"Changing lifestyle and health patterns is the best thing you can do to improve [mental] health." Wes Burgess, M.D., Ph.D. The Bipolar Handbook.
Understanding Bipolar Disorder:
Bipolar disorder is a mood disorder characterized by highs and lows in mood and activity, racing thoughts, impetuous activities, and can also include distractibility.
The National Institute of Mental Health (NIMH) states, regarding bipolar disorder:
"Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in a person's mood, energy, and ability to function. Different from the normal ups and downs that everyone goes through, the symptoms of bipolar disorder are severe. They can result in damaged relationships, poor job or school performance, and even suicide. But there is good news: bipolar disorder can be treated, and people with this illness can lead full and productive lives.
About 5.7 million American adults or about 2.6 percent of the population age 18 and older in any given year, are diagnosed as having bipolar disorder. Bipolar disorder typically develops in late adolescence or early adulthood. However, some people have their first symptoms during childhood, and some develop them late in life."
The diagnosis of bipolar disorder has increased exponentially in a short period of time, from 20,000 cases in youths and children in 1993 to 800,000 in 2003, which represents about 1% of the young population. See Archives of General Psychiatry, September 2007. Off-site link
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Bipolar disorder treatment: Seroquel (quetiapine)-among other prescription drugs- is prescribed for bipolar disorder, schizophrenia and anxiety disordersth adults and children. Seroquel (quetiapine)an atypical antipsychotic - Photo: wikipedia.com
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Childhood Bipolar Disorder
Because the diagnoses of bipolar disorder has risen exponentially, and children as young as 4 years old, even as young as 2 years old, are being prescribed strong medications, which usually are sedating, this has raised red flags to many who are aware of the situation, as there have been deaths associated with drug overdose for children who have been prescribed
multiple medications. Some question whether such frequency in labeling is justified, as well as the intensity with which pharmaceutical treatments are pursued.(Olfman, S. 2007)
Causes of bipolar disorder
There may be reasons why an adult, teen or child is experiencing symptoms of bipolar disorder, if these are addressed, it can often do much to alleviate these symptoms, as will be discussed further in this article.
Bipolar Disorder Types and Symptoms
Bipolar disorder was previously referred to as "manic-depression," which can apply describe the mood swings that can be involved in bipolar disorder, as one sufferer said, before she sought help, she was "hanging from the ceiling," in her manic state.
Bi-polar disorder is broken down into several categories:
Bipolar I, (bipolar 1) and Bipolar II (bipolar 2), Cyclothymia, as well as a further categorization in the case of
"rapid cycling," when manic episodes or periods, and periods of depression are closely spaced together. Intermittent episodes of manic states and depressive states can occur in a short period of time, even within a matter of days or the same day.
Bipolar I is diagnosed when the client experiences a
major depressive episode (as in major depression) and has had one or more manic episodes.
Bipolar II
is slightly less intense, a lower grade disorder, and is diagnosed when a client has had a
major depressive episode and has hand one or more (less intense) hypomanic episodes (almost manic, but not fully manic).
Cyclothymia
During a two year period, experience episodes resembling dysthymia, but also has had one or more periods of hypomania, characterized by elevated, expansive, or irritable mood not of psychotic proportions.
Dysthymia: Depressed mood for most of the day, most days, and at least two other depressive symptoms, but not of sufficient persistence or severity to be considered major depression. No manic or hypomanic episodes.
Major Depression
One or more major depressive episodes in absence of any manic or hypomanic episodes. Symptoms consist of a prominent and persistent depressed mood or loss of pleasure for at least two weeks, accompanied by four or more symptoms such as poor appetite, insomnia, psychomotor retardation, fatigue, feelings of worthlessness or guilt, inability to concentrate, and thoughts of death or suicide.
(Source for definitions of mood disorders: Abnormal Psychology and Modern Life, by Carson, Duke University, Butcher, University of Minnesota, Mineka, Northwestern University; Pub: Allyn & Bacon, Boston;11th edition; 2000).
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Lead singer, Axl Rose of hard rock band Guns 'n Roses is well known for bipolar disorder (and his unwilling compliance with medication). Photo: Long Eaton, England
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The symptoms of
ADHD can resemble those of bipolar disorder. Many have been diagnosed with concurrent disorders, and treated for both, which results in the client taking multiple prescriptions. Also, because symptoms can be similar, misdiagnosis is common, as well as subjective, rather than objective. (Based on interpretation or opinion, rather than scientific rationale.)
