Aaron or not

[Jeff Leahy]

Most of the newer antidepressants are so ineffective that the researchers have to use all sorts of tricks to distinguish them from placebo. Most the older antidepressants are so dangerous that they are rarely given outside of a hospital. All have side effects and many find them worse than the disease, which is not surprising as "only placebo effect and side effects" isn't helpful.

The antipsychotics have such terrible side effects that patients often have to be forced to take them. It's common for people to refuse to take them until they've landed in a hospital, or prison, or worse, at which point that resign themselves to living a non-productive but at least not dangerous-to-self-and-others life. In the meantime, many schizophrenics do try antidepressants, and anticonvulsants, tranquilizers, and lithium.

Lithium has been taken for thousands of years in the form of "taking the waters" at mineral springs. Nowadays someone who takes it has to get his or blood tested weekly to make sure that they're walking the line between therapeutic dose and heavy metal poisoning.

These drugs are anything but specific. Even the modern antidepressants like Prozac (barely more effective than placebo and described as "selective" because it's less dangerous than the older antidepressants) have more effect on the nerves of the digestive system than they do on the brain.

If Aaron were alive today (let's presume he is known not to be the ripper) he'd probably be committed to a hospital and treated with powerful drugs or ECT which would at least keep him from being erratic. The doctors would then evaluate the side effects of the drugs and wean him off of the more powerful stuff, or let the ECT wear off. They'd look at his symptoms, and try out drugs that treat those symptoms and have the minimal side effects. There would be some attempt to understand the underlying disease here. For instance, if his moods were rapidly changing from violent to depressed, he'd get a different drug than if his moods were stable for months.

This would continue until he was free from the worst symptoms. Then they'd look at the side effects, and if they were intolerable, they'd try drugs with theoretically similar therapeutic effects but different side effect profiles. As we are talking about a severely impaired person, he'd probably be forced to settle for the least bad combination, and never be fully free of either his delusions or his side effects. Various drugs would be prescribed to counteract the side effects (sleeping pills, tranquilizers, drugs to treat high cholesterol and diabetes and high blood pressure caused by weight gain) and therapy would be given both to cope with the remaining symptoms of schizophrenia and to help him cope with restricted diet, dizzy spells, and the like. He would probably remain in the care of friends and family all of his life, and although he might do some work in their shops, it's unlikely that he would ever be able to support himself.

Some psychiatrists have complained that the categories are actually more about drugs than underlying organic disease. The best known examples are short and long cycle bipolar. Different drugs are effective for short cycle bipolar than for long cycle, so these two get different entries in the Diagnostic and Statistics Manual. Others doctors claim that the fact that these diseases respond to different drugs is good evidence that they are caused by different underlying brain actions. So maybe R.D. Laing was right after all.

Finally, if Aaron were known to be the ripper, he'd be given the strongest antipsychotics out there, with much less worry about the side effects. Even a hint of dangerous behavior would be enough to get them to up the dose. His family would not care for him, except possibly for short visits, and any work he did would be constrained by the inability to leave the hospital. He might be allowed to dress other patients hair though.

http://www.slam.nhs.uk/about/videos.aspx

First of all the above website has some excellent video content that I recommend you check out if your interested in modern mental health care in the community.

I obviously wasnt in a position to respond to Christines post, I have never claimed to be an expert, I see my position as journalistic. I did however take the liberty of sending the post to my brother to see what he made of it.

I didnt include Christines name, just the post, so he refers as your chap (his way). And to be fair he dosn't totally dismiss Christines conclusion about how Aaron would be treated today.

I've given this some thought and have decided to post his responce in full as I beleive it makes an interesting discussion piont..

however I must stress I'm not trying to start an argument with you Christine I'm just interested in this particular area of Ripper research at present, for my own reasons.

This is what he said:

Re the Ripper posting about mental health. Firstly whoever posted it was very cynical about the medical response to MH and to my mind sounded like someone who might have had a bad experience from the services, either directly or for someone they know. As a social worker I'm not a great fan of medication, but it does have its place and I've worked with many people with chronic paranoid schizophrenia whose lives have been improved by medication. Never without side effects, true, like weight gain or lethargy, but an individual might prefer this to say being tormnted continually by hallucinatory voices in their head telling them their a worthless piece of ****.

