David Bransford MD Blog Vernal Equinox 2012

Incredible gallery of Photos from the London Telegraph today of
Animals in the Wild !

March 20, 2012 was the official date, and major changes are so apparent as the daylight picks up momentum, the snow has melted, and we are very close to ‘Ice Out’ on the major surrounding lakes. People are outside more often, walking, riding bikes, eager for opening fishing, and camping. Not sure if the smelt runs have begun, but if not, very soon. Many Bald Eagles fishing along the open waters edges.

What does Spring have to do with Psychiatry? One would think it would be a time of rebirth, lifting of feeling sad, confined, and bored. But not always the case. Many adults here tell me they are more apt to experience irritability, restlessness, and what they call “depression”
I cannot explain it, but just know that is what people tell me….I agree, it is counter-intuitive. In the Northern Hemisphere, I was always taught suicide was more common in the Spring than in the Fall.
Fortunately, for most, it is a feeling of joy and increased energy, lifting of spirits, etc.
Many different theories, but no hard facts to explain this.

As for Psychopharmacology, I have read Dr David Healy’s Book Pharmageddon and follow his blog at DavidHealy.org Just received Dr Peter Breggin MD’s classic of “Medication Madness – The Role of Psychiatric Drugs in Cases of Violence, Suicide, and Crime. Like Dr Healy’s books, I find this one by Dr Breggin MD so powerful and informative. Some very comprehensive, alarming information out there that-like feeling depressed in the Spring – defies our traditional thinking about mood and meds to alter how one feels. One final Photo from The London Telegraph. I will ask if you believe this baby owl is just shy or suffers from “Social Anxiety Disorder” ?


On last final Photo from the London Telegraph..We have Ruffed Grouse here…as one moves West. Sharptail Grouse, Prairie Chickens.then by Montana – SageGrouse–(seem to be declining in number). But here is a classic male Sage who may have been given access to Risperdal, based on his features (lol)

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DavidBransfordMD BigPharma has highjacked Psychiatry !

Once again, another week of BigPharma in the field of psychiatry, having a profound impact on prescribers, Universities,the Media, and obviously the “consumers” !
Am not certain why I am still amazed that providers (in this region – PCPs, NPs, CMHCs, and State and Private Psychiatric Hospitals) are so eager to accept the marketing of the Detail Men and Women regarding so called “new ” products. Free samples as handed out in great numbers, even though they are not on the approved formularies of the Insurance Companies’ PBMs and therefore not accessible by prescription and with no clear cut advantages over the older generics. One of my highly respected blogger psychiatrist made the strong point he had heard from a friend in the field. “people do not want therapy these days. They want a pill that will make them feel good!” Psychiatrists are viewed as “Chemists” (as is said in OZ) If the patient is not feeling better in a few weeks, it must be because the “chemistry” is not properly adjusted. I cannot stress enough the importance of following the works of experts such as Dr David Healy, MD and his most recent book “Pharmageddon” His daily blog at DavidHealy.org is free and extremely informative Here is Today’s Post.
we-need-to-talk-about-doctors?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+DrDavidHealy+%28Dr.+David+Healy%29

Too many major changes to mention this evening regarding Risperdal, Zyprexa, and Seroquel. And of the new “Me Too” 2GAs, Saphris is already in trouble with the FDA for off label marketing, Latuda and akathisia, etc. Much as was predicted years ago.
Then there is the patent extenders with generic Ambien re-emerging as Intermezzo at an odd ball strength – rapid dissolve under the tonque, and bound to be a major problem as kids attempt to find creative ways to abuse them.

Nothing positive to report this week in the field of psychiatry. So I turn to other areas of medicine for inspiration, hoping someday the human brain will receive similar research and advances. Organ rejuvenation/restoration absolutely fascinated me. I close with an example of the pioneering work of Dr Anthony Atla at Wake Forest University and allow you the opportunity of viewing his team “Print” a new human kidney for a person in critical need. Sounds like science fiction? His research proves otherwise.

Printing You a New Human Kidney Dr Atala MD

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David Bransford MD Blog “Loss of Mind”

I often hear from adults of having a great dread of developing Dementia…usually Alzheimers..with very gradual onset and ending up in a Memory Care Unit. Thru the media, many well known individuals have made us acutely aware of this tragic process. With Former President Reagan, Actor Charlton Heston, and so many more. Over the past year, there has been a very poignant Farewell Tour with major media coverage and family interviews of Singer Glen Campbell, as he and his family address this condition day by day and he still performs. From YouTube will hope that this video opens:

Glen Cambell's Farewell Tour

Until I took the time to read his biography in detail, I had clearly failed to appreciate how much of a musical influence he has had in our Country. I had been more interested in some of the singer/songwriters that had contributed to his success…John Hartford, in particular..whose life was cut too short by many years battling with non-Hodgkin’s Lymphoma.”Gentle on My Mind” is one of my favorite songs written by John Hartford and seems particularly appropriate for its Title in the context of this post. How ironic the destructive forces that people place on their brains via drugs of abuse, prescription medications, life styles so neurotoxic…and then, when a dementia-related illness is discovered -that very organ of the human body – namely the brain – takes on such a different priority. Major Organ transplants common today, but not the human brain.

