Why The Skeptic Community Must Concern Itself With Mental Illness

Here’s my talk from Skepticon IV.

If you agree, please help get the ball rolling.  If you’re a blogger who lives with a mental disorder, write about it.  If you don’t, learn something new about mental illnesses and write a post about what you learned or dispel a myth or share how knowing someone with a mental illness has affected your life and ways you’ve learned to help.  Write a facebook status if you’re not a blogger.  The adoption of this issue by the skeptic community will change the world.  It will save lives.

If you write a blog, send it to me.  I’ll link the best ones here and cross-post the very best.  If there’s anything that became apparent to me during Skepticon weekend, it was after this talk when a bunch of us turned into a huggy, teary mess for about an hour: we give strength to each other.  It is empowering to know there are others out there who not only won’t judge us, but who are like us themselves.

If you want to share about a condition you have anonymously, my email address is on the right side of this blog (in the bio section).  Send it along.

I was always proud to be a part of this movement.  When I went public with my illness I was afraid of rejection and judgment.  But this community showed me it was better than the portions of society who stigmatize mental illness, and it accepted and took care of me, and in so doing endeared this movement to me even more.  This movement will take care of you.  And, if I know anything about this movement, I know that the people in it will take care of you.  We are perfectly capable of forging a future where misinformation about mental illness no longer strangles its victims.

I love you guys.  Thank you for all you’ve given me and thank you for sharing this around the interwebs and personally making the necessary changes happen.

  • teh_faust

    Thank you so so much for this talk, JT. That was an extremely gutsy thing to do and it was extremely touching.
    There were so many things in this I empathically nodded to about which I wished I could have phrased them like this before.

    So far, I’ve only had positive experiences with being open about my issues but there’s still a risk involved and more so when this isn’t just coming out to your friends, but in public.

    I agree that many unsustained unscientific myths around mental illness make it so much harder for people to get help. Perhaps it’s a bit like with STDs the moral judgment around it breeds shame and makes people suffer in silence and lets conditions grow worse. Also, I think the dualist myth that separates body from mind makes it easy to dismiss mental illness or cast blame on the sufferers.
    I’ve suffered from an ED for nearly and it makes me happy every time I read or hear such empathetic words and have that irrational shame lifted from me.

    There’s another important point: As if the general stigma for mental illness wasn’t enough, there seems to be an additional one for if men are affected by something that’s seen as stereotypically female or even “gay” and we know how much disrespect “unmanliness” can get people. This may very well make it harder for male sufferers to get diagnosed and of course, lead to more shaming.
    Given incidence and prevalence of eating disorders in men, you’d expect them to be represented in the support communities, but they rarely seem to be.

    A side note on the increased suicide risk in the initial phase of SSRIS (or other antidepressants with agitating effects: This can be adressed by combining them with meds that have a sedating effect for the first few weeks of treatment – so there’s no need to accept that drawback as a given.

  • Katie Tims

    Thanks.

  • http://langcogcult.com/traumatized DuWayne

    Interesting – I am actually working on just such a post right now – though as an only parent it usually takes me a while to actually write posts.

    It’s nice to see you being supported by the skeptical community. While I will admit that I have a lot of supportive friends in the skeptic/non-theist community, I have also run into a lot of denial of psychology and mental illness. One of the most commom tropes I see is that assertion that psychology isn’t a field of science and therefore shouldn’t be taken the least bit seriously. While some people who make that assertion will at least admit that mental illness exists, many of them will assert that the only “real” mental illnesses are those that are manifestly obvious, such as relatively severe schizophrenia.

    I am rather especially sensitive to this sort of denial, because my dad engaged in it as did my mother – albeit in a different way. My dad just thought, to some degree still thinks that most mental illness is a crock. My mom believes that while mental illness exists, it is demonic by nature (my dad’s an atheist, my mom a fundamentalist, borderline cultist). This made growing up with mental illness extremely problematic – because I believed them.

    Anyhow, I will certainly let you know when I complete my post and will also plan on trying to motivate a couple of other bloggers who are dealing with mental illness to contribute.

  • Melodi

    JT,

    I was waiting for your talk to get posted. I really wanted to see it in person but I had a family thing that night. Thank you for it. As a person who also lives with mental illness I appreciated it when someone talks about the stigma associated with it publicly. I’ve lost people I care about because they did not understand. During a particularly dark period I nearly lost a job. The law does not protect people with mental illness the same way it does people with medical conditions from discrimination. It’s getting better but has a long way to go, just as society does in terms of understanding.

    You were honest about your stuff so here is a bit of my story. A few years ago a string of events happened : I graduated from college, couldn’t find a job with my degree, my parents divorced so I was now dealing with my also mentally ill and untreated father by myself but I was managing it ok. I wasn’t a ray of sunshine but I was managing it. Then finally after 3 very tumultuous years the man I loved(and my best friend at the time) finally walked away. That was it. I fell apart. I never really got understood what a nervous break down was until I had one. I stopped sleeping and eating. I cried until the skin around my tear ducts was raw. I used to take bathroom breaks at work to lye on the floor and sob several times a day. I am very thankful for the patience and the love of the ladies I worked with at that time. It was key in my recovery. Eventually with the love of friends and family, meds, counseling and time I recovered. I recovered a better version of myself because I now treat my anxiety disorder umbrella (panic disorder/GAD/OCD/ social phobia).

    One thing I wanted to bring up was that while I was in my dark place I was told that it was because I didn’t have a good enough relationship with god, repeatedly. This doesn’t seem to be an uncommon thing and I worry for those that are or have families active in religion that suffer from mental illness. I’m concerned about religious organizations try to pray (or prey rather) away mental illness. This is more your area then mine so I thought I would bring it up as something you might like to address.

    Anyway,
    Take care of yourself
    *Hugs*
    Melodi

  • http://langcogcult.com/traumatized DuWayne

    teh_faust -

    There is no “seems” when it comes to men and mental illness, those perceptions are absolutely real. I have written a paper about it, touching on it in another one that was primarily about substance abuse. The stigmas about mental illness are exponentially worse in the context of men. This is especially true when it comes to what many people perceive as being “womanly” mental illnesses – such as eating disorders and depression.

    But across the board the stigmas about mental illness are pervasive and ugly. Few things make me as angry as meeting people who have been acculturated to be ashamed of their own damned brain.

    • teh_faust

      “There is no “seems” when it comes to men and mental illness, those perceptions are absolutely real.”

      Sorry, I’m overly cautious like that when I say things.

      • http://langcogcult.com/traumatized DuWayne

        Nothing to be sorry about, I am a very firm believer in taking great care to avoid making absolute statements when they might not apply. But in this case I am very aware of the evidence and it isn’t even a little controversial. There is a great deal of evidence about the existence of the stigmas surrounding mental illness, the differential between such stigmas between men and women and the harms caused by such stigmas. And given the impact or potential impact of said stigmas on my life, the lives of many people I care for a great deal (including my kids), and the lives of millions of other people, this is an important issue to me – one I have spent a great deal of time and energy on learning about.

        • D. C. Sessions

          There is a great deal of evidence about the existence of the stigmas surrounding mental illness

          Since it comes up later down-thread, let’s note that there are many different types of stigma, and just because two conditions are both stigmatized doesn’t mean that they’re treated equally.

          In particular, many physical conditions are stigmatized (e.g. amputations) but in ways different from other physical conditions (e.g. paralysis.) The degree of visibility plays a part, as do the perceived origins of the conditions.

