Posts Tagged ‘treatment’

After Addiction Comes Families’ Second Blow: The Crushing Cost of Rehab

March 8, 2018

Out-of-pocket expenses to save loved ones are soaring beyond what many can afford, especially when addicts go through multiple rounds of treatment

Michelle Vandecar and Jake, one of three sons battling addiction. BENJAMIN ZACK FOR THE WALL STREET JOURNAL

Michelle and Darin Vandecar have spent nearly all their time and energy in recent years trying to help their drug-addicted sons stay clean. They’ve spent nearly all their money, too.

The Salt Lake City-area couple amassed $120,000 of credit-card debt, took out a home-equity loan and cleaned out part of their 401(k) to pay for multiple rounds of addiction treatment for their three sons, aged 18, 20 and 23. Their insurance covered some of the costs, but because their out-of-pocket expenses were so steep, they sold motorcycles and other belongings to raise cash.

Lasting results have eluded them. The Vandecars’ oldest son just entered his third round of rehab for heroin after more than a year of homelessness. Their middle and youngest sons are smoking pot and attempting to stay off other drugs that have caused multiple overdoses.

“We have incurred so much debt, but I know that if we didn’t do everything we could then I would always wonder if we didn’t do enough to help them,” Ms. Vandecar says.

Michelle and Darin Vandecar, shown with photos of their children, are struggling with the financial burden of treating their three sons’ drug addiction.
Michelle and Darin Vandecar, shown with photos of their children, are struggling with the financial burden of treating their three sons’ drug addiction. PHOTO: BENJAMIN ZACK FOR THE WALL STREET JOURNAL

The addiction crisis that is killing tens of thousands of Americans every year is also creating a financial crisis for many families, compounding the anguish caused by a loved one’s destructive illness. Families are burning through savings and amassing huge debt paying for rehab that often doesn’t work.

Round Trip

Nearly two-thirds of U.S. admissions to substance-abuse treatment involve someone who’s already had one or more rounds of treatment.

The predicament reflects both the difficulty of treating addiction and the haphazard rehab and insurance system many patients face.

The rehab field is highly fragmented, with thousands of small providers offering treatment that often isn’t grounded in science. Some lack medical professionals or licensed counselors, reflecting the field’s roots in 12-step sobriety principles rather than medicine. Yet rehab services often cost big money, which insurers don’t always cover.

Parents and family members desperate to keep their loved ones from overdosing find themselves shelling out again and again through rounds of recovery and relapse.

Federal data show that 22.5% of admissions for substance-abuse treatment involve someone who has already had one previous round of treatment. Another 21% involve people who have had two or three previous rounds, and 20.2% are for those who have had four or more, according to the Substance Abuse and Mental Health Services Administration.

Growth Industry

Per-capita spending on substance-abuse admissions to inpatient facilities has grown far faster than overall healthcare costs, among Americans who get insurance through work.

The insurance claims of Americans with employer-provided coverage show the rising burden. From 2012 through 2016, spending for substance-use admissions to inpatient facilities rose 54% per person in this group, which includes about half the U.S. population, according to an analysis of insurance claims by the nonprofit Health Care Cost Institute. Total health-care spending per person in this population grew 15%.

Consumers’ out-of-pocket spending for these substance-use admissions soared 80% per person, versus 12% growth for their health-care services over all.

For some families, bankruptcy is the outcome. Theo Haskins, a 57-year-old accountant in the Salt Lake City area, says her son’s yearslong fight with addiction contributed to her bankruptcy filing in 2013. She says she spent tens of thousands of dollars on nearly a dozen rounds of rehab, even after insurers kicked in more than $300,000.

Last year, her son Mitchell died of an overdose.

“I spent literally every penny I had,” Ms. Haskins says. “After all this, I failed.”

Theo Haskins, with photos of her son Mitchell as an adult and as a child. He died last year of an overdose after nearly a dozen rounds of rehab. PHOTOS: BENJAMIN ZACK FOR THE WALL STREET JOURNAL(2)

Addiction experts say the system is too ineffective to cope with the growing health crisis. One common approach involves sending addicts to 30- or 60-day residential programs, or to short-term detox, and then releasing them with little follow-up care, which specialists say isn’t enough time and support to have a lasting impact.

“We have an institutionalized addiction treatment system that really can’t provide the kind of care that we now know is appropriate,” says Thomas McLellan, former deputy director of the White House Office of National Drug Control Policy, who is part of a public-private task force attempting to impose some standards on the field.

A better system would treat addiction like a chronic disease, he said, with regular primary-care visits, drug-testing, counseling and medication.

The medical expenses don’t relate just to rehab treatment—many parents are shelling out for ER visits when a child overdoses, sober-living homes where they can live long-term with others in recovery and plane tickets to fly loved ones to treatment centers in other states. In a panic, parents sometimes send their children to the first rehab with a vacancy, even if it’s outside their insurer’s network, adding to the cost.

“You are in an extreme hurry because your kid is on heroin. I had to find a place, not knowing anything, within 48 hours, or he was going to go and start using,” says Susan Carlton Oquendo, a Utah mother who took about $50,000 from her retirement savings to fly her son to a Florida rehab facility she found online after a frantic Google search.

When they are sober, people suffering from addiction often express guilt over the toll on their loved ones.

Betsy LeGallais of Pensacola, Fla., estimates she and her mother have spent $120,000 over the years on addiction treatment for her 25-year-old daughter, Anna Lewis, who started using heroin in her late teens and then turned to alcohol.

A few months ago, copayments for Ms. Lewis’s latest round of detox took what little savings Ms. LeGallais had begun to build back up again. She sat down at her laptop to write her daughter a letter.

“I would give the last breath that I breathe to make you happy and healthy but I know that that has to come from you,” she wrote. “We are tired and funds have been exhausted.”

Betsy LeGallais, of Pensacola, Fla., estimates she and her mother have spent $120,000 on addiction treatment for her daughter Anna Lewis. PHOTOS: BOB MILLER FOR THE WALL STREET JOURNAL(2)

On a recent afternoon near Birmingham, Ala., where she is in a sober-living home, Ms. Lewis teared up, saying the letter felt like “a blow to the knees.” She said she is painfully aware of the money her mother and grandmother have spent, and has felt obligated to pay back what she could when she has been able to work. “I think that I always will,” she said.

The Vandecars’ medical crisis began in 2012, when their middle son, Colton, was hospitalized after attempting suicide. Repeated ambulance rides and high copays for inpatient stays to treat his suicidal tendencies and drug use began to add up.

Their financial stress worsened in 2013, when Colton and his younger brother Jake entered residential addiction treatment around the same time. Jake had just overdosed on a powerful cough medication containing dextromethorphan, which can generate euphoria and hallucinations. His mother found him collapsed on the sofa taking rapid, shallow breaths, and called an ambulance. Colton had previously overdosed on the same drug and was also abusing it with his brother that day.

“You just feel like a failure,” Ms. Vandecar says, her voice breaking as she recalls that day. “You never think it’s going to be your kids.” She took out her frustrations by writing a faux Christmas letter she never sent, summarizing her sons’ year of drug and alcohol use and the “enormous pile of tissues from all the tears that I have cried.”

A local hospital recommended a treatment facility called Youth Care, which is part of Acadia Healthcare Co. , a Tennessee-based mental-health-care provider in 39 states. It required an upfront payment of $12,000, which equaled the family’s annual out-of-pocket spending limit on their insurance. “The treatment centers would check with insurers and say, ‘what is the maximum out-of-pocket?’ And then they wanted that upfront,” Mr. Vandecar says.

They used what was left in their health-savings account, and then a combination of savings and credit cards to make the payment—and did the same again a few months later, in January 2014, when their sons were still in treatment. The insurance calendar-year had reset, with a new $12,000 limit to meet.

