MentalMeds News
A Newsletter from
Issue 5

Dear Reader,

If there is such a thing as the opposite of a holiday, then April 15th must qualify. I tend to think of it as the day I go to work for the federal and state governments (or, at least, the day my money does). It would be interesting to run a clinical study to see if mood disorders peak around Tax Day (funded, of course, by our taxes...).

On a more positive note, welcome to Issue #5 of MentalMeds news, which contains two featured articles. The first one is a first-person account of the onset of bipolar disorder, followed by an  ultimately successful struggle to overcome it. The second is on the always-controversial subject of electoconvulsive therapy, or "shock therapy" as it has often been called. Few subject evoke as much heated discussion as this one, fueled as much by the technique's checkered past as by reasonable disagreement. Is ECT a good idea, or a bad one? Read on.

Kevin Thompson, Ph.D.

P.S. As always, if you do not wish to receive email from me, please let me know, and I will remove your name from my list.

Table of Contents

Calling for Articles

Do you have experiences you would like to share about how you have coped with mental illness? Uplifting stories? Educational stories? Email me with your idea, and if it makes sense, I will be happy to include it in a future issue.


Funny stuff from around the Internet.

A Night at the Asylum, from

Late one night at the insane asylum one inmate shouted, "I am Napoleon!"
Another one said, "How do you know?"
First inmate answers, "Winston Churchill told me!"
Just then, a voice from another room shouted, "I did NOT!"

Philosophically Speaking, from Philosopher Jokes.

Jean-Paul Sartre is sitting at a French cafe, revising his draft of Being and Nothingness. He says to the waitress, "I'd like a cup of coffee, please, with no cream." The waitress replies, "I'm sorry, monsieur, but we're out of cream. How about with no milk?"

The City Boys and the Black Sheep is one of my all-time favorite jokes (which tells you a lot about me). This is also from Philosopher Jokes, where I have spent too much time recently.

An engineer, an experimental physicist, a theoretical physicist, and a philosopher were hiking through the hills of Scotland. Cresting the top of one hill, they see, on top of the next, a black sheep. 
    The engineer says: "What do you know, the sheep in Scotland are black." 
    "Well, *some* of the sheep in Scotland are black," replies the experimental physicist. 
    The theoretical physicist considers this for a moment and says "Well, at least one of the sheep in Scotland is black."
    "Well," the philosopher responds, "on one side, anyway."
- William Knorpp

Doctor's Funnies, from Ajokes

Doctor's stories-You can't make this stuff up. (Sometimes the truth is funnier than fiction!)

A man comes into the ER and yells, "My wife's going to have her baby in the cab!" I grabbed my stuff, rushed out to the cab, lifted the lady's dress, and began to take off her underwear. Suddenly I noticed that there are several cabs, and I was in the wrong one!

At the beginning of my shift I placed a stethoscope on an elderly and slightly deaf female patient's anterior chest wall. "Big breaths," I instructed. "Yes, they used to be," remorsed the patient.

One day I had to be the bearer of bad news when I told a wife that her husband had died of a massive myocardial infarct. Not more than five minutes later, I heard her reporting to the rest of the family that he had died of a "massive internal fart."

I was performing a complete physical, including the visual acuity test. I placed the patient twenty feet from the chart and began, "Cover your right eye with your hand." He read the 20/20 line perfectly.
    "Now your left." Again, a flawless read.
    "Now both," I requested.
    There was silence. He couldn't even read the large E on the top line. I turned and discovered that he had done exactly what I had asked; he was standing there with BOTH his eyes covered. I was laughing too hard to finish the exam.

And of course, the best is saved for last.... I was caring for a woman from Kentucky and asked, "So how's your breakfast this morning?"
    "It's very good, except for the Kentucky Jelly. I can't seem to get used to the taste," the patient replied.
    I then asked to see the jelly and the woman produced a foil packet labeled "KY Jelly!" 

Migraine, also from Ajokes (Hmm. Would this work for depression?)

