We’ll Always Have Camden

At my show, I surprised my wife with a painting that, judging by her response, she likes very much. It is of the Schooner Olad on which we sailed — at sunset — on our tenth anniversary in the summer of 2008. It is, among other things, a reminder of a serene moment in what can often be a daunting life, to say the least. The following afternoon, a customer asked me the secret to being happily married for eleven years. Without thinking even for a second, I told her it was finding the right person from the start — and it’s true. All of the hard work and tips solicited from those who have done it can’t compensate for that.

Back to Your Irregularly Scheduled Program

With the art show and a last minute commissioned piece behind me, I will be able to resume more regular posting. As always, there is plenty to say but for now I’ll just say thanks. I had a great turnout at my show, got some good feedback and people were genuinely interested in a movement toward rights, transparency and truth in the mental health system. To anyone who bought or will buy any of my pieces, a sincere and special thank you. You’re buyers in a town of lookers and will be taking a piece of me home. I’m honored (and sometimes baffled) that you’d want to.

In addition, I will be taking up oil painting, which I haven’t attempted since my youth. There are matters of subject and mood that I don’t think I can touch with watercolor. Oils were made for the heaviness and depth that I’d like to convey in future works. This isn’t an end to watercolors for me, just a shift away for now. Having just shown eleven piece in watercolor, many of them recently completed, I’m ready to put that setup in a drawer for a while and explore other media and I’ve had a crush on oils for a long time.

While I’m happy with the outcome of my focused energies, I had no idea how little I’d be able to work on this weblog which is tough for me because, as all who know me personally know, I am almost constantly bursting at the seams with thoughts and opinions on the state of things befitting Spit, Bristle and Fury and there is no shortage of critical information that is seldom put out by other means than small (even miniscule) outlets like this. Thanks for visiting here and I hope it proves to be something of value.

Diagnosed by the Press

Apparently in the eyes of Dario McDarby of the Examiner, if you live strangely, have a troubled life and don’t step up to claim your diagnosis, you are  not only one of the great number of undiagnosed mentally ill but doing a great disservice to others suffering from mental illness by contributing to its stigma — at least if you’re a celebrity. In his gossipy, agenda laden ramblings, he refers to the late Casey Johnson as “obviously disturbed but possibly undiagnosed” and showing “the negative behaviors of a troubled person suffering from untreated neuroeccentricities.” His explanation for the connection between strange behavior and stigma to strangers:

The impact that this kind of notoriety of obviously disturbed celebrities causes trouble for people struggling to reclaim their mental well-being. It perpetuates the stigma of “mental illness” because of the obscene, grotesque, and ugly behavior of celebrities and others who can afford treatment but resist it because it somehow affects their notoriety. Most people do not have adequate access to services that can help them develop the tremendous talents that may lie undiscovered in their “disorders.”

I’ll never understand how people make the leap  from access to care or a right to care to the duty to receive care but it seems to be increasingly adopted by pro-diagnosis circles pretty consistently. Maybe it’s not one person’s “obscene, grotesque, and ugly behavior” that contributes to other people’s stigma around mental health. If anything, it’s armchair psychiatrists like McDarby trying to diagnose famous strangers through the microscope of gossip press, forcing a connection between serious mental illness and exploitable and tabloid-worthy acting out. One has little to do with the other  outside of the connection we create between them with articles like this. Psych diagnoses are stigmatizing because we try to put every socially unpopular or unacceptable behavior under the umbrella of a mental health label.

Though not diagnosed with any “mental illness,” at least to the public’s knowledge, Ms Johnson showed the negative behaviors of a troubled person suffering from untreated neuroeccentricities. In fact, she used them for notoriety in her alleged love tryst with Tila Tequila, possibly another troubled woman with undiagnosed mental health issues.

Instead, society becomes harsher toward neuroeccentrics because characters, who have the resources to reclaim their mental well-being, become pathetic actors in a tragedy written by scheming journalists and choreographed by dull-witted paparazzi. The blowback from this disgusting show greatly affects those with few resources, but who may possess even greater talents than the dead heiress and her grotesque Internet diva.

