Oprah Is At It - Again

Katherine Stone authors an outstanding blog on postpartum disorders, Postpartum Progress. In a December blog piece on my mental health heroes, I cited her as my "Internet Hero" of the year.

Today, Katherine features a contribution from Alexis Lesa. In response to an open request from the Oprah show, Alexis went to the site and entered in a brief account of her experience with postpartum depression. To the surprise of Alexis, the next day she received a follow-up email requesting more information. One of the follow-up questions included:

After your child's birth...are you feel empty and sad instead of elated and excited?

And another:

Are you scared you were going to hurt your child or yourself?

(The badly mangled grammar is theirs.)

As Alexis writes:

I know that the questions were most likely meant to get a broad sense of what PPD is like and I should probably just let it go, but I can’t help myself. ... It seems that people are intent on pigeonholing PPD as a crazy-making disease, one that turns women into baby haters, baby killers.

She adds:

Why is it that the first thing that comes to people’s minds when they hear PPD is “This woman probably doesn’t love her child,” or “This woman is probably going to hurt her child.”? It’s as though all the literature about the range of PPD symptoms simply doesn’t exist--in the eyes of the world, all PPD moms are a danger to themselves or their children. It’s no wonder many women fear speaking out.

Ah, deja vu all over again.

Three years ago, Julie, a producer from Oprah, contacted me. They were interested in doing a show on bipolar. Julie saw my website and wanted to talk. Who doesn't have time to talk to someone from Oprah?

Soon into our phone conversation a day or two later, it became obvious why Julie was calling. She wanted to know about my mad scene. My mad scene of 20 years ago is fairly boring as far as mad scenes go. (I had merely quit my job in a huff.) A total disaster from my point of view, but hardly a newsworthy one. Depression is the real bane of my life, and Julie didn't want to hear about that.

"Did Bipolar Drive a Mother to Kill Her Child?" read the home page of Oprah's website, about a month later. "Tune in Monday."

The show started out with a 911 call: The mother, Andrea, had just confessed to choking her six year-old son. It turned out her idiot family doctor had been giving her antidepressants. In prison (she is serving a 42-year term), a doctor made the right diagnosis, put her on a mood stabilizer, and now she is doing fine, all things considered.

The entire first segment of the show was devoted to Andrea, while nearly all the second featured Andrea's friends. Then Kay Jamison came on. Two minutes. Kay Jamison, two minutes.

Then came "General Hospital" star Maurice Bernard, talking for 10 minutes about his "blow-out" that turned out to be an anxiety attack. The last segment featured actress Jennifer Lewis who turned out to be smart and personable. Then a hurried one-minute wrap-up with Kay Jamison. End of show.

Three years later: Postpartum depression is about to get the Oprah treatment. Many thanks, Katherine, for tipping me off. My suggestion, Katherine: Time to suit up as an internet hero. Maybe Oprah is way too powerful for the likes of us, but we don't have to take this lying down, either.

Time to make some noise ...

My Mental Health Heroes of the Year - 2009

My true heroes in mental health are those whose efforts never come to our attention, yet change lives: A mother who battles indifferent clinicians and bureaucrats on behalf of her kid; a volunteer who arrives early to turn on lights and arrange chairs and greet visitors; a doctor who refuses to give up on a patient, a postgrad research assistant laboring tirelessly on peasant wages; a middle manager who sticks his neck out on a risky hire; a patient who falls down seven times and gets up eight ...

My choices here are confined to the public realm, and are restricted by my limited awareness - a fact which may have excluded worthy candidates but hardly diminishes the accomplishments of those cited here. Further, they all got started toiling in obscurity. Thus, even though I am singing praises to a select few, I urge you to think of this piece as a tribute to all our mental health heroes.

Without further ado ...

Public person hero of the year - Barack Obama. No question about it. This man has put it all on the line in support of the proposition that the government serves all the people and not just the privileged few. We may not get the health care reform we need, but thanks to the President’s heroic efforts it appears we will get a much better deal than the rotten one that insurance companies, death panel nutjobs, and various enemies of the people tell us we should shut up and be grateful for.

Internet hero of the year - Katherine Stone. Katherine’s blog Postpartum Progress is a must-read on a normal day. In May, she outdid herself with a Mother’s Day Rally for Moms' Mental Health, featuring an all-star line-up of “warrior mother” guest bloggers whose contributions cast a bright light on a dimly-lit area of mental illness.