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  • http://peicurmudgeon.wordpress.com/ peicurmudgeon

    I struggle with mental illness. In fact it has forced me out of the workforce, although that has left me with more time to blog. I cover many topics on my blog, and one of those is mental illness/health.

    http://peicurmudgeon.wordpress.com/category/mental-health/

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  • anon commenter

    Man, when I heard your story I thought woah that makes some other depression look rather rational. But on a more skeptical note: there is criticism of antidepressants out there that from a skeptical point of view should be taken more seriously. But anyway thanks for sharing your story.

  • Becki

    Thankyou so much for this giving this talk.
    I am a recluse, I have been struggling with depression and anxiety for 10 years and it has ruined my life, I have lost family and most of my friends because of this, as they don’t understand and don’t even make the effort to understand, and I am crazy. They just think I’m weak and pathetic,reinforcing how I feel about myself. I was in tears the whole time watching this and have asked my mother to watch it, as you said all the things I can’t bring myself to say, even with my psychology degree and counselling training.
    You have inspired me to face my fears of leaving the house and get back on medication even though it makes me fuzzy and my thoughts, no matter how negative are all I have. Your strength in coming out was deeply moving and you made me feel like I am not alone (even though I kinda am because I can’t socialise). I hope that one day I can pay it forward to someone else, but for now just thankyou so much, thankyou for being you, and for all the work you do fighting ignorance and irrationality, and for making me see it is ok to be batshit insane regardless of what those around me say.
    I know life isn’t as easy when the brain doesn’t work properly, but I wish you the best (for what that’s worth), I hope you are successful, and as healthy and happy as you can be. I thought you were awesome before, but really, you’re a hero. And I don’t feel that that is just hyperbole. Thankyou, thankyou so much. And thanks to your friends who were there for you. I just needed to come here and tell you that.
    P.S. Thankyou.

    • TMJ

      If your medication makes you ‘fuzzy’, you’re on the wrong meds. Work with your doctor to find the right prescription for you. My meds make me feel like a curtain has been pulled back and I see the world in color again.

  • Roving Rockhound, collector of dirt

    This is long and I don’t expect anyone to read it, but I’m sure I’ll be therapeutic to write, so here it goes.

    I saw the video on Friendly Atheist and had to say something. You had me in tears, which is impressive since my crazy meds make it really hard to cry. I haven’t come out as having a mental illness to my family, and I doubt that I ever will, but I have told a few of my closest friends enough to realize that they are amazingly supportive and caring, and that things do get better if I let others help.

    I suffer from what is now moderate depression. It was really bad starting about 5 years ago, when a series of unsupportive and downright hurtful mentors in college made it go from I’m-not-really-happy to full blown, severe depression. I was too afraid to get help because seeing a therapist was only for those crazy enough to be kept away from society, and I couldn’t ask my family for help because feelings and emotions were not something that was ever talked about. I thought that I was weak for not being able to handle it myself, and I was failing because I couldn’t make myself happy. At the worst times, I really wanted the pain to stop, and if dying was a side effect of stopping that pain then it was an acceptable consequence. I knew that I shouldn’t kill myself, but it was such an attractive option that I became afraid of heights, and I came so close a few times that I spent the night curled up in a ball repeatedly hitting my head against a wall just to keep myself from going outside and finding a bridge to jump from. A couple of friends knew that I has having issues, and I know that a few others suspected, but no one ever took charge and dragged me to get help, and at that point it was not something I could do for myself.

    A move and transition to grad school, with a new set of people, made things bearable for a couple of years, but the constant stressors that came with that – never being good enough, the frequent rejections, lack of short-term rewards, no long-term friends – made the depression return. By this point I was a lurker in the online atheist community, but I hadn’t labeled myself as one yet. Then one day this summer one ugly rejection became the last straw and I realized that I was heading straight back into the same depth of depression I had been at before. The options came down to leaving school and letting the despair take over, or walking into the mental health clinic and making an appointment. I was more terrified of the hell I knew than the scary unknown, so I went in. That intake form was actually the first time I officially labeled myself an atheist.

    I’ve been in therapy for three months. It’s the most difficult and painful thing I have ever done, and I dread every appointment, but somehow I keep going. I’ve told my shrink stories that I never told anyone, and things that I had never admitted to myself. He somehow managed to take down the wall that I had built so I didn’t have to feel anything, and every week manages to poke just the right spot of the very raw center to reveal something I never knew about the way I think. Being able to feel anything again drove me at one point to self harm, pushing sewing pins into my legs in an effort to shut my brain down. It didn’t work, and having to admit to my awesome, caring doc what I had done was heart wrenching – it felt like I was failing him and not just myself. Somehow, though, removing the shields and telling someone about the things I had buried to never think about again is making everything better. My emotional baseline is now at moderately content, and I have days when I’m truly happy. I can even reign my brain back when something comes along that pushes me back towards depression. As hard as the process has been, admitting I have a mental illness and doing something about it has been incredibly empowering.

    I’m also on meds, and while I’m not convinced they are fully responsible for lifting my mood, the added motivation and energy are definitely helpful. There’s also a bit of impulsivity and recklessness now that has been quite fun, making me do and say things I would have been too self-conscious to do before. The ones I take are atypical antidepressants, and I have had no side effects to report. The first one I tried, though – an SNRI – sent me into serotonin syndrome after one pill at the lowest available dose. It was scary but completely unexpected, and it should not be taken as evidence that psychotropic meds are evil (just that my brain is even more messed up than I thought it was!). It’s just a reminder that these things are powerful, and that they are directly messing with your nervous system.

    The openness of the skeptic community – people like JT coming out about their mental illness, revealing stories of sexual abuse after the elevator incident, occasionally talking about their present struggles with depression in the endless thread – lowered the threshold just enough for me to accept getting help. Even when I’m not an active part of the community, you guys have dramatically changed my life.

    Thanks, JT. That took guts, but a lot of us feel a little less alone tonight because of you.

  • Melanie

    Hey again! Same Melanie as always, and morphomel on twitter if you hadn’t made that connection already. What you said about becoming attached to your illness really resonated with me. I think that’s a lot of my reasoning/rationalizaion for not getting help. I’ve had depression for over 9 years, with coping mechanisms of SI, drugs, alcohol. Any thought of treatment and getting better/becoming “normal” scares me because I can’t remember what “normal” is.

  • http://naturalneuro.wordpress.com The Nerd

    Yes, and not just mental illness, but disabilities and disorders and differences as well. If we deny that there is a perfectly created mind, fashioned after that of God, then there can only be neurodiversity. We’re not all supposed to have the same hardware in our skulls. If the skeptic movement and the neurodiversity movement could come together, we could use it to show that our brains evolved this way (be it autism, ADHD, schizophrenia, or even neurotypical), and that’s okay.

    • http://itsmyworldcanthasnotyours.blogspot.com WMDKitty

      Thank you, too.

  • http://itsmyworldcanthasnotyours.blogspot.com WMDKitty

    Thank you, from one struggling with depression and anxiety.

  • http://mamamara.wordpress.com Mara

    I thought I’d already blogged about my mental illness. Huh. Anyway, now I have:

    http://mamamara.wordpress.com/2011/11/25/would-you-care-for-some-panic-and-social-anxiety-with-a-soupcon-of-depression/

  • Mark

    If you do not accept the concept of a sin nature, it makes sense that you would have to find something on which to blame your shortcomings.

    • Juniper Shoemaker

      Wow! You’re brilliant! I’ll bet you’re a scientist, too!

    • Ms. Daisy Cutter

      FEEL that xtian lurve.

    • happiestsadist

      Ahh, this must be the Xtian love, compassion and deeper understanding I’ve heard so much about.

  • Dana Hunter

    That was one of the bravest fucking things I’ve ever seen. I didn’t cry, but that was only because I was cheering you on.

