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For These Tragedies To End, We Must Change - SSRIs and Violence

Hello all....

I've taken down my posts recently. I tried to get away from this website and this discussion but -- I can't.

Reading some of the comments that I got which obviously misunderstood what I was saying made me at once sad that my attempts to articulate what I think is causing this horror were being misunderstood. I got paid to talk about public issues for several years but I found it really upsetting when I was getting comments basically accusing me of nonsense. It is much easier to stomach criticism and grow a thick skin when you are talking about institutional racism or economic policy than when you are trying to articulate the cause of mass murder. I especially felt uncomfortable with the fact that I was writing may be hurting or offending people.

I have experienced what is causing these shootings (and the high profile suicides) first hand and I have come out of the other end of it through sheer willpower. I thought, during withdrawal, that my family members wanted to murder me, that I had AIDS and various diseases - I knew I was going crazy and tried to control it as much as I could by doing chores where I was and doing errands but even while doing those tasks, I felt horrified - as if anything I was doing, even walking down the street, was going to kill me. I had never felt like that in my life. I have since started a group on Facebook with 84 members and growing - the stories have sounded almost exactly the same. One woman actually asked me to call her because, since starting the meds for post-partum depression, she started having horrific thoughts of murdering her own children.

Adam Lanza was diagnosed with Asperger's syndrome. His mother shielded and isolated him and according to reports in talks with his family, he was "on medication" to stop various symptoms - which I assume meant anxiety, the most obvious symptom of Asperger's. There is no medication for Asperger's syndrome - physicians usually give out SSRIs and benzodiasipine drugs like Klonopin to treat the anxiety they often have. I have been under the shield of "Asperger's" (I have my doubts not only about the diagnosis but even if Asperger's is even real.) for half of my life - I can tell you reliably that nearly everyone who gets that diagnosis ends up on SSRIs.

When I got home, I did a lot of research. A lot. I have talked with medical professionals about SSRI withdrawal. I had a doctor literally tell me that he had seen children during withdrawal "start to eat the furniture." Another said "strange things happen during SSRI withdrawal." They clearly and bluntly said that "no one knows" how they work. One at Harborview Medical Center even admitted to me that these drugs caused Virginia Tech and Columbine but said "many people still need them." Websites like SSRI Stories document literally hundreds of horrific crimes involving SSRIs.

The guns were not Adam Lanza's own. They belonged to his mother. His mother was a paranoid survivalist and certainly fits in to the mold of the gun idolizer that Michael Maiello talked about in his last article. (Survivalism is as much a hero fantasy as the guy who walks around with a shoulder holster like John Wayne - a survivalist is simply playing the role of The Book Of Eli instead of How The West Was Won.) Gun control could certainly keep guns from ending up in the hands of a woman like that, but the issue of what would catapult a kid like Lanza is something else.

The issue is multifaceted and one needs to look at all of the elements. Lanza, however, is something else entirely, and it terrifies me that the obvious is not being recognized. I realize that there is a lot of emotional and professional attachment to these medications and that what I'm saying is scary. It's scary as hell.

It is very possible that Lanza went into withdrawal, lost his mind in the turmoil that these drugs create and then went and did the horrific things he did. James Holmes actually called his psychiatrist before he murdered all those people in that movie theater - his psychiatrist had actually been reprimanded for having prescribed drugs for friends and family. He kept researching "dysphoric mania" - SSRIs are known to cause an REM Sleep Disorder state in which a person literally acts out their worst nightmare. One British documentary on the Virginia Tech shooting documented that Cho Sueng Hui actually was put on antidepressants weeks before the shooting occurred.

Please take what I am saying seriously. I think I survived it for a reason. I've come out the other end. The thought of ending it was powerful as loved ones who were talking fine to me only a year ago and congratulating me on my achievements were looking at me like I was crazy. Neither gun control or the abolition of SSRIs will happen soon enough - that deadly combo will cause this to happen again. And again. And again. Until we stop this.