Bipolar disorder is one of the most misdiagnosed mental illnesses. One psychologist stated, "It can be difficult to differentiate between the various disorders [referring to ADHD and bipolar disorder in particular] because the symptoms overlap." (Personal Communication, 2006).
Some symptoms of bipolar disorder:
- Excessively euphoric mood
- Extreme irritability
- Rapid thinking or racing thoughts
- Inability to concentrate
- Difficulty sleeping
- Poor judgment
- Increased sex drive
- Abuse of drugs
- Aggressive behavior
- Denial of any problem
Depression:
- Feeling sad, empty, hopeless, guilty
- High levels of anxiety
- Loss of interest in activities once enjoyed
- Decreased energy; feeling lethargic and fatigued
- Difficulty concentrating and making decisions
- Change in appetite
- Unexplained aches and pains
- Thoughts of death or suicide
Source: Kristal, M., (August 2, 2007). Psychology Today.
Anger can also be an issue for some who suffer from bipolar disorder.
Bipolar Disorder: Natural Remedies
There can be a 10-30% reduction in symptoms through [a number of simple] lifestyle and health changes. (Burgess, W., 2006). It is safe, completely free, and free of side effects.
The lifestyle changes that Dr. Burgess recommends are:
Improve your overall stress level
Make sure you get the right amount of sleep, not too much or too little.
Give attention to eating habits and diet
Nutritional
Exercise
Avoid bad habits, caffeine, nicotine, drugs.
Alcohol and marijuana are "destabilizers."
Too much smoking can also trigger mania.
(Adapted from Wes Burgess, p.66, 70)
In the opinion of this site, when these
lifestyle changes are combined with other positive lifestyle changes, symptoms can be further reduced to 50-90%, taking one effectively,
out of the range of a clinical diagnosis of bipolar disorder. This can be accomplished without medication.
Treatment for Bipolar Disorder: Medications
See: Bipolar Medication Notes
The most common treatment for bipolar disorder is currently medication, usually antipsychotics. While medication is usually the most aggressive form of treatment, most responsible physicians also include at least some form of interpersonal therapy, group therapy, or cognitive-behavioral therapy in the treatment plan.
There are two types of antipsychotics,
typical and
atypical. Anticonvulsant medications are also frequently prescribed.
Typical antipsychotics are an older type, they are heavily sedating and have numerous side effects. Atypical antipsychotics were made available in the mid-1990s and have a less sedating quality with fewer side effects. Such drugs are administered to both adults and children.
While it was believed that the newer atypical antipsychotics would be more effective in controlling mood swings than older drugs, recent studies might indicate that older drugs may actually be more effective in controlling symptoms. For some, side effects from medication can be intense, even to the point of being "intolerable".
Some mood stabilizers used in treating bipolar disorder are: lithium, valproate, carbamazepine, or lamotrigine. The most widely known drug for bipolar disorder is lithium, which has a chemical structure that identifies it as a salt, has been used for many years in treating bipolar disorder.
Lithium
Some have experienced relief of symptoms with lithium. When it was first introduced into the mainstream for treatment for manic depression, it was known as something of a "miracle drug". However, in time, it became apparent, that while lithium does help some with symptoms associated with bipolar disorder (manic depression), for many the relief is temporary, many need to progress to other medications after a period of months or years, and for some lithium treatment is not effective. There is really no way of knowing if a certain drug is or is not effective except with experimentation.
The down side of lithium is that it can cause drowsiness or a feeling of being in an unnatural mental state and some have had trouble adjusting to taking lithium. Also, lithium treatment requires regular blood-testing, to make sure that the amount of the drug in the blood stream does not reach a harmful level.
Most other drugs do not require blood-testing.
While lithium is chemically a salt, it is not a "natural medicine," like a vitamin or enzyme, but it is a strong mood-altering drug. (e.g. certain mushrooms grow naturally in the wild, but when ingested they are strong hallucinogenics. Lithium is not a hallucinogenic, but while it is in the salt family, it can have a strong sedating or mind-altering affect on the mind).