Ms. Vandecar said the treatment facility seemed well-run, and she was “very hopeful it would work.” It didn’t, she thinks, because “my boys really did not want to get clean.”

The Vandecars enrolled their sons in a variety of treatment programs, including Youth Care, near Salt Lake City.
The Vandecars enrolled their sons in a variety of treatment programs, including Youth Care, near Salt Lake City.PHOTO: BENJAMIN ZACK FOR THE WALL STREET JOURNAL

Trina Packard, chief executive of Youth Care, said relapse is part of the treatment process, particularly among adolescents not ready to give up substances. “We see a very high rate of families who do need treatment more than once for addiction,” she said, adding that a family’s upfront costs depend on their insurance plan.

After the brothers left residential treatment, Jake attended a Youth Care day program that included therapy and school, but was kicked out for coming to class high after snorting prescription drugs and abusing marijuana and cough medicine, his mother says.

Colton also started using again, and would soon branch out to cocaine, methamphetamine, heroin and acid. The Vandecars put another $10,000 on their credit cards to pay for weekly counseling sessions at home for the family, which their insurer, UnitedHealthcare, wouldn’t cover, they say.

Mr. Vandecar was earning more than $150,000 a year at the time as an executive at an information-technology company, but the couple also had two daughters to feed, along with mortgage and car payments. They started tapping their 401(k) to pay down some of the card balances, Mr. Vandecar says.

Over the years they drained about $300,000 total from retirement to pay credit-card bills and other expenses, including legal fees related to their sons’ troubles with the law, he says.

Undermining their retirement savings didn’t feel good, the 53-year-old says, but they decided “we’ve got to put the life of our boys first.”

A photo shows the Vandecar family as the parents eat dinner in their Salt Lake City-area home with their youngest daughter.
A photo shows the Vandecar family as the parents eat dinner in their Salt Lake City-area home with their youngest daughter. PHOTO: BENJAMIN ZACK FOR THE WALL STREET JOURNAL

In late 2014, a drug court ordered Jake back to rehab, after he failed a drug test and overdosed on alcohol. He entered a state-run facility about an hour from Salt Lake City, where he stayed till the summer of 2015. Halfway through the facility sent the Vandecars a bill for $15,000. After opening it, “I just sat in the car and cried,” Ms. Vandecar, 45, says. “We’d just already paid so much.”

They eventually got that bill reduced through court proceedings, but they were struggling.

“For a long time food bills went on the credit card because we didn’t have the money to pay for it,” Ms. Vandecar says.

At one point, when they needed to pay a medical bill, they decided, “What can we sell?” Mr. Vandecar remembers. They settled on his KTM motorcycles, a pair of Austrian bikes that sold for $8,000 on a local website.

In 2015 they moved to a less-expensive home—and then took out a home-equity loan on the new house to pay down more of their credit-card debt.

Michelle Vandecar, right, with Jake and one of her daughters, says she has run up tens of thousands of dollars in credit-card debt on rehab for her sons.
Michelle Vandecar, right, with Jake and one of her daughters, says she has run up tens of thousands of dollars in credit-card debt on rehab for her sons. PHOTO: BENJAMIN ZACK FOR THE WALL STREET JOURNAL

Around the same time, drug problems were becoming worse for their oldest son, Zak.

He had begun using marijuana in middle school and progressed to prescription medication, acid and then oxycodone when he got a prescription for the painkiller after breaking his big toe. Eventually one of Zak’s brothers told his parents he was using heroin.

In early 2016, the then-21-year-old went to a small rehab run by privately held Turning Point Centers, which was one of the few places insurance would cover in the Salt Lake City area under a new job Mr. Vandecar had started. The couple used a credit card to pay $2,500 upfront—their annual out-of-pocket maximum per family member at the time. Zak stayed for about a month and then moved home, but within a few weeks his mother found needles in the garbage can. He had relapsed.

Zak returned to Turning Point. The insurance stopped paying after about 12 days. His parents moved him to a sober-living home that cost them $600 a month. He soon relapsed again.

Addiction experts are in wide agreement on the most effective way to help opioid addicts: Medication-assisted treatment. But most inpatient rehab facilities in the U.S. don’t offer this option. WSJ’s Jason Bellini reports on why the medication option is controversial, and in many places, hard to come by. Image: Ryno Eksteen and Thomas Williams

Turning Point offers residential and outpatient treatment and recommends that patients commit to 90 days of care, but families and insurers don’t always follow that advice, said Chris Mackintosh, chief executive of Turning Point. He said relapses are common in most chronic diseases.

When the Vandecars needed a rehab facility again, they chose a different institution. This time it was for Colton, who had been abusing a variety of drugs, including heroin, since his last round of residential addiction treatment in 2014. In mid-2016 Jake found him on the floor choking on his own vomit after an overdose, his mother says.

His parents sent him to Recovery Ways, a facility partially owned by private-equity firm Chicago Pacific Founders. Colton went through three separate monthlong stays there. After each visit he would go to a sober-living house, relapse, and repeat the now-familiar cycle, accumulating thousands of dollars in more copays and fees.

After he got out of rehab at the end of August, Colton says he tried to overdose on drugs in an attempt to end his life. When he didn’t succeed, he says he decided to strive for sobriety. He drew inspiration from a fellow patient at Recovery Ways who had spoken glowingly about a previous period of abstinence. Since then Colton says he has been smoking pot but staying off other drugs. “It’s the only part of the last few years that has been worth living, that I can remember,” he says.

His friend from rehab recently died of an overdose, he says.

Michelle Vandecar in the parking lot at Recovery Ways treatment center, where she went for her weekly visit with son Zak.
Michelle Vandecar in the parking lot at Recovery Ways treatment center, where she went for her weekly visit with son Zak. PHOTO: BENJAMIN ZACK FOR THE WALL STREET JOURNAL

Andrew Sidoli, executive clinical director of Recovery Ways, says the facility delivers the “highest quality” care, with a staff including an addiction psychiatrist and masters-level therapists.

Jake, whose use of meth last year landed him in the ER, is living at home. His mother says he acknowledges smoking pot but is trying to stay off other substances. He declined to comment.

In late 2016 the Vandecars kicked Zak out of the house for using drugs and stealing their belongings, which they said he was pawning for cash.

Zak spent about a year living in his car. After getting caught shoplifting for food, he recently began another round of treatment, this time at Recovery Ways—where Colton had relapsed and returned several times. He wasn’t reachable for comment there. “We always want to keep trying,” says Ms. Vandecar. “I think it’s just desperation, hoping this time it will work.”

Write to Jeanne Whalen at

Midge Ure: The moment I realised I was an alcoholic

December 8, 2017

It’s Christmastime, so the airwaves are alive with the chimes of the evergreen Do They Know It’s Christmas?
By Julia Llewellyn Smith

It’s Christmastime, so the airwaves are alive with the chimes of the evergreen Do They Know It’s Christmas?, with every penny of royalties still going to the Band Aid Trust.

You might expect the man who made it all happen to be reflecting proudly on the tens of millions pounds he’s raised to relieve famine and poverty in Africa since that first 1984 recording. But instead, Midge Ure – the-then Ultravox frontman who produced and co-wrote the single then organised much of the follow-up Live Aid concert, a tireless elf to Sir Bob Geldof’s Santa – is, to say the least, ambivalent about his ongoing role as ‘saviour’ of a continent.

“It’s an oddity,” says Ure, in his strong Glaswegian tones. “It’s not something I ever dreamed about growing up in a Glasgow tenement, and I’m still very surprised I got involved. But once I had, I couldn’t get away from it. I had to see it through.” He chuckles. “I’m still seeing it through.”

