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Bipolar News

August 27, 2005

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Evidence of Brain Chemistry Abnormalities in Bipolar Disorder - USA
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USM student riding a rocky road to a normal life

Portland Press Herald (Maine); 8/24/2005; Kim Clifford Staff Columnist

He looks like an angel.

He's also articulate, considerate, a good listener, clean-cut, polite and smiles often. He is gifted with intelligence and curiosity. His wisdom is that of someone much older.
At 25, Patrick Willigar of Portland is finally turning his life around, soaking up college "like a sponge," he said. He aced his first semester at University of Southern Maine, with a 4.0 cumulative average. It was the first time he's been back to school in 13 years.

Last year, he finished an 18-month sentence at Maine State Prison. He was an addict, hooked on prescription drugs.

But by the time he got out, he was clean and ready to face his demons: bipolar disorder, addiction, depression, post-traumatic- stress syndrome and a past that includes homelessness, insomnia, anxiety, blackouts, arrests, jailings, two suicide attempts and being beaten, stabbed, shot at and mugged.

"I finally had to make a choice to live or die," he said. "I recognized I needed help. I didn't know how to relate to the world."

With the help of USM, the city of Portland, a good therapist and an understanding support group sponsor, he's making changes. He's got an apartment and a rent subsidy. He's going to school full-time in the fall on a student loan. He's a volunteer advocate at the Preble Street Resource Center Consumer Advocacy Project and a member of the Region I Homeless Council. He will start volunteer work this fall at Mercy Hospital's Recovery Center, a drug rehab program.

He loves his family and was recently there for his grandmother as she coped with an anguishing loss - the death of Patrick's grandfather and the end of her 50-year marriage.

Patrick himself is still tender, struggling to grow in therapy with someone who, to him, finally understands that people with addiction problems do not equal being criminals. He was somewhat reluctant to tell all for this story.

"I'm trying to repair my life. The thing I worry about is that people do make judgments, and they will slam doors in your face for judgments that aren't right."

But he feels a small, fresh breeze now of what he calls "a normal life."

"There's a real chance for me to get well, independent and off the system. It's gonna take a lot of time. . . . But I have a sense of stability for the first time," he said, smiling.

In the old days when he was in therapy, professionals told him, "Well, have a good week, and don't forget to take your meds." But it was the meds that caused many of his problems. He was too young to know, he said.

"I was very addictive and didn't know it. I started taking higher doses, and then they wouldn't give me anymore. I was having panic attacks and blackouts and wandering into places I didn't belong. I didn't know how to function without (the drugs)."

Looking at him, it's hard to believe he's been through so much. Born in Brooklyn, N.Y., he never knew his father. His mother suffered from depression.

"God bless her, she's a very strong woman. She's a big inspiration for me."

At age 8, he began showing signs of depression, telling his mother he wished she'd had an abortion. By 12, he was "rebelling, not listening, not caring what other people thought." A therapist diagnosed depression and attention deficit disorder. The prescribed medications began.

"At school, I was in an honors program, a gifted program, but I got bored. I started slacking off and cutting classes."

School officials told his mother he had to stay back a year, then discovered he had tested close to a 100-percentile level. Instead, they presented him with a Presidential Achievement Award and offered him a chance to be in a special junior high honors program.

"It was a real pivotal moment in my life to show I wasn't a waste." But he turned it down. It was the wrong decision, one of many he would make in the next 14 years.

Dropping out of school in eighth grade, he was out on his own in the streets of New York City. He slept at first at a friend's home, later on rooftops, benches, tenement hallways, the beach and finally in a squatter apartment.

He never stayed in shelters because he was afraid.

"It's hard to find help in New York City. The resources are limited and the shelters are violent. They steal the sneakers right off your feet."

On the streets, he was mugged and beaten. In jail, he was abused. He stole bicycles and swapped them for food and a little money. "I'm not proud of the things I did to survive," Patrick said.

At 17, he started to fall for a young woman he met while living in a squatter apartment. Someone told him she had AIDS. When he approached her, she acknowledged her illness but rebuffed him with sharp words.

"I cried for two days." Then he called his grandparents in Sullivan and moved to Maine.

"I left New York and put all that behind me. I really thought I could go from hell to heaven in one week, that everything would be rosy. It just didn't work that way."

In trouble because of his addiction to "benzos" - benzodiazepine, or tranquillizers and sleeping pills - he tried to hang himself in jail.

He got in trouble again - trying to illegally secure prescription drugs - and was sentenced to Maine State Prison.

"They've got a lot going for mental health in this state for representation and advocacy. But there's nothing that helps addicts. Addicts are an unwanted part of the system. You just throw them in prison.

"But a lot of addicts have mental health problems and, when they screw up on drugs, the system says, `Oh, we can't help you anymore. Now you're in this other segment.' "

In prison, he saw his future and began to plan. Horrified to be locked up with murderers and rapists, he got along, staying mostly by himself and writing letters to prepare for his release.

