CO - James Holmes Trial Discussion - Begins April 27, 2015 # 7

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  • #441
I do think he had a major depressive disorder but I can't go as far to think of it as sociopathic yet. I think bipolar for sure. Not too sure if maybe the medications might have increased his problems...drugs like abilify and wellbutrin have been known to have bad side effects for some people...including psychosis and suicidal ideation

That's a great point that I thought about earlier. SSRIs like Lexapro (mentioned today) & Zoloft (mentioned in JH's notebook under its generic name, Sertraline) often worsen psychotic symptoms and may even induce them in patients misdiagnosed with depression.

The reason for this is because SSRIs inhibit the brain's ability to break down serotonin and having too much can result in Serotonin Syndrome. (If your brain isn't producing enough serotonin, you become depressed. If your brain has too much, it can lead to excessive nerve cell activity which causes Serotonin Syndrome.) Symptoms of SS can include extreme agitation, confusion, DILATED PUPILS, tremors, twitching, diarrhea and vomiting, and psychosis.

That's why I was extremely surprised to learn that JH was given an SSRI, especially if what the defense claims is true--that he was psychotic at the time and has been diagnosed with schizophrenia. Patients suffering from psychosis are generally given a mood-stabilizing antipsychotic and sometimes a benzodiazepine (like Xanax, Ativan, Klonopin) for anxiety.


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  • #442
That's a great point that I thought about earlier. SSRIs like Lexapro (mentioned today) & Zoloft (mentioned in JH's notebook under its generic name, Sertraline) often worsen psychotic symptoms and may even induce them in patients misdiagnosed with depression.

The reason for this is because SSRIs inhibit the brain's ability to break down serotonin and having too much can result in Serotonin Syndrome. (If your brain isn't producing enough serotonin, you become depressed. If your brain has too much, it can lead to excessive nerve cell activity which causes Serotonin Syndrome.) Symptoms of SS can include extreme agitation, confusion, DILATED PUPILS, tremors, twitching, diarrhea and vomiting, and psychosis.

That's why I was extremely surprised to learn that JH was given an SSRI, especially if what the defense claims is true--that he was psychotic at the time and has been diagnosed with schizophrenia. Patients suffering from psychosis are generally given a mood-stabilizing antipsychotic and sometimes a benzodiazepine (like Xanax, Ativan, Klonopin) for anxiety.

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Serotonin syndrome is a medical emergency and is not something that he would have been experiencing throughtout the months he spent ordering weapons, meticulously planning and carrying out this crime. He wouldn't have lasted that long with it, it would have killed him.

SSRIs can sometimes induce manic episodes in those predisposed to it. That's why those with bipolar often need a medication like an SSRI to treat the negative symptoms like inablity to feel joy and depressed mood, but also a mood stabilizer to prevent the mania. Or sometimes an antipsychotic, which prevents the mania and positive symptoms (like hearing voices, persecutory delusions). If I remember correctly, JH is currently taking an SSRI, risperda(an antipsychotic) l, and cogentin which would make sense. Schizophrenia and bipolar with psychotic symptoms have overlapping symptoms and drug treatments.
I would be interested to know when he began taking the SSRI and how often his doctor had him checking in at the beginning of his treatment.
 
  • #443
Who diagnosed Holmes with Autism? Or bipolar? Or anything else?
 
  • #444
Meds:
- Anti-psychotic: Respirdol (low dose)
- Anit depressant - Lexapro (low/mod dose)
- Side effect meds - Cogentin

What is the point of these medications? How can Holmes participate in his defense if he is doped up?
 
  • #445
Going with what is known so far....

My personal opinion is that he is on the autism spectrum - more like the Asperger's form than regular autism even though that dx has been removed from DSM-V. That is the foundation of his problems. Layered on top of that are a depressive disorder with psychotic features. In addition, he is very intelligent, which can cause additional problems.