Ure, it’s clear, only ever wanted to make music and was dragged into the cause by total fluke. “It was my Sliding Doors moment, when life could have taken one of two paths: I was standing next to Paula [Yates, Geldof’s late, ex-wife] when Bob called saying they had to do something about the Ethiopian famine in Ethiopia, and she put him on to me. I was too embarrassed to say ‘No’.

“It could have so easily been someone else, but luckily it was me, because I had skills Bob lacked and he has skills I lack. I have musicality, Bob writes songs, but he’d be the first to say he’s not a great musician.” Indeed, in Ure’s autobiography, he recalls uncharacteristically snapping at Geldof for commanding the 40 confused megastars who recorded Band Aid to imitate his out-of-tune rendition.

“Yes, he was terrible, and I had to say so. But there was no way I could stand up and shout like Bob about ‘Give us your f—— money.’ So it was a match made in heaven.

“Berating world leaders is not who I am at all,” Ure continues, grinning. “Bob is a big mouth, again he’d be the first person to say it, but he’s a loudmouth of the right kind, he’s still the same guy he was in his punk band in 1977, older and greyer, but very smart and articulate and still with that attitude, and whether you agree with what he says or not, he does it for the right reasons.”

In my imagination, Ure’s still striding around “mystic and soulful” in monochrome dry-iced streets, black-tied and ’tached, warbling “Oh… Vienna”, often voted the greatest song never to reach number one (it stuck at number two for four weeks below the recently murdered John Lennon, then, more gallingly, Joe Dolce’s “Shaddap You Face”).

In person, however, sitting in Soho member’s club, Ure’s a bald 64-year-old in  a denim shirt. He’s far more vocal describing the empty nest syndrome he’s suffering now three of his four daughters, aged between 30 and 18, have left the Bath family home (“My wife’s taking it much better, she’s much tougher than me”), than boasting about his undoubted musical behemoth status – besides Ultravox and Band Aid, he co-wrote the Visage 1980’s classic Fade to Grey and the Top of The Pops theme Yellow Pearl.

Yet at the peak of his fame, he was diverted by the Band Aid juggernaut, obliged to visit Ethiopia when Geldof couldn’t make it, despite his squeamishness (“If I didn’t go the cameras didn’t go, if the cameras didn’t go more people died”), then sitting on endless committees, discussing how to direct the money.

By the time he returned to Ultravox two years later, their new-wave tunes had been eclipsed by dance music. His marriage to model Annabel Giles collapsed, then his fortune – which he’d splashed on a villa in Montserrat that was destroyed by the volcano, a mansion overlooking the Thames and a collection of classic cars – ran out.

With a £170,000 tax bill to pay and Breathe, the solo album he considered his masterpiece, a critical and commercial flop, Ure turned to booze.

“My ego had had a bruising, there were dark moments at night when I’d sit thinking ‘Oh God, why did I get it so wrong?’, it was a great excuse to get maudlin and cry into my drink, but then alcoholics always find an excuse. ‘I drank because it was raining, I drank because it was the weekend…’ With me, it was just the way my journey had exploded,” he says.

His second wife, actress Sheridan Forbes begged him to stop boozing, but he continued swallowing a bottle of Jack Daniels a day, doing the school-run drunk. “I thought I was so much smarter than everyone else, that what I was doing was nobody else’s business and wasn’t harming anyone. But it was everyone else’s business and the ripples created were huge and went on a long time.”

The turning point came 12 years ago on a Cornish holiday, when Ure returned to the car, pretending to have forgotten something, to find his vodka bottle. “I turned and saw my 11-year-old daughter watching me. Until then, all the rehab in the world couldn’t help, but the look of disappointment in her eyes was devastating. That sorted me out.”

He’s been sober for 12 years, but still fears succumbing to booze, saying if he’d suffered Geldof’s travails – both Yates and his 25-year-old daughter, Peaches had drug-related deaths – he’s not sure he would found the resilience to cope with them.

“If what happened to Bob happened to a different person, like the drinker I used to be, it could be fatal. I can’t even begin to imagine what he’s been through, and it has made me hug my daughters closer than ever as you don’t know what is around the corner.”

Reconciled to the fact he would never recapture his mega-star Eighties status – funded their recording by joining the now-booming nostalgia circuit. There’s also been a non-stop stream of greatest hits albums, the latest being Orchestrated, a really rather beautiful, orchestral rearrangement of Ure’s top tracks (If I Was, Dancing With Tears In My Eyes and, natch, Vienna), which – devoid of plinky electronic accompaniment– reveal Ure to be not so much a New Romantic but a bona-fide, old-school crooner.

Today, he sees far more of his 1980s peers than he ever did back in the glory days. “I saw Nik Kershaw last week and [ABC’s] Martin Fry and Steve [Norman] from Spandau Ballet. Then we were so self-important, if you passed someone in the TOTP corridors, you were too busy sucking in your cheeks and trying to be a hottie to say ‘hello’. Now, of course, all of that stuff’s gone.”

He’s impressively gracious about the way he was sidelined from the Band Aid narrative, though at the time he was deeply hurt (Ultravox were pushed down Live Aid’s bill so Geldof’s Boomtown Rats could perform to Prince Charles and Princess Diana): “I was there. That is good enough for me.”

He’s far less certain there’ll ever be another Band Aid single or live event. “I’m not sure music’s the central point of young people’s lives any more, because they get it free they don’t value it. If you put out a concert like that today, I doubt it would resonate.

“I’ve no regrets – no, no, no, no. The bottom line is there are people alive today who wouldn’t have been otherwise – I’ve seen cards from kids who’ve graduated from school whose parents died during the famine. There’s no doubt it made a big difference. Our song saved lives. How many songwriters can say that?”

Philippine President Duterte Revives His Animosity Toward the Catholic Church

January 19, 2017
In this Nov. 26, 2016 photo, President Rodrigo Duterte gestures as he delivers his keynote address during the San Beda College of Law Alumni Homecoming at the Shangri-La Hotel in Taguig City. PPD/King Rodriguez

MANILA, Philippines — President Rodrigo Duterte on Thursday dug up old controversies including the so-called Pajero scandal and clergy sexual abuse in his latest tirade against the Catholic Church, which has been raising concerns over the spate of killings linked to his war on drugs.

Duterte said the religious group of more than 80 percent of Filipinos, has no moral ascendancy to criticize his narcotics crackdown because it also has its own share of sins.

“You expose me, fine. I expose you. Why? When you commit mistakes, it’s okay but when we do, no? B***s***. That’s stupid,” the president said during the oath taking of newly promoted police officials at Malacañan.

“What is your moral ascendancy in the Philippines? Religion? What is the meaning of it? Hindi kayo nakakatulong, daldal kayo nang daldal (You do not help us. You just keep on talking),” he added.

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Duterte cited the issue involving bishops who allegedly asked former President Gloria Macapagal-Arroyo to provide them luxury vehicles.

“Remember you asked vehicles from Gloria? Knowing fully well that the policemen have no vehicles. You had Pajero, you sons of b******,” the president said.

“You were given vehicles knowing that there is a principle of separation between Church and State. It was sheer, purely graft and corruption because you did not deserve it. You cannot use property or money for your comfort. That is not for you but for the government but you had the gall,” he added.

In 2011, then Philippine Charity Sweepstakes Office (PCSO) chairperson Margarita Juico revealed that some Catholic bishops got Pajero sports utility vehicles supposedly in exchange for their support for Arroyo.

Juico eventually apologized to the Senate after it was learned that the bishops did not get Pajeros but utility vehicles, which were then used to conduct humanitarian missions. The bishops returned the vehicles to the PCSO, with one of them admitting to have committed a lapse of judgment when he asked Arroyo for a vehicle as a birthday gift in 2009.

