McMan's
Depression and Bipolar Weekly
Note:
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Jan
30, 2002 Vol 4 No 5
POLLOCK
AND ME
It took me a long time for me to finally "get" modern art, and an even
longer time to relate to it and grow fond of it, but somehow I never had that
problem with Jackson Pollock. Jackson Pollock was the creator of those daring
action drip paintings that are the glory of abstract expressionism which helped
make New York the art capital of the world back in the fifties. Various black
and white photos show him at work crouched cat-like with arms extended, paint
can in one hand, drip stick in the other, methodically laying siege to a canvas
rolled out beneath his paint-spattered shoes, ever-present butt dangling from
his mouth.
As to why I could relate, perhaps it was the unrecognized madness in me making
an unconscious connection to the obvious madness of the artist. The paintings
are like a reverse Rorschach test, where nothing bears the faintest semblance to
anything we can see, yet each drip, each splatter, individually or as a grouping
or as a whole, seems to act as the perfect register to how we think and feel.
Moreover, there is an extra-dimensional quality to a Jackson Pollock opus. With
all other paintings, your viewing stops at the flat surface of the canvas. Not
so with Pollock. You are seemingly drawn into some kind of parallel universe on
the other side. Tom Wolfe said you could literally fly a spaceship through the
things.
So it was that I rented the video, "Pollock," a low budget movie
directed by and starring Eddie Harris in the title role. The film begs an
obvious comparison to "A Beautiful Mind", for both are based on true
stories of genius and madness. (Both also share a common set of actors in Eddie
Harris and Jennifer Connelly.) But whereas John Nash's struggle with
schizophrenia is the main story line in :A Beautiful Mind", no mention at
all is made of Jackson Pollock's bipolar other than a cryptic aside about
his neuroticism. Any behavior that might be taken for bipolar takes place while
he is drunk, which happens to be a good deal of the time.
"Fuck Picasso!" he shouts in a alcoholic stupor one minute into the
film. Picasso to Jackson Pollock symbolizes everything that is wrong about art -
it's not homegrown and it's devoid of any new ideas, with
seemingly nowhere to go. Pollock sees himself as the rightful heir to the
cubists and surrealists, but not even the bohemian art world of New York in the
early forties knows who he is. Nevertheless, he finds a comrade in arms, Lee
Krasner played by Marcia Gay Harden, an equally skilled artist who was to
Pollock what George Sand was to Chopin - lover, mentor, promoter, keeper, and
mother figure. They marry, and she succeeds in securing him a wealthy patron,
then gets him out to a farm on Long Island where he can sober up and work in
relative peace.
There, in a barn he has fixed up as a studio, he unrolls his canvases, only to
paint the type of stuff his contemporaries are painting. The breakthrough he is
so desperately seeking continues to elude him. When it finally comes, it is
fittingly interspersed with scenes of him in the garden growing vegetables and
communing with nature. It is the springtime of the creative soul. "You've
cracked it wide open," Lee Krasner says approvingly.
One after another, those lustrous drips would emerge from his humble barn
destined eventually for places like MOMA, the Wadsworth Atheneum, and the Yale
University Art Gallery, where a naive youth, profoundly moved in ways he could
not describe, would simply gawk in wonder, grateful for the miracle of yet
another soul - another Michelangelo, another Beethoven, another Van Gogh, all
mad - personally reaching out to him from beyond the grave.
Unfortunately there could be no feel-good ending for this film. One summer night
in 1956, a drunken Pollock drove his car off the road, killing him and a woman
passenger. He hadn't done a painting in two years. He was 44.
KAVA
CAVEAT
According to a report in the Washington
Post, the FDA is investigating whether the herbal remedy kava, used for
anxiety, is a public health risk. The action follows from European reports
linking the herb to liver toxicity, including hepatitis, cirrhosis, and liver
failure. Meanwhile, two NIH-funded studies on kava have been put on hold. Kava
had US sales of $53 million in 2000, ranking seventh among herbal supplements.
NEW
ANTIDEPRESSANT
Forest Laboratories has announced that it has received an approvable letter from
the FDA to market it's Celexa derivative, Lexapro, for the treatment of
depression. Final FDA clearance is expected in mid-2002.
Lexapro (escitalopram) is a classic example of less is more. Celexa (citalopram)
contains two mirror-image molecules called isomers, but only one contains the
antidepressant effect. The removal of the other isomer to create Lexapro
preserves the therapeutic benefits while reducing the risk any potential side
effects. Most frequent side effects observed in trials were nausea, insomnia,
and ejaculation disorder. The company is also testing the drug for anxiety and
panic disorders.
