Mental Disorders

Over her life, June Sams has been told she has schizophrenia and four mental health disorders: bipolar, post-traumatic stress, major depressive, and personality. The 60-year-old Chester woman's current diagnoses - she thinks these fit - are major depressive and generalized anxiety disorders plus PTSD due to childhood trauma. A doctor told Elisa-Beth Gardner, 51, of Swarthmore, that she had borderline personality disorder (BPD) in 1996. Three months later, she was told she had bipolar disorder.

The recent shootings in Nebraska and Colorado, while tragic, are only the most recent in a series that have captured national headlines. Like the Virginia Tech and Columbine High School shootings and others, these incidents are notable for the clear signs of mental instability in the perpetrators. Yet, sadly, their cries for help went unanswered, and the interventions and treatments that might have prevented these deadly situations were never implemented. Individually and collectively, these events have exposed the fissures in our mental-health-care system and the tragic consequences to which such failures can lead.

Defense attorneys will not be allowed to present evidence to a Gloucester County Superior Court jury supporting their contention that a Delaware Air Force sergeant was suffering from depression and two personality disorders the day he allegedly shot and killed a Monroe Township man, a judge ruled yesterday. Judge Ernest Alvino said Public Defenders Jeffrey Wintner and Fred B. Last did not prove through a "preponderance of the evidence" during hearings last week that David Mark Russo's behavior on March 7, 1985, was affected by depression and personality disorders.

CHICAGO - For the first time in almost two decades the nation's psychiatrists are changing the guidebook they use to diagnose mental disorders. Among the most controversial proposed changes: dropping certain familiar terms like Asperger's disorder and dyslexia and calling frequent, severe temper tantrums a mental illness. The board of trustees for the American Psychiatric Association voted Saturday in suburban Washington on scores of revisions that have been in the works for several years.

President Bush supports it. A majority in both the U.S. Senate and the House are for it. And 83 percent of Americans, according to a new poll, also believe it's the right thing to do. The issue: A federal bill requiring health insurance plans to recognize that mental disorders are as real and treatable as physical ones. The "mental-health parity" legislation, as it has become known, would mandate equal benefits for both mental and physical complaints. For instance, if a worker had a $15 co-pay for a visit to a gynecologist, she couldn't be charged a higher co-pay for a psychiatrist visit or, as often happens, be forced to pay for most of her psychiatric care.

The United States has a drug problem. Spending on prescription drugs rose from $40 billion in 1990 to a record $307 billion in 2010 as more people came to believe there's a pill for every problem. Pharmaceutical companies fuel this belief by bombarding the public with advertising. Self-medication with over-the-counter drugs, herbal remedies, alcohol, and street drugs compounds the problem. Now drug use has stirred up a heated controversy among mental-health professionals. Last year, 44 million American adults, or more than 22 percent of the population, were treated for mental illness.

AHUNDRED years ago in Europe, combat soldiers who developed tremors and nightmares were executed as traitors or branded as weaklings. We now know that it's normal for combat to cause traumatic reactions. But new research on the mental-health risk of combat in Iraq compels examination of both the short- and long-term psychological impact of this war on our soldiers and their families. A recent study found that one in six members of combat infantry units deployed to Iraq in 2003 exhibited evidence of major depression, anxiety or post-traumatic stress disorder (PTSD)

David Satcher hasn't been surgeon general since February, but he still sounded like one yesterday as he extolled better treatment and insurance for the mentally ill at the annual meeting of the Pennsylvania chapter of the National Alliance for the Mentally Ill. Satcher, who was the first surgeon general to write a report specifically about mental health, said improving treatment for those with mental illnesses needs to be a national priority....

Mental-health experts use such terms as "historic" and "sea change" to describe the mental-health coverage in President Clinton's proposed health- care reform package. But some take issue with the five-year phase-in of the proposal. And many doubt whether its most progressive features can survive attacks by lobbyists as the plan churns its way through Congress. About one in every five Americans - an estimated 41 million people - suffers from mental disorders each year, experts estimate.

Gov. Christie vowed last week to review New Jersey's mental-health services as part of a "violence control" plan following the Sandy Hook school shooting. Mental-health-care advocates say Christie could improve services by expanding programs that already exist, including Medicaid, and broadening the mental-health disorders covered under health insurance for state workers and public-school teachers. New Jersey is one of only eight states that do not offer workers equal benefits for mental and physical ailments, said Paul Lubitz, associate director of the New Jersey chapter of the National Alliance on Mental Illness.

