Showing posts with label In. Show all posts
Showing posts with label In. Show all posts

Saturday, August 5, 2017

Useful Anxiety clinics in chicago


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Wednesday, July 26, 2017

Apparently panic disorder and life in the NBA dont mix



We've talked about Royce White here on PANIC! in the past. He's a young basketball player who's been attempting to make it in the NBA despite a fear of flying and other issues related to severe panic disorder. Last year, he was a bust with the Houston Rockets. This year, he was cut by the Philadelphia 76ers.

My take is that he's been kind of immature in the way he's gone about trying to carve out a professional hoops career -- at least with the Rockets, his approach seemed kind of antagonistic, replete with complaints in the press about the ways the team wasn't accommodating his needs, in a profession where, let's face it, criss-crossing the country is a fact of life and continuity of player availability is a key component of successful team chemistry -- but ultimately there are at least two sides to every story, and I have no idea what really went on behind closed doors.

At the same time, I admire his willingness to put the truth about his condition on the table, to make mental health and how employers deal with it part of the public discussion. I wish him well, and hope he finds his way to an NBA career, because he's a real talent, a big man with scoring ability and excellent court vision and passing skills. And he's courageous. Immature, maybe, but courageous. Let's not forget that.

Sunday, July 2, 2017

States Pick up Where Feds Left Off in Fining Drug Companies for Deceptive Advertising





After the Feds did their job, the states are now getting into the action.  Pharmaceutical companies are now starting to be fined in state courts for fraudulent promotion of their psychiatric medications.

Anyone who is still wondering why there has been an explosive increase over the last two decades in the use of two classes of psychiatric medications  - so-called “atypical” antipsychotic medication and anti-convulsants - for the treatment of a variety of diagnoses for which they are not indicated need look no further than to my previous posts about U.S. Department of Justice fines levied against pharmaceutical companies for said fraudulent promotion. (2/17/10, 3/22,10, 3/27/10, 4/28/10, 4/30/10, 10/1/10, 12/20/10).  

This blog has also focused on how, with an enthusiastic assist from pharmaceutical companies, the definitions of the psychiatric disorders for which the drugs actually are indicated have been expanded to the point where they are in danger of becoming FUBAR’S (F***’d up beyond all recognition).

To summarize what the US Department of Justice previously found:

May, 04. American pharmaceutical manufacturer Warner-Lambert agreed to plead guilty and pay more than $430 million to resolve criminal charges and civil liabilities in connection with its Parke-Davis division’s illegal and fraudulent promotion of Neurontin.  One of these uses was for bipolar disorder.  Studies later indicated the drug was ineffective for bipolar disorder.

January, 2009. Eli Lilly pays a settlement to the DOJ of $1.4 billion for concealing side effects and off-label marketing of Zyprexa just as their biggest seller, Prozac was about to go off patent in 2001.

September, 2009. Pfizer agrees to a settlement for $2.3 billion for off label marketing of several drugs including the atypical anti-psychotic Geodon

April 2010 - AstraZeneca fined $520 million – off label marketing of Seroquel.

April 2010 - Ortho-McNeil-Janssen Pharmaceuticals Inc., fined $81 - off label marketing of Topamax.

September 2010 - Novartis Pharmaceuticals Corporation fined $422.5 million off label marketing of Trileptal.

December 2010 – Elan Pharmaceuticals fined $203 million – off label marketing of Zonegran.

Now the states of South Carolina and Arkansas have fined Ortho-McNeil-Janssen Pharmaceuticals, a subsidiary of Johnson and Johnson, for overstating the effectiveness and minimizing the risks of their antipsychotic medication Risperdal.




The following summaries of what happened are paraphrased without permission from the American Psychiatric Association’s Psychiatric News.  These legal actions were also widely reported by the press throughout the country.

First was South Carolina, from January of 2012:

A South Carolina judge upheld a $327 million civil penalty against Johnson & Johnson for overstating the safety and effectiveness of Risperdal.  A  jury had decided that they violated consumer protection laws by sending doctors a misleading letter in 2003 about this. The jurors also determined that the warning-label information was deceptive.  They found that the company had falsely claimed that Risperdal was better than competing drugs in a letter was sent to some 700,000 doctors nationwide,. The Food and Drug Administration (FDA) issued the company a warning letter about false and misleading claims that minimized risks such as diabetes and overstated the drug’s benefits. South Carolina’s law allows a judge to decide whether the company can be fined as much as $5,000 for each letter sent to South Carolina doctors.

Arkansas got involved just recently:

Johnson & Johnson "lied to patients and doctors" in its claims about Risperdal, said Arkansas Attorney General Dustin McDaniel, after a jury found the company guilty.  This is the latest case regarding fraudulent claims about the company's second-generation antipsychotic). The jury determined that the company downplayed and hid risks associated with the drug, which has been linked to increased risk of stroke and death in elderly dementia patients and to seizures, weight gain, and diabetes. After the jury's decision, Arkansas Circuit Court Judge Tim Fox, issued a penalty of $1.19 billion for the nearly 240,000 violations of the state's Medicaid fraud law. The New York Times reported that he also fined the company $11 million for violations of the state's deceptive practices act. 

