Nimh Quotes

When you’ve lived in a cage, you can’t bear not to run, even if what you’re running towards is an illusion.

By teaching us how to read, they had taught us how to get away.

„It's not magic,” I say. „It's science. Science means you can explain it, that you know how each part of it works. Magic is – I mean, it's science you haven't figured out how to explain yet.” „I can explain my magic,” Nimh replies. „And you just said you could not explain your engines.” Well. Maybe I should shut up, then.

I have lived in this tree, in this same hollow," the owl said, "for more years than anyone can remember. But now, when the wind blows hard in winter and rocks the forest, I sit here in the dark, and from deep down in the bole, near the roots, I hear a new sound. It is the sound of strands of wood creaking in the cold and snapping one by one. The limbs are falling; the tree is old, and it is dying. Yet I cannot bring myself, after so many years, to leave, to find a new home and move into it, perhaps to fight for it. I, too, have grown old. One of these days, one of these years, the tree will fall, and when it does, if I am still alive, I will fall with it.

1976, a FOIA request forced NIMH to acknowledge that it had allowed itself to be used by the CIA as a funding front in the sixties.

It's not magic," I say. "It's science. Science means that you can explain it, that you know how each part of it works. Magic is - I mean, it's science you haven't figured how to explain yet." "I can explain my magic," Nimh replies. "And you just said you could not explain your engines.

The real point is this: We don't know where to go because we don't know what we are. Do you want to go back to living in a sewer-pipe? And eating other people's garbage? Because that's what rats do. But the fact is, we aren't rats anymore. We are something Dr. Schultz has made. Something new.

Still, it seemed to us that the main reason we were hated must be that we always lived by stealing. From the earliest times, rats lived around the edges of human cities and farms, stowed away on men's ships, gnawed holes in their floors and stole their food. Sometimes we were accused of biting human children; I didn't believe that, nor did any of us⎼unless it was some kind of a subnormal rat, bred in the worst of city slums. And that, of course, can happen to people, too.

In 2010, the psychiatrist Thomas Insel, then director of NIMH, called for the research community to redefine schizophrenia as “a collection of neurodevelopmental disorders,” not one single disease. The end of schizophrenia as a monolithic diagnosis could mean the beginning of the end of the stigma surrounding the condition. What if schizophrenia wasn’t a disease at all, but a symptom? “The metaphor I use is that years ago, clinicians used to look at ‘fever’ as one disease,” said John McGrath, an epidemiologist with Australia’s Queensland Centre for Mental Health Research and one of the world’s authorities on quantifying populations of mentally ill people. “Then they split it into different types of fevers. And then they realized it’s just a nonspecific reaction to various illnesses. Psychosis is just what the brain does when it’s not working very well.

One of these days, one of these years, the tree will fall, and when it does, if I am still alive, I will fall with it.

Courage of the heart is very rare. The stone has a power when it's there.

Today, according to the NIMH, bipolar illness affects one in every forty adults in the United States, and so, before we review the outcomes literature for this disorder, we need to try to understand this astonishing increase in its prevalence.9 Although the quick-and-easy explanation is that psychiatry has greatly expanded the diagnostic boundaries, that is only part of the story. Psychotropic drugs—both legal and illegal—have helped fuel the bipolar boom.

Word gets around." "You mean they communicate?" A third voice. "You bet they communicate. And the next time they do come, you can be sure they'll case the place carefully. We were lucky. These rats hadn't been bothered in years. They'd grown careless.

For a psychiatrist who holds the keys to this “kingdom of the sick,” there is rarely comfort about committing a patient to care that they refuse. Yes, the near-term gain is clear, because treatments can control the symptoms and prevent a suicide. But the long-term gain is less clear. The gifted therapist Marsha Linehan, who was one of my advisors at NIMH, used to say that there is nothing worse that hospitalizing a suicidal patient. “When you commit a patient, you are saying they are hopeless. You are saying, ‘I can’t help you.’ A suicidal person does not need a locked unit. He needs a reason to live.