Back to John Hartford’s “Gentle On My Mind” made most famous by Glenn Campbell

"Gentle On My Mind" written by John Hartford and made famous per Glenn Campbell

Perhaps the gradual process of the dementia family accounts for the dread of ever having it. And the fact that to date, there is no cure for the vast majority of types. Life style changes may slow Multi-Infarct Dementia-such as controlling blood pressure, blood sugars, and exercise. For ALZ type, the medications have been very disappointing. Add to that, FDA Black Box Warnings to not give antipsychotics to Dementia Patients – a practice far too common in spite of the warning. Nursing Home Patients too often seem to receive these medications for behavioral control, in spite of increased risk of heart attack and/or stroke from the medications. Their fragile, gentle brains do not handle these potent antipsychotics well at all.

So I post this information with no great news of breakthroughs ,,, but as an update on the painful reality of so many family and friends that are left to live with loved ones whose minds can be found to be slipping away with no known cure.
John Hartford with his "Gentle On My Mind" video -surrounded by some musical greats.

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Dr DavidBransford MD Spinning out of control ?

Tornadic Skies       -

Yet another Tornado with the same stormy night

With the tragic news of so many more tornadoes striking the Heartland, along the Ohio River Valley and on to the East Coast; it becomes beyond belief how quickly our lives can be changed. The death count thus far estimated at 38 and probably will climb much higher. I have posted in the past about tornadoes, hurricanes, floods, fires – here in the USA. I live in an area of the country that is very near the Headwaters of the Mississippi. We do not have floods, earthquakes, tornadoes, nor hurricane seasons. With our wood lands, even blinding wind storms are rare. So I can only try to imagine what people experience when Civil Defense sirens go off and they must relocate, sandbag, seek shelter, etc.
So last evening, I spent time with friends in the protection of the warm home, with great food, feeling very safe and secure – in spite of snowfall occurring all evening..the gentle white snow that has been falling all week and will soon melt in the weeks ahead. We embrace the snow “up north” and are well prepared for it. After an unusually mild winter here, the snow all week was particularly welcomed. So my thoughts go out to those so adversely affected by the storms of yesterday and today. The “Spinning Out of Control” thoughts are related to last night, viewing a classic DVD “The Children’s Hour” from 1961-Starring Audrey Hepburn, Shirley MacLaine, and James Garner. I had seen it decades ago when first released, but not recalling the specifics….just amazed at such a cast of gifted actors. I have never seen the earlier play upon which the movie was based, but the plot is far too credible…In which “One Simple Lie Destroyed Everything They Had” Lillian Hellman’s play about an elite girls boarding school is once again on stage – at least in the UK and I would hope to see it. I have read some interesting reviews, now that it is back on stage. I will post one of them later, but first – the original movie with Audrey Hepburn, Shirley MacLaine, and James Garner.

The Children's Hour 1961 Starring Audrey Hepburn. Shirley MacLaine, and James Garner MGM Based on the play by Lillian Hellman

In the early 1960s, the “L” word was not mentioned, aside from in the most negative fashion. If two school teachers running a girls school were thought to be ‘lovers’, it would most certainly be scandalous to the School and lead to its closure, at the very least. In the 21st Century, I would clearly hope attitudes have changed for most. So many Lesbian and homosexual entertainers are so well accepted by most. Many professionals in teaching, research, science, etc are able to be “out” and well accepted. I doubt that the numbers of ‘gender minorities’ has changed in my lifetime, but as I was growing up, I suspect homosexual couples had to be so extremely discrete. I recall at age 7 or 8 often visiting a friendly couple of ladies who shared a home and would often offer us sweets, cookies…Not their real names, but I will refer to them as “Miss Ray and Miss Dolly” I assumed they were sisters – then in their late 50s or 60s. Two more pleasant women could not be imagined. Supportive to each other and the neighborhood, not a threat to anyone that I can imagine. It was only many years later – upon the death of one – that the reality came out that they had been school teachers from a different State, forced out upon learning of the nature of their lesbian relationship. I realize to many, such “unnatural” relationships are viewed as ‘evil’ and same-sex marriage continues to be a major source of intense conflict and debate. I review this movie of “The Children’s Hour, because I suspect it may have been one of the first major motion pictures to address the subject and how it led to an excellent school and two devoted teachers spinning out of control. After the movie was first released, Life magazine put it on its cover.