In his speech, President Barack Obama said that for these tragedies to end "we must change." We're going to change by looking at all of the potential causes. Our entire way of thinking about almost everything may be off and the reason why things like this are happening.

Everyone take care out there. Thank you for reading.

Orion, so many people (self included) reacted to this with the a kind of blanket notion that we need smarter gun laws and more access to mental health services.  But when I read your observations it becomes very clear that "more access to mental health services," means nothing if we don't figure out smarter mental health solutions.  We've been headed in the direction of psychopharmacology for decades now.  Talk therapy has become almost a quaint notion.  Heck, philosophy is becoming a quaint notion at this rate.

But there's an old problem in psychology that remains.  Say you're visiting a Freudian therapist and one day you realize that there's nothing to it.  These theories don't apply to you.  Your problems have nothing to do with your adolescence or your sexual development.  You tell the therapist.  The therapist says, "you're just repressing the true nature of your anxiety.  You'll need to come five times a week and pay in advance on Mondays."

Though in your case it's worse.  You make the case that the drugs that mental health professionals have been increasingly relying on for decades are making matters worse for at least some people and they say, "he's unreliable on this issue.  He needs these drugs.  Let's up his dose."

It seems that psychopharmacology has not transcended the problems of falsifiability that have plagued other therapies.  Also, you mention your own doubts about the validity of Aspberger's as any sort of diagnosis.  The medical community seems to agree with you, though I'm not sure just calling it autism helps much.  So far as the lay public is concerned, the condition's meaning seems to be defined by whoever's in the news at the time.  "Bill Gates has Aspberger's," they say (without much evidence) and people equate it with having super powers.  Then, something like Sandy Hook happens and people equate it with violent psychosis.

You've peeled the onion a few layers deeper than the rest of us, making it not so clear that more access to mental health care would help if mental health care doesn't vastly improve.  It can't improve if we don't start asking some questions about how we're doing things.  Of course, there are powerful vested interests behind all of these pills.

This is all well said.

It's also worth noting that SSRIs, autism or mental illness certainly don't play in to what on earth is going on. The shooter who killed all of those people at the Sikh temple was a white supremacist - chances are a guy like that may just have been drinking if he was abusing any substance at all.

In all the cases, you have guns getting in to the hands of people who are not at their most mentally fit as individuals. That shows a hole in the mental health field in this country in so many ways it is unbelievable - guns are that freely available and people who are not only homicidal but homicidal toward large mass groups of total strangers are not being committed. You cannot even commit anyone against their will if they are getting that bad!

I've personally taken this shooting to personally expell Asperger's from my life. Right before this, Asperger's was taken out of the DSM IV - making me wonder if the whole thing was ever real to begin with. Alot of Aspies are fake Aspies, I think - they have simply never really sat down and faced the fact they're an asshole and done something to change it like a normal person would.

As horrible as alot of my recent life has been, I've survived it and if anything, I'm suffering from obsessive compulsive disorder. A much more real disorder that I think is exhibited in my writing style and behavior on here. (I've had Michael accuse me of "obsessing" quite a bit and my focusing in on SSRIs might certainly be a case of that.)

I've had Michael accuse me of "obsessing" quite a bit and my focusing in on SSRIs might certainly be a case of that.

Before you get too concerned about that, it's also very natural for a writer to have gravitate towards a "beat."  Michael is working on his second book about American political history, you know. :)

 

Before I jump into my thoughts on this, I want to make it clear that I personally despise it when the FDA gets nanny state about access to prescribed pharmaceuticals in attempts at public health, i.e. for the common good. Like when a couple people have severe side effects to a drug, while thousands are benefitting a great deal, they take it off the market, rather than allow a knowledgeable physician/patient team accept the risks. (I even get angry about non-prescription restrictions for "public health" reasons, like how use of pseudoephedrine in allergy medications is now controlled and discouraged because of its possible use in making meth.)