I’m not sure why any one person’s diagnosis is supposed to be the “public’s knowledge” and While McDarby appears to have some level of respect for people with mental health diagnoses, I’m puzzled by why he would write them into the stories of tabloid characters. To me, it seems a great disservice to link wild behaviors born out of celebrity to the people in this country with perceived mental illness that are leading (or trying to lead) “normal” lives, whatever that means. We are all too willing to throw life changing and stigmatizing diagnoses at people and now, having become quite comfortable trying people in the press, we are moving on to diagnosing people in the press which adds a lot to the notion that mental health is a matter of public opinion. I have to wonder how far McDarby is from the types of journalists and paparazzi he calls into question when he’s using a “dead heiress and her grotesque internet diva” to frame his argument that every one with troubles should get in line for a diagnosis.

Two New Paintings

With my art show drawing very near (tomorrow night), I’ve been working especially hard at getting the ideas onto paper. I thought I’d post up two of the newest pieces — one I don’t have a name for and the other entitled, First, Do No Harm.

Man vs Machine

Further on the topic of  Zyprexa and diabetes, Alaska lawyer Jim Gottstein of the Law Project for Psychiatric Rights is heading to court today to face down the drug’s maker, Eli Lilly in a lawsuit they brought against him for “conspiring to steal” documents that show the company suppressed information regarding the dangers of their star drug.

From Pharmalot:

For those who don’t recall, Gottstein…was accused along with two others by US District Court Judge Jack Weinstein of violating a court order by scheming to leak and publish sealed Zyprexa documents. The Zyprexa documents, which detailed hidden side-effect data and improper marketing, were published by The New York Times (Gottstein provides documents and related background here), setting off a feverish debate over the public’s right to know about concealed side effect data.

As a result of Jim going public with the information, Lilly agreed to plead guilty and pay a 1.415 billion dollar fine for promoting Zyprexa off label. $515 million of that was in the form of a criminal fine — the largest single corporate criminal fine in history. The rest was paid out as civil settlements to the states and the FDA. I don’t know how exactly anyone can pay out a record breaking fine and no one notices but then, the lack of media coverage regarding pharma’s indiscretions and outright deceit is always pretty puzzling. At least the important information was taken to the public and to a degree that has made people aware and force Eli Lilly to take some accountability.

As for Gottstein, he maintains innocence. ‘Ever since Judge Weinstein ruled against me on February 13, 2007, Lilly has threatened me with civil and criminal contempt sanctions and going after my license to practice law,’ Gottstein writes to supporters. “I believe I did nothing wrong – that when Lilly failed to object after being given a reasonable opportunity to do so and then Dr. Egilman sent the Zyprexa Papers to me, they had lost their secrecy protection. I hope the Second Circuit will agree.”

Forget for a moment that Gottstein is an outspoken advocate for informed choice in mental health. He’s a human being. If you know a company is suppressing the fact that its product is directly leading to thousands of deaths from children right up through our elderly and all stops between, don’t you have an obligation to let those people know? It takes people like Jim Gottstein to bring this level of systemic deceit to light because if recent history shows us anything, the corporate conscience isn’t going to do it and a judge who see this as a “trade secrets” issue and not a public safety issue isn’t going to do it.

FDA Warns Docs about Zyprexa

In news of the not-so-surprising, The LA Times reports that the FDA has issued a warning to doctors concerning increased metabolic risks in adolescents taking the drug olanzapine (Zyprexa). Risks include rapid weight gain and an increased likelihood of weight related physical concerns like diabetes and high cholesterol — serious problems that, you may remember, most doctors can’t be bothered to watch for. While this particular warning is limited to young people, you’ll find that the same risks are present in adults though it appears that adolescents are at a higher comparative risk. Interestingly, the warning applies only to those ages 13-17 being treated for diagnoses of schizophrenia and bipolar disorder, leaving out the growing number of even younger people for whom the drug is not approved but administered off label.