Duterte also questioned the supposed failure of the church to explain how donations given during masses were used.

“What did the church do? The Catholic Church earns millions every week all throughout the Philippines. There are many churches. Where is the money of the people?” the president said.

“We explain how we use our funds to the people. You? Priests and bishops, you wear fancy clothes, you have vehicles. Do you have a house, even with just five rooms, for rehab? What did your church do?” he added.

“You count money instead of going around the neighborhoods, explaining to the people why they should not be in that industry because they will die. Now you want the killings to end? All you have to do is to preach because most of the people here are Catholics.”

Earlier, the Catholic Church announced that it would work with local governments to establish rehabilitation centers. One of the church-initiated programs aimed at addressing the drug problem is the Sanlakbay Para sa Pagbabagong Buhay, which was launched last October.

Duterte also cited the clergy sex abuse hounding the Catholic Church as well and the illicit affairs of some priests. The president revealed last year that he was sexually molested by a priest when he was young.

“You asked for it. If you want a showdown, then let’s have a showdown. You mend your ways. If you cannot even give justice to the small boys that you have molested in the past, you do not have that moral ascendancy to lecture (me) on what to do. Sanctity of life? You’re enjoying your worth,” the president said.

“When we were young, I talked to cabinet members. When we were making confessions to you, we were being molested,” he added.

Duterte also scored alleged homosexual acts happening inside seminaries and the alleged failure of the Church to improve the plight of its faithful.

“What will you do with the homosexuality in your seminaries? What have you done to the children there? Did you investigate us? Mga le**e kayo (You fools),” he said.

“You are in palaces while your faithful are in squatters areas and then you talk about  sanctity? Look at your mirror.”

Duterte encouraged the public to read “Altar of Secrets,” a book by the late journalist Aries Rufo published in 2013 that discussed the corruption, sexual abuses and other controversies that rocked the Philippine Catholic Church.

Last Wednesday, Duterte said priests should try shabu so they can understand the seriousness of the drug problem.

Michael Phelps Pondered Suicide After DUI Arrest — Now best of Michael Phelps may lie ahead

November 11, 2015


Michael Phelps in action in the mens 200m butterfly final in London 2012. Photograph: Tom Jenkins for the Guardian

Michael Phelps, the American swimmer whose 22 Olympic medals make him the most decorated Olympian of all time, has revealed that he was “in a really dark place” after he was arrested last year for drunk-driving – and admitted to feelings of “not wanting to be alive anymore.”

Phelps, who has 18 gold medals from three Olympic Games, describes his arrest and subsequent emotions in a revealing interview in Sports Illustrated, and recalls lying low at his home in Baltimore as news media were camped outside. “I was in a really dark place,” Phelps told SI. “Not wanting to be alive any more.”

Shortly after his arrest, he entered a treatment facility in Arizona. He says his 45-day stint rejuvenated him, but at the time he felt frightened. “Hug-hug, kiss-kiss, turn in my phone and go to my room. It’s probably the most afraid I’ve ever felt in my life.”

Read the rest:


US Weekly

Michael Phelps opened up on Tuesday, Nov. 10, about attending rehab after his second DUI arrest, saying it was the most afraid he’s been in his life.

“It’s probably the most afraid I’ve ever felt in my life,” the Olympian, 30, told See the , explaining that he would immediately have to turn in his phone and go to his room after seeing visitors.

The gold medalist checked himself into an in-patient treatment program late last year following his second DUI arrest in September 2014.

“Mentally, I was over,” the swimmer said of the 2008 Olympics. “I didn’t want to do it anymore. I forced myself to do something that I really didn’t want to do anymore. I was in a really dark place, not wanting to be alive anymore. I look back now, I lived in a bubble for a long time. I wound up uncovering a lot of things about myself. . . I saw myself as the athlete that I was, but not as a human being.”

PHOTOS: Celeb rehab centers

The 22-time medalist was arrested on Sept. 30, 2014, for driving under the influence. He previously pleaded guilty to drunk driving in November 2004. Shortly after his second DUI arrest, he apologized to fans via Twitter.

PHOTOS: Celebrity mugshots

“I’m going to take some time away to attend a program that will provide the help I need to better understand myself,” he tweeted. “I am extremely disappointed with myself. Swimming is a major part of my life, but right now I need to focus my attention on me as an individual.”

PHOTOS: Stars who have been to rehab

He also told Us Weekly after his second arrest, “I understand the severity of my actions and take full responsibility, and I am deeply sorry to everyone I have let down.”

Phelps — who got engaged to Nicole Johnson this past February — assured fans that he’s now a “new man” and sober.

“Haven’t had a single sip and will not have a sip,” he exclaimed to Sports Illustrated. “I worked, recovered, slept, and took care of myself more than I ever had.”

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BALTIMORE (WJZ) — Baltimore’s world champion swimmer was in such a dark place, he no longer wanted to be alive. Michael Phelps opens up for the first time about the days following his second DUI arrest last September.

In an emotional Sports Illustrated article, Phelps talks about rehab and his transformation since.

Meghan McCorkell has more.

The Sports Illustrated article reads like a tell-all book, with Michael Phelps detailing his darkest days and his push to come back.

For four days after his second DUI arrest, Olympic champion Michael Phelps was embarrassed, in the fetal position, locked inside his Baltimore rowhouse.

“I was in a really dark place… not wanting to be alive anymore… I look back now… I lived in a bubble for a long time,” he said.

Phelps opens up in a new Sports Illustrated article.

“Reading it, you really feel like, ‘Oh, he’s opening up to me,’” said Shana Harris, Warschawski Agency.

His lowest point–his drunk driving bust in the Fort McHenry Tunnel.

Following his arrest, Phelps was suspended by U.S.A. Swimming for six months and banned from competing at the World Championships.

Family and friends pushed the swimmer to go to rehab. Former Raven Ray Lewis, saying: “I gave him some harsh reality… I said, ‘Bro, what are you doing with your life?’”

The man who’s stood on more Olympic podiums than anyone spent 45 days in an Arizona rehab.

Now Phelps is back in the pool, living in Arizona. He hasn’t missed a practice, and hasn’t taken a sip of alcohol.

“I’ve come a long way in the last year,” he said.

But will that be enough?

“From here, I think he has the opportunity to really continue to be a star and be even further than he was before,” said Harris.

Phelps hopes that, too, saying: “I’m back to being the little kid who once said anything is possible. You’re going to see a different me than you saw in any of the other Olympics.”

Phelps also promises Rio de Janeiro will be his last Olympics, saying he has no shot at Tokyo in 2020.

To read the entire Sports Illustrated article, CLICK HERE.

Robin Williams’s Long Struggle With Addiction and Depression

August 12, 2014


Robin Williams's Long Struggle With Addiction

by Hilary Lewis

Robin Williams’s unexpected death Monday brings to an end the comedian’s long battle with cocaine and alcohol addiction.

Williams checked himself into a renewal center just a few weeks ago, but his battle with addiction dated back more than 30 years. He struggled with cocaine and alcohol abuse in the early ’80s, after his rise to fame on Mork and Mindy.

“Cocaine for me was a place to hide. Most people get hyper on coke. It slowed me down,”Williams told People in 1988, the magazine recalled in a 2006 piece about the actor seeking treatment (again) for alcohol addiction,

Williams was even with John Belushi during the Saturday Night Live star’s all-night cocaine and heroin binge that led to his fatal drug overdose.

Belushi’s death and Williams’s then-wife Valerie’s pregnancy with the couple’s son, Zak, forced the comedian to quit cocaine and alcohol cold turkey.

“The Belushi tragedy was frightening,” Williams told People. “His death scared a whole group of show-business people. It caused a big exodus from drugs. And for me, there was the baby coming. I knew I couldn’t be a father and live that sort of life.”