But maybe because

1) psychiatric medicine is woefully still at a stage of pseudo-science

and

2) the other half of the patient/doctor team in this field is often not in a state to make rational decisions about their own care

in the case of pyschoactive drugs, we may need to regulate much more highly, and also make the physicians much more responsible for what they are doing (like obstetricians are, and keep in mind, this would mean huge malpractice insurance premiums like obstetricians have to pay, and consequently, cost passed on to all of us.)

Orion, the "homicidal ideation" side effect is one that affects only a small portion of the takers of these drugs. But you have to keep in mind that as bad as your experience was, and that of others posting about it on the internet, many many others feel they are helped a great deal and would resent restrictions on the drugs they feel they absolutely need to get up each morning.

The only way around this is to make it much much harder (and consequently expensive) to prescribe them.

Do you think it would be right and fair, for example, to require a lengthy hospitalization to observe the reaction of the patient as he/she starts taking a psychoactive drug? That is the only way you could also make the doctors more responsible. I am starting to lean that this is the only solution. In the past, patients simply thinking about violence were forcibly locked up for long periods, they just weren't allowed on the streets, weren't allowed lives. We don't want to totally go back to that. But maybe we need to require a lengthy-enough hospitalization to observe possible reactions?

The only other alternative is self-education, parents/patients read the internet stories, then decide whether a particular drug is worth trying in concert with physicians, and accept the risk.  But one wonders if someone as smart as James Holmes, a student of neuroscience, couldn't make the right choices, who can?

Sorry we can't wave a wand and make psychiatrics a more advanced field, but we have to face reality in that it's not! What it offers is simply pitiful.

P.S. The extremely well-written HuffPo essay, "I am Adam Lanza's mother..." that oceankat linked to on Ramona's thread,  reminded me that one of the worst horrors is a that of the struggles of a family members with a mentally ill child, and especially when that child is a male who grows to have more physical strength than his caregivers. Well worth the read for a concise and powerful description of what we are dealing with here. That your own family probably overreacted, made bad choices, and did you wrong as a child is part of this whole terrible fix we are in with psychiatrics. We have a few poor tools and they are often used poorly. That's reality.

There may be more to this then the ssri's. I also have a son diagnosed with Aspergers. He loves his laptop, we had to limit his time, is a loner and takes meds for depression and add. Yes, he plays lots of video games and violent ones of course since this type has proliferated. He also has a beautiful mind and is highly intelligent with a wide range of interests, however he must be drawn out in order to have a discussion with him. My son was horribly teased in grade school. As an older child he has told me of the terror he lived with everyday. He also was not protected from his tormentors. The school did next to nothing. This has got to change. This is the most vulnerable time of a persons life. It is my suspicion that Lanza experienced this to a certain degree...tell me, why else would he go back to his grade school and kill children? If this is true he will have this in common with other school shooters. We must start at the foundation and start protecting children. We must DEMAND that the schools start to do something about it. It has to become obvious that it is imperative to do so. This is what I would like to see a discussion about.

A couple of days before Newtown happened, I was talking to my brother, a grade school sports coach, on the phone about another brother, our mentally handicapped brother. We got on the topic about how a bullying incident on a school bus early in our handicapped brother's life caused my mother to be severely overprotective, to the detriment of his development. My coach brother said that now after years of experience, he has come to the conclusion that bullying is one of the most damaging things in society, that the damage is incredibly vast.

Godspeed, do the best you can, my heart breaks for you. To be clear, I have no advice for you, just great sympathy.

The inner wasteland that manifests itself in bullying behavior is so obviously anti- human(e) it should cry out for drastic societal intervention at first light lest it become, when mature, the modus operandi of a private equity capitalist who could, in an unlucky country, be made president.

Everything bad comes from social isolation. Bullying is social isolation, a mom being overprotective is social isolation, getting a mental health diagnosis and the resulting stigma is social isolation, etc. etc. Almost all violent people are people who have been pushed out of the normal social order for some reason or another.