I would wonder how it was for Audrey Hepburn and Shirley MacLaine to accept the roles to act in the movie?
I view it as a very bold decision and not, in any fashion, an attempt to generate publicity for their own respective careers.

My own professional training at the University of Minnesota Medical School, was in the late 1960s and early 1970s. I was there working with experts such as Starke Hathaway PhD of MMPI fame – and Dr Donald Hastings MD head of the Department of Psychiatry. This was the pilot of the first 20 transexual surgeries..in concert with similar work at Johns Hopkins. Working on the 6th floor as a psychiatric researcher, the potential candidates for possible transexual surgeries would need to go thru intensive counseling, hormone therapies, and numerous other steps for a period of at least 2 years. Many other “gender minorities” were evaluated and given therapy–including the genetic conditions of Klinefelter Syndrome, Turners Syndrome, Fragile X, etc. In an effort to train Medical Students to be open minded with their patients, the controversial SAR program was launched and is still in operation today (Sexual Attitude Reassessment Program).. Some Med Students refused to attend the seminars, objecting to the discussions and videos of experienced “Sexologists’ Masters and Johnson had a close link with Dr Donald Hastings MD. And Helen Singer Kaplan MD, PhD was a powerful force from the East Coast. Virginia Satir was a frequent guest consultant, as was Dr Carl Whitaker, MD……Carol and Titus Belleville, MD offered Conjoint Couple Therapy and were extremely informed and Skilled. Some outsiders believed the emphasis on Human Sexuality was rapidly “spinning out of control” with a particular Fundamentalist Preacher – leading strong protests to ‘shut the program down” Fortunately, due to the background and research, Human Sexuality – in all its complexities – continues to be a major part of the Medical School Training Program. But back to a review from the UK of the Children’s Hour back on Stage…BTW, a most pleasant surprise for me happened quite unexpectedly in New Orleans in 2001 at the Annual APA Conference when I had the opportunity to speak at length with Dr Ruth. She so impressed me as scientifically informed, I could not resist writing a review on her then current book “Sex for Dummies” She would appear on TV as a bit of a comic..who – as someones grandmother – couldn’t possibly understand..Not so at all. She was way ahead of the American Academy of Gynecology on the Myth of the ‘G-Spot’. When I mentioned that in a review, I received hundreds of emails and comments stating I (and Dr Ruth) did not know what we were talking (writing) about. Most feedback came from self-professed Sexperts who were practicing (?) Sex Therapists with no appropriate credentials.

Sex For Dummies

A Blog/Review from last year of Lillian Hellman's play – The Children's Hour – back on stage

The Weepies — The World Spins Madly On !

If you do not know of the Weepies, they are one great couple with many albums, great harmonies, and a great couple

Back to the movie version of “The Children’s Hour”. It was clearly a very powerful, poignant depiction of the tragic conditions that can so quickly get out of hand and lead to unexpected destruction, not unlike the deadly tonados affecting so many thousands in their paths.

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David Bransford MD Psychiatry Update as of 2-25-2012

Tattoos, Piercings, and being "Cool" as a teenager today!

At the end of another week of primarily seeing adolescents for Psychiatric Evaluations from around the State of Minnesota, just some generalized observations from these experiences No names nor photos are of actual patients, but I have utilized graphics I have collected over the past years.

Pregancy, STDs, BCPs, and what role should the State or Counties take with these issues?


So many complex issues – Are juveniles that are “Wards of the State” to receive long acting hormone shots to prevent pregnancy – against their wills. She oral contraceptives be ‘voluntary’ or Court Ordered. Should diagnosis or IQ level be a factor in these decisions? It was common to sterilize any “mentally defective” females not that many years ago. Not certain if male adolescent sex offenders were sterilized, castrated surgically or chemically but I would doubt it. Who really makes these decisions? Not the M.D.s

Then, the STD issues, which have been thoroughly addressed in the past by expert bloggers such as Soulful Sepulcher and Gardasil in the USA.Should all teen females be required to receive “the jab” (as it said in the UK) And why not the males, since they are major carriers of HPV.? Bloggers have addressed these issues online for years now. for example – Gardasil Vaccines in California without parental consent.
Soulful Sepulcher post of Gardasil from 2009

The oral contraceptives have been a major area of concern of late, since the “approved pill” had been a brand linked to greater risk of Deep Vein Thrombosis and related C-V complications. On a National Political Level, Birth Control has been a major area of debate within both major political parties. What parental rights, if any, does a 14 or 15 year old mother have in the USA these days….kids having kids—see that too often. Lots of questions, but hoping for input re: some reasonable answers.

