Just Say No

Conventional wisdom says psychiatric drugs save lives, but for some San Franciscans the pills are a prescription for disaster

These days he says it how he did on the radio: If there were a better way, wouldn't you want to give it a try?

Full Spectrum has worked with about 200 people in the last couple of years, Bingham says. He doesn't compile stats, and doesn't track how people fare after they leave. Beyond the several who've given up the meds they were on, many others came in off meds but on the verge of taking them. Some decided to stay off, while others chose to go on them.

"The important thing is they were exposed to an alternative approach," he says. "Whether they're on or off meds is less important than being more consciously on or off them."

Psychologist Alexander Bingham believes the brain's own healing capacity far outweighs that of psychiatric medications.
Paolo Vescia
Psychologist Alexander Bingham believes the brain's own healing capacity far outweighs that of psychiatric medications.
Brooklynne Michelle is bipolar and has been living psych-medfree for more than five years.
Paolo Vescia
Brooklynne Michelle is bipolar and has been living psych-medfree for more than five years.

One young woman, now 20, came in with a schizophrenia diagnosis and a regimen of three anti-psychotic and sedating medications, twice daily. She spoke in various voices and couldn't converse with others. At Full Spectrum, she improved so much that her psychiatrist removed the diagnosis and worked with Bingham to help her off most of her medications. She's down to one pill once a day.

Dr. Robin Cooper is the woman's psychiatrist; she works at the Adult Care Management Program for the Family Service Agency of San Francisco. Cooper, who has been a clinician in San Francisco for 24 years, didn't initially know of Bingham's bias against medication. When he first brought up the idea of helping her wean off, Cooper was hesitant; she'd had a negative experience helping a bipolar patient of her own do the same thing. But in this young woman's case, Cooper came to believe she had been misdiagnosed — that her problems were due to developmental delays, and that previous psychiatrists had prescribed medications as superficial behavioral controls.

Cooper is of two minds about Full Spectrum. She thinks the quality of the psychotherapy and other services it has offered is extraordinary, but disagrees with Bingham's wholesale opposition to pharmaceuticals. She's therefore careful about referring clients, but still inclined to do so — especially given the city's bleak landscape of mental health services.

"A lot of what used to be day programs have been renamed as "re-socialization programs,' which means they're really just drop-ins," Cooper says. "It's horrendous, there's just no investment anymore in really cohesive programs, it's just been cut and cut over the decades. You really can't find a decent day treatment program anywhere anymore."

Full Spectrum is now on the list of casualties. Bingham spent $1.3 million, a quarter of his inheritance, building the clinic. His plan was to use his money just to get it going, and then sustain it with a combination of clients who could pay out-of-pocket and grants to subsidize meager insurance reimbursements for those who couldn't. It didn't work on either side. In January, the day program and supplementary services shut down. Bingham and Morrissey continue to see some clients for individual therapy. Cooper is looking for an alternative day program for her young client.

"The system makes it hard for all mental health practitioners and clinics to survive," Bingham says. "If you add in our perspective on top of that, it just makes it that much harder."

Bingham is sad and frustrated, but says he's not completely discouraged. He's been talking to administrators of the state's Mental Health Services Act, the 2004 voter-approved program that taxes top earners to pay for improvements to county mental health services; he wants them to support alternative treatment approaches like his. He's continuing with his radio show, and thinking about how to rebuild Full Spectrum.

Tonight it's stuffed chicken breast with portobello mushrooms, and a white wine sauce that takes an hour to prepare. Michelle says crafting complex meals slows her down and helps her focus. Lately she's been feeling on the verge of a manic phase, so she's taking steps to keep it in check. She gets manic twice a year, on average, and the phases last from three weeks to three months. When you're on an energy kick and feeling like you don't need to sleep, you can read all the books you want, knit all the socks, paint a new picture. But the higher that high of intense productivity, the harder the inevitable crash.

Michelle's gotten much better at taking the edge off these spells. She generally sticks to a low-sugar, low-carb, high-protein, high-vegetable diet, which controls the severity of her moods quite well. She meditates regularly, and takes warm, scented baths at least twice a week. Depressive phases normally follow her mania, but if she can control how high she gets, the resulting lows become easier to bear.

"I once heard a therapist describe bipolar as your brain attacking itself," she says. "I just try to be like, "You know what? My brain has a different way of processing things, and I'm just going to have to find my own ways to work with it.'"

Last year Michelle found a zine called Navigating the Space Between Brilliance and Madness; A Reader and Roadmap of Bipolar Worlds. It was compiled by Sascha Altman DuBrul and Ashley McNamara, the founders of a support network for bipolar people in San Francisco and beyond.

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