Posts tagged ‘Internet’

What’s Beyond…Beyond Meds?

We shall see. Gianna Kali has announced that her popular and informative blog, Beyond Meds, has reached its end.

Thank you to all my readers for being part of this transformative journey with me. It’s time for me to move on and do other things.

This blog, depending on which ranking system you look at, is between number 1 and number 5 or so of non-pharma funded mental health blogs. I feel good about leaving and that the work has been a success. — Gianna Kali

It was one of the few blogs that I checked regularly and I know many people (myself included) have found it to be of use in so many ways — news, information, inspiration, encouragement or to know they weren’t the only ones experiencing an intensely harsh withdrawal from psych drugs, particularly benzos. It was a great blog and I’ll miss seeing new posts from Gianna. Past posts, however, will remain as a resource — and with such a wealth of information and personal experience, it’s one hell of a resource.

For something as simple as a self-supported means of relaying thoughts and information to have a direct and positive effect on people’s lives is remarkable — maybe the best we can hope for — and she’s done it many times over.

Gianna is ending Beyond Meds to move forward with her life beyond the keyboard and I’m glad she’s at a point in her recovery to even approach that next step. At some as yet undetermined time, we can expect another blog from her, focused on more positive things and free from the heavier issues that make up the broken mental health world. I can’t wait. It’s not one topic that makes her blog what it is, it’s her openness and perspective. I look forward to seeing what she approaches with these qualities next.

I wish her well, both in the “blogosphere” and beyond. I’m sure good things are to come as she determines her own future. If she clues us in, great. If not, I’ll assume she’s out living life — beyond meds and beyond the internet.

September 5, 2010 at 11:02 am 5 comments

iTherapy 2.0

Welcome to the future of reductionist psychiatry. You can now be diagnosed, labeled and treated without a doctor ever having to even look you in the eye or hear the stories that make you tick. Just click the boxes for your symptoms, fill out the questionnaire and the complexities of the human psyche can be unraveled as quickly as e-filing your taxes in the last hour of tax day. Never mind the subtle differences that define us or the experiences that got us here.

This is not some luddite rant about the technology takeover, though to some extent there is a worthwhile wariness in that discussion. I’m talking about the power of the DSM, which was never meant to be a stand-alone collection of boxes to check off in diagnosing, now essentially uploaded and online to be used in just that fashion.

From Australia’s The Age:

MENTALLY ill Australians are increasingly being diagnosed and treated online in virtual psychiatric clinics, without ever seeing a doctor.

Patients suffering from depression, anxiety and post-traumatic stress disorder are being assessed by computer and given ”e-prescriptions” for online counselling courses instead of medication or treatment sessions with a psychologist or psychiatrist…

With e-therapy, patients are clinically diagnosed after completing psychiatric reviews by answering online questions

“Assessed by computer”? It makes you wonder what we need all these psychiatrists for? Apparently all we really need are the DSM committee and a handful of tech guys to work out the interface and we’ll be well on our way to solving those pesky problems that keep cropping up and reminding us how hopelessly human we all are.

One positive point is that it presents a shift from medicine and toward some sort of counseling but I see that aspect of it as short lived. It seems likely to follow the trend of “real life” psychiatry and revert to drug based care, printing out its e-prescriptions for the latest in pharmaceuticals. Also, it makes you wonder — if these kinds of treatments are so effective, why do we need a computer to veer away from drugs? I can see computer based communication and the easy transfer of information as useful but only as a supplement to truly involved care from a living, breathing human – not a replacement. I question the quality of online counseling when compared to real counseling. Of course it’s limited to relatively minor difficulties like depression, anxiety and PTSD. They wouldn’t dare try to treat the as yet uncharted depths of serious mental illness — would they?

In Melbourne, David Austin, the co-director of the National eTherapy Centre’s Anxiety Online program, which is run from Swinburne University of Technology, said the service did not attempt to treat people with more serious conditions such as schizophrenia or bipolar disorder but there was scope for that in the future.

“Within five to 20 years we will have a proven e-therapy for most of the psychological conditions. Once you do that, you have 24-hours-a-day, seven-days-a-week low-cost access for everyone,” said Professor Austin.

Everyone. Oh good. At least they’re planning ahead. This is where the drugs are likely to come into play as most things perceived as serious mental illness are treated with drugs as a chemical problem in the brain not simply a coping, life handling or perception problem.

Patients log on anonymously to complete modules on cognitive behavioural therapy and breathing and relaxation techniques through videos, podcasts, online forums and interactive questionnaires.

Next month, courses will begin for people with eating disorders and gambling addiction.

I’m convinced computers can be of some benefit in a therapeutic setting whether it’s to impart information, the support found in many forums or supplemental counseling. The biggest problem, though isn’t in the counseling aspect of it but in the assessing. While the move to computer based diagnosis promises to extend mental health care to more people, we need to question the level of care and its potential to do more harm than good. We’re talking about diagnosing people online that we’ve never met. The internet has proven to be an unreliable way to get to know people. Something gets lost in translation between the keyboard at one end and the screen at the other. That’s why some people hide behind them, filtering and crafting their online persona and others with the best and most honest intentions just don’t come across as themselves. Many would argue that the computer isn’t even a good way to determine whether someone is dateable but somehow we think we can ascertain someone’s mental and emotional state and diagnose them which will have a huge and far reaching impact on the course of their lives.

We are all complex individuals to varying degrees. One can no more experience another’s state of mind through a computer’s screen than the fullness of a symphony through its crackling plastic speakers. I can’t imagine letting the care of someone’s mental well being hinge on that poor a translation.