It's always a case of balancing pros and cons. In so far as Aaron is concerned the person seems to be confusing psychotic illness with mood disorder, so I'm not sure what they thought Aaron might have been suffering with. Antipschotic medication is for psychotic illnesses primarily such as schizophrenia, whereas antidepressants (eg prosac) is for depression and mood stabilizers (eg lithium) are for MH problems like bipolar disorder/manic depression. Admittedly it's complicated by the fact that antipschotic drugs can be given for other reasons (manic depression) as a 'secondary' purpose. However reading your man's email/posting it wasn't sure whether he was suggesting Aaron was schizophrenic or had 'mood swing' problems. Of course he could have experienced both, but it would have been interesting to know from the person what he thought Aaron was suffering with from the information he had about Aaron.

The person's interpretation about how the Ripper would be treated today if caught, was not far off the mark. Political and criminal justice response would not be dissimilar from that afforded to the Yorkshire Ripper - ie incarceration in a maximum secure psychiatric unit like Broadmoor. But I don't think this is either surprizing or inappropriate given the seriousness of the crimes.

MH problems are varied an not necessarily clear (ie someone can be psychotic, that is to say having experiences which are detached from the 'reality' of most people's perceptions, but also experiencing mood changes such as feeling high and that they are the best in the world at doing something (eg manic phase) at the same time. It would be easier to explain this next time you're in Leigh, but hope this makes some sense.
speak soon

So there it is..and on the whole I guess he dosnt totally disagree with your post christine...

Obviously i am more interested in his views on Aaron and you must remember that he knows nothing about JtR case..

I hope I'm not breaking any Casebook rules by printing his email..let me know if there is a problem..

I just thought it might be interesting to get this line of discussion started again

Yours Jeff

PS there's also some stuff on the above site about genetic research that is of interest.

[Natalie Severn]

That was a very helpful post Christine.You obviously know a lot about the subject.
Many Thanks for the time taken and information given.
Norma

[Varqm]

Varqm,

Yes, I am beginning to think that the surveillance was known only to a select few higher up police officials and members of the Home Office. Anderson and Swanson would have known, also Macnaghten and Matthews. Other lower offials would have been aware of Kozminski as a suspect, such as Abberline for example.

Note that Swanson, Matthews and Monro never made any public statements about this, or contradicting Anderson. And if the Met really believed they knew the identity of the Ripper, it may have been considered a state secret... both because they could not convict in the absence of legal proof, and also because revelation of the killer's identity would have sparked more anti-semitism.

This is perhaps why Swanson underlined Anderson's sentence "it would ill-become me to violate the unwritten rule of the service"... because Swanson saw the irony in Anderson's stament here... because Swanson was well aware that (as John Malcolm says) "the "traditions of my old department" did in fact suffer because Sir Robert spited his fellow policemen by letting the cat half out of the bag..."

Swanson also noted in the marginalia (as is rarely if ever pointed out) that the author of the Dear Boss letter was "known to Scotland Yard head officers of CID” underlining the word “head” twice." Although this is not at all about Kozminski, it does indicate that certain facts were known to "head officers" only. Again, perhaps another implicit reference to Anderson's letting info out of the bag, when he should not have done so.

Rob H

Rob,

Interesting and not surprising, it could happen even now. I assume the policemen who did the actual observation, street work and arrest kept quiet.
Unfortunately there is not a recollection on Aaron's behaviour on the days of the or sorrounding the murders.

[Christine]

Most of the newer antidepressants are so ineffective that the researchers have to use all sorts of tricks to distinguish them from placebo. Most the older antidepressants are so dangerous that they are rarely given outside of a hospital. All have side effects and many find them worse than the disease, which is not surprising as "only placebo effect and side effects" isn't helpful.

The antipsychotics have such terrible side effects that patients often have to be forced to take them. It's common for people to refuse to take them until they've landed in a hospital, or prison, or worse, at which point that resign themselves to living a non-productive but at least not dangerous-to-self-and-others life. In the meantime, many schizophrenics do try antidepressants, and anticonvulsants, tranquilizers, and lithium.

Lithium has been taken for thousands of years in the form of "taking the waters" at mineral springs. Nowadays someone who takes it has to get his or blood tested weekly to make sure that they're walking the line between therapeutic dose and heavy metal poisoning.

These drugs are anything but specific. Even the modern antidepressants like Prozac (barely more effective than placebo and described as "selective" because it's less dangerous than the older antidepressants) have more effect on the nerves of the digestive system than they do on the brain.

If Aaron were alive today (let's presume he is known not to be the ripper) he'd probably be committed to a hospital and treated with powerful drugs or ECT which would at least keep him from being erratic. The doctors would then evaluate the side effects of the drugs and wean him off of the more powerful stuff, or let the ECT wear off. They'd look at his symptoms, and try out drugs that treat those symptoms and have the minimal side effects. There would be some attempt to understand the underlying disease here. For instance, if his moods were rapidly changing from violent to depressed, he'd get a different drug than if his moods were stable for months.