And though David never mentioned it in his writing, his work owed a clear debt to the landmark research of another NIMH psychologist, John B. Calhoun, who’d studied rat populations since 1946. Calhoun reported that rats in confined groups—even without drugs—became uncharacteristically aggressive. They’d erupt in rape, murder, cannibalism, and infanticide. A dominant male rat emerged in the “behavioral sink”—Calhoun’s term for his aggregated rat cultures—subjugating other males into a tribe of cowering, enfeebled followers and organizing female rats into a “harem” of sex slaves. The strangest group to emerge was “the probers”: “hypersexualized” male rats that stalked and raped both males and females, and often cannibalized their young. The probers would commit “frenzied” and “berserk” attacks against rat families sleeping in their burrows, leaving the remains of half-eaten victims. Again, no drugs were involved here; the probers emerged simply as a result of their confinement. They deferred only to the dominant male rat, fleeing if he caught sight of them.

As many speakers noted, this tool wasn’t particularly well suited for assessing outcomes of a psychiatric drug. How could a study of a neuroleptic possibly be “double-blind”? The psychiatrist would quickly see who was on the drug and who was not, and any patient given Thorazine would know he was on a medication as well. Then there was the problem of diagnosis: How would a researcher know if the patients randomized into a trial really had “schizophrenia”? The diagnostic boundaries of mental disorders were forever changing. Equally problematic, what defined a “good outcome”? Psychiatrists and hospital staff might want to see drug-induced behavioral changes that made the patient “more socially acceptable” but weren’t to the “ultimate benefit of the patient,” said one conference speaker.11 And how could outcomes be measured? In a study of a drug for a known disease, mortality rates or laboratory results could serve as objective measures of whether a treatment worked. For instance, to test whether a drug for tuberculosis was effective, an X-ray of the lung could show whether the bacillus that caused the disease was gone. What would be the measurable endpoint in a trial of a drug for schizophrenia? The problem, said NIMH physician Edward Evarts at the conference, was that “the goals of therapy in schizophrenia, short of getting the patient ‘well,’ have not been clearly defined.

consequently a more rapid return to work?” Dewa wondered.60 In a similar vein, University of Iowa psychiatrist William Coryell and his NIMH-funded colleagues studied the six-year “naturalistic” outcomes of 547 people who suffered a bout of depression, and they found those who were treated for the illness were three times more likely than the untreated group to suffer a “cessation” of their “principal social role” and nearly seven times more likely to become “incapacitated.” Moreover, while many of the treated patients saw their economic

The catastrophic outcome of deinstitutionalization, which displaced hundreds of thousands of mentally ill and disabled patients from state hospitals to the streets, nursing homes, and prisons (largely for petty, nonviolent crimes), had provoked stinging critiques of the government agencies responsible—particularly the Alcohol Drug Abuse Mental Health Administration (ADAMHA), the NIMH, and the Substance Abuse and Mental Health Services Administration (SAMHSA)—for failing to provide the community mental health care services needed to support the deinstitutionalized patients.

Most studies backed by the NIMH and other federal agencies and private organizations like Autism Speaks are committed to an endless search for potential causes and risk factors, while projects devoted to improving the quality of autistic people’s lives are perpetually underfunded.

and all the strange rats we saw looked, to us, surprisingly weak and puny. So we were set apart from even our own kind.

all winter, far into the night, we read books and we practised writing. 20.

