicide rate in per captia in the developed world. The reasons
are mixed and not only because of the traditional place of suicide as an
accepted part of Japanese culture but related to a culture sheering
because of the rapid rate of change and the clash of traditional and new
Western ideas.

If you read this quickly someone has killed themself in Japan in the
time it took to read this. If you're a slow reader 2 people will have
killed themselves by the time you reach this fullstop.

The new 10 commandments

Its the Mental Health Foundation's action week.
http://www.mentalhealth.org.uk/mhaw10/

They've introduced some commandments for good mental health.

"

Here are 10 practical ways to look after your mental health:

1.

Talk about your feelings
</information/how-to-look-after-your-mental-health/talk-about-your-feelings/>

2.

Keep active
</information/how-to-look-after-your-mental-health/keep-active/>

3.

Eat well </information/how-to-look-after-your-mental-health/eat-well/>

4.

Drink sensibly
</information/how-to-look-after-your-mental-health/drink-sensibly/>

5.

Keep in touch
</information/how-to-look-after-your-mental-health/keep-in-touch/>

6.

Ask for help
</information/how-to-look-after-your-mental-health/ask-for-help/>

7.

Take a break
</information/how-to-look-after-your-mental-health/take-a-break/>

8.

Do something you are good at
</information/how-to-look-after-your-mental-health/do-something-you-are-good-at/>

9. Accept who you are
</information/how-to-look-after-your-mental-health/accept-who-you-are/>
10. Care for others
</information/how-to-look-after-your-mental-health/care-for-others/>

"

I have to admit they're quite good. They've been handed down by
committee rather than god so nothing about not coveting my neighbour's
donkey.

Miaow Miaow

The latest recreational drug is nicknamed Miaow miaow or Plant food. Its a new "research chemical" or "research ligand". It was developed by an Israeli enthogeon research company that designs legal highs. I haven't yet tried this drug but I think I need to.

Its soon to be made a Class B drug which flies in the face of expert opinion and is making the governments draconian drug policy all the more obvious for being prejudice rather than evidenced-based policy.

It is seen as a moral choice to say these drugs should be illegal. Many drug dealers must be rubbing their hands at the prospect of yet another new market for them thanks to the government.

The impact of making the drug illegal will not reduce its availability as is clear from the current drug situation in the UK. There is no drug problem as far as I am concerned because everyone can get them.

The UK government doesn't care about the lives of drug users however I and many other people do. By making them illegal it leaves the distribution purely in the unregulated hands of crime. A taxed, regulated system has so much potential for physical and mental health as
well as the social harms that come from addictions. The value for healthcare has already been demonstrated in the US for cannabis and more research into the other drugs will undoubtably lead to new treatments. MDMA, for example, could be used before ECT, high-CBD weed for psychosis before antipsychotics and alcohol and fun before antidepressants.

Drugs will have to be legalised one day but the political prejudice will be hard to breakdown. It's so high that they fire senior government advisors who don't tow the party line. It feels very Stalinesque to oust those with opinions that aren't of the group.