This would continue until he was free from the worst symptoms. Then they'd look at the side effects, and if they were intolerable, they'd try drugs with theoretically similar therapeutic effects but different side effect profiles. As we are talking about a severely impaired person, he'd probably be forced to settle for the least bad combination, and never be fully free of either his delusions or his side effects. Various drugs would be prescribed to counteract the side effects (sleeping pills, tranquilizers, drugs to treat high cholesterol and diabetes and high blood pressure caused by weight gain) and therapy would be given both to cope with the remaining symptoms of schizophrenia and to help him cope with restricted diet, dizzy spells, and the like. He would probably remain in the care of friends and family all of his life, and although he might do some work in their shops, it's unlikely that he would ever be able to support himself.

Some psychiatrists have complained that the categories are actually more about drugs than underlying organic disease. The best known examples are short and long cycle bipolar. Different drugs are effective for short cycle bipolar than for long cycle, so these two get different entries in the Diagnostic and Statistics Manual. Others doctors claim that the fact that these diseases respond to different drugs is good evidence that they are caused by different underlying brain actions. So maybe R.D. Laing was right after all.

Finally, if Aaron were known to be the ripper, he'd be given the strongest antipsychotics out there, with much less worry about the side effects. Even a hint of dangerous behavior would be enough to get them to up the dose. His family would not care for him, except possibly for short visits, and any work he did would be constrained by the inability to leave the hospital. He might be allowed to dress other patients hair though.

[Mitch Rowe]

Seroquel does have some antipsychotic properties too. It seems to be the cure all drug of the 21st Century. Im taking it now. Because Im a lifelong sufferer of BP Disorder. And I can tell you this. It ruins parts of your life that should be normal.
So...Here are two links:

http://dailystrength.org/c/Bipolar-Disorder/support-group

http://dailystrength.org/c/Schizophrenia/support-group

I trust that you all are intelligent People and will use these links to learn from. This stuff aint no joke. Believe me!

[Victor]

Hi Rob,
I am interested in your friends theory about schizoaffective disorder.I know Mum was very interested in the views of RD Laing,who took LSD in order to experience the schizophrenic "experience" which it is very similar to,apparently.
Mum was a great admirer of RD Laing .He came to the conclusion that there was only one "mental illness" -mental illness!
However it seems to me there are the development of anti psychotic drugs to control much of the worst of the mania, there are now very specific drugs for Schizophrenia----and the ones for manic depressive psychosis [bipolar disorder]are equally precisely targeted and specific,eg phenothiazine drug for mania and anti depressant for depression---or electroconvulsive therapy in some cases.Lithium can now prevent the severity of attacks.
So Rob,can you ask your friend what chemical therapy would be given to control a person"s symptoms if they were exhibiting both types of illness?
Cheers
Norma

Norma,

My flatmate suffers from Bipolar Disorder and takes seroquel and epilim (sodium valproate). The latter is a drug designed for Epilepsy! hardly "precisely targeted and specific".

Lithium is problematic in that it is poisonous in large enough doses and unless you continue to take it actually makes things worse when stopped.

ECT is about as specific and targetted as leeches!

The Stephen Fry documentary on the BBC last year gave lots of useful information about Bipolar.

My point is that Bipolar is not well understood even now.

[Jeff Leahy]

Varqm,

Note that Swanson, Matthews and Monro never made any public statements about this, or contradicting Anderson. And if the Met really believed they knew the identity of the Ripper, it may have been considered a state secret... both because they could not convict in the absence of legal proof, and also because revelation of the killer's identity would have sparked more anti-semitism.
Rob H

Just a quick observation on this point. I seem to remeber a few years ago a discussion on Monroe's family possessing 'notes' on the subject written by Monroe himself.

I was just wondering if they had ever come to light or whether anybody else new anything about this matter?