The agency has not approved the marketing of olanzapine — sold under the commercial name Zyprexa by the drug maker Eli Lilly — for use in children under 13 who are diagnosed with schizophrenia or bipolar disorder. But the medication, one of a class of psychiatric medications called the “atypical antipsychotics,” is widely prescribed for young patients, despite growing evidence that call its safety profile into question for this population.

The warning comes in the wake of the October publication in the Journal of the American Medical Assn., in which a study showed that children and adolescents taking their first-ever course of Zyprexa gained, on average, more than 17 pounds over a 12-week period, as well as dramatic increases in triglycerides and cholesterol levels — all factors that put them at higher risk of developing cardiovascular disease. While two other antipsychotic drugs — Seroquel and Risperdal — were implicated in significant weight gain and metabolic changes, Zyprexa was found to carry the highest risks of all three.

More than 17 pounds in 12 weeks? Whether a parent or a doctor, you wouldn’t think you’d need clinical trials and an FDA warning to notice such rapid weight gain in a kid. A pair of eyes and even vague concern should do the trick and while the primary problem is not cosmetic, rest assured — if you don’t notice the weight gain, the other kids will. So in addition to battling the middle school years with a psychiatric label, they can now do it overweight and worrying about their heart health and diabetes. That should do wonders for their emotional well being in the formative years. Actually, the LA Times erred on the conservative side in reporting those numbers. From the JAMA study that prompted the warning:

Patients taking their first-ever course of drugs marketed as Abilify, Risperdal, Seroquel and Zyprexa experienced weight gains ranging from about 9.7 pounds for Abilify to 18.7 pounds for Zyprexa. (Seroquel users gained about 13.2 pounds and Risperdal users gained about 11.7 pounds over 12 weeks. A comparison group of children with a diagnosis of severe mental illness but who were not on the medications gained less than a half-pound in the course of the study.)

With the youth market for antipsychotics constantly expanding and these drugs being approved or used off label for a range of behaviors broadening well into the mildest end of the spectrum (attention deficit, irritability), we need to be taking these risks seriously. The shift from using drugs as a last resort to using drugs as a means of grooming children for desirable behavior can’t be ignored in a discussion about antipsychotics in children and little good can come from making a child’s physical health take a back seat to a theory on mental illness. Do we really want to expose young people to greater risks of cardiovascular disease, diabetes and high cholesterol to “correct” moods and behaviors?

With the influx in young people on antipsychotics you might think this is the time to be looking into these problems but I think the time was fifteen years ago when Zyprexa was poised to enter the market. Now here we are repeating an often seen pattern — downplay risks for the duration of a drug’s patented life and spill it all at the end when its exclusivity is about to sunset — making the older, cheaper drug poor competition for its maker’s new and exclusive replacement. I wonder what the kids think about all of this. Something tells me no one’s really asking.

Are You S.I.C.K.?

I sometimes tune in to different television shows that touch on mental health issues — some that are intended to be informative and, less often, the more sensational offerings — just to see how the issue is approached. A&E’s Hoarders is easily the most successful and most talked about show to cash in on the social sideshow that is televised “mental illness.” Having watched just a couple of episodes, maybe I’ll share my opinion of the show some other time. For the moment, I’ll concern myself with one thing that jumped out at me from one exchange.

On a recent episode, a therapist referred to one person as fitting the “S.I.C.K.” model —  a clever little acronym for “Sensitive, Intellectual, Creative and Kind.” She lost me. I cannot understand why someone would choose to attach the word sick to positive traits. I don’t know whether that little gem is in common use in her professional arena or if that’s just something she thinks is clever — a brilliantly reductionist little acronym to keep in her back pocket, just itching to use it on the next guy. Either way, nothing good can come of throwing a word as stigmatizing as sick around so liberally in regard to emotional distress, much less, positive attributes and in general we need fewer labels — not more.

For anyone who thinks I may be taking things too seriously, let’s remember it only took Prozac Nation to make the phrase “chemical imbalance” a household name and an accepted truth, despite its standing squarely in the realm of theory. These are two different things, to be sure, but we must be careful with our words. Simply put, words mean things and when you have a viewing audience of 2.5 million, words mean plenty.

