This case is getting so much press, I guess because it just went to trial.

MySpace: “You’re the Kind of Boy a Girl Would Kill Herself Over”

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A man came by here today --70s, Jewish, disheveled, dirty clothes, toothless, wearing an Eagles hat and puffy Nike jacket. He also had a hospital bracelet on. He said he was an investigator and wanted me to do a book and movie based on a case he had -- something about a Catholic nun who was trying to solve the mystery of his wife's rape and was then killed by a hit-and-run driver because she'd gotten too close to the truth. I listened to him talk for about 20 minutes, and the narrative became less and less cohesive. He told me if I worked on the story with him, it would be published by Good Housekeeping and William Morris would make it a book and then a movie and I would star. There were so many allegations and threads of things and names of people and endless streams of slights and grievances and TV-movie-style true-crime horrors. But everything kept coming back to the murder of this nun.

In the past, I might have been more inclined to indulge someone like this -- clearly mentally ill -- for more time. But I learned while working at Horizon House that the best thing you can do with a person like that is to redirect him. I tried to do that several times, asking if he'd gone to synagogues, though I know if this man showed up a number of local temples they'd just want him the hell out of there.

I suggested numerous social service agencies, asked if he had a caseworker, asked if he had a safe place to live. I tried to turn the conversation to practical matters. He would not be redirected, and ultimately I just had to tell him I wouldn't do the story. He said he was disappointed in me, that he thought I could be counted on to help given that I'd written about mental illness in the past, though that wasn't the story he was pitching. I hated to cut him off, but it's sort of like a break-up: the cleaner the break, the better.

I came back to my desk and thought about how people must see him, given that he's going around and pitching this "story" to every reporter and newspaper in town. People hear about delusions and they assume it's all crazy bullshit. But there are always elements of truth within the delusions. In this case, I did a quick Google search for Sister Paul, and there it was: She had been killed by a hit-and-run driver in 2006 at exactly the intersection he mentioned and by the car he described with such specificity. He was also correct about the reward offered for the offender, who's still at large.

He said he'd had a close relationship with this nun, who had probably been one of the few people to reach out to him without judgment. In the Daily News account of Sister Paul's death by Ronnie Polaneczky, the Sister's brother said: "Mercy was like that. She just wanted people to feel loved."

To see a video news report about Sister Paul's death, click here. There's no real reason to watch it, I guess, except to honor Mr. Greenblatt and the nun who cared about him.

Posted by liz at 11:42 AM | Permalink | Comments (7)
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From the Guardian U.K.:

Australian rockers the Vines have cancelled their live commitments due to a deterioration in their frontman's mental health. In a disarmingly frank website post, the band confirmed that they were withdrawing from live and festival appearances indefinitely.

In 2004 Craig Nicholls was diagnosed with Asperger's syndrome, a high-functioning form of autism, after his behaviour became increasingly erratic. He received treatment and the band were able to continue recording, even returning to the road.

But the situation appears to have deteriorated. The band wrote: "It is with a great deal of regret that the Vines today announce that they have cancelled all of their Australian festival appearances – Homebake, Pyramid Rock and Big Day Out – and their forthcoming Japanese tour, scheduled for late November. Craig Nicholls' mental condition has deteriorated to the point where he requires immediate help over an extended period of time."

I don't know a lot about treatment for Asperger's but I do wonder what kind of behavior could have prompted such dramatic, acute need. He was diagnosed in 2004. According to an article written around that time:

Asperger's also goes some way to rationalising the complete communication breakdown that could occur between Nicholls and journalists. During his very first UK interview, with NME at an American rock festival, he tried to smash the writer's tape recorder. Then locked himself in the bathroom. For 90 minutes.

Nicholls's erratic behaviour, then, ticks all the Asperger's boxes. He's not another messed-up rock star who's an accident waiting to happen. He's neuro-divergent. In other words, 'rock star' is the worst career Nicholls could have chosen.