Assuming that I basically have that right, his decision to commit a mass murder, although a highly statistically unlikely thing for someone to do, does not entirely surprise me, for these reasons:

- people on the autism spectrum often have problems with depression, anxiety, ADHD, etc. It is nothing out of the ordinary for someone on the spectrum to also have these problems. So he is not unusual in that regard - to be on the spectrum and then to also have a mood disorder

- as people on the spectrum grow in age, they slowly become more aware of how different they are from others. It is very normal that JH, as he got into his late teens/early 20's, would begin to feel increasingly socially isolated as his peers' social skills and developmental levels exceeded his. This social isolation and inability to make and keep friendships and romantic relationships would cause him to feel frustrated and helpless.

- an additional difficulty for JH is that he is very intelligent; this reduces the number of people who he will feel he can truly relate to/connect with on an intellectual level. Even if he had none of the other problems, this issue alone could cause him some difficulties

- neuroscience was a major part of his life - not only as an intellectual interest (something that would be very important for an intelligent person on the autism spectrum), but also as an area where he could succeed (unlike the social side of his life); I think that his burgeoning awareness that he was not succeeding in graduate school the way his peers were was a major contributing factor to his depression

- I believe he had a loss of a relationship with a girl prior to the shooting; this would be another major trigger for feelings of isolation, rejection, failure, and perhaps rage as a result of those painful feelings

- as depression develops and deepens, the hopelessness, feelings of being disconnected from others, obsessive thoughts about being rejected/hurt, anger, and wanting relief from these thoughts and feelings increase.

- males are more likely to externalize their anger, so projecting his hate out onto others, and obsessing about violence, rather than committing suicide doesn't surprise me

As I learn more about JH, I see many parallels to Elliott Rodgers. ER was more fixated on not having relationships than JH appears to be, but in terms of being on the spectrum and having severe depression, and then choosing mass murder to cope with those feelings, they are very similar.

I also see some parallels to Seung-Hui Cho (Virginia Tech mass murderer).

Again just my preliminary humble opinion

Great Post.
 
  • #446
SAD

That is my overall reaction from yesterday.
Sad about everything.

-Sad about the victims and their families.
-Sad that some people get mental issues.
-Sad that mental issues are very complex.
-Sad that there is not always a perfect cure or a quick fix to help people with severe mental issues.
-Sad that some medical professionals dont always know how to properly treat or even properly recognize how severe someone has mental issues.
-Sad that some medical professionals dont always recognize when someone is a real danger to society or themselves.

- Just plain SAD about it all.
 
  • #447
my other thought today (I'm blonde, I only have a few) was that what if the defense uses the insanity defense knowing they won't win, but the playing of the tapes to the jury garners enough sympathy and empathy for Holmes (despite and in spite of) the monstrous thing he did, he won't get the death penalty. They essentially win.

I'm blonde and had exactly the same thought. Lol.

:seeya: Another blonde here, and yes - :moo: will go a long way for mitigation as he'll be personalized without taking the stand. :moo: I've never watched a trial where they put on so many hours. As Dr. Demarte said iic, after too long, even professionals can attach themselves to the patient. 22 hours....that poor woman who was asked about sleeping before is going to have a hard time with lights down perhaps.
 
  • #448
I wonder if they are planning on putting Veronica Moser Sullivan's mother on the stand after the psych evidence to bring everyone back to why we are here in the first place. I believe her testimony will be powerful and heartbreaking.


