Getting new friends can help (ask Britney)

So much has been written about Britney Spears, which has dedicated an entire file to her (Coping with Life: General Mental Health Issues (Britney Spears file)).

But now she's proving that, sometimes, the road to mental stability can start with a simple move: getting new friends.

Based on her appearances on television and in the gossip magazines, the former pop star appears to be getting it together.

On Wednesday, an attorney for Britney Spears said he will not seek an extension for a restraining order against Osama "Sam" Lutfi, but that doesn't mean the pop star wants her former sidekick back in her life.

"Britney has made clear to everyone that she does not want to be further harassed or contacted in any way by Osama 'Sam' Lutfi, now or at anytime in the future," Spears' attorney Samuel D. Ingham III said in a statement to The Associated Press.

Lutfi, for the time being, seems willing to go along with those wishes, according to the AP.

He called the AP late Wednesday and released the following statement: "Mr. Lutfi and Mr. Spears have mutually agreed in private that no hearing or order is necessary at this time."

He declined further comment.

Attorneys for Spears and her father, James, are expected to appear in a Los Angeles courtroom Thursday morning to give an update on the conservatorship, according to the AP. A hearing on a temporary restraining order barring Lutfi from having contact with the pop singer was also scheduled for Thursday. The order issued earlier this year required Lutfi to stay 250 yards away from Spears or her homes.

Lutfi represented one of the strangest twists in Spears' downward spiral earlier this year. The singer's mother accused Lutfi — who described himself as a friend and sometime manager — in court papers of keeping Spears a hostage in her own home, drugging her and taking over her finances, according to the AP.

He was a fixture in Spears' life during a period when the star exhibited erratic behavior, including being photographed without underwear, and occasionally looking dazed in public and had to twice be hospitalized.

Spears' father has control over his 26-year-old daughter's personal life and finances.

That power negates the need for a restraining order against Lutfi since James Spears' role as conservator allows him to decide who sees his daughter, according to Ingham's statement.

He serves as a court-appointed counsel representing Spears' interest in the ongoing conservatorship case.

"During the temporary conservatorship, the conservators have the power to insure that Lutfi will not harm Britney anymore," Ingham wrote.

Thursday's hearing had originally been scheduled to decide whether the conservatorship should be made permanent, but Los Angeles Superior Court Commissioner Reva Goetz decided weeks ago that she would instead consider other issues, according to the AP.

It is unclear how long Spears' affairs will remain under her father's control, but Ingham wrote that he does not expect her feelings about Lutfi to change, according to the AP.

"If Mr. Lutfi makes any future attempt to contact Britney after the temporary conservatorship has concluded, Britney has made clear she will take all appropriate legal action," Ingham wrote.

Shooting Star by Bad Company

Johnny was a schoolboy
When he heard his first Beatles song
Love Me Do I think it was
And from there it didn't take him long

Got himself a guitar
Used to play every night
Now he's in a rock and roll outfit
and everything's all right
Don't ya know

Johnny told his mama
Hey, Mama, I'm going away
I'm gonna hit the big time
Gonna be a big star someday

Momma came to the door
With a teardrop in her eye
Johnny said "Don't cry Momma,
Smile and wave goodbye."

Don't you know

(Chorus)
Don't you know
That you are a shooting star...(don't you know, don't you know)
Don't you know that you are
A Shooting Star
And all the world will love you
Just as long..as long as you are?

Johnny made a record
Went straight up to number one
Suddenly everyone loved to hear him sing his song
Watching the world go by
Surprising it goes so fast
Johnny looked around him
And said "Well I made the big time at last."

(chorus)
a shooting star.....

(chorus)

Johnny died one night
Died in his bed
Bottle of whiskey, sleeping tablets
By his head

Johnny's life passed him
by like a warm summer day
If you listen to the wind
You can still hear him play

Don't you know...