Like the title to one of my previous posts, the hits just keep on coming.  Unfortunately, the companies are treating these fines as a cost of doing business and are still making huge profits on these medications.  They know quite well that the damage has already been done.


With Rispiridal, it’s kind of a shame, since in my clinical experience its side effect profile in some ways actually does compare somewhat favorably with two of its main competitors -  for patients who are actually psychotic, of course.

In which I see an owl And rivers of blood!


I am undarkening my blog ever-so-briefly to tell a tale of my woodland adventures in NH. As a wilderness trip leader, I recently took a group of four young girls (age 9-10) and their counselors to Kinsman Pond in Franconia Notch. As we arrived in the parking lot, we discovered that every space was occupied. One fine fool had parked his car, plastered with Boston College bumper stickers, smack across two spaces. Upon finally finding our own space after much circling, the "adults" in our group left him a note that read: "Your genitals will be snacked upon by lemurs as punishment for your hideous parking skills." I included a smiley face to let him know that the snacking would be done in a kindly, lighthearted manner.

Onward to the trail. Each of the young girls had been given a horrible load to carry. One had a sack of 6 bagels. Another had five pieces of pita bread. A third had a few packets of hot cocoa. In addition, each of the girls was forced to carry her own chewy bar, an apple, and orange, and a cup/bowl/spoon set. (Unlike my previous trip, on which I'd failed to bring bowls and cups for the children and thus almost resorted to dumping globs of Mac n' Cheese on a tarp for each place setting, I'd successfully remembered to stow these items.)

"Any of you want to give up your arduous load of food?" we offered. But the girls were stout-hearted; they would carry their lumps of bread to the very top!

We mastered the first couple of miles to arrive at a trail junction at Lonesome Lake. Day hikers strolled by, some with young children toting stuffed animals and wearing flip-flops. This was clearly a strenuous and dangerous trail. A family of four with a dog passed us and headed down toward the parking lot; one member of the group was wearing a distinctive Boston College T-shirt.

Past Lonesome Lake, the journey took on a more sinister character. We had chosen the Fishin' Jimmy trail, part of the larger Appalachian Trail. As such, thru-hikers on their way to Maine, fragrant and sometimes bloodied, left us gasping in clouds of body odor. Long-legged fellows with trekking poles would stride with ease down over slippery roots and near-vertical rock faces studded with wedged, wooden steps. The girls struggled up the same route, sourcing out the best holds for their little hands. We leaned to the side to allow the thru-hikers passage and the girls pinched their noses and said "faugh." And so we clambered higher and higher into the woods along the edge of the mountain. We crossed mossy streams where mushrooms grew, so round and bright that I thought one was an orange tumbled from someone's pack. A foot would slip; someone would squeal and right herself.  A toad trundled across the trail.

My pack was from the 1980s--a gift from a former trip leader. It was old-school indeed, a classic frame pack covered with small sewn patches from the various AMC huts I'd visited in an earlier lifetime as a trip leader. And it was the most painful and wretched pack I could imagine carrying. I'd thought it would be kind of cool and retro to use this pack on the trail this summer. However, I had failed to recall some of its lesser virtues from the last time I'd used it. One, whenever the waistband was tightened to anywhere nearing comfort, it would pop open at the moment of greatest stress, thus sending something in the realm of 40 pounds of weight down on my shoulders. The best recourse was to leave it loose, which also let the 40 pounds sit firmly on my shoulders. Second, the pack was ungainly and off-balance, so that when I clung to a rock face on the Fishin' Jimmy trail, I came within an inch of toppling over backward into scrubby gullies. I reeled like a drunk on the edges and clung to tree branches. The tent bound at the top swung wildly and caught on pine branches. And third, if I decided that I needed to crouch low and clamber over a rough spot, the external frames at the base of the pack would scrape and catch on the rock. Scritch, scritch, the pack would scream, as I slid down the rocks.

We made camp at the lovely Kinsman Pond shelter. Our second day in the woods was uneventful, and included a hike to the top of North and South Kinsman in the fog. On the way up, we passed an older hiker who appeared to have wrapped his head in cheesecloth. He had a ragged gash on one arm and a haunted look in his eyes. "It's very rough," he said. "Very steep. Very dangerous. Hold onto anything you can!" He took a peek at the young girls and shook his head mournfully.

This fellow must have come up via a different trail, for we encountered nothing more hair-raising than that which we'd seen on Fishin' Jimmy. No trauma ensued but for two girls scratching their legs near the peak of South Kinsman and howling bitterly about it. They insisted on giant gauze patches lashed on by surgical tape. Another girl had to go poo near the peak so I dug her a hole with my hiking pole and handed her a patch of moss. (Moss soaks up urine well enough but can be grubby on the undersides.)

On the second evening, we sat by the pond and watched clouds roll down from the mountains. J and M were snogging and lover-making or some such, as 17-18 year olds will do when presented with romantic scenes such as remote mountain ponds under darkening skies. I didn't blame them a wit. E and I departed and were snuggling into our sleeping bags when I heard something whisking by my head. I trained my headlamp on the creature. It was an owl. A very petite and round-eyed owl that we later determined to be a Saw-Whet owl.