Williams even joked about the dangers of cocaine addiction in his Live at the Met stand-up performance (video below).

After 20 years of sobriety, though, Williams checked himself into rehab for alcohol abuse in 2006.

He later told the New York Times that he hadn’t confronted the underlying issues at the root of his addiction.

“There was still, in the background, this voice, like, ‘Psst,’ ” he told the newspaper. “So when I relapsed, I went back hard. The one thing I hadn’t dealt with was, how honest do you want to live?”

Once again, it was his son, Zak, who was an integral part of Williams’s decision to get sober. Without going into detail, the younger Williams told The Times of his father’s rehab stint, “There was an ultimatum attached to it. I’m pretty confident that if he continued drinking, he would not be alive today.”

Williams checked himself into Oregon’s Hazelden Springbrook treatment center in August 2006; after two months of treatment, he recalled his battle to get sober in an interview with Diane Sawyer onGood Morning America.

He said it was a “very gradual” descent back into using.

“It’s the same voice thought that … you’re standing at a precipice and you look down, there’s a voice and it’s a little quiet voice that goes, ‘Jump,’ ” Williams told Sawyer. “The same voice that goes, ‘Just one.’… And the idea of just one for someone who has no tolerance for it, that’s not the possibility.”

More specifically, Williams told Parade in 2013 of the moment that led him to drink again: “One day I walked into a store and saw a little bottle of Jack Daniel’s. And then that voice — I call it the ‘lower power’ — goes, ‘Hey. Just a taste. Just one.’ I drank it, and there was that brief moment of ‘Oh, I’m okay!’ But it escalated so quickly. Within a week I was buying so many bottles I sounded like a wind chime walking down the street. I knew it was really bad one Thanksgiving when I was so drunk they had to take me upstairs.”

And as with his cocaine crisis, another star also spurred Williams to seek help. This time, it was Mel Gibson, Williams told GMA, whose DUI arrest served as a “wake-up call” for him to get help; Williams joked that Gibson’s public struggle took the spotlight off him.

Williams also joked about being an alcoholic in his stand-up act.

Just recently, Williams had checked into a center that is affiliated with the 12-step program to help him focus on his ongoing sobriety.

At the time, the comedian’s rep told The Hollywood Reporter, “He has been working hard and now has a break in his schedule, so wants to come back and be the best that he can be. This is his version of a retreat.”


Robin Williams Death: The Difference Between Depression & Normal Sadness

By Karen Rowan, Health Editor

Emergency personnel found Williams unconscious and not breathing at 12:00 p.m., local time; he was pronounced dead at 12:02 p.m., according to a news release from the Sheriff’s Office. Authorities are investigating the circumstances of death.

“At this time, the Sheriff’s Office Coroner Division suspects the death to be a suicide due to asphyxia, but a comprehensive investigation must be completed before a final determination is made,” the news release said.

A representative for Williams told Entertainment Weekly, “Robin Williams passed away this morning. He has been battling severe depression of late. This is a tragic and sudden loss. The family respectfully asks for their privacy as they grieve during this very difficult time.”

Major depression is one of the most common mental disorders in the United States, according to the National Institute of Mental Health. In 2012, an estimated 16 million U.S. adults had at least one major depressive episode, or bout of depressive symptoms, in the past year.

But despite how common the illness is, many people do not understand exactly what it means to have depression, and often think of it as being the same as sadness. [5 Myths About Suicide, Debunked]

“Depression is one of the most tragically misunderstood words in the English language,” writes Stephen Ilardi, an associate professor of clinical psychology at the University of Kansas, in a blog post on the Psychology Today website. “When people refer to depression in everyday conversation, they usually have something far less serious in mind,” than what the disorder actually entails. “In fact, the term typically serves as a synonym for mere sadness.”

Here are some facts about depression:

  • Although major depression can strike people of any age, the median age at onset is 32.5, according to Washington University School of Medicine in St. Louis.
  • Depression is more common in women than in men, according to Washington University.
  • Men with depression are more likely than depressed women to abuse alcohol and other substances, according to Jill Goldstein, director of research at the Connors Center for Women’s Health and Gender Biology at Brigham and Women’s Hospital in Boston. Depressed men may also try to mask their sadness by turning to other outlets, such as watching TV, playing sports and working excessively, or engaging in risky behaviors, Goldsetein told Live Science in an interview earlier this year.
  • Men’s symptoms of depression may be harder for other people to recognize, and the illness is missed more frequently in men, Goldstein said.
  • Men with depression are more likely than women with the condition to commit suicide, Goldstein said. Men with depression may go longer without being diagnosed or treated, and so men may develop a more devastating mental health problem.
  • Symptoms of depression extend far beyond feeling sad, and may include: loss of interest and pleasure in normal activities, irritability, agitation or restlessness, lower sex drive, decreased concentration, insomnia or excessive sleeping and chronic fatigue and lethargy, according to Mayo Clinic.

The number for the National Suicide Prevention Lifeline is 1-800-273-TALK (8255).

Cari Nierenberg contributed reporting to this article.

Follow LiveScience @livescience, Facebook & Google+. Originally published on Live Science.

There is still a long way to go before the public can accept imperfection

April 18, 2014

Living with anxiety and stress is difficult for everyone but perhaps more so for elite athletes under the scrutiny of the public eye

Jonathan Trott: I am unable to function at 100 per cent after feeling same anxieties that occured in Australia

Feeling the strain: Jonathan Trott has suffered a repeat of his Ashes illness Photo: GETTY IMAGES

All successful modern sport stars train their minds as hard as their bodies these days. The public, too, understands that mental toughness is as crucial to results as the ability to run, hit or swim with speed, accuracy or duration.

Yet when it comes to injury, it’s still more acceptable to break a leg than it is to fall ill with some sort of mental health problem.

No wonder then that England cricketer Jonathan Trott seems to have slightly fudged the reason for taking another extended break from the sport at which he excels.

Trott, who was forced to return home early from last year’s Ashes tour of Australia with what has been termed depression – more recently adjusted by him to “burnout” – said in March that he was hoping to win back his England place.

But last week his Warwickshire team-mates were informed that he will take a break from all cricket for further treatment with no time frame set on a return, if indeed he ever plays again.

Sadly for Trott, commentators are suggesting his career at international level now looks over with the ECB highly unlikely to thrust him into a high-pressure situation that is causing him so many problems.

But he is facing criticism too – former England captain Michael Vaughn has said that if Trott’s exit was not for mental health reasons as serious as then suggested, he for one feels “conned”.

Trott’s story apparently demonstrates many of the problems still surrounding mental health: the difficulty of labels, uncertainties about severity, the non-patient’s need for a “cure” – all of which may be amplified when the patient is heroic – and highly successful.

Part of the problem is that mental illness, which affects one in four Britons, is wide-ranging: it encompasses a whole host of diagnoses from relatively short episodes of low mood (which may not need specific intervention, although support from loved ones is beneficial) to the sort of severe enduring mental illnesses such as schizophrenia with which the public is much more au fait.

Current medical orthodoxy is that mental illness, thanks to advances in talking therapies and pharmacology, can be treated or controlled. This is all good news. But perhaps our optimism goes too far?

Because the reality is that doctors can’t always intervene and make our patients better – or control their condition – for good.

Actually, we know now that in some cases, mental illness can be a recurring illness with episodes – of depression, say – which come and go, regardless of therapy.

And although the public is much more aware of mental illness and more compassionate towards those with it, there really is a lot less sympathy for someone who just keeps falling ill.

It’s understandable. If you knew someone who kept breaking the same leg in the same place, wouldn’t you lose patience with them?

There is a theory that society can be understanding towards the sick as long as the sick play by the rules – in other words, if you get help, you must then get better. Fail to do that, or fall sick again, and you breach the rules, and society starts to turn away.