Mrs Frisby could not bear to watch; and yet, even more, she could not bear not to watch. She

B. Pert, fallecida en 2013, directora del NIMH (Instituto Nacional de Salud Mental de Estados Unidos) y autora del best seller Molecules of Emotion (Las moléculas de la emoción) sobre

Today, as provost of Harvard University, Steve Hyman is mostly engaged in the many political and administrative tasks that come with leading a large institution. But he is a neuroscientist by training, and in 1996 to 2001, when he was the director of the NIMH, he wrote a paper, one both memorable and provocative in kind, that summed up all that had been learned about psychiatric drugs. Titled “Initiation and Adaptation: A Paradigm for Understanding Psychotropic Drug Action,” it was published in the American Journal of Psychiatry, and it told of how all psychotropic drugs could be understood to act on the brain in a common way.46 Antipsychotics, antidepressants, and other psychotropic drugs, he wrote, “create perturbations in neurotransmitter functions.” In response, the brain goes through a series of compensatory adaptations. If a drug blocks a neurotransmitter (as an antipsychotic does), the presynaptic neurons spring into hyper gear and release more of it, and the postsynaptic neurons increase the density of their receptors for that chemical messenger. Conversely, if a drug increases the synaptic levels of a neurotransmitter (as an antidepressant does), it provokes the opposite response: The presynaptic neurons decrease their firing rates and the postsynaptic neurons decrease the density of their receptors for the neurotransmitter. In each instance, the brain is trying to nullify the drug’s effects. “These adaptations,” Hyman explained, “are rooted in homeostatic mechanisms that exist, presumably, to permit cells to maintain their equilibrium in the face of alterations in the environment or changes in the internal milieu.” However, after a period of time, these compensatory mechanisms break down. The “chronic administration” of the drug then causes “substantial and long-lasting alterations in neural function,” Hyman wrote. As part of this long-term adaptation process, there are changes in intracellular signaling pathways and gene expression. After a few weeks, he concluded, the person’s brain is functioning in a manner that is “qualitatively as well as quantitatively different from the normal state.” His was an elegant paper, and it summed up what had been learned from decades of impressive scientific work. Forty years earlier, when Thorazine and the other first-generation psychiatric drugs were discovered, scientists had little understanding of how neurons communicated with one another. Now they had a remarkably detailed understanding of neurotransmitter systems in the brain and of how drugs acted on them. And what science had revealed was this: Prior to treatment, patients diagnosed with schizophrenia, depression, and other psychiatric disorders do not suffer from any known “chemical imbalance.” However, once a person is put on a psychiatric medication, which, in one manner or another, throws a wrench into the usual mechanics of a neuronal pathway, his or her brain begins to function, as Hyman observed, abnormally.

For the APA and pharma companies, the emergence of NAMI could not have come at a more opportune moment. This was a parents’ group eager to embrace biological psychiatry, and both the APA and pharmaceutical firms pounced. In 1983, the APA “entered into an agreement with NAMI” to write a pamphlet on neuroleptic drugs, and soon the APA was encouraging its branches across the country “to foster collaborations with local chapters of the National Alliance for the Mentally Ill.”61 The APA and NAMI joined together to lobby Congress to increase funding for biomedical research, and the beneficiary of that effort, the NIMH—which saw its research budget soar 84 percent during the 1980s—thanked the parents for it. “The NIMH in a very meaningful sense is NAMI’s institute,” Judd told NAMI president Laurie Flynn in a 1990 letter.62 By that time, NAMI had more than 125,000 members, most of whom were middle-class, and it was busily seeking to “educate the media, public officials, healthcare providers, educators, the business community, and the general public about the true nature of brain disorders,” said one NAMI leader.63 NAMI brought a powerful moral authority to the telling of the broken-brain story, and naturally pharmaceutical companies were eager to fund its educational programs, with eighteen firms giving NAMI $11.72 million from 1996 to 1999.64