Kids having Kids  -  "ROCK"  Support Group for grandparents - Raising our childrens kids

So who do we turn to for guidance and guidelines regarding our youth of today and hopefully productive adults of tomorrow? Clergy, Wisemen, Doctors, Scientists, Teachers, Insurance CEOs, the Government ???? How about BigPharma??

So many ethical issues in the news around the world just this week. Early abortions in the UK, if the testing shows it to be a girl rather than a boy? China’s Provinces in some regions only were allowed 1 son/family.

And not to overlook a huge area of debate in the field of Mental Health, is the safety of antidepressants in children and adolescents..Fortunately, Soulful Sepulcher, 1boringoldman.com , and DavidHealy.org are actively addressing the flawed studies, suggesting antidepressants are safe with kids. Hogwash, of course,but so very hard to convince PCPs, NPs and other indirect prescribers about this (psychologists, teachers, etc)

Hogwash to the studies that claim antidepressants are safe for kids !

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David Bransford MD More on Psychiatry Updates

Companion Pets - Such an important part of the Family

After yet another week of “Cognitive Dissonace” (H.T. to www.1boringoldman.com for refreshing my memory of the classic work by Leon Festinger and his research on Social Psychology), I return to the theme of Companion Dogs and their unique role as formal or informal Therapy Pets.

That incredible bond between a person and a pet

I have witnessed the highly trained Therapy Dogs working with people with special needs, particularly the Large Breeds with small autistic children. But the most common bonds I view are not dogs with years of special training, but a child with his/her special pet…one that accepts them unconditionally, is loyal, protective, and so devoted. A relationship far too many of these children have not consistently received from humans in their lives.

From a scientific backdrop, the research and lifelong hard work of Dr Joan Esnayrah, Ph.D has been most inspiring and warrants a complete documentary on her contribution to this field.Psychiatric Service Dogs website Jane Miller and many other therapists have written tirelessly, given TV and radio interviews about the great value of Therapy Pets for people, but Jane is my “Go To” reference. And, of course, Temple Grandin, PhD is our Gold Standard -with so many informative books, DVDs, and free YouTube videos.

Dr Joan Esnayra PhD gave personal family interview recently about her own life Joan on YouTube – without any mention of her dogs – discloses her personal history with Bipolar Disorder.

Mark Everett – inspiration of the Eels Rock Group and author of Things Grandchildren Should Know “E” and his Dog are so closely bonded.

Olive - a very special dog that is so natural, friendly, and protective of young children

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David Bransford MD – I would rather be Salmon Fishing !

I'd Rather Be Fishing for Salmon!

Very early this morning, after midnight, I checked the website of 1boringoldman….not expecting his Sunday Post yet at that early hour. But it had been a very active day, interacting with bloggers via Twitter over the all too common concerns about the reliability of various studies, specifically in the field of Psychopharmacology. The LA Times has printed an article regarding antidepressants and the potential risk of suicidal thinking/actions in adolescents..with numerous concerns about the researchers and the reporter. Same general themes regarding credibility, conflicts of interest, etc. Much of the recent discussions have intensified with the Blog of www.DavidHealy.org and the release of his Pharmageddon new book. I was growing tired, but still motivated. One quick switch to 1boringoldman’s Sunday post and it was all right there. See here:

The definitive work regarding Janssen, Risperdal, TMAP, and so much more!

With years of concern, months of expecting the Landmark Trial in Austin, Texas of Janssen (JNJ) versus the State of Texas, and weeks of daily updates from professionals at the Court House blogging, it seemed like it was finally over, once Janssen settled for about 150 million dollars. Then the questions of why did they cave, why did they settle for a relatively small sum, instead of going to trial over possible over a billion dollars in the State of Texas alone? Questions continued to fill the twitterverse and then-very early this morning – Dr Poses’s post seemed to bring some closure for me personally. Not that the “overweight” opera star has sung…but at least some temporary time out.
So after reading the reports, I was thinking of Chicago the Musical..having seen in on Broadway and, of course, the Movie. But this was not entertainment the way Broadway can be. This was (and is) about young children being harmed by well intended, but misinformed clinicians, Social Workers, Foster Care Provider, and Parents….and so much more .
Opening Fishing in Minnesota is usually about Mid May of each year….using in conflict with the Annual American Psychiatric Association meeting – This year in Philly.
I plan to be fishing, in spite if the weather in true Minnesota Tradition. Thanks to the many bloggers that have made this big step a reality.

Opening Fishing in Minnesota - typically Mid May

Health Care Renewal Blogspot on the Texan TMAP, Risperdal, Janssen, and more

davidhealy.org

Chicago the Musical – Razzle Dazzel Em – (sorry. could not resist – too similar to BigPharm)

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