The correlation between Mental illness and mass shootings

All too often we are inundated with the same tragic cycle. An individual with an assault weapon opens fire on a large amount of people. The media talks about mental health problems in the individual, the victims are laid to rest and the story fades away then it happens again and the cycle repeats. Gun laws remain relatively unchanged as does the mental health system. This blog will attempt to shed some light on some of the current issues related to this horrible phenomenon.

Mr. Muncie speaking
While watching the recent events in Parkland, Florida unfold through the media in real time I was struck by an interview with the Parkland schools superintendent Mr. Robert Runcie. The full scope of the calamity as well as the identity of the shooter had yet to be announced, but he made a very ominous and all too familiar suggestion at the end of his interview, “Mental health issues are growing and they are a big challenge and it’s something that’s going to need to certainly be addressed.” As more information came out, we learned the shooter was essentially a ticking time-bomb, who had suffered many losses and displayed many red flags as to his ability to cope with them in the form of maladaptive behaviors.  We have heard how the community reached out to authorities to express their concerns relating to this individual and those calls went unheeded. There are many systemic failures in this case and I will attempt to shed light on some of them


Anyone who watches mainstream media, reads alternative media or just bops around social media can see that gun control is a hot topic following these events. The voices of certain groups call for a ban on everything from assault rifles, to a ban on guns altogether while another group rushes to defend the second amendment.  Within those two camps are litany of ideas and the one that I think bares the most relevance to this blog post is the idea of stopping mentally ill individuals from purchasing guns. Statistically the mentally ill are more likely to be victims of gun violence than they are to perpetrate it. (Gold, Simon & Knoll, 2015) Yet according to Knoll mass shootings by  people with serious mental illness represent only 1% of yearly gun related homicides or 110 individuals killed. Knoll also rightfully discusses the fact that calling out those with a mental health diagnosis reinforces a negative stigma to mental illness, which creates a major barrier to treatment and worsens the overall public health burden of mental illness.

110 people killed per year in mass shooting events is still a high number so what is being done about it? According to Knoll, attempting to bar the mentally ill from owning firearms will yield little return in terms of lives saved as only 1% of mass shooting deaths can be attributed to the mentally ill, yet lawmakers have written and passed plenty of legislation to do just that. Federal law dictates that anyone committed to a psychiatric hospital or anyone deemed incompetent by a court can be barred from purchasing or owning a firearm according to the Gun Control act of 1968. Yet there are many who don’t understand what that means. People can be held in a psychiatric hospital for anywhere from 72 hours to 10 days while they are being assessed. Those individuals are not necessarily barred from owning firearms. Someone may have had a very difficult day, and made a non-fatal attempt at suicide, at which point they were brought to a hospital against their will. After 72 hours they may report that they feel their suicide attempt was an error, they may discuss future oriented goals, and may then be released. These individuals would not be deemed certified and therefor would be able to walk out of the hospital, and barring any other issues, they would be able to purchase a gun. If after they are held, a psychiatrist deems they need to remain hospitalized that psychiatrist must bring that patient to mental health court and ask that the patient be committed to continue treatment. If the court agrees, the patient is then committed and according to federal law, they are now banned from purchasing or owning firearms.  Being deemed incompetent similarly requires court action in conjunction with a medical professional who must assess an individual. One must file a petition in court to have an individual assessed for competency through psychological testing and if the court sees fit, they will rely on the results of that competency evaluation. These cases may involve an elderly individual suffering from dementia, or someone who commits a crime, but is unable to understand the court proceedings and/or communicate meaningfully with their attorney secondary to mental illness, developmental disabilities, Brain injury, etc. (“How to Legally Declare Someone as Mentally Incompetent?”, 2018) For example, imagine someone who is involved in a car accident while driving intoxicated and is left in a vegetative state after the accident. That individual would be more than likely deemed incompetent, as they wouldn’t be able to understand the proceedings. This may also be the case in the event someone is deemed a threat to themselves or deemed unable to manage their own affairs.

Now that we understand the criteria for someone with mental illness to be banned from owning a gun, we can see that as long as an individual is not committed or deemed incompetent, then they cannot be barred from purchasing a weapon based on mental health issues.