Seroquel XR’s New Ad

You may have seen the relatively new direct-to-consumer ad from Astra Zeneca for its long acting atypical antipsychotic, Seroquel XR. Creepy and pandering to say the least. I’ve heard a few people say that if you’re not depressed before watching it, you will be after — and isn’t that the point?  Like a carefully and corporately crafted emo/indie/whatever hit song, it’s made to strike a chord and sometimes it takes a panel of well payed analysts and some market research to find out how best to strike that chord in a way that shows that the company truly understands how you feel. Look at any one of the current pharmaceutical ads. The focus isn’t so much on selling you the drug as the disease. Once you’ve bought the idea of the disease, you’ll find the drug.

Here, they are positioning their Seroquel XR as a fix for “bipolar depression.” They show scene after dreary scene of miserable looking people who have half faded into the grays and browns of their equally dreary  environments, all while an instrumental from Badly Drawn Boy plays in the background. Oddly, one thing that separates this ad from a lot of the others is that it doesn’t switch to bright scenes of people laughing with friends at parties or rolling around in green, sun bathed fields. It stays pretty gray, though one woman does find the strength to get up off the couch. At least in that respect it’s a little closer to reality, considering a lot of people’s experience with this drug and others like it.

Another thing you can’t miss is that the health risk disclaimers take twice as much time as the first part of the ad telling you how great the drug is for treating “bipolar depression.” I’ll be the first to admit that a risk vs benefit scenario can’t be weighed out in seconds of air time but with such a vague diagnosis, based not on objective medical evidence but a nebulous cluster of feelings and behaviors laid out in a questionnaire, one has to wonder when the perceived benefits justify the very real risks. The question may now be more important than ever as we see these drugs being used in increasingly mild situations and in an ever broadening range of indications and demographics. Even with twice the time dedicated to the risks, the likelihood of those risks hasn’t fully been put forth and while they touch on metabolic symptoms and state the need for cholesterol and triglycerides to be checked, the reality is that only about ten percent of doctors prescribing these drugs are looking into metabolic responses by running those tests. With these companies downplaying, often even lying outright about the risks of these drugs to the FDA, prescribing doctors and now — via direct-to-consumer ads — the public, even with their FDA mandated obligations fulfilled, truth in advertising remains questionable at best.

Just as with the ad marketing Abilify as an add-on for “treatment resistent depression,” a viewer who sees this ad would have no reason to see Seroquel as anything but an antidepressant. It’s not an antidepressant though — far from it. It’s an antipsychotic designed to combat the cluster of “symptoms” associated with a diagnosis of schizophrenia — but then, when your product was designed for a perceived illness that affects only 1.1 percent of the population, you have to expand your market somehow.

The Sparrow in Your Heart

Carry on with the Countdown…

The ubiquitous art imitates life/life imitates art debate has given way to the more localized art interrupts life/life interrupts art — for me, at least. I suppose like most people who call themselves artists (and I don’t call myself an artist often), I’d love to devote vast amounts of time to drawing and painting. I’d love to immerse myself in the process for days on end, crawling out of my cluttered studio a crumpled, unbathed, paint-covered mess, feeling as though I’d created something huge or at least part of something huge — only to emerge in search of some more life to imitate (or however that goes), and then repeat. In that regard I even envied Henry Darger but that’s not my lot. That’s not my life. I am pulled in other directions, often at once and blessed — truly blessed — with a life to interrupt. So I’m left to find a balance among interests, passions, responsibilities, and obligations. I work on paintings in fits and starts as life allows or when I just have to step away and take a moment.

This show is going to be the distillation of captured moments, stolen hours. Nothing rushed, nothing thrown together. I can’t even say it will be lacking but I know I had hoped to start working larger, varying style and media a little more. I had hoped to carry out some common threads a little longer through a more prolific showing. I will do all of that next time, perhaps for a summer show. Instead it will be a sampling of the images most pressing to me — stripped down to the visual equivalent of the few things you’d say if you only had a moment and maybe that’s a good thing.