Also to be remembered is that medicines
address symptoms, they do not treat the illness itself, so while a person may experience some relief from the symptoms related to bipolar disorder with the use of medication, this does not mean, that the disorder is in remission or that it is being cured. There is still an underlying "illness," if one wishes to use that term, or mental state below the surface, that persists, which is why, when many persons try to discontinue treatment, relapses do often occur, sometimes more earnestly than were present when the original symptoms began to surface. One of the reasons for this is that the mind can become dependent, or accustomed to, the medication, and also because lifestyle issues and social issues that underlie the disorder may not be addressed, in lieu of
aggressive pharmaceutical treatment.
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Zyprexa, atypical antipsychotic medication for bipolar disorder. Photo: wikipedia.com
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Examples of medications for bipolar disorder:
Antidepressants and Bipolar Disorder
While it was thought that the newer atypical antipsychotics would be more effective in controlling mood swings than older drugs, recent studies seem to indicate that they are not more effective and that older drugs may actually be more effective in controlling symptoms. Depakote has outpaced lithium in its being prescribed for bipolar disorder. However, the suicide rate is thought to be 2.7 times higher with Depakote than with lithium use. The suicide rate for persons suffering with bipolar disorder is 10-30 times that of the general population. (Goodwin, Fredrick K., M.D., et al., September 17, 2003).
One of the other potential difficulties with lithium, besides some physical side-effects, are the possibility of birth-defects in pregnant women, women who become pregnant while on lithium can have babies with birth defects. Second, in 5-30% of those who use lithium, it can result in thyroid problems. This, in turn, can cause mania. Doctors generally address this issue by giving clients thyroid medication, in addition to the mood stabilizer.
Multiple Concurrent Prescriptions
The practice of prescribing multiple medications for mental health conditions is very much in question, though an increasingly common practice. Studies have indicated, that a second and third medication is not effective in remedying mental health disorders. (Sachs, G., 2007). What is more, side effects increase as well as the potential for serious complications. Both atypical and typical antipsychotics carry with them serious side effects and risks.
All of the thoughts developed on the page
16 Keys for good mental healthcan be of help for persons with symptoms related to bipolar disorder. Spirituality is also of vital concern in serious mental health issues.
To sum up, there is not one single cause for bipolar disorder, but there may be many contributing factors, that, when combined with a genetic predisposition, can contribute to the symptoms of BD.
To say that bipolar disorder is a chemical imbalance that needs to be corrected with medication is an oversimplification of a complex problem and there likely are many contributing factors. If the issues underlying the symptoms can be addressed one by one, it can do much to help a person to develop a much improved mental health profile.
Bipolar Disorder Causes - Possible contributing factors leading or aggravating bipolar disorder for some.
What causes the “chemical imbalances” that lead to mental health disorders?
Joel Robertson in his book Natural Prozac, gives a most informative and insightful discussion on depression and even for those experiencing some of the symptoms of bipolar disorder. The thought is developed that what we take in through our senses into the mind can have an effect on our brain chemistry. Through what we choose to let enter into our brains through our senses, which is largely controllable, we can to a certain extent, control or influence the chemical balance of our minds.
The daily flow of water on the ground causes channels and rifts (e.g. the Grand Canyon). The daily flow of stimuli through our brains, love from our family, beautiful music, or conversely, violence or harshness, sets up mental patterns that become etched in the synapses and neurons in our brains. We eventually become “hardwired” a certain way. To a certain extent, we have freedom to choose what our “brain-food” will be, which has a tremendous impact on our behavior and emotions, our mind’s chemical balance.
The causes of bipolar disorder itself are many and varied. Everyone is unique, and what is true for one person may not be true for another. Furthermore, bipolar disorder is the most misdiagnosed and overdiagnosed condition among all mental health disorders. The label, bipolar disorder, is based on a subjective, (observational or opinion-based) rather than scientific, so while one clinician might diagnosis bipolar disorder, another might have a different idea.
Bipolar Disorder Overdiagnosed reafirms a recent study by Zimmerman, associate professor of psychiatry at Rhode Island University.
However, fairly conclusively, we can say that the idea that bipolar disorder is a disorder that can be corrected with medications, is most likely a very surface evaluation of the subject, or erroneous, a "fallacy," or "deceptive" are two words that have been used in one mainstream college textbook on abnormal psychology . Any serious, more in depth look at the subject looks much more deeply.