Jeff

[Natalie Severn]

Natalie - Hi. Regarding Sir Bob, I think you & I are on about as different wave lengths as two people can possibly be who still basically agree. The difference is that you are interested in what might be called the 'truth value' of Anderson's drooling schitzophrenic Polish Jew theory. Not me. I'm not interested in whether or not it is true; I'm interested in that Anderson was insisting that it was true. Thereby hangs a tale. What interests me more than the drooling Jew theory is that, sometime around 1907-1910, Anderson felt the need to place (excuse the coarse languge) his 'nipple in a ringer' by insisting the Ripper had been caught. And lo and behold, as soon as he does the skeletons come rattling out of the closet. Major Smith immediately pipes in; the Jewish Chronicle gets in on the act; Macnaghten has to throw in his own two cents, as do Abberline, Reid, Littlechild, and, of course, Monro and Swanson (the latter two in private). This, to me, is very suggestive. It suggests, for one thing, that there was trouble in River City. Do you know the song? Trouble. Right here in River City. Trouble with a capital T that rhymes with D and that stands for drool.... Imagine it as the Littlechld Letter sung to the tune of a 1950s American musical.

Its possible RJ.........but do you mean they were all in on it ? Because I doubt that I really do.

[robhouse]

OK Jeff, thanks

[Jeff Leahy]

Just a quick post as I am watching Russia v sweden.

I will try and contact my brother this evening and see if he will talk in confidence with you Rob...obviously he can not discuss any confidencial patient relationships...

[robhouse]

Natalie,

I really don't know much about this, and it is only one person's opinion. And as has been pointed out, we are trying to diagnose based on these case notes, so it will be very difficult to get an accurate diagnosis.

Also, I noticed this on the wikipedia page for schizophrenia:

"People diagnosed with schizophrenia are likely to be diagnosed with comorbid conditions, including clinical depression"

I really don't know much about this topic, I am just researching it online.

Rob

[Natalie Severn]

Hi Rob,
I am interested in your friends theory about schizoaffective disorder.I know Mum was very interested in the views of RD Laing,who took LSD in order to experience the schizophrenic "experience" which it is very similar to,apparently.
Mum was a great admirer of RD Laing .He came to the conclusion that there was only one "mental illness" -mental illness!
However it seems to me there are the development of anti psychotic drugs to control much of the worst of the mania, there are now very specific drugs for Schizophrenia----and the ones for manic depressive psychosis [bipolar disorder]are equally precisely targeted and specific,eg phenothiazine drug for mania and anti depressant for depression---or electroconvulsive therapy in some cases.Lithium can now prevent the severity of attacks.
So Rob,can you ask your friend what chemical therapy would be given to control a person"s symptoms if they were exhibiting both types of illness?
Cheers
Norma

[Observer]

Hi c.d.

Thank you, Rob.

As far as surveillance of Kosminski goes, I guess the question is when did it take place? If it took place during the period of time when the murders took place, it must have been pretty piss poor surveillance.

c.d.

Here's some of the sensationalism that I seen to excell at, and which has in all probability earned me a "not to be taken seriously" tag here in this forum.

How about if Mr Wideawake as observed by Sarah Lewis was one of London's finest, and had been tracking Kosminski prior to Kelly's murder.

To be taken with a large pinch of salt obviously

all the best

Observer

[Jeff Leahy]

I'm sorry, but even a brilliant person like your brother is unable to make that conclusion based on a few notes, in outdated terminology, about someone he hasn't met. I assume that what your brother means is that schizophrenia is the most likely diagnosis based on the very limited information he has. I suggest you ask your brother for clarification, because if he's as competent as you say he is, he would NEVER make a diagnosis based on the information at hand.

As you may have noted Christine, I have consistantly posted that even today the illness of Schizophrenia is note fully understood.

So if we are heading into samantic's then PROBABLY suffering schizophrenia given the known FACTS, would PROBABLY be more accurate.

Most of the information I was given was based on his day to day dealing with schizophrenia. My brother of course 'Caviat'ed' his comments with regard to use of modern drugs and historical terminology.

And of course he NEVER got around to a personal examination of the patient.

Yours Jeff

PS. I did make a post earlier in this thread regarding Martin Fido's position on Anderson, Martin is a historian and expert...given the important nature of the claims and information being given by Rob House at present...could the Anderson discussion stay on the Anderson Thread, unless directly relivant to 'Aaron or Not' discussion, many thanks.

[Christine]

Thats odd Christine, because my brother who is in charge of mental health in South East Essex, and who sections people on a daily basis and is an expert in the area, had know problem reaching the conclusion having been given Aaron's Asylum records.

I'm sorry, but even a brilliant person like your brother is unable to make that conclusion based on a few notes, in outdated terminology, about someone he hasn't met. I assume that what your brother means is that schizophrenia is the most likely diagnosis based on the very limited information he has. I suggest you ask your brother for clarification, because if he's as competent as you say he is, he would NEVER make a diagnosis based on the information at hand.