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  • iknklast

    I am a recovered anorexic. Depression nearly ruined my life, led to the loss of a job, and nearly led to the loss of my life. I have fought it, and I have won, but it is not a war that ends just because you win the battle. Every day, I encounter the temptation to slide back into deep depression…and yes, it is a temptation, strange as it may seem, because it is familiar, and comfortable in some odd way. I have been out of therapy for over a decade now, and manage to get by pretty well, but I was once so deep down in the darkness that I could see no light. I dropped so much weight that everyone who saw me was scared for me. I wanted to die, and I nearly did.

    I actually reached out to the church for help at one point, feeling the need for someone to help me hold on. Fortunately for me, the church shunned me and turned its back, because they weren’t willing to reach out to a woman who didn’t fit their idea of deserving; i.e., I was divorced, I had only one child, and I was depressed. But I’ll never forget how badly I needed someone at that point, being surrounded by a family who thought the best answer to my problem was to pray it away.

    I think JTs right; we need to embrace this issue, and form some sort of support for those who are struggling. Especially those of us who have beat the problem, at least for now. Let them know they have friends. I was alone in my despair, and with no one there for me, I probably would have ended up among the churched if they had been more welcoming.

    Thanks, JT, for sharing your experience. I’ve shared mine a few times, and usually find there are people, total strangers, who are helped just to hear someone strong and intelligent admit to sharing their problem.

    • D. C. Sessions

      Especially those of us who have beat the problem, at least for now. Let them know they have friends.

      I honestly don’t know whether this is a case where others in the same boat will help or hurt. I’m not on that cruise, so the absolute most I can do is express concern for the possibility of adverse consequences.

      On the other hand, there’s nothing but good I can see from recruiting more of us who aren’t afflicted. We may not understand, but we can listen. And damned well should.

  • Juniper Shoemaker

    I really liked your talk, JT. I must quibble with your description of clinical depression, though. Clinical depression is a complex medical condition whose associations include low levels of the neurotransmitter and precursor to adrenaline called norepinephrine*; loss of volume of a key learning and memory region of the brain called the hippocampus; low levels of a major nerve growth factor called brain-derived neurotrophic factor (BDNF) in the hippocampus; reduced blood flow to a region of the brain that registers pain signaling called the anterior cingulate cortex and irregular glucose metabolism in the brain.

    However, these objections are insignificant to the point of your talk, and I only voice them to underscore it: clinical depression is a medical condition, not a “character flaw”. It’s real. It’s not an excuse that people are using to get out of work or an invitation for people who don’t know any fucking science neuroscience and who don’t suffer it themselves to make inept remarks about “mental illnesses” being “en vogue” among skeptics.

    Which, incidentally, brings me to this gem of the thread:

    But on a more skeptical note: there is criticism of antidepressants out there that from a skeptical point of view should be taken more seriously.

    Jesus Christ. This assertion is frequently made. It is ludicrous. I can tell you as a graduate student in pharmacology and neurobiology in a medical school there is no lack of “skepticism”, by which you really mean “doubt”, of the efficacy of antidepressants among PhD’s and MD’s who specialize in neuroscience. There is no end of frustration over the difficulty in characterizing depression, the fact that various antidepressants work fabulously for some patients while utterly failing to help others (see my footnote below), their long laundry lists of adverse effects and their lack of selectivity. Go to any Society for Neuroscience conference and talk to the depression researchers at the poster sessions and symposia yourself. Oh, by the way, most of these researchers as well as my own physicians are hard-core advocates of lifestyle changes as part of treatment, by which they mean undergoing psychotherapy**, eating a very healthy diet and getting a healthy amount of exercise. There’s no worship at the altar of the almighty antidepressant here.

    Where are you getting the idea that the case is otherwise? And what would you have us do, anyway? Throw out some of the only tools we have for treating clinical depression altogether because they’re flawed?

    I submit that this trope is the result of anti-science efforts in the U.S. by New Age mystics who hold the natural to be sacred and Christian wingnuts obsessed with what they call “meritocracy”. These ignoramuses are hell-bent on insisting that depression doesn’t exist. They are often scientifically illiterate, too. Talk about reasons for skeptics to care about mental health as an issue! Anti-science attitudes have manifold consequences for real people.

    I’m an atheist and scientist who began to suffer episodes of depression at age nine and who’s had severe clinical depression since the age of sixteen. Meanwhile, I’ve had all kinds of people in my life who don’t think depression exists. It has not been fun. So I’d like to thank you for your talk, JT. That was a brave as well as an immensely helpful thing to do. You are not alone, and I am glad that you are receiving treatment. And maybe I will write a response to this post.

    * The atypical antidepressant bupropion, which I used for a long time, and which is contraindicated for anorexic patients due to its propensity to obliterate appetite, increases synaptic norepinephrine and dopamine levels. I do not tolerate SSRI’s; my present psychiatrist attributes this to my probably being on the high-functioning end of the autism spectrum.

    ** In the U.S., medical insurance companies will cover the cost of antidepressants much more readily than they will cover the cost of psychotherapy. Maybe you are confusing people’s willingness to use antidepressants simply because they’re cheaper with a “lack of skepticism” about them, Anonymous.

    • teh_faust

      “Clinical depression is a complex medical condition whose associations include low levels of the neurotransmitter and precursor to adrenaline called norepinephrine*; loss of volume of a key learning and memory region of the brain called the hippocampus; low levels of a major nerve growth factor called brain-derived neurotrophic factor (BDNF) in the hippocampus; reduced blood flow to a region of the brain that registers pain signaling called the anterior cingulate cortex and irregular glucose metabolism in the brain.”

      Thanks for mentioning that.

      Plus, as of today, diagnosis of mental disorders is made by looking at the symptoms. Mentall illnesses are grouped by how they present themselves on the outside, not by their biological causes. If bioloists had to operate like clinical psychologists, they still might be calling dolphins “fish”^^
      It’s very well possible that the physicological mechanisms underlying the depressed states of two persons are different from eacht other, e.g., there’a a subset of patients whose Depression seems course by hypothereosis and can even be effectively treated with thyroid hormons.

      And the way I’ve experienced it, the people responsible for psychological treatment are cautious and responsible when it comes to medication.
      There’s no good reason to deny help to people who are suffering and that includes medication.
      There may be, however, instances when medication isn’t the best solution as in say, agoraphobia or other clear-cut types of anxiety, because anxiolytics can hinder extinction of fear reaction as a certain amount of fear/ emotional processing seems to be necessary for exposure therapy to work.

      But that’s not a matter of pharmacology against “nice and old-school” psychotherapy. It’s a matter of determining the exact advantages and drawbacks of any specific treatment. It’s a scientific question, and ideology won’t solve it.

      You’ve mentioned that antidepressants usually have a hig non-responder quote. It’s similar with psychotherapy and other forms of treatment (e.g. sleep deprivation) – which may well be because the underlying conditions are different. It’s important to note is that the non-responders to one treatment can be the responders to another. That’s why I think we need a hierarchi/ list of possible treatments and a better way to discriminate between the conditions of different people.

      Also, there being a biological substrate – like a neurotransmitter imbalance – in no way means that classical psychotherapy cannot be helpful.
      Because ultimately, any “psychological” process has to be implemented in the brain. And in that sense, a therapeutical conversation is a physical intervention.

      Gotta look that up again, but if I remeber correctly, both antidepressants and cognitive behavioural therapy yield similar results that don’t necessarily add up. With an advantage of CBT in catamnesis after a year. (I don’t know why this is, but my guess is that psychotherapy provides you with techniques to fall back on when there’s a danger of lapsing whereas when you go off your medication and the sensitivity of your serotonin receptors increases again, you don’t have a handle on it.)