Turning "Nothing" into something

I've got a friend named Robin who writes books, and she's funny. But now she's downright serious -- well, to a point, I guess. And I'm pleasantly surprised.

Not that I didn't think she had the ability. I guess it's hard for any author be ticklish when the topic is mental illness -- especially when the subject involves kids. Throw bulimia into the mix, and the book may sound a little too depressing for a 15-year-old who only goes to the library so he can neck with his girlfriend behind the stacks.

The challenge is to elevate the work of art into something mainstream; convert it into something that's quirky, simplistic but intriguing like a Stephen King novel; and then sell it to a public that's thirsting for something that's not so formulaic.

In other words, give them a reason to spend $10 in the middle of the summer when there are no holidays to buy for, and a weak economy that's keeping everybody away from Barnes & Noble.

That may sound a little too challenge -- and maybe even a little impossible -- when the subject is bulimia. But what if I told you that the main character, the afflicted, is a boy?

And that Robin Friedman, the writer, still managed to capture the dark and light elements of eating disorders without having to resort to the learn-a-lesson-each-day, Disney-channel-style of scriptwriting that's not so amusing and as tedious as shucking corn?

Surprised yet? Frankly, I'm amazed.

Robin has already written a series of critically acclaimed children's and young-adult novels that explore the trivial -- though often humorous -- experiences of kids as they grow up. But her next book, Nothing, which will be released next week, is a personal triumph because she was able to conquer a topic that would be tough for anyone to describe -- including the people who live it -- without having to resort to exploitation or derision.

Friedman even admits to being surprised herself when I told her of my experiences that began in college. Men, or boys, are not typically associated with an illness that's more closely associated with women -- and nearly glamorized by female stars who regularly appear on the cover of Us magazine.

"When I tell people I have a book coming out about a boy with bulimia, they are very, very surprised," Friedman said. "Most people, including myself, were not aware that men and boys could suffer from eating disorders."

Nothing shows how Friedman has the ability to easily crossover into another, more serious topic without losing her voice -- particularly her ability to peer into the human soul and discover what's uniquely compelling about each individual.

"It was a challenge for me to present this story from the point of view of my main character, 17-year-old Parker Rabinowitz, because it's told in first person in his voice," Friedman said. "And, like all of the other characters in the book, Parker does not know, nor understand, what's happening to him -- why he's binging, why he's purging, what it means, what it is, what the consequences will ultimately bring."

The characters are the typical ones usual found in Robin's novels -- young adult teenagers with, presumably, nothing much to lose. But they're not the players in another simplistic Disney channel show or Brady Bunch episode that barely scratch the surface of serious issues (hey Jan -- I saw Greg smoking!).

Indeed, these are young adults with adult problems. And they're problems that are not typically associated with age, socio-economic class and, in particular, their gender. Robin has done enough research to show how they confront their troubles with a combination of vulnerability but also maturity.

"It was also important to me to present bulimia in all its complexity," Friedman said. "My research showed eating disorders aren't about food, but about control. I needed to create a sadly familiar world of modern teenage pressures, in which competitiveness, stress, the need for approval from others, and the pursuit of unattainable perfection can wreak total, tragic havoc on a seventeen-year-old's body and soul, in ways that last a lifetime."

The book isn't without Robin's typical lightheartedness, either. Another voice in the novel is Parker's little sister, Danielle, who gets into a little bit of spat with another character about movies they're choosing to watch -- just as Parker's life continues to crash, and impact those who love him.

"Is 'Singing in the Rain' any good?" Rachel asks.
"Yeah, it's good," Danielle says. "It's happy and there's a lot of dancing."
"How about 'The Band Wagon?' "
"Same."
"'Seven Brides for Seven Brothers?' "
"Same"
"'The Music Man?' "
"They're all the same! They're all happy and...unrealistic!"

Then as part of an ongoing series within the book, Danielle writes broken poetry to her brother that he may or may not ever read. It ends thusly: "Dear Parker... Are you ever coming back? Love, Danielle."