See
Urie Bronfenbrenner's bioecological model of mental health.
Lifestyle Adjustments:
Music:
There are several lines of thought with bipolar disorder and the roots of it that can be explored. First is music. Music effects both our minds, the chemical balance of our minds, and our moods. The lead singer, Axel Rose, of Guns and Roses is well known for his bipolar disorder, (also his use and disdaine for medication).The hard driving rock and roll that is a daily part of his and millions of other young person's lives may be, for some young people, a significant factor in destabilizing one's mood. (For young people who listen to Limp Bizkit, Korn or Linkin' Park daily, one wonders how they cannot develop bipolar or some other disorder.)
Music can be a positive force in mental health. It can help one to unwind and calm down, it can bring peace of mind. On the other hand, if music is used in a way that agitates, overwhelms or depresses, over time, this can effect one's mental health in a way that leaves one more vulnerable to mood disorders.
See here for more on
bipolar disorder and music.
Violence in the media:
Violent Sports
Similarly, violence in the media, whether it be through movies, or even overexposure to violent sports can have an effect on mood. The violence and sadism of the "sport" of pro-wrestling is something that can become a part of the psyche of children and teens. Pro-wrestling in the US is typically aired twice, sometimes three times weekly, and many children follow this entertainment with passion. For some persons, other forms of violence such as NFL Football and hockey, can be a contributing factor towards chemical imbalances and the "rage" that is often associated with a bipolar diagnosis and mood swings, especially when combined with other forms of media violence (even overexposure to the news), and other factors.
Movies:
Violence in films has escalated as well. Violent movies, once R-rated are now PG13, many of which are violent, and children as young as kindergarten are viewing extremely violent R-rated movies, horror movies, and "slasher" type movies on a regular basis, often times when parents are not at home, or with older siblings. In one grade school class over 50% of 2nd graders watched violent R-rated horror, slasher movies. In another class in the same city, 50% of 1st graders watched such movies, sometimes with their parents. Violent and somewhat violent video games also can contribute to "rage" inside of a youngster.
Violent TV, Video games:
Many children and youths often spend up to 6 hours daily on the media, much of it violent or somewhat violent. It is probable that the increase in violent content in the various forms of media can be contributing to the corresponding increase of the diagnosis of such disorders as bipolar disorder and ADHD, which can be coexisting or have related symptoms. Some children may play video games 8-14 hours in a single day, many of them aggressive or violent. This is true of many children in special education classes. (Personal teaching diary 2005-2008).
Pornography:
Another thought for both counselors and parents, as well as for those who are suffering with bipolar disorder, is pornography's role. Pornography addiction is common and it can be a contributing factor in many cases of bipolar disorder. Children are being exposed to pornography from as young as eight years old, and in one special education class, three of eight ten year olds were already indulging in pornography. (e.g. One kindergarten teacher related how a child in her class was exhibiting sexual behavior. His mother related that he watched sexually explicit films on television with his older siblings.
Long-term exposure to pornography can be destabilizing for children, and might be one other factor that leads some children to exhibit symptoms such as irritability or rage). Children who have been
sexually abused are often mistakenly diagnosed with bipolar disorder.
"Children who have been sexually abused or have witnessed adult sexual behavior often exhibit hypersexual behavior similar to that demonstrated by children with bipolar disorder. A careful assessment over time are extremely important in differentiating between sexual abuse and bipolar disorder." (Fawcett, J., M.D., Golden, B., Ph.D. 2007. p.248).
Solutions for Bipolar Disorder
Overcoming Problems with Anger
All of the aforementioned possible contributing factors can be factors that are related to anger problems that are sometimes associated with bipolar disorder. For persons who have been abused, sometimes talking things out with a sympathetic listener, minister, friend, mate, or professional, can be of value in overcoming anger problems.
The need for positive emotional relationships can also be something to be considered. Violence in the media can contribute to anger issues for some. Substituting time spent with violent media with positive activities such as time outdoors,
green time, or
art, can result in gains in the psychological profile of both children, teens, and adults who struggle with anger problems.
Attention to
spiritual aspects of life, time for prayer and
bible reading/study, are also of value. One must be careful, also, not to isolate oneself, which can lead to an unbalanced view of things and negative emotions.