      I’d just like to prevent the misunderstanding that is meds vs. psychotherapy. It isn’t. Or it shouldn’t be.
      It should be between treatment that works and pseudo-treatment that doesn’t.

      • Juniper Shoemaker

        I’d just like to prevent the misunderstanding that is meds vs. psychotherapy. It isn’t. Or it shouldn’t be. It should be between treatment that works and pseudo-treatment that doesn’t.

        No problem. I appreciate your pointing this out. I hope that I did not come across as decrying the use of antidepressants. I most definitely do not oppose the use of antidepressants. I think many clinical depression patients need a combination of antidepressants, regular psychotherapy and lifestyle changes in order to manage their depression. So I agree with you wholeheartedly.

        I just get angry about the mischaracterization of science-based treatment of depression, which includes the judicious use of antidepressants. Joe Blow on the street thinks that depression is a fake disease and a character flaw in lazy, self-absorbed people and that antidepressants are magic pills prescribed by thoughtless doctors. At the same time, he accepts diabetes as a real disease. He probably misunderstands diabetes as a disease with a simple solution, which is problematic in itself, but he still accepts it as a real disease.

        Yet diabetes and clinical depression are analogous in several ways. They both involve physiological disorders of critical organs. They are both associated with multiple variables. Patients presenting with major clinical depression need individualized treatment regimens because their endogenous neurotransmitter production, growth factor production and cerebral blood flow isn’t identical; patients presenting with diabetes mellitus type II need individualized treatment regimens because their endogenous insulin production isn’t identical. The degree to which patients with depression can manage it with diet and exercise alone varies; the degree to with patients with diabetes can manage it with diet and exercise alone varies. Moreover, pharmacological treatments for depression are as varied as SSRI’s, SNRI’s, bupropion, electroconvulsive therapy and even ketamine, while pharmacological treatments for diabetes are as varied as insulin, metformin, alpha-glucosidase inhibitors, amylin mimetics, GLP-1R agonists and DPP4-inhibitors. Meanwhile, no researcher or clinician thinks any of these agents are magic and perfect. One of the many good things about JT’s talk was the aptness of the diabetes-depression analogy on multiple levels.

        Science: learning it works. As several people have already pointed out, more people need to think of the brain as another organ. That’s what it is. They need to discard the “mind-brain” dualist nonsense so beloved by mystics, too. Everyone’s thoughts have a biological, chemical and physical basis. The argument from incredulity of OMG I DONT KNOW SCIENCE AND I DONT UNNERSTAND HOW THOUGHTS ARENT SPIRITUAL doesn’t comprise proof against the reality of depression. This bears repeating over and over again until more people start listening and learning.

        Anyway, I don’t disagree with you, teh_faust. I don’t disagree with you anymore than I think that JT doesn’t understand that depression/depression presenting with other conditions such as anorexia nervosa or anorexia athletica involves multiple variables. I am just very exasperated with the tropes about depression: depression is not a big deal, depression is fake, all antidepressants are Prozac, Prozac is prescribed wantonly out of some sort of tyranny of scientific political correctness, etc. That’s the only reason why I wrote what I did.

  • pahapillon

    I love your singing voice. I also love how you stand there with all your pain and chose to not run away, but to continue with your talk. Thank you for sharing.
    I wish more people would realize that the brain is just another part of the human body that can get sick; still so much stigma, prejudice, and taboo.

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  • http://peicurmudgeon.wordpress.com/ peicurmudgeon

    Due to some computer problems, I haven’t been able to listen to JT’s talk, so I don’t know what he covered. One thing I wanted to point out is that depression is a potentially fatal disease. Very close to being fatal in my case. 4 1/2 years ago, I was taken to the hospital with an overdose, and awoke very disappointed as I was firmly convinced that the world would be much better off without me in it. Since then, I have come to understand that despite how I may feel on that subject, my children and other people who love me have a different opinion on that.

    I had struggled most of my life, but was only diagnosed in 1991. Since then I have been on and off meds, but since that serious episode in 2007, I have been unable to work and focus on staying well, with varying degrees of success. I do know now that my choice in the future will be the hospital.

  • Icaarus

    Damn you JT, because of this presentation I can no longer resist not reading your blog too. So add one more blog to my RSS reader and one more reason I can’t get any work done.

    Seriously, I think your solution to mental illness (let’s just extend this to all of humanity’s problems shall we) is ultimately the way to improve the world. Keep your friends close, if you think they could be headed for trouble keep them closer. Best of luck.

  • http://freethoughtblogs.com/almostdiamonds/ Stephanie Zvan

    All right, sir. Written and posted. Bugger, but that was hard to do: http://freethoughtblogs.com/almostdiamonds/2011/11/26/the-next-thing-i-know-im-going-down/

  • teh_faust

    @ Juniper Shoemaker: “I am just very exasperated with the tropes about depression”

    So am I. And I don’t think either of us doesn’t understand that there’s many facets…I just found the treatment aspects besides medication to be understressed in this discussion.

    I think the analogy to diabetes is a good one, too. I have sort of a first person perspective on this double standard, since I’ve lived with Type 1 for 5 years and an ED (which fortunately has improved a lot) for longer. (Btw, it isn’t just their individual awfulness added up, but teaming up those two create lots of extra complications.)
    I don’t see a fundamental difference between the two.
    And still, it was only about the Diabetes that talking was easy, that I could joke about it and make people laugh instead of getting concerned looks. It took only a few days until my friends knew about it, whereas it took me a lot more time and floundering until I could talk to my friends about my other issues.

  • http://psychoticatheist.blogspot.com/ Psychotic Atheist

    Thanks JT, for doing the talk that I have wanted to see done for some time now. I’m glad someone is doing some consciousness raising for mental health issues in the skeptic community.

    As my username suggests, I suffer from a psychotic disorder that is as yet not fully diagnosed (the philosophy of the NHS seems to be to not diagnose these kinds of illnesses for various reasons, stigma I think is included in them). I have a blog, where mental health is occasionally discussed, but I struggle with severe apathy issues, so it isn’t as regular as I’d like it to be. I’m working on that, and your talk served to inspire me considerably.

    I’m glad your medication has had such a positive impact, even with the unfortunate fuzzy side effects. There is unfortunately a lot of shenanigans in the mental health medication trade (and the rest of pharmaceutical companies, unfortunately). Ben Goldacre discusses some of them in Bad Science. My own medication was at the centre of a large lawsuit because the drug company suppressed information about some of the side effects (which can be very serious).

  • dfl42

    naamah_darling on Livejournal writes absolutely magnificently on mental illness, both in general and about her own experiences. I cannot recommend her highly enough. In particular, these posts:

    On the Idea of Suicide Being Selfish: http://naamah-darling.livejournal.com/311749.html

    On the Difficulties with Getting Help: http://naamah-darling.livejournal.com/437140.html

    Exhaustive list of her entries related to mental illness: http://naamah-darling.livejournal.com/tag/lycanthropy

    • Ms. Daisy Cutter

      LOL, Naamah_Darling. Sure, if you like loads of twee pretension (“lycanthropy”? GMAFB), plus an f-list full of special-snowflake pagans, liberal xtians, and NewAge/SewAge types who get very upset if you challenge their pweshus beweeefs.

      As for mental illness, funny, but after I and a few other of her then-LJ friends challenged one of her real-life friends on his sexism, she had no problem with him calling me “crazy” – or her husband coming over to my LJ and doing the same. She said nothing to me about it but effusively buttered up the real-life friend and told him he wasn’t a bad person, really!

      Dropped her and never looked back. Who needs that shit?