ATYPICALS
From an article on Psychiatric
Times, written in the context of schizophrenia:
"Two medication classes that have clearly expanded are the selective
serotonin reuptake inhibitors and the atypical antipsychotics. Unlike the SSRIs,
the atypical antipsychotic medications are each unique and differ on more than
pharmacokinetic properties (eg, chemical structure, spectrum of receptor binding
affinities, in vivo neuroimaging profiles)."
SAD
A Yale study of the
blood samples of nine patients receiving light therapy for SAD found
significantly higher levels of the light-sensitive bile pigment bilirubin and
lower depression at the end of two weeks. According to a report on WebMD,
bilirubin may protect neurological pathways that regulate moods and is known to
have a circadian rhythm whose levels peak at night and diminish by day.
BIPOLAR
MIGRAINE
A Norwegian survey
of 62 psychiatric inpatients has found migraine more common in bipolar II
patients that in those with bipolar I or unipolar depression. According to the
author of the study Dr Ole Bernt Fasmer: "These results support the
contention that bipolar I and II are biologically separate disorders."
OLD
AGE
A Swedish study
of 347 healthy subjects aged 85 and over found after three years that 10 percent
of the group had hallucinations, 5.5 percent had delusions, and 6.9 percent had
paranoid thoughts - higher than previous studies reported, according to the
study's authors.
RIGHT
TO DIE
Previous Newsletters have reported on Diane Pretty, the UK terminally ill mother
who is paralyzed from the neck down and has been seeking permission from the
courts for her husband to help her take her own life. A few weeks ago, the House
of Lords, the UK's highest court, turned down her appeal. Now she has
taken her case to the European Court of Human Rights who said her application
would go "right to the top of the pile."
COLD
WAR STATE SECRET
This comes from one of my subscribers:
A new German-language biography reveals that one of the great Cold War statesmen
suffered severe bouts of incapacitating depression. West German Chancellor Willy
Brandt (who died in 1992) was Time magazine's Man of the Year in 1970 and
winner of the Nobel Peace Prize in 1971. Yet there were periods when he spent
all day in bed in a darkened room. Only one trusted aide dared enter, who would
prod him and command: "It's time to govern!" Never a word got
out to the public.
CAMPUS
CRISIS
The parents of Elizabeth Shin have filed a case against MIT for not notifying
them of their daughter's self-mutilation and threats to commit suicide.
Had they known, the parents contend, they would have intervened and possibly
prevented her suicide two years ago. According to Elizabeth's father,
"there wasn't even one phone call." Last year MIT came under
fire from a Boston Globe expose, which reported 12 student suicides at the
school since 1990.
According to the International Association of Counseling Services reported in
the Chicago Tribune, of the 274 campus counseling centers they surveyed for the
2000-2001 school year, 89 percent reported hospitalizing students for mental
illness and 30 percent had at least one student commit suicide. A 2001 MIT
survey found 74 percent of students suffered an emotional problem that disrupted
their daily lives.
YOUTH
A Florida International University study
of South Florida youths, most aged 16 to 20, has found more than 60 percent have
experienced depression, alcohol dependence, or other psychiatric disorder or
substance abuse problem, 38 percent over the past year. Childhood conduct and
major depressive and alcohol abuse disorders were the most prevalent. Females
experienced twice the affective and anxiety disorders as males, but the males
experienced higher attention-deficit/hyperactivity disorder, conduct disorders,
and antisocial personality disorders, which evened out the overall percentages.
African Americans had substantially lower rates for depression and substance
abuse. Foreign-born Hispanics fared better than their US-born counterparts,
particularly for the substance abuse disorders.
THE
FACE OF MADNESS
Words can't do justice to this remarkable photo essay from Colors
Magazine. We have an inmate Midalia who says, "I am the Devil when I'm
here; I'm God when I'm outside." There is love in an
institution in Cuba, people chained to trees in the Ivory Coast, believed to be
possessed by spirits, integration in a hospital in South Africa, and enlightened
community treatment in Belgium. Please check this out.
ANDREA
YATES
From a Time magazine article on Andrea Yates who drowned her five children,
shortly after her arrest and before she was stabilized on drugs:
"Later she told jail doctors that nothing could mute the patter that said
she was a lousy mother. The death of her children, she said, was her punishment,
not theirs. It was, she explained, a mother's final act of mercy. Did not the
Bible say it would be better for a person to be flung into the sea with a stone
tied to his neck than cause little ones to stumble? And she had failed her
children. Only her execution would rescue her from the evil inside her - a
state-sanctioned exorcism in which George W Bush, the former Governor and now
President, would come to save her from the clutches of Satan. Had not Scripture
taught that the government is a minister of God, an avenger who brings
wrath on the one who practices evil?' She told the doctors she wanted her
hair shaved so she could see the number 666 - the mark of the Antichrist - on
her scalp. She also wanted her hair cropped in the shape of a crown, perhaps the
kind the Bible says Jesus will give to those who have won salvation."