Soon after, in July, Katherine publicly scolded the editors of Time Magazine “for allowing an article on a topic that they clearly knew so little about to be published,” then rallied fellow advocates and experts in a letter to Time. Of all things, in its Person of the Year issue, Time singled out Katherine’s letter as one of its “Letters of the Year” of 2009.

Research hero of the year - David Braff MD. Think of this as homage to all of those brilliant individuals who have dedicated their lives to figuring out new ways to improve ours. Earlier this year, Dr Braff of UCSD received the prestigious Warren Award from the International Congress of Schizophrenia Research. In his Award lecture, I heard Dr Braff discuss “endophenotype,” a field he has pioneered and which is revolutionizing psychiatric research.

Endophenotype allows researchers to investigate an outward feature (phenotype) such as psychosis by looking at underlying phenomena, such as the inability of the brain to filter out sensory stimuli. Today's thinking-outside-the-box translates into tomorrow's practical applications. As this blog says, "Knowledge is Necessity."

Advocate hero of the year- Kathi Stringer. The reason you have probably not heard of Kathi is that she is smart rather than loud. Loud is the unfortunate tendency of mental health advocacy and it has gotten us next to nowhere. For years, Kathi, who is based in Riverside, CA, has quietly championed quality improvement (QI). For years, hardly anyone listened. This year, people are listening.

Kathi comes from a machinist background, where things need to be done right. As an example, if aeronautics refused to apply QI, we would constantly have planes falling out of the sky. QI, which is well-known in every aspect of manufacturing and services, including health, is ignored in mental health. But, as Kathi explains, nearly all the standards we need to improve mental health services are already codified into law and in contracts. We just need smart advocates to act as vigilant watchdogs. Then change can happen, and happen fast.

This summer, at a NAMI CA conference, I heard Kathi lead a workshop on QI. You could have heard a pin drop.

Media hero of the year - “The Soloist.” The movie, based on Steve Lopez’ book of the same name, recounts the real-life relationship between journalist Lopez and homeless music prodigy Nathaniel Ayers. Unlike “Shine” and “A Beautiful Mind,” which end triumphantly on major chords, “The Soloist” concludes on an uneasy note. Rather than the hero-outsider making it in “our” world, we must come to terms with the outsider choosing to remain firmly planted in his. In doing so, we are forced to face our own fears and ignorance.

My guess is that as recently as a few years ago, even the most informed amongst us would not have been ready for this. The fact that the movie met with the success it has is a tribute to our ability to change.

Recovery hero of the year - Abraham Low Self-Help Systems (ALSHS). Recently, Recovery Inc changed its name to Recovery International, then merged with the Abraham Low Institute, which resulted in its present name. Recovery Inc was founded in 1937 by neuropsychiatrist Abraham Low (pictured here), who espoused the radical idea that - with the right cognitive skills and peer help - patients could recover from even severe mental illness. Some 600 self-help groups exist worldwide.

In its new incarnation, ALSHS is retooling to reach out to a wider audience. Stay tuned  ...

My profound appreciation to this year's heroes, both the ones mentioned here and all those who in their own ways are making our world a better place.

Extreme Idiocy in the Media

Katherine Stone writes a terrific blog, PostPartum Progress, which is undeniably the best source of information on postpartum mental illness anywhere, online or off. The other day, she referred me to a Vanity Fair piece that Todd Purdun wrote about Sarah Palin. Here's Katherine's take:

I just LOVE it when pundits and politicians talk about postpartum depression. In the latest issue of the magazine Vanity Fair, Todd Purdum writes this in his article on former Vice Presidential candidate Governor Sarah Palin and the 2008 Presidential campaign:

"Some top aides worried about her mental state: was it possible that she was experiencing postpartum depression? (Palin's youngest son was less than six months old.)"

Purdum doesn't go into why Palin's aides would have thought that. In the paragraph in which he refers to postpartum depression, his only explanation is that Palin was doing what she wanted to, rather than following the campaign's direction, and was "maintaining only the barest level of civil discourse" with certain handlers. ...

Katherine points out that PPD is NOT about being able to get along with others. (Otherwise, I hasten to add, men would qualify for PPD, as well.) As Katherine notes, the article would have been believable had Gov Palin, among other things, been "wondering how on earth she could get through the next five minutes and even possibly considering suicide."