In his film entitled “Bowling For Columbine” Michael Moore went after the pharmaceutical industry and their role in the current spate of mass shootings.  Moore suggests that the Columbine shooting occurred for no other reason than the fact that the shooters were prescribed Prozac. If we consider that claim we find a mixed bag of data. According to Yasmina Molero and her research, the data regarding homicidal behavior is inconclusive and individuality cannot be ruled out. She did report an interesting observation regarding dosing of Selective Serotonin Reuptake Inhibitors IE: Prozac, Zoloft Etc. and increased potential for violence. She found that adolescents on low doses of SSRI medications are at a greater risk for the potential to violence and suggests further study on this topic. She did not find the same risks in older patients or adolescents on higher doses of SSRI’s. Since 2004 Fluoxetine also known as Prozac carries a black box warning regarding increased risk of suicidal ideation. When we combine the black box warning with the observation of Molero, one may see an easy leap to the conclusion that Prozac was to blame for Columbine, but like many areas of information in the modern world this is only a superficial correlation. A study from Hungary showed the exact opposite to be true. The authors of this study found contradictory data to the FDA warning and rather than seeing a decrease in completed suicides, the countries where the black box warning was displayed saw decreased usage of antidepressants and increased numbers of completed suicides. In Hungary where the black box warning was not issued the authors found increased usage of antidepressants and decreased numbers of completed suicides. (Ekundayo et al. 1-18). In the case of mass shooters who are taking psychotropic medications it is important to realize that they were prescribed these medications for a reason. Someone was concerned enough to take these individuals to a Doctor and that doctor saw enough behavioral symptoms (maladaptive behaviors) to decide to try a medication to help alleviate those symptoms. In other words, theoretically the behavior of the individual was already outside the societal norms and the current medical model is to treat maladaptive behaviors with therapy and/or medicine.

When we look at mass shooting events we need to remember one thing, At the end of the day, an individual carries out an act. That individual may be suffering from a mental illness, they may not be. They may or may not be able to manage their thoughts or their moods. They may be on specific medication, they may not be, but for all mass shooting events two variables remain the same. The individual who perpetrates a mass shooting needs a gun and themselves to complete the act. Without that combination there is no mass shooting.  That to me is the area where we have the most pressing need to make changes. The media plays a very important role in pushing agendas after these tragic events, whether filling the airwaves with pundits calling for more gun control, or calling for more guns. It is very difficult to find answers and I hope this blog helps one to understand at least some of the mental health debate that often comes up. At the end of the day, we will never know who is going to perpetrate a horrendous crime such as a mass shooting. We can certainly look for warning signs, but how to decipher a cry for help versus an imminent threat remains an area where we must be vigilant. We also must be vigilant not to make assumptions about someone because they have a mental illness. Mental illness is a disease like diabetes, or heart disease. Sometimes lifestyle choices may have led them into it, sometimes it is completely organic and there was nothing anyone can do. We must remain empathetic if we are to create avenues to treatment and healing as opposed to pathways to a police state. In the early 1960’s Bob Dylan penned his song “Blowing in The Wind” “/” as I worked on this blog I was reminded of the line “How many times must the cannonballs fly, before they are forever banned.” We all know, the answer is blowing in the wind.

References:

Ekundayo, Otuyelu et al. “ANTIDEPRESSANT DRUGS AND TEENAGE SUICIDE IN HUNGARY: TIME TREND AND SEASONALITY ANALYSIS.” International Journal of Psychiatry in Clinical Practice (2015): 1-18. Web. 6 Feb. 2018.

Gold, L., Simon, R., & Knoll, J. (2015). Gun violence and mental illness (1st ed., pp. 81-99). Arlington Virginia: American Psychiatric publishing.

How to Legally Declare Someone as Mentally Incompetent?. (2018). The Law Dictionary. Retrieved 20 February 2018, from https://thelawdictionary.org/article/how-to-legally-declare-someone-as-mentally-incompetent/

Molero, Yasmina et al. “Selective Serotonin Reuptake Inhibitors And Violent Crime: A Cohort Study.” PLOS Medicine 12.9 (2015): e1001875. Web.

Medical Marijuana and Epilepsy

Epilepsy effects millions of people in today’s society. Imagine someone close to you is suffering from epilepsy and having multiple seizures a day. Medication after medication bring on side effect after side effect and nothing’s helping to stop the seizures. Imagine if there was a new drug that could help reduce seizures with minimal side effects.

Medical Marijuana is a new type of drug that is being used to treat those living with severe epilepsy.