  • Joe

    Thank you for the speech. It was nice to see a crowd of atheists supporting your effort.

    Unfortunately, you wouldn’t get the same reception among a crowd of mental health advocates. Organizations, like NAMI, MHA, DBSA, have all embraced a faith/spirituality-based “recovery” approach to supporting persons with mental illnesses. These groups are not welcoming to atheists.

    There is currently no organization/group/website where people who are both atheists and have mental illnesses can come together.

    • CC

      I was part of a DBSA support group for a while and it was entirely secular. Perhaps a better way of putting it is that the group was completely supportive of whatever worked for the individual, whether that be religion or no religion. No one in the group ever tried to convert me or mentioned praying for me. I would encourage non-theists not to write off DBSA until they have learned about the character of their local group.

  • http://eternalbookshelf.wordpress.com Ani Sharmin

    JT,

    Thanks so much for giving this talk, and all the best to you in the future. I’m glad you have such supportive family and friends who are there for you.

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  • tigerlily

    Thanks JT. I needed that. Gives me some hope.

  • http://saltycurrent.blogspot.com SC (Salty Current), OM

    I think you’re brave for talking about your story and urging the community to address these problems, and I applaud that.* I do, though, think that skepticism shouldn’t spare any realm (in fact, some of us have been talking/arguing/citing about the subject for quite some time on the skeptical/atheist blogs), and this is one that has been shaped by multibillion-dollar corporations in their interests. I’m going to leave one comment and then exit, because I’m tired of having these discussions online and, well, it’s my birthday and I don’t want to today:

    The monoamine (neurotransmittor deficiency/imbalance) hypothesis, examined over decades, is not supported by the empirical evidence. In fact, there is significant evidence against it. It continues to be promoted by the drug companies and in the media, and many of the people who otherwise recognize that it’s wrong irresponsibly and unethically allow this to go on. (See posts tagged “health” on my blog.)

    This is unrelated to the question of stigma, and I should note that psychological problems as nonexistent or character flaws vs. diseases in the sense talked about here are not the only possibilities. But the claim that calling these problems illnesses works against stigmatization doesn’t appear to be supported by the research. My most recent post parenthetically talks about the empirical findings regarding stigmatization – it seems that the characterization of problems as illnesses or having biogenetic causes increases rather than decreases the stigma.

    ***

    I submit that this trope is the result of anti-science efforts in the U.S. by New Age mystics who hold the natural to be sacred and Christian wingnuts obsessed with what they call “meritocracy”.

    Wrong. Skeptics include Irving Kirsch, Marcia Angell, a significant portion of the psychiatric community, and in the realm of science and skeptical blogs Jerry Coyne and myself.

    These ignoramuses are hell-bent on insisting that depression doesn’t exist.

    Baloney.

    They are often scientifically illiterate, too.

    Irrelevant if some criticisms have a scientific foundation, which they do.

    *Not thrilled about “pussy,” though.

    • http://langcogcult.com/traumatized DuWayne

      SC -

      The monoamine (neurotransmittor deficiency/imbalance) hypothesis, examined over decades, is not supported by the empirical evidence. In fact, there is significant evidence against it. It continues to be promoted by the drug companies and in the media, and many of the people who otherwise recognize that it’s wrong irresponsibly and unethically allow this to go on.

      First off, all depression isn’t the same. Depression is likely caused by a variety of mechanisms. While there is ample evidence that blanket use of SSRIs and other neurotransmittor type antidepressants is ineffectual for many, possibly most people, we can actually observe their impact on the brains of people who suffer severe/debilitating depression.

      Like talk therapies, antidepressants have limited efficacy. In part this is because on both fronts all we have are imperfect tools. We do the best we can with the tools we have, while constantly trying to improve the tools we have.

      But the claim that calling these problems illnesses works against stigmatization doesn’t appear to be supported by the research. My most recent post parenthetically talks about the empirical findings regarding stigmatization – it seems that the characterization of problems as illnesses or having biogenetic causes increases rather than decreases the stigma.

      Bottom line – they are illnesses and the stigmas are wrong, regardless of what is motivating them.

      Skeptics include Irving Kirsch, Marcia Angell, a significant portion of the psychiatric community, and in the realm of science and skeptical blogs Jerry Coyne and myself.

      Who the hell are you? I should care that you’re skeptical why? Jerry Coyne on the other hand is evobiologist and ecologist, Angell’s an MD and Kirsch is a borderline conspiracy theorist. I’ll take my cues from psychology and neurobiology research.

      Baloney.

      So you lump yourself into a group of people you weren’t originally included in and then decide that they aren’t what they demonstrably are?

      Irrelevant if some criticisms have a scientific foundation, which they do.

      So show the scientific foundation.

    • D. C. Sessions

      SC, it took a while to parse out your thesis but if I understand correctly it boils down to “research in depression is dancing to Big Pharma’s tune and only Brave Skeptics dare to speak The Truth.”

      Which leaves me wondering if the same is true of immunology, oncology, etc?

      And, yes, I realize that having dropped that one comment you won’t be back to respond. Oh, well.

      • Ms. Daisy Cutter

        She’s also become an animal-rights zealot.

        Pity.

        • http://saltycurrent.blogspot.com SC (Salty Current), OM

          For the reasonable people out there who are open to real skeptical and science-based discussion of these issues:

          This is why I’ve come to wish to avoid these discussions. I typically come to spend hours or days presenting references and links to articles, including reviews, in the peer-reviewed literature and books with extensive citations. My interlocutors in turn present a string of ridiculous ad hominems (directed at me or at Angell, Kirsch, Coyne,…) and a refusal to engage with evidence. It is extremely disappointing, especially because no one’s asking anyone to uncritically accept any arguments or evidence – merely to examine them fairly and critically as people seem capable of doing in other realms. If JT wishes to read more about the subject, he can find the threads on the other science blogs or the various links at my blog or contact me.

          • http://langcogcult.com/traumatized DuWayne

            You didn’t present any evidence to engage. Meanwhile, neither I, nor anyone else has presented you with even the tiniest ad hominem. The closest anyone has come was my reference to Kirsch as a borderline conspiracy theorist. But that is not an ad hominem. I’ve read Kirsch and I have also looked at his so called evidence. He crunches a lot of numbers that aren’t necessarily related to each other, ignores aspects of studies he’s getting his numbers from and after including disparate groups decides that antidepressants are no better than placebo for everyone.

            Only that is not the case at all. The evidence suggests that antidepressants are no better than placebo for most people who suffer mild to moderate depression. The evidence also suggests that antidepressants can be a lifeline to people who suffer severe clinical depression, bipolar II and in some cases, ADHD. Obviously people who fall into the category for whom antidepressants are more likely to work are a much smaller group, so when you lump them in with the larger population of people who suffer mild to moderate depression it is going to skew the statistics significantly.

            That is exactly what Kirsch did and why rather than being an ad hominem, the assertion that he is a borderline conspiracy theorist is giving him the benefit of the doubt and assuming he crunched figures the way that he did out of honest ignorance, rather than intentional dishonesty.

            As for a refusal to engage with evidence…From where I am sitting, you’ve presented nothing yourself – except to ask us to click over to your blog and look through your tags. So I’ll respond in kind. While I haven’t posted a whole lot, there are biblios that include SSRI studies posted to my blog. If I have the time later, I will front post a rather more detailed response to you and Kirsch’s travesty of a book. I have been meaning to address him and a couple of his disciples anyways.

          • D. C. Sessions

            For the reasonable people out there who are open to real skeptical and science-based discussion of these issues

            Which issue? I spent a fair while diagramming your original comment and all it seems to have come to is that Big Pharma is making the scientists dance (barring your Brave Maverick heroes.)