This is exacerbated in situations of workplace stress. “Stress” itself is a nebulous term – is it an illness, a symptom, a fashionable complaint? It is used indiscriminately.

How much worse this attitude is when the perpetual patient happens to be famous too – like an international cricketer. Here, we see a man who has a life so many of us aspire to (or did).

His inability not to get better – particularly from an illness that is neither defined or visible – can seem almost insulting to anyone whose own life or career is mundane. Why can’t he try harder?

Yet, perhaps we should be using them as an example for why this type of unpredictable, difficult to diagnose, recurring metal illness should be considered more kindly. Elite athletes are put under incredible pressure – much of it financial.

They are aware of having dedicated thousands of hours to being good at one, often very narrow, skill. If that should fail, it is not just a match that may be lost, but an entire career. This in turn, piles on more internal anxiety.

Plus – unlike the teacher or doctor who takes time off for mental health problems with privacy – sports people are publicly exposed. We all feel some sort of ownership and the right to comment.

Thankfully, there are therapies that can help with performance-related anxieties, which are beneficial whether you are an England cricketer or run your own business.

I’ve found simple advice around work can help: pointing out that you can walk away from your current career to another which may be more enjoyable and successful has been liberating for some anxious patients.

Often if a patient feels it is OK to take a break, that can free them from anxiety enough to get back to work.

Indeed, we are getting better at accepting and understanding mental health issues – but Jonathan Trott’s case shows that there is still a long way to go before the public can accept imperfection.

How can someone completely ignore a disease for so long? Ignoring a disease almost always makes it worse…

March 30, 2014

The New York Times

Not so long ago, a middle-aged patient came to my office for a checkup. He cheerfully admitted that he hadn’t been paying attention to his diabetes for the last few years. He’d stopped taking his medicine, stopped seeing his doctors, stopped thinking about the disease altogether. When I checked his blood sugar in the office, it wasn’t just a little elevated — it was four times the normal level.

For doctors, it is always a shocker to hear a case like this. How can a patient completely ignore a disease for so long? How can a life-threatening illness just disappear from someone’s consciousness?

The patient was not in denial; he knew he had diabetes. It just wasn’t on his priority list at this point in his life. For me, it was flashing neon at the top of my list with seven exclamation points.

It’s not surprising that doctors and patients have contrasting agendas. We come to illness from entirely different perspectives and backgrounds. Moreover, the angles of our respective lenses are mismatched.

For my patient, his wide-angle lens took in the whole of his life, of which diabetes was one small part. For me, in the 20 minutes allotted, my lens was narrowly focused on the disease that posed the gravest and most immediate risk to his health.

The challenge that lay ahead of us was to help each other adjust the angles of our respective lenses so that our visions could come into common focus. Otherwise, we’d slip into futile haranguing.

The diabetes algorithm taped to the wall could tell me exactly how much insulin to administer for his staggering high sugar level. But my patient didn’t need me to tell him; he was perfectly aware of the algorithm himself.

What the algorithm couldn’t tell us was how to understand the disease from different perspectives, how to tease apart the elements that had led up to the current situation, and how come up with a workable plan to prevent an otherwise healthy man from ending up blind, impotent, on dialysis and in a wheelchair from foot amputations.

Life flight air ambulance

That required extended discussions over the next few months that touched upon matters both practical and philosophical. We had to figure out how a taxi driver who relied on street-vendor food and whose only exercise was pressing the gas pedal could adhere to the diet and exercise requirements to control diabetes. We had to talk about the diarrhea that his diabetes pills caused. We had to discuss how his religious background influenced his approach to the future. And we had to talk bluntly about his life expectancy and the legacy he would — or would not — leave to his children.

It was fascinating to be in on the complicated, messy and individual way that people make decisions in real time. Both of us had to reconsider our assumptions about diabetes and how it should best be treated.

He flatly refused insulin, my opening bid for the most efficacious way to control his sugar. I had to fight back my clinical instincts to appreciate that bringing down his glucose level simply was not his top priority. He was most concerned about keeping his life “workable,” and needles were distinctly not part of that.

We had to compromise on a medical regimen that involved pills only, and agreed on an initial goal of getting his sugar just low enough to prevent the symptoms of excessive thirst and urination. Beyond that, it was negotiations that rivaled the Mideast peace process.

Was this a success? Well, his glucose did not get anywhere close to the normal range, as had been my initial goal. Certainly the scientific consensus is that getting glucose close to normal decreases the risk of many of the bad outcomes of diabetes. Letting go of this goal ran against all my training as a doctor.

But we did manage to get diabetes back onto his radar. While we both would have preferred that he didn’t have this disease at all, the reality was that it was there, like it or not. By being aware, he could now begin to think about how his food choices and activity level could sway the disease — for better or for worse.

His sugar is now lower than it was, and this should result in some harm reduction, even if the level never approaches normal. He is taking his meds and has made a few modest changes to his diet.

On my end, I’ve learned that there are times that I need to modify my own priorities and figure out with the patient what goals are achievable, at least at a given time. I’m also reminded how much more intriguing and challenging medicine is when we have the opportunity to delve in deep with a patient.

By the “quality measures” scorecard, this patient will count as a failure on my watch, since I have not succeeded in normalizing his glucose — or his cholesterol or his blood pressure, for that matter. The objective, outcome-driven data would rate me as a better-quality doctor if diabetes fell off his radar again and he dropped out of my practice.

Luckily for both of us, he continues to come to his appointments, and we both call that a success.

Danielle Ofri’s newest book is “What Doctors Feel: How Emotions Affect the Practice of Medicine.” She is a physician at Bellevue Hospital and an associate professor at the New York University School of Medicine. She is also editor in chief of The Bellevue Literary Review.


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After Third DUI, David Cassidy’s Wife Sue has Reportedly Filed for Divorce

February 11, 2014

By Daily Mail Reporter


David Cassidy’s wife Sue has reportedly filed for divorce from the actor after 23 years of marriage.

Her decision comes after the 63-year-old actor was charged with driving under the influence of alcohol for the third time earlier this month.

The Partridge Family star is now in rehab following last month’s arrest, but his now estranged wife has made no indication as to whether his battles with alcohol have anything to do with the split.

Split: David Cassidy's wife Sue has reportedly filed for divorce after 23 years of marriage

Split: David Cassidy’s wife Sue has reportedly filed for divorce after 23 years of marriage


She is quoted as telling ‘I’m glad David is getting the help he needs and I am confident he will come back better and stronger than ever.’

Happier times: David and Sue with their baby son Beau in 1991

Happier times: David and Sue with their baby son Beau in 1991

The website also quote Sue as saying that the divorce had been coming for a while, adding: ‘This has been looming for some time.

‘I am truly heartbroken that our marriage is ending.’

MailOnline has contacted a spokesperson for David for comment.

According to the site, the couple, who have been together for 28 years and are parents to 23-year-old son Beau, have been living separately for the past four months.

Earlier this month, David was charged with one count of DUI after he was found to be more than twice the legal limit when he was stopped by police in Los Angeles in January.

According to reports, David is now facing a potential year in jail due to his prior convictions, and will serve a minimum of 96 hours behind bars if he is convicted.

His manager previously came out to say his client was driven to alcohol due to an ongoing dispute over Partridge Family profits.

Jo-Ann Geffen has claimed her client had just undergone treatment for his  drink problem, but the stress of stern questioning by lawyers had caused him to fall off the wagon.

She said: ‘David just completed a stint in rehab and was doing very well in sobriety.

‘He was in Los Angeles to attend depositions by Sony Pictures Television,  respondents in a lawsuit filed by Cassidy in 2011 over what he claims  are monies long due him from Partridge Family merchandise, home video,  etc.