Gov. Christie vowed last week to review New Jersey's mental-health services as part of a "violence control" plan following the Sandy Hook school shooting. Mental-health-care advocates say Christie could improve services by expanding programs that already exist, including Medicaid, and broadening the mental-health disorders covered under health insurance for state workers and public-school teachers. New Jersey is one of only eight states that do not offer workers equal benefits for mental and physical ailments, said Paul Lubitz, associate director of the New Jersey chapter of the National Alliance on Mental Illness.

It took only a few hours after Friday's mass shooting in Newtown, Conn., for the media to ask if the perpetrator, Adam Lanza, had a history of mental illness. Reports have suggested that Lanza suffered from Asperger syndrome and that he may have been on psychiatric drugs. Pundits have asked if the killer's actions could have been prevented had he received proper psychiatric help. These may be obvious questions and statements, but just how useful are they? Some social commentators wonder whether the status of Lanza's mental health will ever give a satisfactory answer to the horrific mayhem unleashed at Sandy Hook Elementary School - or any of the other estimated 61 mass killings in America since 1982.

CHICAGO - For the first time in almost two decades the nation's psychiatrists are changing the guidebook they use to diagnose mental disorders. Among the most controversial proposed changes: dropping certain familiar terms like Asperger's disorder and dyslexia and calling frequent, severe temper tantrums a mental illness. The board of trustees for the American Psychiatric Association voted Saturday in suburban Washington on scores of revisions that have been in the works for several years.

Over her life, June Sams has been told she has schizophrenia and four mental health disorders: bipolar, post-traumatic stress, major depressive, and personality. The 60-year-old Chester woman's current diagnoses - she thinks these fit - are major depressive and generalized anxiety disorders plus PTSD due to childhood trauma. A doctor told Elisa-Beth Gardner, 51, of Swarthmore, that she had borderline personality disorder (BPD) in 1996. Three months later, she was told she had bipolar disorder.

It was a challenge to get the label rip started Saturday. So many "psychiatric survivors" were milling around outside the Convention Center that it was hard to get them to pick one of the big cards printed with names of mental illnesses. "Who wants a psychotic one?" yelled Faith Rhyne, a North Carolina woman who belongs to MindFreedom International, an Oregon-based group that helped organize the protest outside the annual meeting of the American Psychiatric Association. "Who wants obsessive-compulsive?"

When upward of 10,000 members of the American Psychiatric Association meet here this weekend, they'll be met by protesters - there are always protesters - and tough questions about where their profession is headed and how it will define normalcy for the rest of us. The official theme of the annual meeting, which opens Saturday at the Pennsylvania Convention Center, is integrated care, a nod to the increasingly interdisciplinary nature of medicine...

The United States has a drug problem. Spending on prescription drugs rose from $40 billion in 1990 to a record $307 billion in 2010 as more people came to believe there's a pill for every problem. Pharmaceutical companies fuel this belief by bombarding the public with advertising. Self-medication with over-the-counter drugs, herbal remedies, alcohol, and street drugs compounds the problem. Now drug use has stirred up a heated controversy among mental-health professionals. Last year, 44 million American adults, or more than 22 percent of the population, were treated for mental illness.

Hoarding may be bizarre enough behavior to sustain several reality TV shows, but, surprisingly, it isn't an official psychiatric disorder. That may change in May 2013, and University of Pennsylvania therapists will play a key role in the decision. Penn Medicine is one of seven institutions chosen as field trial sites for the forthcoming edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5. Therapists at Penn's outpatient mental health clinic will test how well the revised guide to mental illnesses, which introduces hoarding disorder, works in the real world.

JEFFREY BOHEN watched Russell Crowe's portrayal of schizophrenic scientist John Nash in "A Beautiful Mind" and saw himself. Not just himself, but the thousands of people whose struggles with mental illness or retardation are complicated by the fact that people refuse to see them as functioning members of society. "I thought, '[Nash] is not the exception. He's not an anomaly,' " Bohen said. "There are thousands of us who live normal lives. We go beyond our illness. It doesn't define us. " Bohen is bipolar and a recovering addict.

God messages I find it interesting to see people spending thousands of dollars to argue whether or not there is a God. ("Reverent rebuttal on a billboard," Aug. 7). If I had a dollar for every person who claims there is a God but could care less about living up to God's ethical and moral code, especially as it applies to friends, family, neighbors and strangers in our midst, I'd be a rich man. If there is a God, I would think that he would prefer that we spend our time doing good works rather than claiming to speak for God. Ian Wachstein Collingswood Learn the anthem During the Olympics, a few U.S. athletes will earn the honor of standing on the top step at award ceremonies, wearing the gold, as our country's flag waves in China and the band plays our national anthem.