WORSE
THAN SURVIVOR
Considering that the largest de facto mental institutions in the US are the
nation's prisons, this is of particular relevance:
A BBC
replication of the infamous Stanford
experiment of 1971 had to be terminated two days short of its scheduled
10-day run. The original Stanford experiment created a prison situation with
student "guards" and "prisoners". That project, too, had to
be cut short after the "prison's" dehumanizing regime and
brutal behavior of the guards caused considerable distress among the prisoners.
Midway into the Stanford experiment, the demoralized prisoners identified
themselves to a chaplain only by their numbers. According to Philip Zimbardo,
who ran the Stanford experiment, toward the end the prisoners "felt
powerless to resist. Their sense of reality had shifted, and they no longer
perceived their imprisonment as an experiment." Only six days had passed.
DEPRESSION
AND DIABETES
An article on Psychiatric
Times by Patrick Lustman PhD of Washington University notes patients with
diabetes (for both type 1 and type 2) are twice as likely to experience
depression as those without diabetes, more so in women. According to Dr Lustman,
the course of depression in diabetes "tends to be severe, with recurrences
being the norm and not the exception."
Dr Lustman notes that although the prevailing view is that depression is
secondary to diabetes, the opposite may be true: One study found that depression
was associated with a twofold increased risk of type 2 diabetes. But whatever
the cause of the co-occurrence, when the two are present, "interactions at
behavioral and physiologic levels are likely." Studies have associated
depression with poor glycemic control, the major cause of diabetes
complications, and from this obesity, physical inactivity, neuropathy, kidney
problems, eye problems, and macrovascular disease. Sadly, major depression is
recognized only one-third of the time.
Tricyclic antidepressants were found to have an adverse hyperglycemic effect
while another study found Prozac actually improved glycemic control.
Psychotherapy has also been found effective for both depression and improving
glycemic control.
ATYPICAL
DEPRESSION
A Brown University study published in the Archives of General Psychiatry of 130
outpatients with atypical depression compared to 449 patients without atypical
features casts doubt on several commonly-held assumptions about the illness.
According to the DSM-IV, the atypical subtype features mood reactivity plus at
least two of the following: hypersomnia, increased appetite, leaden paralysis,
and abnormal sensitivity to rejection and criticism. The study's main
finding, however, showed no evidence that mood reactivity is associated with the
other symptoms.
The study confirmed the following commonly-held assumptions: Preponderance of
women, a younger age of onset, and a longer duration of illness.
... but disputed others: Depressed patients with atypical features were not
younger, they were found to be more rather than less severely depressed, and the
diagnosis was not more prevalent in patients with bipolar.
Other findings: Patients with atypical depression were more likely to have
agoraphobia and social phobia (but no other differences in other anxiety
disorders), and had higher mean scores for personality disorders.
The authors conclude that although their results partially validate the DSM-IV
for atypical depression, "we could find no evidence ... to suggest that
mood reactivity is a valid component of the subtype, and this feature should be
dropped from the diagnostic criteria set."
SILVER
RIBBONS
An organization called TEARS (To Educate and Reduce Stigma) is looking to have
everyone involved in the Oscars, especially those from "A Beautiful
Mind", wear a silver ribbon along with their red, and mention that it is in
honor of John Nash and the more than 50 million Americans with some form of
mental illnesses, a number that has been increasing dramatically since September
11.
Right now, TEARS is a few highly dedicated people with a dream and no
connections. If any of you out there has a rolodex with Hollywood numbers or has
a cousin who is a friend of the guy who cleans Ron Howard's pool please
contact: TEARS_ORG@aol.com
WHAT'S
IN A NAME
Last week's Newsletter mentioned similar sounding drugs such as Prozac
and Prilosec, and Celexa and Celebrex, amongst others. Jessie writes:
The one that always really bugs me is Clonidine and Klonopin. OK, so one has a K
- still doesn't help me.
A
BEAUTIFUL MIND
Roberta writes:
I was experiencing an approach/avoidance desire to see this fabulous film, and
I'm very glad that I went to see it yesterday. There is much illness in our
family, and I was so impressed by Ron Howard's intelligent and kind treatment of
mental illness. Crowe's performance was phenomenal, and I was particularly
impressed by the fact that Mrs Nash stuck by her husband through difficult
years. In the fifties especially, this was surely the exception. My only
criticism of the film was a minor and funny one. Howard used a push button piece
of Tupperware in a 1950s kitchen when that product line was not introduced until
the 70s. Maybe he was just testing us!
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