            But I could be wrong, which is why I phrased my comment as a question, despite your declaration (hmmm …) of not returning to reply. And which question you haven’t answered.

            So, just for the lulz: is Big Pharma also calling the shots for research in immunology, oncology, etc?

            This is why I’ve come to wish to avoid these discussions.

            Is that a flounce, or was the original “I won’t be back” a flounce and this a reflounce?

          • julian

            The evidence suggests that antidepressants are no better than placebo for most people who suffer mild to moderate depression. -DuWayne

            When SC said something almost identical to this over at Pharyngula half the commentariat bit her head off over it, providing testimonial after testimonial of how antidepressants had helped them, how she had no business talking about them because she didn’t use them and that she was a conspiracy nut.

            research in depression is dancing to Big Pharma’s tune and only Brave Skeptics dare to speak The Truth. -D.C.

            Interestingly enough, last time this came up and she tried showing that antidepressants were over prescribed and marketing for them overstated their efficacy, she got greeted by much the same accusation. (even though later posters said almost the exact same things she did but with a more ‘pro’ antidepressant bent, they weren’t accused of being Jenny McCarthy.)

            She’s also become an animal-rights zealot.
            -Ms Daisy Cutter

            That, however, does look like a new one.

          • http://langcogcult.com/traumatized DuWayne

            Julian -

            You conveniently ignore the line that followed it, which was rather key. I don’t know anyone who actually knows anything about neurobiology and psychopharmacology who doesn’t accept the evidence that suggests SSRIs are effective for mild to moderate depression. That would include Juniper.

            The problem with taking that statement and generalizing it to those who suffer moderate to severe depression is that it can be very useful for people in the latter category. People in that category are the people who really *really* need something to work. Then they see some bullshit about how SSRIs don’t work, how doctors shouldn’t prescribe it and they may well refuse the best treatment option for them.

            Now I note that SC didn’t say anything about it – except that she seems to be pretty hard on pharma in general and she is lumping herself with Hirsch, whose position I know all to well.

  • http://psychoticatheist.blogspot.com/ Psychotic Atheist

    @ SC (Salty Current)

    I posted this over at PZ’s blog, where apparently female based insults are often criticised:

    Pussy doesn’t necessarily refer to female genitalia. Some wordsmiths have suggested that when it is used to denote cowardice, it might have been derived from the word ‘pusillanimous’. The two words may therefore have different origins. It isn’t, as many people assume, necessarily implying that somehow vaginas are weak-willed or something like that.

    I’m not saying its true, but it makes more sense than the alternative.

    • Ms. Daisy Cutter

      Aside from what Sili said over on Pharyngula about argument from etymology… please. None of us were born last night, and some of us are etymology buffs ourselves.

      • http://psychoticatheist.blogspot.com/ Psychotic Atheist

        None of us were born last night

        I don’t recall implying anyone was foolish. Not everybody has access to all the same information, and it is a duty to share information with one another.

        some of us are etymology buffs ourselves.

        Therefore, clearly, my post was not aimed at you. It was aimed at people that aren’t etymology buffs. Or perhaps at those that are etymology buffs but who had never, for whatever reason, investigated the etymologies of the word ‘pussy’.

        It seems unusual for you to berate someone else for being an etymology buff and sharing that love with others. What’s with the attitude?

        • Ms. Daisy Cutter

          “Attitude”? Excuse me, I don’t appreciate people downplaying sexism, then throwing tone arguments at me about it. The idea that “pussy” comes from “pusillanimous” is a load of crap. I’ve never heard it before, and I’ve been an etymology enthusiast for a few decades now.

          JT is a big boy, and pretty well spoken. He can deal with being criticized for using a gendered term without one of his regulars making up bullshit to excuse him with.

          • http://psychoticatheist.blogspot.com/ Psychotic Atheist

            “Attitude”? Excuse me, I don’t appreciate people downplaying sexism, then throwing tone arguments at me about it.

            And I don’t appreciate being berated for sharing my thoughts. If you don’t want people to criticise you for being unnecessarily confrontational, then I can only suggest you try polite disagreement instead.

            The idea that “pussy” comes from “pusillanimous” is a load of crap. I’ve never heard it before, and I’ve been an etymology enthusiast for a few decades now.

            Maybe it is erroneous, yes – I even indicated its tentative nature. If that was your view you could have simply said so.

            The fact that you’ve never heard it does not mean it does not exist, nor does being an etymology enthusiast for a few decades mean you know the proposed etymological roots of all words. Either way, I didn’t say it was necessarily a position held by etymologists, but the more informal group of ‘some wordsmiths’. It may well be bullshit, naturally.

            He can deal with being criticized for using a gendered term without one of his regulars making up bullshit to excuse him with.

            I’m not a regular, though I may turn into one. Especially if JT gets involved in an Secular Mental Health Community. Which should really be the focus here I think, rather than on the words a person uses when they are under intensely stressful conditions. Perhaps we could agree on that, even if you do think the potentially sexist expletives he uses are of some importance.

        • Ms. Daisy Cutter

          Since there’s no reply link on your last comment:

          And I don’t appreciate being berated for sharing my thoughts.

          Not all thoughts are worth sharing. Some of them deserve flak.

          If you don’t want people to criticise you for being unnecessarily confrontational, then I can only suggest you try polite disagreement instead.

          Nah.

          …Which should really be the focus here I think, rather than on the words a person uses when they are under intensely stressful conditions.

          I can chew gum and walk at the same time, thanks. And using words that denigrate others while under “intensely stressful conditions” is one thing; using them in a prepared speech is another.

  • http://post-modernenlightenment.blogspot.com/ Enigma

    I’m no stranger to blogging about my battle with bipolar II disorder and AD/HD, and the destructive effects both have had on my life (for those who don’t know, bipolar II is form of bipolar where there is no mania – you get hypomania, which is best described as a more controlled mania, or a mania that’s taken down a few notches. Half the mania, twice the depression, it seems, with none of the same great taste). I’m still struggling with it, even though I’m taking medication to combat it. It’s so good to see someone else out there talking about it; sometimes it can be hard to acknowledge that you’re not alone, and it has a really positive impact to see first hand that you’re not.

    Thanks a lot. I’ve done what little I can get your message out; hopefully more people will blog about mental illnesses.

  • PJ

    JT, you are my hero!

    • Pia

      Hey! You have usurped my ‘nym.

      But I could have indeed made that comment myself.

      I have battled with depression and debilitating anxiety since I was in my early teens. It has devastated my career hopes and has had severe impact in my ability to form close relationships. For there is the *shame* of letting people see what a mess I am inside, so obviously the solution is to keep people at distance…

      During the years I’ve had working SSRI-treatment, not-working SSRI-treatment, disastrous efforts at therapy and now, finally a therapist with whom I have a good, trusting relationship. It took awhile to learn what trust even means. Hiding the inside comes so naturally to me.

      While I give full kudos to the psychiatric community for what it has done for me, the most empowering thing in my life has been peer support in the intertoobz. And I mean support very broadly. Just seeing that you are not alone in your suffering can make all the difference.

      Pia (formerly pj)

  • Jeweli

    Can we please start a community of Atheists dealing with mental illness? I’m tired of suffering alone. Too many people think faith is the only way to deal with these issues. We can build community too and we have proved it before. There should be some central website to talk about these things and support each other. How about it?

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  • Stein

    Thanks for your talk JT. I had a boss who had trouble in that area.

    He made my life hell.

    But I hate his guts now, and that gives me satisfaction.

    As does the fact that an angry loud mouth like yourself is on Meds and is representing Atheism on campus.