‘After attending his and his manager’s depositions, it appears as if the pressure led to a brief relapse.’

Former fame: David (front left) during his time on hit show The Partridge Family

Former fame: David (front left) during his time on hit show The Partridge Family

She added he was on his way to the Los Angeles airport ‘to return to his  home in Florida and to transitional rehabilitation’ when he was stopped  by a California Highway Patrol officer.

The Seventies  heartthrob was stopped by police in Los Angeles after he was spotted  making an illegal right turn when exiting the 405 freeway.

It is claimed that when an officer smelled alcohol he was asked to take a  field sobriety test, which subsequently showed he was more than twice  the legal limit.

After blowing a .19 on the test he was  booked for DUI and released hours later on $15,000 bail. The legal limit in California is 0.08 per cent.

Mugshot: David was arrested for DUI for the third time in January. He is now in rehab

Mugshot: David was arrested for DUI for the third time in January. He is now in rehab

Caught on camera: A video was released after David's 2010 arrest for DUI in Florida

Caught on camera: A video was released after David’s 2010 arrest for DUI in Florida



His arrest came just months after a similar incident occurred in Albany, New York.

Cassidy was stopped for driving with his full lights on and failed a sobriety test administered by the officer.


And in 2011 he was banned from driving for six months after pleading ‘no contest’ to drink driving.

The actor – whose daughter is Arrow star Katie Cassidy – was sentenced to a year’s probation and ordered to complete 50 hours of community service  by a Florida court.

The charges stemmed from his arrest  in St Lucie, Florida on November 3, 2010, when his car was spotted  weaving across the motorway.

Keeping busy: David's actress daughter Katie, whose mother is model Sherry Williams, has been attending various events during New York Fashion Week over the weekend and this week

Keeping busy: David's actress daughter Katie, whose mother is model Sherry Williams, has been attending various events during New York Fashion Week over the weekend and this week

Keeping busy: David's actress daughter Katie, whose mother is model Sherry Williams, has been attending various events during New York Fashion Week over the weekend and this week



Keeping busy: David’s actress daughter Katie, whose mother is model Sherry Williams, has been attending various events during New York Fashion Week over the weekend and this week

As is standard for suspected drunk drivers he was asked to take a roadside test, and was found to be almost twice the legal limit with a blood alcohol  reading of 0.141. The legal limit in Florida is 0.08 per cent.

He was also ordered to pay $500 in  fines, complete an alcohol education class and attend a DUI ‘victim  impact panel’, which requires him to meet people affected by drinking  driving incidents.

Following his arrest, police released roadside footage of the incident, showing  the singer attempting and failing to follow orders as part of a roadside sobriety test.

The arresting officer could be heard growing increasingly frustrated with the star as he failed to carry out his instructions.

He was then asked to put his hands behind his back where they are handcuffed.

A half empty bottle of bourbon was found under one of the seats of his white Mercedes car. He claimed he had a single glass of wine and had taken the drug hydrocone, a painkiller.

Read more:

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Meditation Often Overlooked As Help With Anxiety, Depression and Pain

January 8, 2014

Meditation can’t hurt, might help

By Andrew M. Seaman

NEW YORK          Mon Jan 6, 2014 4:18pm EST

NEW YORK (Reuters Health) – Mindfulness meditation may be useful in battles against anxiety, depression and pain, according to a fresh look at past research.

Using data from 47 earlier studies, researchers found moderate evidence to support the use of mindfulness meditation to treat those conditions. Meditation didn’t seem to affect mood, sleep or substance use.

“Many people have the idea that meditation means just sitting quietly and doing nothing,” wrote Dr. Madhav Goyal in an email to Reuters Health. “That is not true. It is an active training of the mind to increase awareness, and different meditation programs approach this in different ways.”

Goyal led the study at The Johns Hopkins University in Baltimore.

He and his colleagues write in JAMA Internal Medicine that meditation techniques emphasize mindfulness and concentration.

So-called mindfulness meditation is aimed at allowing the mind to pay attention to whatever thoughts enter it, such as sounds in the environment, without becoming too focused. Mantra meditation, on the other hand, involves focusing concentration on a particular word or sound.

Approximately 9 percent of people in the U.S. reported meditating in 2007, according to the National Institutes of Health. About 1 percent said they use meditation as some sort of treatment or medicine.

For the new report, the researchers searched several electronic databases that catalog medical research for trials that randomly assigned people with a certain condition – such as anxiety, pain or depression – to do meditation or another activity. These randomized controlled trials are considered the gold standard of medical research.

The researchers found 47 studies with over 3,500 participants that met their criteria.

After combining the data, Goyal said his team found between a 5 and 10 percent improvement in anxiety symptoms among people who took part in mindfulness meditation, compared to those who did another activity.

There was also about a 10 to 20 percent improvement in symptoms of depression among those who practiced mindfulness meditation, compared to the other group.

“This is similar to the effects that other studies have found for the use of antidepressants in similar populations,” Goyal said.

Mindfulness meditation was also tied to reduced pain. But Goyal said it’s hard to know what kind of pain may be most affected by meditation.

The benefits of meditation didn’t surpass what is typically associated with other treatments, such as drugs and exercise, for those conditions.

“As with many therapies, we try to get a moderate level of confidence that the therapy works before we prescribe it,” Goyal said. “If we have a high level of confidence, it is much better.”

But he noted that the researchers didn’t find anything more than moderate evidence of benefit from meditation for anxiety, depression and pain.

There was some suggestion that meditation may help improve stress and overall mental health, but the evidence supporting those findings was of low quality.

There was no clear evidence that meditation could influence positive mood, attention, substance use, eating habits, sleep or weight.

“Clinicians should be prepared to talk with their patients about the role that meditation programs could have in addressing psychological stress, particularly when symptoms are mild,” Goyal said.

Dr. Allan Goroll, who wrote an editorial accompanying the new study, told Reuters Health the analysis is an example of an area of much-needed scientific study, because many people make treatment decisions based on beliefs – not data.

“That is particularly the case with alternative and complimentary approaches to treating medical problems,” he said. “It ranges from taking vitamins to undergoing particular procedures for which the scientific evidence is very slim but people’s beliefs are very great.”

Goroll is professor at Harvard Medical School and Massachusetts General Hospital in Boston.

Goyal said people should remember that meditation was not conceived to treat any particular health problem.

“Rather, it is a path we travel on to increase our awareness and gain insight into our lives,” he wrote. “The best reason to meditate is to gain this insight. Improvements in health conditions are really a side benefit, and it’s best to think of them that way.”

SOURCE: JAMA Internal Medicine, online January 6, 2014.

Everything in proper amounts


A review of medical literature finds meditation can’t hurt, might help. Getty Images

By    Lindsay Gellman

Certain types of meditation may provide some modest relief from anxiety, depression and pain, a new study found.

But the study found little evidence for other reported benefits of meditation, including help in curbing substance abuse, poor eating habits, sleep disorders and weight problems.

The report, published Monday in the journal JAMA Internal Medicine, reviewed the findings from 47 previous studies, all randomized clinical trials, with 3,515 adult participants in total.

Many people use meditation to ease stress and promote general health. The purpose of the report was to examine the accumulated evidence to help doctors determine how best to counsel patients on the possible benefits and limitations of meditation, said Madhav Goyal, assistant professor of general internal medicine at Johns Hopkins University in Baltimore and the report’s lead researcher.

In each of the underlying studies, participants received professional instruction in one of two types of meditation: mantra meditation or mindfulness meditation. A popular form of mantra meditation is transcendental meditation, which involves repetition of a phrase “in such a way that it transcends one to an effortless state where focused attention is absent,” the study said. By contrast, mindfulness meditation emphasizes training in “present-focused awareness,” or mindfulness. The study noted that the distinctions between the meditation types aren’t always clear.