Other Links to Bipolar Disorder
Substance Abuse
There is also a strong correlation between bipolar disorder and substance abuse, both past and present. Alcohol and drug abuse are said to be contributing factors or part of the diagnosis in 60% to 80% of cases of bipolar disorder. (Burgess, W., 2006, p. 65)
Some other links to bipolar disorder
It has been suggested that depression or ADHD treated with medication sometimes leads to bipolar disorder. One of the reasons for this might be that there are often unpleasant side effects with antidepressants. This can cause one's medication to be switched from one to another, and sometimes combinations are experimented with, sleeping pills added to the mix and so on. At times, because of side effects, some might abruptly end their medication regimen. This mixing and starting and stopping of powerful drugs, which antidepressants are, for children or adults, can contribute, for some, along with other factors, towards symptoms of bipolar disorder.
See page: Bipolar disorder treatment
complications for children and teens.
Further Bipolar Disorder Solutions - Some ideas in naturally restoring balance and good mental health.
Exercise
One suggestion that has been made as to factors that contribute to BD is that stress can trigger bipolar disorder. BD is "stress related). (Burgess, W., 2006). Vigorous exercise early in the morning can help to keep one calm and balanced throughout the day. Similarly, a brisk walk, outdoors in the evening can work better than a sleeping pill. Persons with bipolar disorder need exercise. Walking, swimming, biking, all affect a person's psyche in a positive direction, forward and with a feeling of purpose. The physical activity helps to burn off the stress which can fuel both depression and manic episodes. Chemically, exercise also has a positive effect on the mind, which can balance out highs and lows in one's mood and can even help lead one to full recovery.
Diet
Similarly, a healthy diet can also be of value, part of a healthy lifestyle which can contribute to better mental health. One doctor who writes about Bipolar Disorders states that 5-30% of all symptoms associated with BD can be addressed through attention to diet, nutrition, exercise, and cutting out alcohol, smoking, and any other substance abuse.
Avoiding alcohol and smoking are of the utmost importance for persons with bipolar disorder and any other form of mental illness. For many people, drinking moderate amounts of alcohol from time to time is a harmless pleasure in life. However, over 60% of those diagnosed with BD have at one time, or are at present, abusing alcohol or drugs. (Polcin, D. L., 1992). For anyone, then, who is diagnosed with BD or really any other mental health disorder, abstinence from alcohol is a necessity.
Also, avoiding caffeine in coffee can be of help to some who might be prone to overindulge at times. Caffeine lifts the mood and energy level, but with every lift can come a corresponding low, and it can be one contributing factor for some. For many with BD, doing without coffee can also result in positive gains in more balanced mood. For some, coffee can be as powerful and addiction, but physically and psychological as smoking or heroin. It takes a tremendous amount of willpower to wean oneself off of an aggressive coffee habit.
By giving balanced attention to diet, avoiding too much sugar, high fat or processed foods, it can contribute to a healthier body, loss of weight and stronger mind.
Changing one's lifestyle and habits takes effort. One man suffering from bipolar disorder said he would rather deal with unpleasant medications than stop viewing pornography, give up violent video games and movies, or cut down drastically on television. (his friends would surely think he had lost his mind). (Personal Communication, 1997). Bad habits are not easily shaken. But for those who are determined to overcome even a disorder as serious as bipolar disorder, it can be done, and can even be accomplished without needing to be on a lifetime of heavy medications.
ART as a natural mood stabilizer
For persons with bipolar disorder, OCD, ADHD and some other mental health disorders or difficulties, art is an excellent therapy. It can be, for many persons, a natural mood stabilizer, in addition to whatever other steps one might take. It can also be helpful in building self esteem. Visiting art museums, purchasing some books on art around the home, can help a person develop an interest that takes his mind off of the problems he might be dealing, and for some, to develop a skill that is soothing and calming. It helps a person to get away from perfectionist thinking, in that, especially in the beginning, no one's art is perfect, and in that respect, it is helpful as well. This can be very beneficial for children especially who are suffering with symptoms of BD or other serious mental health disorders.