    Swell, we are all better off.

  • LadyBlack

    The stigma around mental illnesses is alive and well. I was diagnosed a few years back, and went through a set back a couple of years ago. My manager told me that he would support me etc. etc. He then tried to get me to be his “bit on the side” whilst his wife was ill and when I said no, used everything I had told him to try and get me fired. HR sat in the meeting, wouldn’t listen to me and treated me like a big embarrasment.

    I managed to get a new job, but I can’t ever trust management again, and I feel virtually raped by a man who said, “Trust me” and then betrayed me so completely.

    Since depression means you are emotionally vulnerable, it means people take advantage of that.

    I don’t know if Ellen is reading this – I tried responding on the previous thread and my computer threw me out! I am trying again with the doctor – I wasn’t going to bother because it seemed like less effort to just take myself out of this life, but I will have another go. Some days are better than others…

  • http://criticallyskeptic-dckitty.blogspot.com Katherine Lorraine, Chaton de la Mort

    I suffer from often crippling anxiety… but it’s not that bad. Thank you all for your stories.

  • TV200

    This certainly was a eye opener. I have a friend that I now realize I have wronged. I didn’t get why willpower was insufficient to “stop being crazy”, which, unfortunately, led to some frustration and anger on my part. You have explained in a way that makes sense.I will definitely apologize the next time I see him. So, thank you for your talk, for changing my perspective, for showing me what I can do to be a better friend.

    • D. C. Sessions

      I didn’t get why willpower was insufficient to “stop being crazy”, which, unfortunately, led to some frustration and anger on my part.

      It’s really a hard thing to learn, isn’t it? Having LD kids is what it took for me, and it took far too long even with that hammer being repeatedly applied.

      Sometimes I wish we had safe ways of inducing temporary depression, etc. so that people could find out what it’s like, especially with everyone around you telling you that you’re just not trying.

      The late Mark Probert had two sons. One has rather severe physical handicaps (as in, wheelchair for life) and the other is seriously ADHD. The son in the wheelchair tells people that he has it better than his brother because people can see his handicap.

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  • Dima
  • changeable moniker

    JT, at “I just needed it to stop”, I understood: perfectly, and personally. (emoticon fail.)

  • Malimar

    I’ve struggled with depression my whole adult life.

    I’ve always been pretty open about it, and rarely encountered the sort of stigma I’ve heard horror stories about. I vaguely remember being told to “suck it up” maybe once, if that. I usually get a complete nonreaction whenever I mention it. I don’t have any of the kind of good friend who force me to seek help about it or anything.

    Which is for the best: seeking help has never helped me. I’ve been on two SSRIs, neither of which had any effect at all, so I gave up on the whole thing.

    Then I was diagnosed with low testosterone. But testosterone supplements did nothing.

    I saw several different therapists, both alone and concurrent with the above two treatments, but that did nothing.

    It’s possible that a combination of testosterone supplements and SSRIs (the next thing they wanted to try) might have accomplished something, but by that point I was so tired of the fruitless weekly visits to the endocrinology clinic and the therapist that I just gave up on the whole thing again. All the fuss was doing nothing more than adding unnecessary stress to an already bad mental state, so I washed my hands of it.

    And then, several months ago (some year or two after giving up on medical science), I was suddenly fine. Happy, even. I enjoyed my schooling, had no worries, got in a relationship that I didn’t hate, everything was going swimmingly. It was amazing. All the symptoms were gone.

    With one exception: I still thought about suicide just about every day. (Which was one part of JT’s talk that rang kind of jarring to me – how could anyone go through life and seriously consider suicide a number of times they can count on one hand? I have a hard time wrapping my head around this.)

    Anyhow, that didn’t last long (apparently I foolishly wagered more of my happiness on the relationship than I ought to have. Then I had to have my cat euthanized. So I guess that’s two of the risk factors), and now I’m back to my old gloomy self. (I thought at first it was mere sadness, but no, the sadness mostly went away and the depression is back.)

    Take note: I’m not trying to make a fallacy of misleading vividness by providing an anecdote to “disprove” the efficacy of modern medical science at curing mental illness. Mine is hardly a good anecdote for that purpose, anyway — if I had tried every concievable option before getting frustrated and giving up, instead of just the most obvious several options, then maybe I would have had a real shot at making the misleading vividness fallacy. I freely admit that I’ve probably just had very poor luck so far, and just happen to not have hit on the one combination that will actually do anything. I just don’t have the patience (or the resources) to keep trying combinations, especially when I’ve grown so used to just feeling bad all the time.

    I’m not sure what I am trying to say. Not quite “SSRIs don’t work for everyone”, because that goes without saying for all medicines. Not even quite “modern medicine can’t fix everyone”, because that goes without saying, too. (Obviously, alternative “medicine” isn’t going to fix anything modern medicine can’t. That’s such a stupid prospect that I must contain it within parentheses to keep it from infecting the rest of the post.)

    Oh, I know what I might be getting at: JT’s emphasis on SSRIs bothered me, because he makes it seem like SSRIs are the be-all and end-all of fixing depression, and it discomfits me to think that I have some non-standard form of depression that doesn’t respond to the standard treatment, that this makes me weird and unusual, and perhaps more importantly, it makes my depression seem almost less legitimate, at least in my head.

    tl;dr version: If the take-away from the talk was “It’s normal to have mental illness, it can be managed”, where does that leave those whose mental illness can’t be managed?

    • http://langcogcult.com/traumatized DuWayne

      I spend rather a lot of time on depression, because of my own, my partner’s and because it is more than peripherally related to the research I will be doing when I finish my undergrad. My partner is struggling with depression that doesn’t seem to want to respond to *anything* in terms of “normal” treatment modalities. And that isn’t at all uncommon.

      The unfortunate truth is that the tools we have for treating depression are far less effective than we would like. This is likely largely due to the fact that depression is probably (read; extremely high probability) caused by a variety of mechanisms – so of course it is unlikely that there will be universal treatments.

      What you are experiencing is absolutely as real and valid as what many of us are struggling with. It would be flat fucking ridiculous to base the legitimacy of anyone’s mental illness on our ability to treat it successfully. We’re using science to constantly improve and expand our ability to treat mental illnesses, but for the most part we’re stumbling around in the dark. While we have made more progress in understanding the brain in the last decade, than in the five decades preceding it, we have mostly picked up on how little we understand.

      We will get better and better at it and I will be contributing to that before long. But please – don’t ever think that there is something wrong with your mental illness, or supposed lack thereof. You absolutely should not be blaming yourself for our failure – and that is exactly what we’re talking about here. Not your failure, but our own.

    • Juniper Shoemaker

      Oh, I know what I might be getting at: JT’s emphasis on SSRIs bothered me, because he makes it seem like SSRIs are the be-all and end-all of fixing depression

      You are right. As I stated in my former comments, not all depression is associated with low levels of serotonin, not all antidepressants are SSRI’s, not all antidepressants work for all depressed patients, the judicious use of antidepressants is part of the evidence-based treatment of depression*, and all antidepressants have extensive adverse effect profiles. And it is important to note that not all peer-reviewed neurobiological research on depression can be attributed to fidelity to a single overarching (and garbled) hypothesis, because not all scientific investigations of depression are focused on monoamine oxidase, monoamines or catecholamines.**

      The fact that antidepressants do not in general help people with mild to moderate depression: 1) says nothing about the efficacy of their use in some of the people with severe, incapacitating depression, 2) has been trumpeted all over the media and 3) does not constitute proof that the entirety of depression research is evidence-free garbage perpetrated by Big Pharma and conducted by their unquestioning, credulous, unreasonable minions. I could go on, but I have to get back to doing neurobiology.***

      *There is empirical evidence that SSRI’s increase blood flow to the anterior cingulate cortex in some patients. Those patients have reported amelioration of their severe depression. Therefore, physicians who use SSRI’s for this purpose are not necessarily subscribing to the hypothesis that depression is caused by a lack of serotonin (or a lack of any other monoamine or catecholamine, for that matter). Pharmaceutical agents are tools, not hypotheses unto themselves. Some people don’t make the distinction.