A man goes to the doctor with a long history of migraine headaches. When the doctor does his history and physical, he discovers that the poor guy has tried practically every therapy known to man for his migraines and STILL no improvement.
    "Listen," says the doc, "I have migraines, too and the advice I'm going to give you isn't really anything I learned in medical school, but it's advice that I've gotten from my own experience. When I have a migraine, I go home, get in a nice hot bathtub, and soak for a while. Then I have my wife sponge me off with the hottest water I can stand, especially around the forehead. This helps a little. Then I get out of the tub, take her into the bedroom, and even if my head is killing me, I force myself to have sex with her. Almost always, the headache is immediately gone. Now, give it a try, and come back and see me in six weeks."
    Six weeks later, the patient returns with a big grin. "Doc! I took your advice and it works! It REALLY WORKS! I've had migraines for 17 years and this is the FIRST time anyone has ever helped me!"
    "Well," says the physician, "I'm glad I could help."
    "By the way, Doc," the patient adds, "You have a REALLY nice house."

Send me your favorite joke, funny story, or amusing picture, as long as it is related to mental illness. Keep it upbeat, please! Jokes involving mental illness are welcome, but jokes that demean mental illness are not. If it's appropriate, I'll put it up on the humor page.

Preppy Psychedelia: A Bipolar Journey

by "Squiggles"

It was easy and human to understand the emotional highs and lows when you were an adolescent growing up in the 60s and 70s.  The exuberance and social revolution of those times seemed right and healthy.  We were on the edge of creating a new society, new values, new music, and new, altered states of consciousness. Conventional thinking and expectations were regarded as restraints on creativity and the potential for individual freedom to experience. So, it was a great time to go through fluctuations in moods and even mental alterations without considering them as abnormal. Infact, they were seen as a sign of the kaleidoscopic possibilities of a free mind.

I grew up in that age.  And I think that this special period in our culture, with its optimism, hedonistic values, and intellectual rapture, may have blinded me to the ominous signs of psychologial trouble ahead.  Wild parties at college, with the typical props of the time, like concert speakers, strobe lights, smoking paraphernalia, and deep conversations into the night about the infinite number of states of consciousness, felt like an induction into a new esoteric world, closed to the mundane majority.

If I felt ecstatically happy, dancing down the street of a small university town with my friends, it was because we were young and happy.  If I fell into the depths of depression, it was because my parents couldn't appreciate and accept my cool boyfriend.  If I talked too much in class, it was because I was so bright and had so many pertinent things to say.  If I went to the library to borrow a book, and came out with a dozen hard-cover texts that I could breeze through over the weekend, it was because I wanted to do a good job on my project.  And I did do a lot in my teens.  My family was impressed at the amount of energy I had.  I would get up at 5:00 a.m., exercise, then go to my job downtown, and at the end of the day, would take night classes, arriving back at home around 1:00 a.m. every day.  Having finished college, I then entered university studies, and finished an Honours B.A. in two and a half years.  I then immediately entered the M.A., which I completed in two years.  All this, while having a whirling social life and getting married on the same summer I completed my Masters thesis.

The marriage was a very elaborate and joyful affair as I am an only  child and my parents went out of their way to make it really special.  My husband was a college sweetheart in the same Major and attending some of the same classes.  Everything looked like a fairy tale during that year.  He too had finished his degree and was accepted into law school.  It was as if, life was a challenge for me to see how much I could accomplish in how little time.  I didn't care how exhausted I had become.  The race gave me a high.  The future looked wide open with opportunity and success seemed inevitable in every endeavour.

The Gathering Storm

It was a strange and unexpected surprise to find out that the harder they come the harder they fall.  I had continued my "supergirl" agenda, working at the Computer Sciece Department of my university, and other departments, when the idea struck me.   I was not doing enough.  I thought I could accomplish more: the final degree and I could become a professor. I applied and and was accepted to one of the top universities in Canada.

The work was demanding, and within one and a half years, I finished all the course requirements, the Comprehensives, four Teaching Assistantships, and had begun the dissertation.  A fellow student with possible mental problems had begun to harrass me and my husband while we were at the university, and the Department tried to accelerate the completion of my degree as fast as possible-- hence the one and a half years covering so much work.

The congruence between a possible underlying affective disorder, and the impetus that that may give to ambitions and plans in your life, is often overlooked.   The gathering conflicts and stresses were easily blamed on the sheer amount of work that had to be done.  Mental illness is not perceived as such when it drives your emotions without any perceptible cognitive disorders. If it has not crossed the barrier between normal and abnormal experiences you are familiar with, it is easily overlooked.  Paradoxically, that can also apply to people close to you, as they live with you and travel the same pace, developing familiarity with your habits.