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  • #449
Jen's Trial Diaries ‏@TrialDiariesJ · 3m3 minutes ago
Watch the #theatershooting trial live here! http://thetrialdiaries.com/trial-livestream-links/ … #theatertrial
--
Complete Colorado ‏@CompleteCO · 36m36 minutes ago
Video shows Aurora theater shooter saying he regrets attack... http://oncomplete.co/2t8 via @washingtonpost #theatershooting

--
The Aurora Sentinel ‏@aurorasentinel · 1h1 hour ago
#Aurora #theatershooting trial jury begins watching taped sanity interview http://bit.ly/1Qf8Gdh #theatertrial

--
The Denver Post ‏@denverpost · 2h2 hours ago
For the first time, jurors heard at length from Aurora #theatershooting gunman James Holmes: http://dpo.st/1Ks8jKJ

--
John Ingold ‏@johningold · 1m1 minute ago
Day 20 of the Aurora #theatershooting trial: The prosecution's star witness throws the trial into brief chaos. http://www.denverpost.com/theater-shoot
 
  • #450
What is the point of these medications? How can Holmes participate in his defense if he is doped up?

Currently I have seen him talk with his atty once---and that was very very brief
 
  • #451
That's a great point that I thought about earlier. SSRIs like Lexapro (mentioned today) & Zoloft (mentioned in JH's notebook under its generic name, Sertraline) often worsen psychotic symptoms and may even induce them in patients misdiagnosed with depression.

The reason for this is because SSRIs inhibit the brain's ability to break down serotonin and having too much can result in Serotonin Syndrome. (If your brain isn't producing enough serotonin, you become depressed. If your brain has too much, it can lead to excessive nerve cell activity which causes Serotonin Syndrome.) Symptoms of SS can include extreme agitation, confusion, DILATED PUPILS, tremors, twitching, diarrhea and vomiting, and psychosis.

That's why I was extremely surprised to learn that JH was given an SSRI, especially if what the defense claims is true--that he was psychotic at the time and has been diagnosed with schizophrenia. Patients suffering from psychosis are generally given a mood-stabilizing antipsychotic and sometimes a benzodiazepine (like Xanax, Ativan, Klonopin) for anxiety.


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I thought he had Klonopin in his medicine cabinet in his apartment....May be wrong but I thought I heard somewhere he had anti anxiety med
 
  • #452
I found a lot of similarities between JH's notebook ramblings and the incoherent YouTube videos made by Jared Lee Loughner - especially the equations and (il)logicical parts.

http://youtu.be/nHoaZaLbqB4

I believe he (JLL) was also diagnosed with Schizophrenia.

Although I don't believe JH was insane, I do feel he was/is extremely sick. I guess I feel pity for him. What really gets me too is that he seemed to be reaching out for help to psychiatrists for help or even to give warning - even confessing he wanted to murder people. Can't figure out why he wasn't committed or seen as a danger.


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Totally agree. It is REALLY sad. Maybe misdiagnosed, wrong meds. I dunno

For now, I'm going with Aspergers but there's something else going on too like you say schiz. Maybe even side effects of medication or combination of drugs.
 
  • #453
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  • #457
Good Morning, y'all...

Happy Friday!

And here we go...
 
  • #458
Larry Ryckman ‏@larryryckman · 2m2 minutes ago
Day 21 of the Aurora #theatershooting trial begins. Jury is in the courtroom. Psychiatrist Dr. William Reid is back on the stand

--
The Gold Patrol™ ‏@thegoldpatrol · 1m1 minute ago
#theatershooting

Back in session. Watch live at http://www.thegoldpatrol.com
 
  • #459
Will C. Holden ‏@will_c_holden · 1m1 minute ago
#TheaterShooting is back live as Dr. Reid continues testifying on the video of Holmes' 22-hr mental evaluation. Live: http://link.kdvr.com/1JbYnWJ

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The Gold Patrol™ ‏@thegoldpatrol · 50s51 seconds ago
#theatershooting

Pros:

1st clip gets us to clarifying point. Reid says there are different styles in forensic psychiatry
 
  • #460
The Gold Patrol™ ‏@thegoldpatrol · 1m1 minute ago
#theatershooting

Some have more directive style - use lists and more structures. I ask open ended questions, specific questions

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The Gold Patrol™ ‏@thegoldpatrol · 54s55 seconds ago
#theatershooting

Benefit to not being “structured” - questions may not be complete, may not cover everythign
 
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