      ** This would include hypotheses about glia, brain-derived neurotrophic factor and pro-inflammatory cytokines.

      *** Before my PI, a brilliant scientist who incidentally likes to say that no neuroscientist worth her salt thinks that depression is a character failing instead of a medical condition, really does kill me for blogging too much. I do not do depression research, by the way, and I receive no payments from pharmaceutical companies who sell antidepressants.

    • Juniper Shoemaker

      P.S.

      My partner is struggling with depression that doesn’t seem to want to respond to *anything* in terms of “normal” treatment modalities.

      This is very true. So I am currently off meds. I’m trying a whole lot of time-consuming and aggressive lifestyle changes that I have the luxury of making because I have no children, a good job, medical insurance, a loving partner and supportive boss and friends. Will it work? WHO KNOWS! But I’m done with this shit called depression. I can’t stand it anymore. I will give it everything I’ve got.

      I think I should have avoided the bait and stuck to saying that I greatly sympathize with you, Malimar. I know what it’s like to have serious and treatment-resistant depression. I wouldn’t wish it on anyone. I hope that you find some solutions to work with soon.

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  • http://atheistlogic.wordpress.com/ Zach

    JT,

    I went into this video without really any knowledge about who you are. I knew about the SSA and had heard your name, but apart from that I didn’t really know much.

    About 3 minutes in you stood on a stage in front of a group of people and sang for them, and I thought to myself “I could never do that, this guy is pretty damn brave.”

    Then I watched the rest of your talk and couldn’t believe how much of an understatement that was.

    Thank you for opening my eyes to this issue. I’m more or less at a loss for words right now. So just thanks. :)

  • docslacker

    All I have to say is, thank you.
    You have taught me so much in just 40-some minutes.

  • Jurjen S.

    I never had a better day in my life than when I finally admitted to myself I was crazy, because it meant that it wasn’t my fault.

    Speaking for myself, I wouldn’t put it that strongly because I’ve had better days, but yes, the day I realized that my periodic bouts of massively asocial, inconsiderate, self-destructive and generally asshole-ish behavior over the previous years might be explained by clinical depression, I felt an intense feeling of relief; partly relief that my behavior hadn’t simply been a result of my being an asshole (though if that had been the problem, why would I have felt bad about behaving like one?), but mostly relief that it meant that I could seek help to deal with it and stop behaving like that.

    Anyway, powerful talk, JT; a lot of sounded awfully familiar, though my own experience has been nowhere near as bad. And I like your ideas re: the skeptical community and mental illness. Hell, I haven’t entirely come out to my family about having major clinical depression because I have a nasty suspicion they’re not going to get it, that they’re going to think it’s a weakness rather than an illness.

    Yeah, I need to work on that, clearly.

  • Natasha

    Fuck, dude. Where to begin?

    1. You’re not a Dr and don’t claim to be, so I don’t see why everyone is all up in your grill about perceived imperfections in your talk. You’re an advocate, not the DSM IV. Like, totally, yes, share more info in forums, but don’t wave fingers and be a jerk.

    2. Thanks for the shout out, you madman. I’m glad the internet now knows I buy stash cases for xanax. Also, welcome to the fold. Feel free to blow-off a month cruising through existing mental health forums like DBSA (that one is hard to navigate, but for good reason, it keeps assholes out,) and even Craigslist (whut, I know, but it gets serious there.)

    3. In relation to the above, please feel free to compile a list of mental health resources and post it in your blog. Be sure to do your reading, though, because some groups are unhealthy and disorganized and really isolated from the central causes.

    4. Out and proud, dude. I sort of like to dare anyone who thinks Team Crazy is weak, to bring it. We may function differently, but society would be lost without us. I will drag Virginia Woolf and Beethoven out of the lives of haters so fast… Wait, wait, morons don’t listen to symphonies or read. How about DMX or Axl Rose? Kurt Cobain? Not that they are morons, but easier to identify for many people.

    5. Some of the things I left on Greta’s blog, because I do things backwards, on addressing some of the controversy about your emotional state during the talk and so on:

    Natasha here. JT mentioned me in the talk (which was cute, he sent me a link on my phone to the exact point in the video where he mentions me, that flirt.) I am late in wandering into the forums, as always.

    Here are my two cents.

    Expecting the entire breadth of mental health activists and advocates to hold the same position on something like this, is unreasonable. Healthy debates within the group are good, but splintering is bad. We have a common goal, even if not a common approach.

    Think of it like feminism. There are different schools of thought, passionate views, heated arguments, and when they get out of control, it gets ugly. (Can someone say “sex positive controversy”?) We’ve had some decades of this going on already, so we all know it’s counterproductive to shoot the movement in the foot. Mental health advocacy is relatively new, though, so we haven’t all learned (yet) that there are different ways to do this, but a common goal. Moreover, we need (NEED) to remember that these aren’t just principles and rights we are rolling around for examination, but often personal traumas. It is, by nature, an emotional subject to most people involved, in ways that often directly tie-in to hospital stays, overall struggles with mortality, psychosis, and who knows what else?

    Now, I’m one of those assholes that had really successful treatment, so I’m good at being pragmatic and calm and dropping my personal journey at the door. I can talk about being suicidal like I’m discussing the weather, or make jokes, whatever works. And while people like me are important for bridging certain gaps, people like JT are also important. I don’t inspire much empathy, frankly, I’m just a good voice of reason and a practical tour guide. But empathy is such an important thing to bring to the table and to inspire in others, not to mention that people in different stages of recovery, who speak out, are vital to those who need to feel like they have company.

    (I want to point out, here, that this isn’t the only talk in the world about this. We can refer to other lectures and look over the debates there for some historical insight. DBSA, for example, has many forums and links to talks given at their events.)

    Some people may have a problem with his, shall we say, poise? Others may not. Some people may dislike the entire notion that he is connecting two controversial fields (mental health activism and atheist activism) with each other to begin with, simply because it’s hard to undo the associations people make when public figures make mixed tapes of issues. But here is the bottom line, as I see it: This is a lot like voting. If you don’t do it, don’t complain that your representatives suck. If you don’t like how JT is representing those with mental illness, find an advocate that represents your view and support them, or, gasp, get your own ass up there and try not to cry.

    And much like in politics, you’re an asshole if you seriously just watched a single video and constructed a whole opinion around it. Do some homework before getting on someone’s ass. Dur.

    But really, I welcome all views, as long as whoever is sharing, isn’t judging their peers in advocacy.

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  • Hengest

    Always stand up for the mentally ill. Unless they have delusions that are religious in nature. Then fuck ‘em.

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    Your blog does not show up appropriately on my iphone 3gs – you might wanna try and repair that

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    Mental illness denial is a pseudoscientific topic, it is well within the scope of scientific skepticism. I would love to see the skeptic community tackle mental illness & neuroscience. I’ve seen too little of it, and actually more against it. Skeptic Magazine and the Skeptical Inquirer have been unfairly critical of mental illness and psychiatry yet I never see anything published about the actual evidence for mental disorders, of which there is plenty. Skeptic Magazine even published an article by Thomas Szasz, a mental illness denialist and fringe psychiatrist.

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