Researchers found that only mindfulness meditation produced some benefits. For example, the improvement in patients with mild symptoms of depression was similar in magnitude to what might be expected from the use of an antidepressant, the study said. It also noted that there were few mantra-meditation studies to include in the JAMA review, which could help account for the lack of evidence of benefits from this type of meditation.

The study didn’t find any evidence meditation was harmful.

Researchers culled through nearly 19,000 previous studies on meditation to select the most scientific. Dr. Goyal said his team used rigorous inclusion criteria. Each of the 47 included studies was a controlled trial in which at least one group received either a therapy with known psychological benefits, such as exercise, or a placebo instructional or educational session, he said. Studies that looked only at children or adolescents, or those without a control group, were excluded.

“Although uncontrolled studies have usually found a benefit of meditation, very few controlled studies have found a similar benefit for the effects of meditation programs on health-related behaviors affected by stress,” the JAMA report said.

The report’s findings show that meditation is perhaps less effective in alleviating stress-related symptoms than is widely believed, said Allan H. Goroll, professor of medicine at Harvard Medical School-Massachusetts General Hospital, in invited commentary also published Monday in JAMA Internal Medicine. “The studies overall failed to show much benefit from meditation with regard to relief of suffering or improvement in overall health, with the important exception that mindfulness meditation provided a small but possibly meaningful degree of relief from psychological distress,” he wrote.

Still, Dr. Goroll noted that participants only received 30 to 40 hours of training in meditation, which could indicate that “meditation is a skill that takes time to master.” He also said more evidence is needed to draw more robust conclusions about any benefits to meditation.

“People come to a meditation class because they’re suffering in some way,” said Jon Aaron, an instructor at New York Insight Meditation Center, which promotes mindfulness meditation. Through meditation, they learn to relate to their stress in a way that is more productive, he said.

Write to Lindsay Gellman at


Photo: Amy Winehouse

Trying to chase away depression and anxiety with depressants is often a path toward the greater risk of addiction and death.

The Temptation of Christ on the Mountain by William Hole

Rise In Global Use of Anti-Depressants

November 21, 2013
Rate not matched by increase in global diagnoses, prompting concern among psychiatrists about over-use of medication

By , health editor, and

The Guardian,

Link to video: Taking the tablets: a personal guide to anti-depressantsThe use of antidepressants has surged across the rich world over the past decade, according to the Organisation for Economic Co-operation and Development, raising concerns among doctors that pills are being overprescribed.Figures show that doctors in some countries are writing prescriptions for more than one in 10 adults, with Iceland, Australia, Canada and the other European Nordic countries leading the way.



Separate data from the US shows that more than 10% of American adults use the medication. In China, the antidepressant market has grown by about 20% for each of the past three years, albeit from a lower base.

Global rates of depression have not risen to the same extent, even though more people are being diagnosed in some countries.

In its Health at a Glance report to be released on Thursday , the OECD said that rising consumption levels could be explained by the use of antidepressants in milder cases. “These extensions have raised concerns about appropriateness,” it said.

It added that the financial crisis may have been a factor in more recent increases in usage, noting that in Spain and Portugal, for example, antidepressant prescriptions have jumped by more than 20% over the past five years.

Most psychiatrists agree that antidepressants work for people with severe illness but are not supposed to be the first resort for those with mild depression. Counselling and talking therapies, such as cognitive behaviour therapy (CBT), are recognised as just as effective over the long term. But counselling is in short supply in many countries.

“We know that antidepressants work for moderate to severe depression,” said Dr Mark van Ommeren, of the World Health Organisation’s department of mental health and substance abuse. “The explosion of antidepressants you see in most countries reflects the fact that lots of people with moderate to severe depression are getting treatment – that’s a good thing.

“But the negative thing is that a lot of people are getting antidepressants who shouldn’t be getting them. Doctors and healthcare providers should be able to recognise depression correctly so that those who need antidepressants get them and those with only mild cases do not get prescribed.”

The modern antidepressants known as SSRIs (selective serotonin reuptake inhibitors), such as Prozac, took off in the 1990s and gained almost cult status with the publication of Elizabeth Wurtzel’s book Prozac Nation in 1994.

Doctors were happier to prescribe them because they did not have the addictive properties or side-effects of pills such as benzodiazepines. But the bubble seemed to burst within a few years, with stories of some, particularly younger, people attempting suicide while on the drugs. Some companies paid large sums to settle court cases in the US and UK doctors were warned in 2003 not to prescribe them to the under-18s.

But the issues around the various medications do not seem to have affected the long-term upward trend. The OECD figures show Iceland to have the highest prescribing rate, at 105.8 doses a day for every 1,000 inhabitants in 2011, up from 70.9 in 2000 and 14.9 in 1989, when it first submitted figures.

Three countries have figures in the 80s in 2011 – Australia, up from 45.4 in 2000 to 88.9 in 2011; Canada, up from 75 in 2007, when it first submitted figures, to 85.9 and Denmark, up from 34.8 to 85.2. The lowest rate in 2011 was in Chile, where 12.8 daily doses were prescribed for every 1,000 inhabitants. In the UK, rates have roughly doubled over the past decade to 70.7 for every 1,000 people.

Most experts say that antidepressants are over-prescribed for some people but underused in others. “Antidepressants are widely oversubscribed to get rid of unhappiness,” said Professor Tim Cantopher, consultant psychiatrist with the Priory Group in the UK. “They were not designed for that. Unhappiness is part of the human condition. But real clinical depression does respond to antidepressants. And not to prescribe in these cases is to sentence an individual to a far longer illness than he or she need suffer.”

Harvey Whiteford, Kratzmann professor of psychiatry and population health at the University of Queensland, Australia, said depression was very common and was the second leading cause of health-related disability. But in most OECD countries, he said, only about 50-60% of those suffering from depression got treatment, although the rates were increasing.

The sort of treatment people needed varied according to their illness, he said. “There is good evidence that only major depression is likely to respond to antidepressants and other forms of depression much less so.”

Primary care physicians tend to prescribe drugs rather than CBT, although some countries, including the UK and Australia, have initiatives intended to increase the availability of counselling.

Whiteford said: “My view is that antidepressants are often prescribed for the increasing numbers of people now coming to treatment for depression (including mild to moderate forms of depression) where CBT would be the better treatment. Thus, the prescribing rates are going up and some of this prescribing would be for types of depression better treated non-pharmacologically.”

A Better Access scheme, which subsidised CBT for common mental disorders, increased treatment rates in Australia from 37% in 2006-07 to 46% in 2009-10, Whiteford said. “To get access to psychologists for CBT under the scheme required referral from a GP who made the diagnosis and ruled out medical causes for the anxiety and depression. We hoped this would decrease the prescribing rates of medication with referral to a psychologist being substituted as first-line treatment for mild to moderate disorders. However, what seems to have happened is that most GPs prescribed and referred for CBT.”

Professor Tim Kendall, director of the National Collaborating Centre for Mental Health in the UK, said he doubted whether the rise of antidepressant prescription was a result of better recognition of depression in so many countries. “It’s much more likely a testament to the effective marketing by the pharmaceutical industry,” he said. “I also wonder if, in better-off countries, which OECD countries are, we don’t have time to be depressed and seek chemical solutions to ‘get rid of it’.”

Dr Jordi Alonso, director of the programme of epidemiology and public health at the IMIM-Institut de Recerca hospital del Mar in Barcelona, Spain, said: “In my opinion, one major issue is that GPs have become familiar with the indications and results of antidepressants. Possible explanations of this fact are the time elapsed since new SSRIs were available and of course, the dissemination and publicity about their efficacy – with the lead of the companies who have produced them.”