We probably have more social isolation than is normal for most cultures because people in this country don't have solid identities. They aren't able to look across the street and recognize the neighbor as being his neighbor because they are from the same tribe - they look across the street and see their neighbor as being their neighbor because they have the same income. That's why this country is falling apart hard and fast. Most cultures in hard times would turn to their family and their clan - people in this culture don't have one.

I still think your connection between SSRIs and violence is too speculative, but this is by far your best essay on the subject, more thoughtful and descriptive without losing the emotion.

I did some googling of SSRIs and violence. I found a bunch of crackpot websites full of anti-medical establishment screeds reminiscent of the vaccine hoax. That doesn't mean there is no link between SSRIs and violence, but if you want to establish a credible argument for it, you have to distance yourself from the wild-eyed ranters demanding that the government immediately ban SSRIs.

A credible article would include case studies, on-the-record quotes from psychiatrists, and reviews of the current research (including studies that don't support your hypothesis). Scientists may not study sensational massacres, but they do study the side effects of SSRIs. There are numerous studies about suicide risk and some about violence. Try using google scholar. (And remember that not all studies are created equal.)

Based on my very cursory overview, it looks like a mixed bag. The studies showing a link seemed to focus on anecdotal evidence, while the studies showing no link are more statistical. That could be because SSRIs are good for some people and bad for others, so the overall average may not reflect peoples' particular experiences. Or it could be that the anecdotal research is bad science.

There also seemed to be less research on withdrawal symptoms, which is when you were affected. Most of it seemed to focus on physical sensation, not mania or suicide risk.

I doubt you're ever going to find a "hard" connection here.  But, keep in mind that drug companies already routinely rank "thoughts of suicide" as a possible side effect of advertised anti-depressants.  These are, by definition, mind-altering substances.  But it's got to be hard to get people to self report a lot of these things, right? Even in a study?  Again, we run up against the wall of falsifiability.  I don't know what the answer is.

I doesn't have to be "hard." Orion is not a scientist and not expected to be one. But if he wanted to influence public opinion by publishing an article in a mainstream magazine, say, he would have to conduct a more rigorous and even-handed investigation.

(That's not to say, Orion, that your own experience should not be part of it. Your experience is what makes it a compelling read. But you'd have to balance it with credible scientific opinion that at least calls the effects of SSRIs into question, even if it's not definitive.)

It's excellent advice, Michael.  The mainstream successful Orion piece in this regard will necessarily support the subjective with something else and it will have to rise above some of the din.  To the extent that we Daggers can, we should keep an eye out for credible sources that he can use in his research.

 I don't have either experience or expertise to give me any confident opinion of the veracity of anything on this subject but here is some more discussion of it.

http://www.washingtonsblog.com/2012/12/no-mentally-ill-people-would-not-...

I hope it has some value. Cheers, Orion and all.

Oddly enough, the discussion of SSRIs may bear some resemblance to the discussion of guns. Right now, they're wildly popular and people have all kinds of beliefs about them, which may or may not be true.

At some point, problems come up, people's faith in the product is tested, and as reality presents itself, fewer people want to buy that product, or at least realize that its effectiveness is narrower than previously thought.

Say what we want about gun control, the real gun control will happen when more people start saying "Yeah, whatever, why would I bother spending the money?"

   All I know is that the medication seems to have done me good. I'm not qualified to say anything else about anti-psychotic or anti-anxiety meds.

I medicate my ADD with unseemly enthusiasm ...I recommend y'all to do likewise...SSRI's not so much...( but I "suffer" from an excess-150% normal- number of serotonin receptors...ymmv.)

Selective Serotonin Reuptake Inhibitors had nothing to do with Adam Lanza's spree killing.

It stretches credibility to speculate that Asperger's had anything to do with his spree.

We will likely never know exactly what his illness was; and we have no indication that his mother was paranoid. Paranoia is a diagnosis with multiple criteria; not a colloquial carrying a meaning equivalent to "damn they craaa-zzee!"

I think the most certain thing that can be said is that Adam was paranoid; maybe paranoid-schizophrenic. It's also the case that he was at the age when such problems begin to really manifest.

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