Drawing is helpful to develop powers of concentration, and oil painting is especially soothing. Many quiet hours can pass in drawing or painting, and it can quiet the mind and soothe the soul. For anyone who has symptoms of ADHD or bipolar disorder, art is an excellent choice as a secular occupation or as a hobby. One such person, who became an art teacher, said that it was the only place she felt really at home, that is, the art classroom, she found peace there as well as fulfillment in working with young people and children. (Barroqueiro, Daniella.)
Art can be, for some, a natural mood stabilizer and contribute to healing the mind.
Taking the television out of the home for a year or more, as well as keeping movie viewing hours to a minimum, substituting these hours with positive and mind-strengthening activities is of much value. This might seem like a drastic measure, but it can result in positive gains in mental health, and is a sacrifice that a family can make in behalf of the person suffering with a mental health disorder. It will make a difference. The same can be said for
video games. These tend to weaken the mind and fragment it, making the mind more susceptible to mental health disorders of all types. The news can both stimulate and depress, and those who suffer from mental illness often have sensitive emotional dispositions. Reading, is a positive activity that can result in a stronger mind. (Read for Emotional Relief. November 12, 2006. Healthy Person).
See also:
50 non-pharmaceutical strategies to overcome bipolar disorder
References and Bibliography About Bipolar Disorder
1. Burgess, Wes, M.D., Ph.D., (2006). The Bipolar Handbook. London: Penguin.
2. Carson, Robert. C., Butcher, James, N., Mineka, Susan, (2000). Abnormal Psychology and Modern Life. 11th Edition. Boston: Allyn & Bacon
3.
Drug Withdrawal. (2004, December 20). Time magazine. off-site link
4. Eide, Brock; Fernette Eide, (2006). The Mislabeled Child. New York: Hyperion.
5. Fawcett, J, M.D., Golden, B., Ph.D., (2007). New Hope for People with Bipolar Disorder, 2nd edition. New York: Three Rivers Press.
6. Goodwin, Frederick K., MD; Fireman, Bruce, MA; Simon, Gregory E., MD; Hunkeler, Enid M., MA; Lee, Janelle, MHA, DrPH; Revicki, Dennis, PhD. (September 17, 2003).
Bipolar Disorder: A Mistaken DiagnosisSuicide Risk in Bipolar Disorder During Treatment With Lithium and Divalproex. JAMA. 2003;290:1467-1473.
7. Kristal, M. (June 1, 2007).
Bipolar Disorder: A Mistaken Diagnosis. Psychology Today. off-site link
8. Kluger, J. (2003, November 3). Are We Giving Our Kids Too Many Drugs? Time Magazine.
9. Moreno, C., MD; Laje, G., MD; Blanco, C., MD, PhD; Jiang, H., PhD; Schmidt, A. B., CSW; Olfson, M., MD, MPH , (September 9, 2007).
National Trends in the Outpatient Diagnosis and Treatment of Bipolar Disorder in Youth. Arch Gen Psychiatry. 2007;64(9):1032-1039.
10. Mondimore, Francis Mark, M.D. (2006).Bipolar - A Guide for Patients and Families 2nd Edition. Baltimore: The John Hopkins University Press.
11. Olfman, S., (2007).
Bipolar Children. Praeger
12. Polcin, D. L. (1992).
Issues in the treatment of dual diagnosis clients who have chronic mental illness. Professional Psychology: Research and Practice, 23, 30-37.
13.
Read for Emotional Relief. Healthy Person. November 12, 2006.
14. Robertson, J. (1998). Natural Prozac. San Francisco: HarperSanFrancisco.
15. Sachs, G. (2007, March 28). Adding antidepressants to mood-stabilizing drugs does not affect (positively) bipolar depression (disorder). The New England Journal of Medicine.
Tanner, L.
16. Schmidt, Barton, D. (1991). Your Child's Health. New York: Bantam.
17. Wallis, Claudia. (March 19, 2006).
The Multitasking Generation. Time Magazine. .
18. Zuckerman, M. B. (February 20, 2005).
Why TV Holds us hostage. U.S. News & World Report.
Other References:
Able Child (Off-site link) is a non-profit parents' rights organization dedicated to protecting full informed consent and the right to refuse psychiatric services. Able Child educates parents on risks associated with drugging children and promotes drug free education in schools.
Brody, Howard, (2007). Ethics, the Medical Profession and the Pharmaceutical Industry. Bowman & Littlefield. Detailed discussion of ties between pharmaceutical companies and medical profession.
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