Toddler’s seizures treated with medical marijuana

 

How it Works

Seizures are caused by abnormal brain activity. Although they can be caused by infections that can be treated with medications there are many cases of people living with epilepsy that are not caused by infections. Instead these people living with epilepsy have a misfiring of synapses in their brain causing seizures to happen. Medical Marijuana has the ability to change brain activity and preventing and stopping seizures.

 

Meet the 14-Year-Old Who Helped Legalize Medical Marijuana In NY [Documentary] | Elite Daily

 

According to the Chief of the Comprehensive Epilepsy Program at Denver Health and Hospitals, the use of CBD (cannabidiol):

  • CBD can drastically reduce the number of seizures someone with epilepsy experiences. Charlotte, a little girl who had on average 50 convulsive seizures a day, was featured on a CNN special to discuss her success with taking cannabidiol, Charlotte was given a high concentration of CBD daily for 3 weeks straight. After being exposed to the CBD her seizures reduced from 50 a day to only 2-3 nocturnal convulsions per month. Not only did the CBD have an overall positive effect on Charlottes seizures, but she was also able to be taken off of her other seizure medications. This experiment shows medical marijuana can improve seizures in those living with severe epilepsy.

Marijuana Cures Child’s Seizures

 

Medical Cannabis owns this epileptic seizure

 

According to the epilepsy foundation and their research on if medical marijuana has a positive impact on seizures report to their site:

  • Evidence from laboratory studies, anecdotal reports and studies on the use of cannabidiol (CBD) showed positive outcomes
  • Experiments with epileptic patients were given medical marijuana for 12 weeks
  • Reports show a decrease in seizures by 54%

 

Side Effects

Like any medication out there, there are always a possibility of side effects. These side effects can include but are not limited to fatigue, diarrhea, and a decrease in appetite.

 

A study done by Robert Preidt decided to take a look at the effects of medical marijuana on patients with epilepsy:

  • This trial used cannabidiol (CBD) on 130 participants living with epilepsy
  • Reports from this study show that the drug gave some negative side effect
  • 12 patients had to discontinue treatment with CBD because of harsh side effects
  • These effects included diarrhea, tiredness, and decreased appetite

After researching the benefits of medical marijuana and its effect on those living with epilepsy I have concluded that the media does in fact support its medical use that can be backed up by research. These media reports show the effects that research proves.

References

Preidt, R. (2015). Liquid Medical Marijuana Shows Promise for Epilepsy. Retrieved

August 15, 2016, from Web MD:

http://www.webmd.com/epilepsy/news/20150413/liquid-medical-marijuana-shows-

promise-against-severe-epilepsy

Sirven, J. MD (2015). Medical Marijuana and Epilepsy. Retrieved 08 15, 2016, from

Epilepsy Foundation: http://www.epilepsy.com/learn/treating-seizures-and-

epilepsy/other-treatment-approaches/medical-marijuana-and-epilepsy

Stong, C. (2014). Is Marijuana Effective for Epilepsy?. Neurology Reviews, 22(4), 18.

 

Chronic Obstructive Pulmonary Disease

The concept of COPD does not seem to be a controversial topic. All of the literature located directly correlate to the media clips that I chose, as well as to the primary authorities regarding the disease. WebMD suggests that some of the ways to combat COPD are building stamina through cardiovascular exercise guided via pulmonary rehab, oxygen use, and cessation of smoking. They also recommend during an attack to breathe through pursed lips in order to steady oxygen intake. See what WebMD has to say in the clip below:

COPD on WebMD

dt_140310_inhaler_senior_800x600 Healtihnation’s media clip provides a breakdown of the types and effects of COPD; chronic bronchitis, emphysema, and asthma. It describes each respectively as the hardening and enlarging of the aveoli in the lungs, increases mucus production and inability to clear mucus from the lungs, and the constriction and/or inflammation of the bronchial tubes. It also states that these constitute a long term blockage of airways and describes that although there can be some genetic or hereditary cause, 85% of COPD cases are due to the effects of smoking. Take a look at the clip here:

What is COPD? on HealthiNation

quit-smoking-hi The New York Times ran a report in 2007 highlighting the case of one COPD sufferer, and her coming to terms with the effects and treatment of the disease. She is a part of the 85% of diagnoses caused by smoking. The report also cited that COPD is the fourth most frequent cause of death in the US, and predicted to be third by 2020. Actual number of cases beat their time estimate, as COPD is now the 3rd leading cause of death according to the NIH as of 2016. The clip also provided some demographics of sufferers, such as half of the diagnosed COPD patients are under 65 and that there are at least twelve million people diagnosed, with estimates of double that figure due unreported cases. The reason for the unreported cases is that many sufferers may think they are simply out of shape or have chronic flu or cold symptoms. The report also listed treatment options, such as antibiotics, anti-inflammatories, bronchodilators, surgery to excise infected lung tissue, dietary restrictions, and increased exercise, as well as the primary diagnosis method of thermometry, also known as spirometry.  See the report below:

The primary authoritative sources generally are uniform in information regarding COPD, as the disease process is well understood. Each similarly states the cause of, process, symptoms, and treatment options. The National Institute of Health has a more comprehensive of the three, thoroughly detailing all aspects from cause through treatment. According to it, the disease process is defined by less air flow in and out of the airways due to the airways and air sacs losing their elastic quality, the walls between many of the air sacs being destroyed, the walls of the airways become thick and inflamed, or the airways make more mucus than usual, which can clog them. codp1 The American Lung Association describes COPD as including two main conditions; emphysema and chronic bronchitis, cause by long-term exposure to lung irritants that damage the lungs and the airways. The most common cause being cigarette smoke, but also breathing in secondhand smoke, air pollution, or chemical fumes or dust from the environment or workplace also can contribute to COPD. It also describes a rare genetic factor called alpha-1 antitrypsin deficiency of the liver that may also play a role in causing COPD. This condition exacerbates the damage the lung experience if exposed to smoke or other irritants. It also suggests people who have asthma can develop COPD due to the chronic inflammation it causes, narrowing the airways. Treatment usually can reverse the inflammation and narrowing, though if not, COPD can manifest. healthy-vs-copd The CDC website indicates treatment of COPD requires a careful and thorough evaluation by a physician. “COPD treatment can alleviate symptoms, decrease the frequency and severity of exacerbations, and increase exercise tolerance. For those who smoke, the most important aspect of treatment is smoking cessation. Avoiding tobacco smoke and removing other air pollutants from the patient’s home or workplace are also important (CDC.gov, 2016)” While each site provides its own format, all three provide essentially the same information which supports the details given in each of the video clips chosen. This leads me to conclude that there is a widely agreed upon consensus on how COPD is caused, how the disease progresses, and how it can be treated, as well as that since there is no cure, prevention of the disease through abstaining from smoking is the best recommendation to avoid COPD. images References: Chronic Obstructive Pulmonary Disease (COPD). Retrieved November 02, 2016, from http://www.cdc.gov/copd/index.html COPD. Retrieved November 02, 2016, from http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/copd/ Living With COPD – Watch WebMD Video. Retrieved October 28, 2016, from http://www.webmd.com/lung/video/living-with-copd Olsen, E., & Grady, D. (2007.). Gasping for Air: Life With C.O.P.D. – Video – NYTimes.com. Retrieved October 28, 2016, from http://www.nytimes.com/video/health/1194817104570/gasping-for-air-life-with-c-o-p-d.html What is Chronic Obstructive Pulmonary Disease (COPD)? Retrieved October 28, 2016, from http://www.healthination.com/lungs/copd/what-is-chronic-obstructive-pulmonary-disease-copd/ What Is COPD? – NHLBI, NIH. Retrieved November 02, 2016, from http://www.nhlbi.nih.gov/health/health-topics/topics/copd/

Facts or Fictions on Diabetes

 

 

Literature Review

Diabetes mellitus is a chronic illness. According to Frazier and Drzymkowski, who wrote Essentials of Human Diseases and Conditions, “diabetes mellitus is a chronic disorder of carbohydrate, fat, and protein metabolism caused by inadequate production of insulin by the cells” (p. 177). In other words, diabetes occurs when there is a lack of insulin in the pancreas. A functional pancreas produces insulin which balances glucose levels. Insulin decreases “blood glucose levels by transporting glucose into the cells for use as energy and storage” (Frazier & Drzymkowski, 2009, p. 177). In the video, Facts and fiction on diabetes spoken by reporter Snyderman, she speaks about facts and myths. A few myths she mentioned was you grow out of it, and diabetics cannot eat chocolate or sweets. She covered the same information previously stated earlier  regarding illnesses and diseases.Insulin reduction can lead to hyperglycemia where cells begin to lack fuel and break down fats and proteins, which lead to an accumulation of ketone bodies, which are wastes in the blood. This illness’ signs and symptoms are hyperglycemia, hypoglycemia, thirst, increased urination, hunger, and impaired vision.