June 13, 2010 at 1:07 pm

Don’t Do It (But First, a Word From Our Sponsors)

This was at the bottom, but given the nature of the post and how some, maybe you, might have found this, I thought it was worth putting first.

There are options out there. Some problems can be left behind with a bus ticket, a breakup, a new job — some  not so easily. Some have to be faced head on but there are options. Those options — while safe and effective — don’t have the power of industry behind them. That’s okay though. If you are on the edge of an irreversible decision, you don’t need industry or Adsense. You sure as hell don’t need to be anybody’s demographic, consumer or marketing opportunity. If suicide seems like a viable option, you’ve probably lost perspective. You may not be seeing your problems from every angle. Enlist the help of a friend — if you are afraid a friend will mess things up further, enlist the help of a stranger. Someone out there would be genuinely concerned about you in particular and what you’re dealing with if they only knew. This is just one option: National Suicide Prevention Lifeline (1-800-273-8255)

We’re all familiar with common internet marketing approaches like keyword generated ads and sponsored links on some of our favorite search engines. You can’t really complain when you can breeze through a million interests, look up old friends, find jobs, maybe even stumble upon a ranting impassioned weblog — endlessly, quickly and for free. They have to pay the bills somehow. I expect to see ads in the margins of the page and sponsored links do make sense — sometimes. Sure, If I’m looking for a new car, a tv or a pair of jeans, I expect to see sponsored links from the major makers but what happens when you’re not looking for a product at all?

Immediately after the earthquake in Haiti, I was watching a video clip (from some news outlet or another) of a man pleading for help in finding his missing daughter. He got about four words in before a video pop-up ad…well, popped up. The volume of the ad made it so you couldn’t hear the clip and the smiling, bouncing figures stood right in front of the footage of this pleading, crying father. The ad was for tourism in tropical Saint Lucia. The juxtaposition was glaring and it was as if they were saying, “Is Haiti getting a little corpsey? Come visit bright, sunny and still intact Saint Lucia!” It was a clear case of keyword generated ads gone wrong and I’m sure no one actually thought it would be a good idea to tastelessly suggest other vacationing ideas in light of Haiti’s disaster — or am I?

When you enter the word “sadness” in your Google search bar — which one could conceivably do for any number of reasons — you’ll get a few definitions from the likely sources like Webster’s and Wikipedia and  some fairly random entries for which “sadness” is a keyword but only after a word from your concerned friends in pharma. How strange that you can search for an emotion and get search results for a drug. Remember when drugs were for diseases? Yesterday, the search brought up three ads in the form of sponsored links for Cymbalta, Lexapro and Seroquel (today, only Seroquel). Of course they don’t say they’re for drugs in the links. They merely offer information. Two of them had some misleading heading about symptoms and treatment options for bipolar disorder or depression which of course didn’t lead to any objective information, just sales pitches with as much credibility as the new tv gimmicks on fast weight loss. (You know, the ones with the diagrams and the digital people eating pills and getting smaller.) While I think most major corporations tend to act without conscience, it has to be said — they’re not in the conscience business.If they’re going to crop up in every search that’s even tangentially related to their product, what can you say? They should at least present themselves as purveyors of psych drugs instead of answers.

The worse example, in my opinion, comes up when you search “suicide.”Google has added the number for the National Suicide Prevention Lifeline (1-800-273-8255) to certain search result pages based on keywords like “suicide.” They’ve gotten mixed press for intruding on their searches but, by and large, a lot of people think it’s the good and responsible thing and no one is more impressed by them than they are themselves.

What I want to know is why the lifeline comes up second. The first entry is secured by Eli Lilly (presumably at a premium) with the headline “Symptoms of Depression” which of course takes you to an ad page for their antidepressant, Cymbalta. The implication is that if you are searching out of interest in suicide, you’re their target market. There are a number of reasons to search for suicide — statistics, synonyms, history, legal issues but those are not markers that make Lilly think they can sell you something. If you want to kill yourself, however, they have a product for you. It’s pretty shameless  and the last thing someone needs if they are reaching out is someone reaching back with an ad, much less a life on drugs. Never mind the fact that suicide is a side effect for their antidepressants. Sure, some will say the drugs are people’s last hope, but that’s debatable at best and let’s be honest — Eli Lilly isn’t a do-gooder group trying to ease troubled minds. They’re a business trying to move massive amounts of their product for as much money as possible and they have no intentions of letting class, tact or taste  (or even law, effectiveness and patient deaths, but that’s another story) get in the way. This is typical of pharma in general and Lilly in particular, so not too out of character.

If Google is so concerned, they should have the number come up first — before they help anybody sell a product. That, however, conflicts with the notion that the sponsor is always first. I can’t imagine what Eli Lilly and the rest pay for sponsorship but I’m sure it’s an obscenely high number and for that price, you don’t take second place to anything — even suicide prevention. It’s a sadly predictable sign of the state of things when an increase in suicides or coverage of suicides is seen as a marketing opportunity.

I mentioned these meager findings on a social networking site and within five minutes, someone — a stranger, really — mistook my interest for need and sent this simple message, “It sounds like you’re feeling a little down and want to talk.” If more people put themselves out there, quickly and sincerely and with nothing to gain, things would be headed in a different direction. We can talk about alternative mental health, corruption in pharma, government and NAMI, abusive and misguided systems but it’s not enough to complain about the state of things — or even to fight it. We have to be the alternative — and not just for ourselves.

April 16, 2010 at 10:04 am 2 comments


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