Submitted by Charlton Stanley, guest blogger
(Otteray Scribe)
What is mental illness? It’s a hot topic in the news recently, because of proposed gun control legislation. I saw a photo yesterday of people holding up a huge sign saying, “Keep guns out of the hands of mentally ill.”
There is far more to the demonization of the mentally ill than just the firearms issue. It spills over into the Federal Aviation Administration and the Department of Transportation. It is not just guns; it is airplanes and trucks as well. This brings us to the core question of, “What is mental illness?” The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) is the current handbook for classifying mental disorders. DSM-V is in the final stages of development and will be published in May 2013. That is only next month.
Which brings us back to the original question of what exactly is mental illness? In New York, a man’s home was raided, his Concealed Carry Permit revoked and guns confiscated because someone told the police he was taking an anti-anxiety medication. I have received emails in the past week from several friends about this issue. One of them is a vet, M→F transgendered. She is concerned about being able to renew her own Concealed Carry Permit (CCP). As a veteran and avid target-shooting hobbyist, she is well trained in gun safety and use. As a transgender woman, she is a target and prey according to FBI statistics. Hate crimes against LGBT people are at a 14-year high.
According to the DSM-IV-TR, “Gender Identity Disorder” is one of the mental illnesses. In the DSM-V, it is renamed “Gender Dysphoria.” While claiming it is not a mental illness, the fact that Gender Dysphoria is in the DSM-V in the first place makes it suspect in the eyes of many. Two days ago, she sent this excerpt from a local outlet:
The enforcement action started on March 29th when New York State Police asked the Erie County Clerk’s Office to pursue revoking the man’s pistol permit because he owned guns in violation of the mental health provision of New York’s newly enacted guns law called the SAFE ACT.
The allegation turned out to be untrue and his guns returned to him. As it turned out, the police, sua sponte, initiated the action. The only lawyer involved in the matter was the man’s own attorney.
Erie County Clerk Chris Jacobs said, “When the State Police called to tell us they made a mistake and had the wrong person…it became clear that the State did not do their job here, and now we all look foolish.”
Flaws in the mental health reporting provisions of the NY SAFE Act were blamed for the misunderstanding. The county clerk added, “Until the mental health provisions are fixed, these mistakes will continue to happen” (source: WKBW-TV)
The bigger issue is how come taking an anxiolytic prescribed by one’s family doctor disqualifying? It would be interesting to know just how many of those raiding officers, and their supervisors, are taking medication for anxiety, depression or sleep.
Is mild anxiety a reason to stigmatize someone, and possibly violate his or her civil rights? It gets better. The FAA Medical Examiner will not allow psychiatric medications for any class of Medical Certificate. If a psychiatric medication, it is an automatic disqualification. Several non-psychiatric medications are disqualifying as well. When Tagamet (cimetidine) was first released to treat ulcers and hyperacidity, it disqualified one from holding an FAA Medical Certificate in order to fly. I first heard about that from a friend who was an Aviation Medical Examiner at the time. He told me the FAA put Tagamet on the list because, “It acts on the central nervous system.”
What is mental illness? Some say it is anything that is in the DSM. However, as I have pointed out in court many times, the DSM is a handbook put together by a committee. Everyone has heard the old joke about what a committee produces: “An elephant is a mouse designed by a committee.”
The new DSM-V will be expanding the definition of ADHD. The definition of PTSD is supposed to be clarified in the final definition. Homosexuality was removed from the DSM-IV. If it was a mental illness, the why was it removed? The answer to that is simple. It is not a mental illness.
Let’s look at posttraumatic stress disorder (PTSD) as a single example of a single disorder. PTSD is classified as an anxiety spectrum disorder. Symptoms include feeling anxious, vivid dreams or memories of a traumatic event, and avoidance of situations that might remind one of the traumatic event. Those are called “triggers.” Some claim that only combat veterans can suffer PTSD. That is nonsense. The original trauma can be anything causing one to fear for their own life or safety, or that of others. No one knows how many Americans suffer from PTSD, but the NIMH estimates 7.7 million adults have diagnosable PTSD. That is about 3.5% of the population. 22% of Vietnam veterans returned with PTSD. My personal impression is that number is too low by a significant margin. Many people with PTSD have never been diagnosed. Why? Because they are afraid to talk to a doctor or clinical social worker.
