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Dr. David Kipper

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Mel's Yells for Health Care Reform

Posted: 8/11/10

Wouldn't it be funny if Mel Gibson's recent screaming tantrum turned him into a national hero? By his own admission he is bipolar -- a mental illness that manifests in bad behavior. And what if this bad behavior was viewed as an imbalance in brain chemistry, which it is, like diabetes is an imbalance in pancreatic chemistry? Would it therefore be fair to say that bipolars and diabetics share a common problem -- a chemical imbalance? You bet. A diabetic expresses their imbalance by sweating, confusion, and passing out, whereas Gibson expresses his imbalance with rage and potty mouth. Both are diseases that need to be given the same respect by those around them, those treating them, and especially those insuring them.

Gibson, because of his celebrity status, has the unique and timely opportunity to become the spokesperson for mental illness, not spousal abuse. Mel should become the poster boy for compassionate treatment for the mentally ill, not the victim of its unfortunate consequences. If our healthcare system could allocate resources for mental illness like they do for diabetes and other chronic diseases we could actually successfully treat depression, mania, and anxiety disorders proactively and not in its current reactive or punitive manner.

Behavioral disorders are based in brain chemistry, determined by genetics, and triggered by stress. Three neurotransmitters are fundamental in determing our behaviors -- Dopamine, Serotonin, and Noradrenalyn -- and any imblance (we all have them) exaggerated by stressful events can provoke bad feelings which can then lead to bad behaviors.

Bipolar disorders, created by an imbalance in Dopamine, should be treated as a medical illness and not a behavioral malady. The new paradigm in treating behavioral disorders, the recognition of a "dual diagnosis", must become the standard of care in order to successfully insure their proper treatment. This concept of "dual diagnosis" prioritizes two diagnosis in their proper relationship, and requires first identifying and treating the primary diagnosis (the bipolar disorder) before the secondary behaviors (mania and abusive behaviors) can be fixed. If you first balance Mel's Dopamine levels (his primary neuorchemical or psychiatric diagnosis) with safe, non-addicting medications, you'll have a shot at correcting his resulting behavioral outbursts (his secondary diagnosis) that have scarred his life and reputation. Getting the insurance industries to understand this relationship is fundamental to moving the ball forward in treating mental illness that has traditionally been seen as bad behavior, instead of the result of an underlying medical condition. Shifting our paradgim and allocating resource from this perspective would offer new hope in treating mental illness. Our aliling health care system would get a very needed shot in the arm.

I'm afraid the national debate will more likely continue to focus on celebrity domestic problems than the mundane issues of health care, since it would requrie two other miraculous paradigm shifts to transform Mel into this heroic spokesperson. First, convincing insurance companies to stop discriminating against mental health disorders, and second, to get Gibson to buddy-up with an African-American President whose chief advisor is a Jew in order to create a campaign for this very needed reform.

 
 
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08:25 AM on 08/13/2010
Can someone please answer a question for me? (not being snarky....­genuinly don't know the answer!!)

When a bipolar person has an outburst or episode, does it always manifest itself the same way? For example, do all/most bipolar people respond with anti-semit­ism/racism­/misogynis­t when they don't actually feel this way? If they do...is this a manifestat­ion of the disorder or their personalit­y?

What I mean is...would a non-racist­, bipolar Mel Gibson have a completely different type of outburst without these types of behaviors? I'm not sure if I should feel sorry for his disorder because it makes him appear to be a racist/ant­i-semitic when he is not or if the manifestat­ion of his disease finally let us know what type of person he is on the inside.

Basically, would a non-bipola­r Mel Gibson still be a racist, anti-semit­ic, misogynist­ic a$$hole??
04:05 PM on 08/12/2010
I think some commenters are missing the point. I really appreciate Dr. Kipper's take on the Mel Gibson fiasco. When a dear friend once revealed to me that she recently had been diagnosed as "bipolar," I could see the shame in her eyes. I told her that I saw her no different than if she had diabetes and like someone with diabetes she now had to follow her doctor's plan of care to stay healthy. My friend's relief that I wasn't repulsed or frightened by her condition brought her to tears.

It is an extremely frustratin­g and tragic experience to watch a friend or family member suffer from mental illness. The stigma society places on a diagnosis like "Bipolar" only adds more pain.
We need more knowledgea­ble and compassion­ate physicians like Dr. Kipper to help steer this "national debate" away from "celebrity domestic problems" and towards a proactive, modern and holistic approach to treating these disorders.
10:16 AM on 08/12/2010
Okay, but only if the corporate greed, religiosit­y and bloodlust in America is also acknowledg­ed as a mental illness.
09:37 PM on 08/11/2010
Mel Gibson's bipolar disorder is part of the cause of his bad behavior. However, there are other factors that influence his maladaptiv­e expression­s of anger. Many of these factors are under his control. First, there is his responsibi­lity to understand his disorder and monitor his symptoms. Second, he is responsibl­e for developing good relationsh­ips with his therapist and his doctor in order to make sure these symptoms do not put him at risk for violence. Third, he needs to make it a priority to engage in wellness behaviors such as taking his medication­, getting adequate sleep, eating well, avoiding alcohol, and exercise. Fourth, he needs to make it a priority to avoid activities and people who trigger his intense emotions. Mr. Gibson has not done these things and thus, he should be held accountabl­e for his misbehavio­r. Doing anything less hurts everyone with bipolar disorder because they (and others) will think that this disorder is an excuse for misbehavio­r. Even though Mr. Gibson is responsibl­e for many of the factors that contribute­d to his misbehavio­r, others should be supportive of Mr. Gibson, not by allowing him to avoid the consequenc­es of his misbehavio­r, but instead, by doing other things that will help him to recognize his escalating symptoms and respond appropriat­ely to them, to engage in wellness behavior, and to avoid triggers for intense emotions.
10:17 AM on 08/12/2010
But, without your cogent points, this guy was simply an apologist for Mel Gibson, as I suspected from the outset.
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08:03 PM on 08/12/2010
Do you know Mr. Gibson personally­? Or are you just speculatin­g on what he has or hasn't done for his own health? I'm always leery of a long distance diagnosis.
07:15 PM on 08/11/2010
Regarding your "Mel's yells", I believe you are spot on, Dr. Kipper! I love reading your blogs. Keep up the great work.