It took the right author to present this in such an engrossing, balanced, effective and even inspirational way. Perhaps Robin Friedman, and no one else, was just the right fit.

When I first told Robin about my history, I could see her connecting in a way that displayed a combination of humility, empathy and sympathy -- a rare trait for anybody in a society that's too busy to communicate in ways that are more complex than a one-sentence e-mail.

Robin, in fact, is on a short list of people in my life who, I believe, can connect with people on an emotionally deep level. She has a sincerity -- as well as a raw and honest, but affecting laugh -- that can put the most unrefined person at ease.

So, maybe I shouldn't be so surprised, huh?

This story originally appeared in The Huffington Post on July 29, 2008.

Did Heath Ledger's commitment to his craft come back to haunt him?

The release of "The Dark Knight" - and the critical raves regarding Heath Ledger's portrayal of the Joker - brings to mind a comment made by Jack Nicholson, who originally played the role in the 1989 movie version of "Batman."

The New York Daily News reported that Ledger thought that landing the demanding role was a dream come true, but Nicholson allegedly warned him that the role could take a dangerous toll.

Indeed, Nicholson - and who was furious he wasn't consulted about the role - offered a cryptic comment when told Ledger was dead, the newspaper reported.

"Well," he said, "I warned him."

Nicholson may be flashy, brash and outspoken, but his credibility is rarely called into question. Indeed, the comment may point to the physical and mental expense actors suffer when they assume a role that plays to the dark side of their soul.

For method actors, especially, assuming any role that requires using deep emotional energy can have an even larger impact. The acting style requires the person to wrap themselves in a character's personality - sometimes to the point of strangling themselves.

Marlon Brando, in fact, pointed to that issue when he decided to no longer pursue demanding roles after "Last Tango in Paris." After that, he only took easy roles - his performance in the blockbuster "Superman," for instance - that did little to improve his stature but raked in a lot of cash.

Last year, Ledger told reporters he "slept an average of two hours a night" while playing "a psychopathic, mass-murdering, schizophrenic clown with zero empathy," the Daily News reported.

"I couldn't stop thinking. My body was exhausted, and my mind was still going."

Prescription drugs didn't help, he said in the story. Later, they ended his life.

Taking fanaticism too far

The Mets are my team, my life.

Now, after heartbreaking collapses, playoff losses and this season's roller-coaster ride, I'm still feeling empty, wondering what happened.

In 2006, during each playoff game, I was glued to the TV, punching the air when they did well and slapping my hip when they failed. After the decisive play - a three-run home run by the St. Louis Cardinals - I moped, and even cried. It's possible I cared more than some of the players.

Surely, I know why my team lost. They lacked pitching, depth and, perhaps, nerve. But what was happening to me?

Sports fanaticism isn't necessary a mental illness. But it can fuel behavior that can paralyze the mind, mental professionals say. A simple baseball game can transform even the average fan into an incorrigible human being.

Psychologists debate whether the deep affection sports fans have for their teams has an adverse impact on behavior and lifestyle. To some, the question is this: If you're not participating, then why should you care?

"I have seen abusive fans who [act abusively] in front of their own children, and that seems reprehensible to me," says Arnold LeUnes, a sports psychologist at Texas A&M. "Abusing kids or young adults [at a sporting event] in front of children cannot send the correct message."

Picking a team usually speaks to one's identity, professionals say. LeUnes says people are drawn to sports largely as a way to build their self-esteem.

In some ways, people want to be associated with winners - like the Yankees. Teams like these appeal to those who appreciate a sense of order, LeUnes says.

To others, however, favoring a particular team could be rooted in family history. Robert Udewitz, a psychologist at Behavior Therapy of New York, says people don't normally torture themselves in choosing a favorite team. But once they do choose, they're hooked, and their passion is often handed down to the next generation.

"I think our identity becomes wrapped up at an early age," Udewitz says. "It says a lot about our families. We adopt a lot of things."