While these reports did tell of a new drug that was superior to the old class of antidepressants, this still was not a narrative of a “breakthrough” medication. There was no sense of why this drug worked better, but as FDA approval for fluoxetine neared, a new “fact” began to appear in the scientific reports. In a 1987 article in the British Journal of Psychiatry, Sidney Levine wrote that “studies have shown that [serotonin] deficiency plays an important role in the psychobiology of depressive illness.”25 While this was not what had actually been found—Levine had apparently missed the 1984 NIMH report that “elevations or decrements in the functioning of serotonergic systems per se are not likely to be associated with depression”—this article set the stage for fluoxetine to be touted as a drug that fixed a chemical imbalance. Two years later, University of Louisville psychiatrists surveyed the fluoxetine literature in order to provide “prescribing guidelines for the newest antidepressant,” and they wrote that “depressed patients have lower than normal concentrations of [serotonin metabolites] in their cerebrospinal fluid.” A delusional belief was now spreading through the medical literature, and perhaps not surprisingly, the Kentucky psychiatrists concluded that fluoxetine, which theoretically raised serotonin levels, was “an ideal drug for the treatment of depression.”26

beneath

Dr. Banks and his team could have learned a lot from watching The Secret of NIMH a few times. Maybe it would have convinced them that modifying the genetic code of living organisms wasn’t as much fun as they thought it was.

In April 2013, a few weeks before DSM-V was formally released, NIMH director Thomas Insel announced that his agency could no longer support DSM’s “symptom-based diagnosis.”32 Instead the institute would focus its funding on what are called Research Domain Criteria (RDoC)33 to create a framework for studies that would cut across current diagnostic categories.

The Feminine Boy Project turned into a cash cow for the university, attracting six-figure grants from the NIMH and the Playboy Foundation until 1986. Children wore wrist counters to monitor whenever they were tempted to play with the “wrong” toys, and parents were enlisted to surveil their children’s closets, steer boys away from the kitchen, and keep girls out of the garage.

The case propelled Rekers to teaching positions at the University of Miami, Kansas State University, and other institutions, and he was awarded more than $1 million in grants from the NIMH and the National Science Foundation. He also became a sought-after speaker on the subject of treating sexual deviancy before committees of the U.S. Senate and House of Representatives. In 1983, he co-founded the Family Research Council, an influential Christian lobbying group that helped craft the plank in the 2012 Republican national platform calling for an amendment to the Constitution defining marriage as the union of one man and one woman. Rekers’s ubiquity in courtrooms coast to coast, furnishing expert testimony against gay marriage and gay adoption in pivotal cases, inspired the New York Times’ Frank Rich to call him “the Zelig of homophobia.” In the meantime, his star patient wasn’t faring nearly as well. Kirk hanged himself in 2003 at age thirty-eight, following decades of depression.

This led NIMH to conclude that excess dopamine is one of the reasons people’s brains malfunction.

In her 1968 book, The Epidemiology of Depression, Charlotte Silverman, who directed epidemiology studies for the NIMH, noted that community surveys in the 1930s and 1940s had found that fewer than one in a thousand adults suffered an episode of clinical depression each year. Furthermore, most who were struck did not need to be hospitalized. In 1955, there were only 7,250 “first admissions” for depression in state and county mental hospitals. The total number of depressed patients in the nation’s mental hospitals that year was around 38,200, a disability rate of one in every 4,345 people.

In the short span of forty years, depression had been utterly transformed. Prior to the arrival of the drugs, it had been a fairly rare disorder, and outcomes generally were good. Patients and their families could be reassured that it was unlikely that the emotional problem would turn chronic. It just took time—six to twelve months or so—for the patient to recover. Today, the NIMH informs the public that depressive disorders afflict one in ten Americans every year, that depression is “appearing earlier in life” than it did in the past, and that the long-term outlook for those it strikes is glum.

When, to give just one example, the director of the U.S. National Institute of Mental Health (NIMH) proclaims that illnesses categorized as “mental” or “behavioral” actually are brain disorders, that diagnoses should be aligned with neural systems, and that psychiatry must become a neuroscientific discipline (e.g., Insel 2012, Insel and Quirion 2005), his statements reflect a position that, regardless of its explicit incorporation into people’s self-concept, regulates public health policy and the allocation of resources. Whether individuals like it or not, NIMH considers them cerebral subjects, and that has a significant effect on their lives—and even more so since Thomas Insel, NIMH’s director for over a decade, became in 2015 head of the new life sciences unit of Alphabet, the company better known as Google (Regalado 2015).