There were some prodromal signs that could have rung an alarm bell to someone experienced with the development of mental illness-- the depressions, insomnias, elations, wild parties, numerous love affairs, intense and sometimes brilliant intellectual work. But all these could be accounted for within the normal scope of human experience in the life of a university student.  If it was the beginning of hypomania, it was certainly pleasant enough to accept as living life to the fullest.

The crash came as suddenly as a tornado hitting the hot spot.   It was preceded by some strange mental states now and then, attributed to fatigue, Valium, and disappointments.  There were states not experienced before: panic attacks, flatness of emotion,  depression, changes in libido, and something like a loss of emotional equilibrium, akin to vertigo.  Ultimately, these states progressed to severe insomnia, lasting about five days, and a full-blown breakdown to what old Psychiatry might call, regression. At first, doctors guessed that I may have had depression, and was given imipramine.  This drug only made me very anxious, sleepless, and also gave me hives.  Perhaps, the hives were a blessing in disguise, as I asked to be taken off it, preferring the depression.  I think the doctor did not like the hives, and agreed.

About half a year elapsed, and I continued to struggle through the doctorate, feeling very ill at ease, but pushing on to the finish line. My failure to meet the grades of two more courses required for the Ph.D., gave the department the opportunity to kick me out.  This may have enabled them to avoid the bothersome conflict that had stirred up divisions and trouble in the department.  I did not take it well, but it was an opportune break from overwork.

Down the Rabbit Hole

I experienced the critical breaking point of my mental and emotional stability in my bedroom one day after returning from a class.  What was vaguely familiar in the past as a kind of vertigo, turned into a vortex of blackness and despair.  Physically, I suddenly felt as if some great magnetic force was pulling me into a hole.  Terror, anxiety, and depression alarmed me. I felt as if I was being moved by some invisible force into an abyss and had no control to pull myself out of it.   I exerienced a sadness and despair unknown to me in even my darkest and most traumatic events of my life.  It felt like the exctinction of the flame of life, as if the very essence of volition, and existence was smothered--a death in life.

My instinct told me to escape, and I ran outside the door, looking for the next coming car on our street to step in front of--anything to escape that terrifying sinking feeling like Alice falling into the rabbit hole.  The emotional part of the experience must have been far greater than the cognitive self-awareness.  I think that saved me from suicide, as I made quick turn from the middle of the road. For at the time, our hospital was only a block away and instead of following the impulse to terminate my life, I made a conscious decision to run to the hospital for help.  How many decisions do people make in their life that determine what their next  year, their next, month, even their next minute will be.  The nearby hospital, which two years later was closed by the government, was a fateful moment in time.

I was seen by two doctors, one of them a psychiatrist and the other one who has been my personal doctor through most of my life, and the same one who had removed me from imipramine about a year before.  The interview was quite lengthy and this time, some new incidents made them suspect that depression was not the correct diagnosis.  One incident in particular, was an irrepressible urge to walk for hours all over the mountain of the city.  I had an incredible amount of energy which I felt I had to dispense somehow, through physical exertion. Another, was a surge in libido and the delusion that I was in love with someone whom I had only briefly met in the library.  And the most disturbing one of all, was the outburst of tears and exquisite sensitivity at the slightest sad event or idea, such as a scene of two elderly ladies crying over their dead cats during my summer work at the SPCA.  Such incidents, led the doctors to suspect manic-depression.

I was put through a number of both physical and psychological tests for two-three days.  I confess to not remembering everything that happened at that time, as I was quite a mess emotionally.  If I recall correctly, it was the psychiatrist who recommended a list of possible medications: lithium, carbamazepine, Valproate, and three others which I cannot recall.  His first choice was lithium, and he wanted me to try it first.  I had a very vague idea of psychiatric medications then, and one drug was as good as the other for me; anything was good as the other, if only to escape the distress I was in.

My family was on vacation at the time.  I learned later that the doctors had contacted them and told them of my diagnosis.  It must have disturbed them immensely and been a great disappointment, as they never spoke of it to me personally.  My husband himself, could not believe it, and thought like them, that there must have been a mistake.