I worried about how my behavior would affect my 8-year-old son. He's a big Mets fan, too, and he shared my pain over the loss. In fact, he probably felt it more. He's very competitive - perhaps overly so. Is that my fault?

It scares me, because I see how others transform that competitiveness into violence. It's not just soccer fans who cause riots - in recent years, fans have attacked players and coaches as they've stood on the field. Little League coaches have come under attack from parents - verbally and physically.

In 90 percent of the cases, LeUnes says, the goodness of rooting for a particular team outweighs the bad aspects.

"But fan behavior at youth sport events is a whole different deal, and we are all familiar with the out-of-control parent," he says.

Fans who take sports too seriously likely have other mental disorders that go way beyond simple fanaticism.

"It depends on how much they're functioning," Udewitz says. "If it affects their relationships, and their focus becomes so narrow, then it's probably problematic. Then maybe they need to develop coping strategies."

Udewitz, at least, understands my passion. He's 40, and he's a life-long Mets fan. Unlike Yankees fans, he says, Mets fans aren't necessarily looking for the win. They're looking for the surprise. Fans like underdogs. If a team like the Mets wins the World Series every 20 years, then they're meeting the expectations.

"For me, 1986 [the last time the Mets won the World Series] will last a long time," he says.

Udewitz says he treated the 2006 playoff loss better than he did in 2000, when the Mets lost the World Series to the Yankees.

"I had a nephew [this year] who was 11 years old, and he was extremely upset," he says. "That kind of put me in a different role, and I had to put it in perspective.

"It put me in a better frame of mind."

The Coping column was originally published in The Record of Bergen County, N.J. on Nov. 21, 2006.

Suffering from cancer, but still a force

Sen. Edward Kennedy has drawn much criticism in his long life, but few debate his skills as a senator - particularly his ability to bring opposing sides together to pass critical legislation.

And no one, it appears, argues with commitment toward making a difference in legislation - even as he suffers from brain cancer - that would help people with mental illness.

Debra L. Wentz, head of the New Jersey Association of Mental Health Agencies, Inc. noted that Kennedy has continued his lifelong commitment to protecting the health and well-being of seniors and disabled citizens by rallying to block Medicare fee cuts and to push for a mental health parity bill.

Congress recently passed the latter bill, which awaits President Bush’s signature by the end of this month.

Wentz said these efforts are a fitting testament to the impact Kennedy has had on health and mental health care throughout his life.

"We will be hard pressed to find another advocate who is equally skilled at garnering bipartisan support for vulnerable populations, as well as the elderly,” she said.

Drugs can only help - not hurt, doctors say

An Oregon doctor has taken issue with comments from a spokesperson for the MAD Pride movement who argued that new anti-psychotic drugs can be dangerous.

Chuck Areford, a long-time health worker in the Oregon area, made his comments in a July 10, 2008 blog post on Coping with Life.

Richard Staggenborg, a board certified psychiatrist working for the Department of Veterans Affairs in Oregon, said Areford makes some highly debatable, "if not flatly false," assertions about the risks vs. benefits of antipsychotic medications.

Staggenborg said he only perfunctorily acknowledges the risks of discontinuing these medications without medical supervision before going on to argue essentially that they should never be prescribed.

"His entire thesis undermines the credibility of the doctors under whose supervision he states patients should adjust their medication," he said. "The effect is to encourage them instead to make decisions to stop their medications on their own or on the advice of well-meaning but misinformed nonmedical experts such as himself."

He challenged Areford's assertion that “the life expectancy of those treated in mental health centers has plunged to an appalling 25 years less than average (since the introduction of atypical antipsychotics).”

Rispiridone, he said, the oldest antipsychotic in widespread use, was not introduced until 1993. "Clearly, this remarkable claim is based on extrapolation from highly questionable assumptions," he said.

