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Dr. David Kipper Headshot

Mel's Yells for Health Care Reform

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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.