How many rights should be taken from all those citizens and veterans, simply because they have PTSD?
When some of the most prominent mental health experts in the world cannot agree what mental illness diagnoses are, how are lawmakers, judges and law enforcement officers supposed to know? Is being transgendered a mental illness? How about homosexuality—oops, never mind, they took that out of the DSM-IV. There are many people with bipolar disorder walking around and you will never know it, especially if they are taking their medication. Should a person with well-controlled bipolar disorder be allowed to drive an 18 wheel truck, fly a light airplane, or own firearms?
It is interesting that the FAA has created a new class of aircraft, call Light Sport Aircraft” or LSA, which do not require an FAA medical certificate to fly. A light sport pilot may fly with a valid and current driver’s license. Glider pilots can exercise the privilege without a medical certificate.
This brings us to driver’s licenses. If a person, who is taking Xanax or some mild anti-depressant is not allowed to own firearms or fly a Cessna 172, why can they drive? An average automobile or pickup truck weighs almost two tons. They drive on two-lane roads at 55 or 60 mph. That means on a two-lane road, they are passing within two to four feet of each other with a closing speed of about 120 mph.
Just what is mental illness, and where is that bright line drawn for different activities and privileges of ownership? Think about it. Your physician has to give you a formal diagnosis in order to write a prescription for any medication. Almost any Primary Care Physician, especially family doctors, will tell you that a large percentage of their patients are receiving medications for diagnosed psychiatric conditions. The most common are depression and anxiety, either situational or endogenous.
Alcohol, in my opinion, is much more dangerous than any antidepressant or anxiolytic on the market. Yet, alcohol is legal in most areas. The individual is responsible for keeping their alcohol level under the legal limit, without any government official monitoring them. The rule for pilots is, “eight hours from bottle to throttle.” In other words, if you intend to fly, there should be at least eight hours between the last drink and flying. My rule was always 24 hours just to be on the safe side. Alcohol is involved in far more assaults, shootings, auto crashes, and suicides than any psychiatric medication I know of. That is because alcohol is a disinhibitor.
It is unfortunate that Congress saw fit to suppress data collection on firearms violence back in 1996. I see many pronouncements on violence related to firearms, but without real science, those pronouncements are meaningless. Last January, President Obama lifted the 17-year drought on data gathering. Some members of Congress and the NRA are demanding that the data not be used to promote or advocate any position on violence. Fine. That is the way data should be gathered—content neutral. That honors the null hypothesis approach to research. However the results of the data fall, it should be accessible to other researchers. It must not be buried.
Legislation and administrative rules that limit rights are already having negative effects on people with mental health issues. They do not get treatment, or ask their doctor for advice. Sometimes they lie. Sometimes a patient will show up, insist on paying cash, register under a John Doe alias, give a vacant lot as an address and use 888-88-8888 for a Social Security number. Most people who need mental health medications or treatment refuse to seek help. If anyone thinks that is a good thing, they are not paying attention.
As my father used to say, “Anybody with one eye and half-sense could have seen that one coming.”
HIPAA is supposed to keep your records private, but they are accessible with a court order. Alternately, any agency issuing a license or certificate can insist on the applicant signing a HIPAA complaint medical release form. Sign the form or you do not get your license. One must always beware the Law of Unintended Consequences.
Here are a few tidbits to chew upon. Please discuss. Where is that bright line?
Bettykath: I like the extent that you go to avoid the smokers. Upwind. We got a dog named BreakinWindDog who tries his best to get upwind of the whole group and then let out a bad artFay. He is worse than FartinDog who is very considerate. The smoking thing is in my mind indicative of the hyperactive side of a bipolar individual. It is drug abuse and the docs overlook it as a causal effect of the hyperactivity. Does it cause the illness or condition? Probably not, but it is like meth, only legal and perhaps less toxic. Until it kills you.