Here is a video on symptoms you should watch out for:

Here is a video on type 2 diabetes symptoms:

In the article Cigarette Smoking Affects Glycemic Control in Diabetes, it states smoking increases glycemic control imbalances. People with diabetes that cease smoking is able to control blood glucose levels. People with diabetes are able to decrease having any insulin imbalances. There has been a study done on people who smoke cigarettes on a daily basis. Smoking does cause type 2 diabetes in the long run. In the article Does Smoking Cigarettes Cause Type 2 Diabetes? It Could Depend On Your Race, it states that people who cease to smoke will get diabetes because the body is immune to the change. The glucose starts to become imbalanced. By preventing smoking less it will help the insulin stay balanced.

Type 2 diabetes is a worldwide epidemic. It threatens a lot of countries. Many factors of diabetes is smoking, excessive alcohol drinking, high intake of refined carbohydrates, and physical inactivity. Diabetes is common among the poor. They cannot live a healthy lifestyle. Obesity and overweight is causing  massive diabetes epidemic. Asians have a higher chance of obtaining diabetes due to weight gain in adulthood. Type 2 diabetes can be prevented through diet and lifestyle modification.  According to Ulene and Pauley, who reported life on NBC news. The topic they spoke about was, “What is diabetes?”. They mentioned how diabetes occurred and how you can check your blood sugar throughout the day by using an automatic device.

What is Diabetes?

By: Victor

References:

  1. Castillo.S. (2016, June).Does Smoking Cigarettes Cause Type 2 Diabetes? It Could Depend On Your Race.http://www.medicaldaily.com/smoking-cigarettes-type-2-diabetes-racial-disparity-390186
  2. Davies, L., Fulcher, G.,  Gunton, J., McElduff, A., Wilmshurst,E. (2002,April).Cigarette Smoking Affects Glycemic Control in Diabetes.Diabetes Care, 25 (4) 796-797; DOI: 10.2337/diacare.25.4.796-a
  3. Frazier, M., S., & Drzymkowski, J., W. (2009). Essentials of human diseases and conditions. Philadelphia, PA: Saunders, 177-179.
  4. Hu, F. (2011,Jun). Globalization of Diabetes.Diabetes Care, 34 (6) 1249-1257; DOI: 10.2337/dc11-0442
  5. Snyderman, N. (Reporter), & Vieira, M. (Anchor). (2007, November 29). Facts and Myths About Diabetes. [Television series episode]. NBC Today Show. Retrieved from https://library.neit.edu:2336/portal/site/HigherEd/browse/?cuecard=32367
  6. Ulene, A. (Reporter), & Pauley, J. (Anchor). (1980, December 29). What Is Diabetes? [Television series episode]. NBC Today Show. Retrieved from https://library.neit.edu:2336/portal/site/HigherEd/browse/?cuecard=32241

Its always been show time!

For years there has been an underground battle with in the TV industry, that very little people think about. In the 2007-08 prime-time Television season, females contained 43% of all characters, which was a slit increase from the 2006-07 prime-time Television season. If we take a look back to 1996-96 females in television where at 37%.  In the following years 2000-05 there had been a 42% increase of women working, writing, performing and producing TV shows. In any case, as females contain 51% of the U.S. populace, they still stay under-spoke to in prime time. Slowly but surely the industry is changing.  The most important thing is know how much women have influenced the TV industry.

 

Female characters were most likely to play parts in dramatizations and reality programs and less likely to play parts in comedies. About (45%) of female characters played parts in dramatizations and 45% played roles in reality programs. Just 10% of female characters showed up on comedies. Male characters were destined to play characters in dramatizations (51%), in reality programs (38%), and  comedies (11%).

Gender roles have also been one of the most talked about issues in the TV industry.  Many issues are rooted to the marketing of products and the writing of the characters.  Many of the roles played by females were not the true representation of the real word woman.

Here are some links that explore this issue further.

Sorry, Ladies: Study on Women in Film and Television Confirms The Worst

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