In which case, we might expect a show of sympathy and concern from the author (Ha!). Instead, Purdun piles it on by recklessly applying the diagnosis of narcissistic personality disorder to the epithets "erratic" and "whack job."

Unfortunately, Vanity Fair is to journalism what Caspian beluga is to caviar.

It turns out that Katherine caught me at a time when I'm less than upbeat about my own profession. Seven months ago, I took out membership in the Association of Health Care Journalists. A few months ago, I also made a donation. My general belief is that journalists "get" mental illness, but something happened last month that strongly challenged that notion:

The AHCJ maintains a listserve, which is mostly devoted to inquiries by reporters looking for leads on various stories, but which is also used for dialogues on issues germane to our profession. In response to a Newsweek cover story that was highly critical of Oprah and the irresponsible "wacky cures" she featured on her show (see my blog post), I posted this question to the list:

"Opinions, anyone?"

A first gatekeeper to the list, Jeff, responded that I needed to be more specific. Okay:

Two years ago, Oprah had devoted an entire show to "Did Bipolar Drive a Mother to Kill Her Child?" The show was as appalling as the title.

My opinion: Oprah is an unmitigated idiot, a menace to society, and the antithesis of everything we stand for as health journalists. I'm delighted a major news outlet finally had the guts to call her out. I would be very interested in your take on the Newsweek article, your own Oprah experiences and impressions, and your views in general.

Also: Should AHCJ take a position?

A second gatekeeper, Ivan, dressed me down for my ad hominem remarks. Fair enough. Out they went. Then Ivan responded that he would "mull" over whether he would post the piece. Apparently, I was not being specific enough.

This is a small sample of my response:

"Ivan, this is your listserve and your rules, but as a member of the AHCJ and a donor I take strong objection to your officious attitude regarding my posts. ..."

Following, in part, was Ivan's reply:

"I have shared your rewritten posts with board colleagues, and we continue to have concerns. ... Your post remains vague and does not include any specifics about what you found objectionable about the Oprah episode you cite, nor about the Newsweek piece."

Okay, let me see if I got this right. I wrote: "Two years ago, Oprah had devoted an entire show to 'Did Bipolar Drive a Mother to Kill Her Child?' The show was as appalling as the title."

That wasn't specific enough to Ivan and AHCJ board members. Hmm. "The show was as appalling as the title." Could it be that they found nothing appalling about the title? That Oprah making our population out to be baby-killers was somehow - okay?

Let's just change one word so we get: "Did being African-American Drive a Mother to Kill Her Child?"

Or perhaps this: "Did being Lesbian Drive a Mother to Kill Her Child?"

Would that have been specific enough for Ivan and the AHCJ board members?

I was going to reply to that effect, then I decided I would be wasting my time. I will be allowing my membership in the ACHJ to lapse and won't be making any more donations. I have a very low tolerance for idiots, especially ones that practice my profession.

Katherine Stone apparently feels the same way. This is how she ends her blog piece:

"Despite my complete lack of psychiatric training, I feel very confident in giving Purdum and his editors at Vanity Fair this diagnosis: They are a bunch of idiots."

Mother's Day Rally for Mom's Mental Health

Tomorrow, fellow blogger Katherine Stone will be hosting a special Mother's Day rally at Postpartum Progress. Her blog is undeniably the best source of postpartum information on the web, which every mom-to-be, new mom, and their families need to be reading religiously.

Following her own recovery from postpartum OCD, in 2004 Katherine launched her blog. In 2008, WebMD honored Katherine as a web hero.

Tomorrow's event promises to be especially noteworthy. As Katherine explains in her blog:

The Mother's Day Rally for Moms' Mental Health is an online event featuring 24 open letters to new mothers on the importance of maternal mental health. All of the letters will be written by survivors of and experts on perinatal mood and anxiety disorders, including postpartum depression and postpartum psychosis, as well as by others who care about the emotional well-being of moms and moms-to-be.

Each hour, on the hour, for 24 hours straight, Postpartum Progress will post a different "Letter to New Moms". The letter writers were given a blank canvas to share their humor, experience, tips and ideas, focusing on the mental health of women during pregnancy and postpartum.

I'm proud to be included in Katherine's list of "mommy bloggers." What am I doing there? Stay tuned for my big announcement, tomorrow, Mother's Day.

Again, important reminder: Mother's Day Rally for Moms' Mental Health.