Staggenborg said it is "indisputably true" that some of these medications have substantial risks of metabolic side effects, such as high cholesterol and increased risk of diabetes. But others have not been clearly linked to these problems, he said, despite the mandatory Food and Drug Administration class warnings.

"These risks have to be balanced against the devastating consequences of schizophrenia and bipolar disorder, the illnesses for which they are most clearly indicated," he said. "One of these risks is a substantially increased chance of suicide in untreated mania, bipolar depression or schizophrenia. Treatment of these conditions has been shown to reduce suicidality and therefore would be expected to increase life expectancy."

It's better to be "mad" than be medicated, some say

Now that "MAD Pride" seems to be gaining momentum, some leaders of the movement are trying to steer people away from anti-psychotic drugs.

Chuck Areford, described by the organization "Mind Freedom International"- an organization that opposes the heavy prescription of medication to treat mental illness - as someone who has worked in the public health system for years, says a new class of drugs, such as Clozaril, Zyprexa and Risperdal, have largely replaced older medications such as Thorazine, Haldol and Prolixin.

But research and advertising sponsored by the pharmaceutical industry, he says, have led to the widespread belief that the newer medications were indisputably safer, more effective and well worth additional billions of dollars in taxpayer money.

"Since then, the life expectancy of those treated in community mental health centers has plunged to an appalling 25 years less than average," he said. "Life expectancy may have fallen by as much as 15 years since 1986. Indications are that the death rate continues to accelerate in what must be ranked as one of the worst public health disasters in U.S. history."

He said people who need mental health services already suffer from high rates of cigarette smoking, lack of exercise, substance abuse, poor nutrition, homelessness and poor access to health care. Adding medications "pours gasoline on a fire," he said, and the "lethal" combination is almost certainly driving the spiraling death rate.

"Advances in brain imaging techniques show that antipsychotic medications cause brain damage," he says. "Animal and human studies link the drugs to shrinkage of the cerebral cortex, home to the higher functions."

The patriotic thing to do after Independence Day

(In recognition of Independence Day, I'm reprinting a blog entry I wrote last year about postpartum depression legislation.)

Congress is just about ready to take a giant leap in the world of postpartum depression treatment.

Sen. Robert Menendez and Congressman Bobby L. Rush are finalizing postpartum-depression treatment and education legislation for its anticipated victory in the U.S. Congress.

The new name of the legislation will be "The Melanie Blocker Stokes Mom’s Opportunity to Access Help, Education, Research and Support for Postpartum Depression Act."

The lawmakers want to honor the substantial contributions each has made to this issue and continue to remember the woman - Melanie Blocker Stokes - who has become a symbol of the illness.

Blocker-Stokes was a Chicago native and pharmaceutical sales manager who, after the birth of her daughter, developed a psychosis that ultimately caused her to jump from a 12-story window ledge to her death on June 11, 2001.

The bill, if enacted, would require the secretary of Health and Human Services to expand and intensify research activities regarding postpartum depression and psychosis. The bill would also require additional support for basic and clinical research, epidemiological studies, diagnostic techniques and educational programs.

Tare still some Republicans who need some convincing.

"I assured our legislators that we will be ready to do whatever it takes - writing, blogging, calling, adding our voices, spirit and energy to help achieve this historic victory for America's mothers and children," said Susan Dowd Stone, president of Postpartum Support International.

"Julia," by the Beatles (A song that John Lennon dedicated to his mother)

Half of what I say is meaningless
But I say it just to reach you,
Julia Julia, Julia,
oceanchild, calls me
So I sing a song of love, Julia
Julia, seashell eyes,
windy smile, calls me
So I sing a song of love, Julia
Her hair of floating sky is shimmering, glimmering,
In the sun Julia, Julia,
morning moon, touch me
So I sing a song of love, Julia
When I cannot sing my heart
I can only speak my mind,
Julia Julia, sleeping sand,
silent cloud, touch me
So I sing a song of love, Julia
Hum hum hum...calls me
So I sing a song of love for Julia, Julia, Julia