BarkinDog, re: smoking. One of them is a heavy smoker. I don’t know about the other two. I don’t allow smoking in my house, in my car, or upwind, so it’s possible that they might and I wouldn’t know.
The Bright Line, the decisive border in the mental illiness world occurs when someone is charged with a crime and they invoke the defense of not guilty by reason of insanity. Now if you are the defendant’s lawyer do you want a shrink that is gonna say the guy had two polar bears for a companion or do you want the defendant to be diagnosed as paranoid schizophrebnic with delusions of persecution– that Floyd saw the victim and saw double, and shot what he thought to be two polar bears and not the night watchman. The paranoid schiztzo diagnosis might cut it with judge and jury while the soft as toast suburban diagnosis of biipolar will get the guy life without parole. Bright Line? This is where you want old school Renardian medical doctor to put the mean label on the guy.
BettyKath: Just wondering. Did any of those bipolars smoke? Did they smoke more when manic? Smoke more when depressed? Seemed to me that all the bipolars or manic/depressives whom I have known were chronic smokers. They smoke right in front of the doc and dont get chided for it. Of course, what is a guy in a mental hospital gonna do? Clean up the act for the doc?
What is mental illness? Where is the bright line drawn?
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http://en.wikipedia.org/wiki/I_know_it_when_I_see_it
least i hope i will. unless it’s me.
{music}
Docter, Docter, what do ya say.
How bout letten me out today.
Aint no reason for me to stay.
Cause, everbodies far away.
Chorus:
Get me back on my feet again.
Back on my feet again.
Open the door, let me free.
Get me back on my feeeet again.
-Randy Newman.
iSee4uDog, I know at least 3 people w/ bipolar disorder. All 3 had lots of behaviors that left family and friends frustrated. Once diagnosed and receiving the right meds in the right dosage, all began functioning w/o the horrific behaviors. Better diet might have been helpful but I don’t know that any of them tried it. I know that some food allergies can cause weird behaviors and it’s hard to pinpoint the food as the problem.
FWIW:
“Former FBI agent: Boston bombing suspect might not get Miranda warning”
….”“Well, even in U.S. custody I think there are situations now where a lot of people would say, ‘Look, you don’t need to read them Miranda rights right away.’ If a very strong suspect is picked up, or someone who could provide very significant information, I think that decision could be discussed.”
The Supreme Court ruled in 1984 that mandatory Miranda warnings can be waived if law enforcement officials are asking questions to deal with an imminent threat. The decision created the so-called “public safety exception” to Miranda rights.”
http://www.rawstory.com/rs/2013/04/15/former-fbi-agent-boston-bombing-suspect-might-not-get-miranda-warning/
Getting back to mental illness. Where is the bright line drawn. Well, it is drawn between psychotic illnesses and the lesser illnesses. Bipolar is some nice word to make suburban folks with hypertension (mania) and alternating depression [manic depressive illness] not have to live with a label like Paranoid Schizophrenic. They who labeled in the past were over labeling some people and over medicating and electrocuting their brains. Those who label now are kindlier, more gentile doctors. No pun intended.
Don’t let the flowers fool ya. The doctors are still out for number One and the Big Pharma is out for Big Pharma.
If you are hyper then stop smoking, tend to a less hyper diet, exercise, sit in the sun, get a dog and watch television shows like Leave It To Beaver. Forget apCray like This Old House or movies like Gone With The Wind. Listen to symphonic music and go to the local symphony or classical music forums. I suggest Mozart if you are manic and Rachmainoff if depressed.
If you live in NYC then move to Vienna, Austria not Vienna, Illinois. Walk the streets with your favorite dog and visit the StaatOper to hear the Vienna Philharmonic Orchestra.
The Bright Line of mental illness if you are of the polar bear type is to live healthy and not fall for the drugs given out by the druggies who call themselves doctors. I think BarkinDog would agree. My blind guy is bipolar by the way.