I felt as if I had somehow come of age.  It was a strange feeling of initiation into a different social status.   Secretly, I was glad. I think I felt that now, I could rest.  I must have gone to the pharmacy with my prescription and picked up the medication -- lithium carbonate. They looked like innocuous vitamin capsules.  I was desperately unhappy and felt helpless and forlorn. I did not think there was much left in my life, having let everyone down and lost my emotional stability.  I can't recall which capsule was the one that switched the neurochemistry from misery to happiness, but the one that did, was like a switch.  I compared it to the immediate transition of the ON/OFF change when rebooting a computer or turning on a light.  You could only have one state but not the other.  If you had a euthymic state, then you could not have a depressed state.   Some sort of therapeutic level must have been reached, changing the brain chemistry from one state to another. It was nothing short of miraculous.  If I were a religious person, I would say that at that moment, I had left the crypt and been born again.

This miracle did not come without a price.  The side effects were--especially in the beginning-- an adventure in psychopharmacology. If I had been Icarus, my wings were certainly clipped. I felt as if I had been grounded by some lead weight.   I recall walking downstairs and feeling like a hippopotamus-- heavy and lumbering and careful not to lose my balance.  I slept every afternoon for a couple of hours, and my mouth felt metallic and dry as the Sahara desert.  Lethargy, frequent voiding, spaced-out concentration, thirst, and sleepiness..... but Peace at last.  It was a powerful drug, but I was no longer unhappy.   Gone were the mood swings and the wild temperament, the hellish depression and the exhausting willpower .   It was a transformation.   I was finally, a Stoic. almost. :-)

ECT: The Method of Last Resort

by Kevin Thompson, Ph.D. 

What is Electroconvulsive Therapy?

Electroconvulsive Therapy (ECT) is an electrical-stimulation technique used to treat severe depression, bipolar disorder, schizophrenia and psychosis, and catatonia. It is a remarkable fact that ECT is an effective treatment for so many apparently unrelated types of mental illness. It is perhaps equally remarkable that so little is known about why it works, beyond the consensus that it is the seizure induced by ECT that leads to the benefits.

During an ECT session, the patient is given a general anesthetic to induce brief unconsciousness, and then a voltage is applied to cause an electric current to flow through one (right lateral) or both (bilateral) sides of the brain, inducing a seizure. For reasons that are not well understood, this electrically-induced seizure can dramatically alleviate depression.

Bilateral treament acts more rapidly than unilateral treatment, but has more severe side effects. Right unilateral treatment produces less severe memory loss, and is preferred for depression. Bilateral treatment is generally restricted to emergency situations involving severe depression with psychosis, severe manic episodes, severe psychotic episodes, and catatonia.

When is ECT Used?

ECT is typically used in these circumstances:
  1. When it is essential to provide the fastest-possible relief for depression, mania, or psychosis (for example, in the case of someone who is suicidal).
  2. When medications have proven ineffective, and symptoms remain severe.
  3. For patients with bipolar disorder who need immediate stabilization of their condition, or who are experiencing severe manic episodes. ECT helps both the manic and depressive aspects of this disorder, something that is not normally true for individual medications.
  4. For patients with catatonia, a dangerous condition that is often resistant to medication.
ECT is a proven technique. It does not always work, but it works more often than medication for severe depression, and generally as well as medications for bipolar disorder and schizophrenia. It often is the only treatment that works for catatonia.

What are the Drawbacks?

There are a number of drawbacks to ECT, including

Conclusion: The Picture is Mixed

It should also be said that some people not only respond well to ECT, but do so without experiencing significant deficits. For these people, most of whom have exhausted the set of available medications, ECT is very much a life saver.

The drawbacks, plus a somewhat sensational and checkered history of past abuse, has led physicians and possible candidates to shy away from ECT. However, ECT should be considered for the circumstances described above.

Kevin Thompson, Ph.D. is the author of Medicines for Mental Health: The Ultimate Guide to Psychiatric Medication. You can find information about treatments for depression, bipolar disorder, schizophrenia, and sexual problems on his Web site at

Spotlight on Resources: Mental Help Net

Mental Help Net, in its own words, is a a Web site "dedicated to educating the public about mental health, wellness, and family and relationship issues and concerns." Run by a panel of mental health experts, Mental Help Net supplies
The site is visually appealing, and the material well-organized and comprehensive. Check it out.

Are You Looking for Writers?

If you are looking for articles on mental-health and medication issues, for an online or printed publication, send me a note. I write for various publications, and may be able to help.

MentalMeds News -- Copyright © 2008 by Kevin Thompson
May be freely distributed in whole or in part, provided material is attributed to Kevin Thompson, Ph.D. at