"I applied to college from prison. I tried to open doors before I got out because I knew what a challenge it was going to be. I got a DHHS (Department of Health and Human Services) case worker, a bunch of information on apartments and all these listings. I got all kinds of information on business. I want to start a business some day. I even got information from the U.S. government on health and nutrition."

His outlook now is optimistic but cautious.

"I've lived half my life in hell and taken all this time to dig myself out. My advocacy work (for the homeless) keeps me humble. I'm grateful for the things I have.

"Being in prison for another 18 months really took a toll on my self-esteem. . . . I felt so crummy about myself . . . . These days, I'm good. I've got a lot more hope than I ever had. For me to finish a semester of school, get all As, to hold an apartment, to not get in trouble, to be sober for 22 months. . . ." He shook his head in amazement.

Sometimes his depression overtakes him. "Then I'm nonfunctional for a week. I cycle through these things. I think, `Is this all worth it?' I want so much to be normal."

Patrick knows he needs help and that his journey is far from over. But he's determined to stay on course and help others along the way, like the homeless. He knows the life.

"I know what it feels like not to have a voice. . . . I have a sense of purpose now. I'd like to part of the solution instead of part of the problem."

Kim Clifford can be contacted at 791-6485 or at:

Copyright 2005 Blethen Maine Newspapers Inc.


The Cincinnati Post (Cincinnati, OH); 8/24/2005

Byline: Michael Cerullo, M.D.

During what was supposed to be a promotional interview for his new movie, "War of the Worlds," Tom Cruise launched into a tirade against psychiatry on the June 24 "Today Show.'' Three days later, the president of the American Psychiatric Association, Steven Sharfstein, M.D., was interviewed on "Today" to respond to Cruise's comments. Sharfstein stated, "Mr. Cruise may be a halfway decent actor but when he starts to play doctor, he is being totally irresponsible."

I think this rebuttal doesn't go far enough. Reading over the transcript of the Cruise interview with Matt Lauer, Cruise appears as a ranting, nearly incoherent self-proclaimed expert on all things psychiatric. Well, Mr. Cruise, let me do a little ranting of my own.

First, you have ruined the experience of the very movie you were trying to promote. Now there is no way I can bring myself to see "War of the Worlds," a movie I was looking forward to as a sci fi enthusiast. I would be distracted by the image of you lecturing Matt Lauer on how, "You don't know the history of psychiatry; I do."

I am all too familiar with the history of psychiatry. Psychiatry as a profession is still struggling against claims arising out of the 1960s that mental illness is nothing but a social construction. Psychiatrist and patients (and their families) continually fight against the stigma and misunderstanding surrounding mental illness.

Research has clearly demonstrated the existence of mental illness, and to pretend otherwise is simply not an intellectually defensible position. Research over the last few decades has shown that depression is a brain disorder, partly genetic and partly arising out of the body's reaction to stress. In people who are depressed, parts of the brain are damaged, and there are abnormal levels of both neurotransmitters and stress hormones. Similar findings have been shown for the disorders of schizophrenia, bipolar disorder, post-traumatic stress disorder, and many other mental illnesses. This well-documented scientific evidence directly contradicts Cruise's claim that there is no such thing as a "chemical imbalance" in mental illness.

I now want to focus on the most disturbing part of the whole interview, and that was Cruise's attack on Brook Shields for taking an antidepressant for post partum depression. Cruise's attack vacillates between telling Shields that her depression is just a fantasy that is all her head and playing doctor and prescribing Shields "vitamins" and "exercise" as a remedy for her condition.

First, depression is not a fantasy. Depression appears in the earliest writings of civilization (King Saul and King David, among others) and the disorder was well-documented as a disease during the last century. Around 10 percent to 15 percent of the population will suffer from depression at some point during their lives, and it can be a devastating disease. In addition to the direct suffering caused by depression, it also causes thousands of deaths each year by suicide as well as increasing the risks for heart disease and many other medical conditions.

When Cruise vacillates and decides to "allow" for the reality of Shields' experience, he needs to look at the evidence before playing doctor. Contrary to Lauer's claim during the interview that "clearly you've done your homework," I give Cruise a failing grade. Vitamins and exercise have been tried in depression, but they don't work. Post-partum depression presents a real danger to both the mother and the baby, and no psychiatrist would endorse Cruise's prescription. Instead they would prescribe an antidepressant or psychotherapy -- or maybe both. The drug Shields took was not an "anti-psychotic medicine," but was an anti-depressant medicine. These medicines are indeed "mind altering" as Cruise claims, but only in that they stop the state of depression and allow the person to return to their baseline, normal self.

This whole outburst is a losing situation for everyone. I don't get to see my movie, and people everywhere may listen to a know-nothing celebrity rather than their doctors. I would implore people suffering from depression and other mental illnesses to get the help they need. In addition, the popular press needs to stop giving Cruise media coverage regarding a topic he has no expertise in.

Michael Cerullo, M.D., is a clinical assistant professor of psychiatry at the University of Cincinnati.

COPYRIGHT 2005 The Cincinnati Post. All rights reserved. Reproduced with the permission of the Dialog Corporation by Gale Group.

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