'That's what the professor told me,' Nicholls smiles, presumably referring to his therapist. ...

Given his extreme behaviour, why wasn't it diagnosed earlier? 'I wondered the same thing,' Nicholls says wryly. ... What did smoking pot do for Nicholls?

'Ahm. It just fit with my personality. I never drank alcohol. [Smoking] was just the thing I did. It made me calm. But it started not making me calm at all. It made me edgy, so that wasn't good.'

Whether cannabis use caused Nicholls's mental and emotional problems, or exacerbated existing ones, is unclear. But Robin Turner, the Vines's A&R man and long-term confidant at their UK label Heavenly, always thought his habit was a hindrance, not a help. He witnessed the toilet incident with NME in America. 'It just wasn't rational behaviour,' he recalls. 'But because Craig was smoking such massive amounts of spliff, I wondered whether his behaviour was down to a schizophrenia caused by cannabis.'

This is a tough one. I think many people with Asperger's would be uncomfortable with people saying Nicholls -- who's violent and hostile -- is a classic case. Of course, I'm generally suspicious with diagnoses that are embraced as easily and eagerly as this one was, especially when, if you read this article, it sounds like no one really finds many commonalities between Nicholls and someone with Asperger's.

Whatever the reason for Nicholls' problems, it's good that he's getting help now rather than touring.

[Photo from twelvemajorchords.com]

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Though the subject of a New York Times article today is gallows humor, there's something discomfiting in the way the author so casually mentions the treatment of ECT. After the patient makes a cute remark about the treatment, the author, a psych intern, writes:

If this were a friend or colleague, I would laugh easily. But this is a patient I barely know. He has bipolar disorder, a previous suicide attempt and a history of bizarre, impulsive behavior. In that context, his joke just feels inappropriate and overly familiar.

I’m taken aback. Is it O.K. to laugh, I wonder? An intern, with years of experience being inexperienced, I quickly glance around to take stock of the room.

The nursing assistant laughs and the anesthesiologist grins broadly. The attending psychiatrist remains stone-faced, and says, “Clearly he’s improving.” As the anesthesiologist injects a sedative, a telephone rings. Everyone’s hands are occupied; the ringing continues. Just as the patient starts to drift off, he looks over at me and says: “Can you get that? It might be the governor calling to stay my execution.”

A moment later, he’s out. The attending hands me the leads, and I feel slightly uncomfortable as I bring them to the patient’s head. The nurses are still laughing as he begins to convulse.

In Psychiatry, Can a Punch Line Be a Lifeline?

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I think people use the term Seasonal Affective Disorder rather loosely, but as offenses go, it seems rather minor. For example, I'm sure we could all benefit for this advice to beat SAD from Matt Roberts (pictured), a person trainer who writes for the UK's Times Online:

Make the most of daylight hours

With mornings and evenings getting darker, focus on working out at lunchtime or at any other spare time you have during the day. You don't always have to sweat it out for 60 minutes; even just 30 minutes at a lower intensity, preferably outdoors, can be fantastic.

Exercise regularly

Aim to be active four times each week, doing at least two workouts at a high intensity, and the other two at a more leisurely pace. A walk in the park for 30-40 minutes, for example, could replace your usual 20-30 minute run. Adjust your expectations and do the best you can.

Work out together

There is plenty of evidence to show that if you do a team sport, exercise in a group (eg, circuit training session) or with a friend, you will stay much more motivated and exercise at a higher level. Knowing that others are relying on you is often just the spur you need to stop slipping into inactivity. It's also much more fun than slogging it out on the treadmill alone.

Do weight training once a week

High-intensity weight training produces a life-affirming shot of adrenalin, testosterone and serotonin. The immediate impact on your shape also ensures that your self-image stays as high as possible, which keeps the blues at bay.

Try something new

Lift your spirits by trying something new that you can do indoors when exercising alfresco isn't an option. You'll find a wealth of exercise DVDs in the shops or at your local library, enabling you to experiment at home. Invite a friend to join you and make a social occasion of it.