In April 2013, a few weeks before DSM-V was formally released, NIMH director Thomas Insel announced that his agency could no longer support DSM’s “symptom-based diagnosis.”32 Instead the institute would focus its funding on what are called Research Domain Criteria (RDoC)33 to create a framework for studies that would cut across current diagnostic categories. For example, one of the NIMH domains is “Arousal/Modulatory

I say, why start from nothing if you can start with everything? We've already got a civilization.' 'No. We haven't. We're just living on the edge of someone else's, like fleas on a dog's back. If the dog drowns, the fleas drown, too.

According to National Institute of Mental Health (NIMH), the following anxiety disorders exist within adults with Asperger’s:     1.   Panic Disorder     2.   Obsessive Compulsive Disorder (OCD)     3.   Social Anxiety Disorder / Social Phobia     4.   Generalized Anxiety Disorder (GAD)

In April 2013, a few weeks before DSM-V was formally released, NIMH director Thomas Insel announced that his agency could no longer support DSM’s “symptom-based diagnosis.

He refers to a National Institute of Mental Health (NIMH) study (Shaw et al. 2007) in his explanation that the brains of those with ADHD develop differently than the brains of others. It appears that with ADHD, the primary motor system matures early, while the higher-level brain center (the part that gives self-control) develops late.

Correspondingly, despite many decades of expensive and exhaustive research, no specific biological markers or mechanisms have ever been reliably linked with diagnostic labels like schizophrenia or depression, a fact recently acknowledged in the United States by the National Institute of Mental Health.26 Indeed, NIMH announced its intention to “reorient” away from existing psychiatric diagnoses because of their invalidity, preferring to focus on classifications based on genetics and neurobiology (despite the acknowledgement that there is still insufficient data to develop such a system).

In fact, the horror show that is our mental health care system today makes Rosenhan’s critiques seem obsolete. “It shows just how quaint the study is—and how misguided it is in a funny way… Psychiatry [was seen] as the arm of the state, when in fact [it is] just as much of a victim of the larger relationships of power,” said psychiatrist and historian Joel Braslow during an interview. “It’s on the other end of the spectrum today,” added Dr. Thomas Insel, former director of the NIMH. “You have people who really do need help who don’t get it because there’s no place for them to go.

The work of the Program focused on the alpha-theta brainwave biofeedback process and was at first funded primarily by the National Institutes of Mental Health (NIMH), constituting very high societal approval and support.

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As explained by Francis Collins, director of the National Institutes of Health (of which NIMH is a part), “The connectome refers to the exquisitely interconnected network of neurons (nerve cells) in your brain. Like the genome, the microbiome, and other exciting ‘ome’ fields, the effort to map the connectome and decipher the electrical signals that zap through it to generate your thoughts, feelings, and behaviors has become possible through development of powerful new tools and technologies.”37 The connectome is now being mapped in detail under the auspices of NIMH.

A group of young researchers, among them Steve Southwick and John Krystal at Yale, Arieh Shalev at Hadassah Medical School in Jerusalem, Frank Putnam at the National Institute of Mental Health (NIMH), and Roger Pitman, later at Harvard, were all finding that traumatized people keep secreting large amounts of stress hormones long after the actual danger has passed, and Rachel Yehuda at Mount Sinai in New York confronted us with her seemingly paradoxical findings that the levels of the stress hormone cortisol are low in PTSD.

Smith may have had ulterior motives when he told Manson to move to Haight-Ashbury. As part of his criminology research, he’d been tapped to lead a study on amphetamines and their role in the violent behavior of Haight-Ashbury hippies. The National Institute of Mental Health funded this study, as they had the San Francisco Project. In 1976, a FOIA request forced NIMH to acknowledge that it had allowed itself to be used by the CIA as a funding front in the sixties.

To Mrs. Frisby he added: “But you should know

Mrs. Frisby said: “But why did they want to catch you? And how did you ever get away again?

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