The Magnitude of the Event. i.e. the Bombing: I wonder what the people in the middle east who get bombed by drones think of all of this publicity and the objection to terrorism. We need to stop the drones, pull out of Afghanistan now like Obama’s father should have, and let others wallow in Watergate.
RWL,
You are right about this having repercussions. There may be fallout from this for years to come. The conspiracy theorists are no doubt just getting cranked up. I just hope the FBI and ATF don’t behave like Keystone Kops, as happened with the anthrax and Atlanta Olympics bombing.
I suspect this is domestic, but more information is needed before I form any kind of opinion. I do, however, have a list of “rule-outs.”
BK,
You are right on not needing a DL for flying a glider.. Went into brain lock on the glider thing. When I got my glider rating, I was well past my 14th birthday, so I could be classified with the “whatever” crowd.
Right On Betty Kath: Diet, exercise, supplements but no pharmaceuticals, and lastly sunshine.
That response shines a great light on the topic.
Trying not to change the tune of OS’s great article, but this bombing in Boston is a major event, and there will be reprecussions felt world wide. People, you don’t know the magnitude of this event.
OS, Actually, you don’t need a driver’s license to get a glider rating. You can solo at 14. Well, not you nor anyone else here, but just sayin’.
For private glider rating:
Are at least 16 years of age; and
Have logged at least 10 hours of flight time in a glider and that flight time must include at least 20 total glider flights, and
Have 2 hours of solo flight time in a glider, and
Have passed the FAA written examination; and
Have passed the flight exam with a FAA Examiner.
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I was given something for being depressed (prescribed by a psychiatrist w/o seeing me but continued after). After I left my husband who insisted that I “just get over it”, I quit the medication but visited a medical dr. who made an incorrect diagnosis but the treatment fixed one problem so that I felt a bit better. Some time later I saw another dr who did a blood test and found the actual physical reason for the depression and other symptoms. Better diet, exercise and supplements, NO pharmaceuticals, and I’m rarely down in the dumps. So it depends. SOME mental health issues can be fixed with diet, exercise, supplements, and sunshine.
RWL.
I do not do TV interviews. Seldom give interviews of any kind any more. I have been known to slip out the rear service door of courthouses in order to avoid the press gaggle on the front steps.
OS,
Be careful. You may get a call from FoxNews, asking you for your expert opinion, since FoxNews seems to not even consider bringing in a ballistic/bomb expertist.
Bron,
Yes. They are linking the bombing to ‘man with a foreign accent’.
I have just looked at dozens of photos of the Boston bomb blast aftermath. I noticed a couple of things. First, the smoke is white, which means it was probably either black powder or smokeless powder. Smokeless is not really smokeless, there is just less smoke than black powder generates. If it had been C-4 or similar military grade explosive, the smoke would have been black. My money is on black powder, because it is more explosive than smokeless powder.
The next thing I noticed was the horrific leg injuries. Far more than to the upper body. These devices were designed to maim and cripple more than to kill, based on the injuries in the pictures. The way the blasts were directed indicates the bomb builder(s) knew what they were doing. It appears the blast zone was focused outward from the bombs between knee and ankle height. It is not clear from on-scene reports if these devices had shrapnel in them like claymore mines, or just relied on blast effect.
Triggering devices have not been located yet, so the mechanism is unknown. Could have been cell phone, timer or any number of other signaling/switching devices. After the explosions, cell phone service in Boston was shut down, but that horse had already left the stable.
Based on my experience studying violent acts, I think the target area is significant. What worse thing could one do to a competitive runner than to destroy their legs without killing them? This was sophisticated at multiple levels beyond just the construction of the bomb itself.
There are a couple of other things as well. Homemade black powder is untraceable. A bomb can be made to look like anything but a bomb. If the trigger was a garage door opener, shutting down cell phone service is a useless gesture. Whoever did this has to be some kind of pro. Catching them will not be easy unless they manage to blow themselves up.
Gene H:
hell does freeze over once in a while.
WMAL reports a saudi national was seen running from the explosion with burns and was tackled by a civilian.