Check out your local health club or sports centre. Many offer workouts such as climbing, martial arts and numerous variations on dance and yoga for those who are not keen on the gym.

For more, go here.

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Depressed People Spend More Time Watching TV

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This is a fun game. I want to play it every week now. Dave Nold writes:

Who's Next an EMBARRASSING old favorite??? Why toe tap when you can windmill on air guitar? Unless you also find that embarrassing, of course. I'm not familiar with the Ricky Ricardo group but I did see the original Who in 1975 at the apex of their power. OH to go back to teenage wasteland. Dave

An interesting fact: I have never, ever, never ever ever never written anything about the Who without someone yelling at me. I don't know why. They are my all-time favorite rock band, but I think it's fair to admit that it might be a little embarrassing. I mean, when is the last time the Who was any good? Isn't it painful to see those reunion tours? Pete is deaf! I love the man, but when you have to have someone else windmill for you, musically, it's time to pack it in.

Is it true that when I most want to return to my old self I blast "Teenage Wasteland" or "Won't Get Fooled Again"? Maybe. But is that a little goofy? You betcha.

Now. On to more important things. Is the FDA useless when it comes to drug advertising? It appears so. Philip talks about it in relation to Abilify ads here.

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My parents and I are undergoing a lot of change right now, and it makes me anxious. But sometimes the right music can make all the difference. Rather than retreat to embarrassing old favorites, like Who's Next, I'm listening to Marino Marini, and I'll say this: You will toe-tap. Oh yes, you will.

Of course, I'm very pleased by the change the country is facing. I wept girlie tears of joy when Obama got to 270. I told myself I'd never feel sad again. Whoops!

Coping with change is something I've blogged/vlogged about before. But it's always worth discussing, especially with psychiatrists who have access to yummy benzos. Heh. Just kidding. Sort of.

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The Huffington Post reported last week that psychologists in London find paranoia to be much more commonplace than previously thought, and it's continually on the rise.

According to British psychologist Daniel Freeman, nearly one in four Londoners regularly have paranoid thoughts. Freeman is a paranoia expert at the Institute of Psychiatry at King's College and the author of a book on the subject.

Paranoia is defined as the exaggerated or unfounded fear that others are trying to hurt you. That includes thoughts that other people are trying to upset or annoy you, for example, by staring, laughing, or making unfriendly gestures.

Surveys of several thousands of people in Britain, the United States and elsewhere have found that rates of paranoia are slowly rising, although researchers' estimates of how many of us have paranoid thoughts varies widely, from 5 percent to 50 percent.

The obvious question seems to be: Does anyone find this surprising? For the better part of eight years, the most powerful people in the world have been instigating psychotic associations in individuals through the use of paranoid, hysterical rhetoric. Feelings of mass helplessness, suspicion and uncertainty stemming from the ever-increasing pace of change have been deepened by perpetual messages and policies meant to reinforce those feelings.

It’s not enough to make mental health a public issue. Public issues need to be taken seriously in the public sphere as mental health issues. A doctor who treats an individual for paranoid delusions in the midst of rising rates of paranoia without giving consideration to the mood of the milieu does a disservice to his/her patient by forcing the patient to further internalize the society’s illness.

Likewise, a public discourse that ignores, denies or trivializes the existence of mental illness on the social level (i.e. pretending that certain policies are merely political and not signs of psychological disturbance, or calling them signs of disturbance but failing to take the next step in addressing the problem)—such a public discourse is doomed to slip away into its own unacknowledged madness.

As Stephen Colbert noted in his Word the day after the election, the real victory was the victory over fear. As we regain our strengths in our new climate of hope, perhaps we can also be more vigilant in observing the danger signs of unconscious psychotic impulses playing themselves out on a mass level so we can nip them in the democratic bud.

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AstraZeneca receives approval for bipolar drug

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