The owl flew about the shelter, lighting on various beams and gazing at us as if for advice. Eventually it settled atop my garbage-bag-wrapped sack of clothing, not more than a foot from my head. It blinked at me.

"It's sitting on my luggage!" I said. The presence of the owl, so otherworldly, rendered my speech loose and excitable, like a child who has seen his first lion. "It's on my luggage," I repeated. "There it is, on my luggage!" The owl gave a little hop and landed back on the bag. I slowly withdrew my camera and as I did so it flew straight out of the shelter. It was better that way, really. I didn't want to see my last glimpse of the owl through a camera lens. We were assured that our bonny owl was a good omen and would bring us doubloons and blessings for the year to come.

The blessings began the very next morning! I woke up and prepared to light the camp stove. Then my nose started gushing blood. I used to have a lot of nosebleeds as a kid, so I pinched my nostrils shut and waited a minute or two. It didn't stop. I figured it was due to altitude or something and didn't panic, although I thought about panicking. Through some fluke, I had also acquired a cut on the side of my nose and that, too, started to bleed profusely. So I was lying on my back in the shelter with a pack towel over my face, wondering if the bear that had been reportedly sighted in the area appreciated the scent of blood in any way. The shelter featured a large "Bear Box" where we stored our pepperoni, chicken, and other items of interest to a bear, and the bear had visited and fumbled with the lock on the first night and had loped away without satisfaction. Now he would come back, and he would eat me. And the Saw-Whet owl would observe this from atop my luggage.

Finally, finally, I got the bleeding to stop. I affixed a Band-Aid to the side of my nose. I'm sure it was unsightly. When the campers woke up for breakfast and noticed my blemish we hatched a scheme in which we would all put Band-Aids on our faces and make many ominous comments to the day hikers heading up the trail. We'd scare the wits out of them just like that old feller had scared us!

We set out to hike down the Fishin' Jimmy. I had researched a few alternate trails but they all listed things such as "rough and intolerably steep" and "lousy with trolls" and "slippage to certain death inevitable." So we went back to Farkin' Jimmy. It was slow and wet from the previous night's rain. The girls took their time and made their way with steady progress.

We were crossing a small stream in a flat section of the trail when I heard a cry. One of the little girls, L, had pitched forward and was lying prone atop the rocks. She had failed to put her hands out to arrest her fall in any way. And her forehead was spurting blood. Having seen head wounds before, I knew they could bleed badly even if superficial. We gathered around and soothed her. She was remarkably calm, until another little girl squealed in a high-pitched voice: "Oh my God. So much blood! It's GUSHING. I have never seen so much blood! Oh my God, it's like a fountain of blood! The blood! The blood!"

This dramatic outpouring sent poor L into tears. And the tears themselves were filled with blood, too. L was a pretty girl with long, thick hair, which she'd brushed and brushed until it was gleaming and then had sorted it into a braid. Even the braid, which had fallen forward, was bloodied. We pressed the wound with my pack towel (already encrusted with dried blood), and then E pulled it away and looked and went white and mouthed two words: "Puncture wound."

I looked and my stomach dropped, for this little girl had a hole in her forehead. It wasn't a huge hole, but any hole in the forehead is a bad hole. It was shallow enough, but the skull isn't far from the surface. Touch your forehead now and you'll see what I mean. I thought I might be able to see the glimmer of bone at the base of this hole.

Adrenalin is a strange thing. Readers of my blog know that I suffer from panic attacks and have experienced the push of adrenalin, misplaced and false and unneeded. This time it did what it was meant to do. We all acted quickly and cleanly. I flung the shoes lashed to the outside of my pack onto the trail in order to access the med kit. (I never saw the shoes again in this lifetime.) We stuffed in a gob of Neosporin and bound up the wound.

A man with a dog stopped by and informed us that he worked at a local hospital. No, he wasn't a doctor or a nurse, but he offered to carry the little girl's pack, and that was good enough and made him a hero. We legged it to the hut, one mile away, where the crew wrapped up little L even more thoroughly such that she looked like a Revolutionary war solider. Her face was blotchy and her eyelashes were gummed with blood.

At this point E and I decided we'd hike her out to the hospital while the rest, commandeered by hardy crew members M and J, lagged behind. I hadn't eaten anything, so I opened the communal jar of peanut butter and thrust a grimy paw into it to bring up a big scooping handful. This I licked as we hiked down. Some ways down the trail a bee shot out and stung me on the leg. E was carrying the little girl's pack on her belly, with her own pack on her back, so that she looked like a strange double-humped creature. I was wearing two knee braces and wielding two trekking poles. The day hikers with their teddies and lollies and pinafores continued to pass us as we made our way down, and at one point little L (cheering up now) turned back to us and conspiratorially said: "I think our plan to intimidate them is working." What a champ that kid was. Her eyes were still gummed-up with blood and still she had a hole in her head and still she managed to laugh.

We hiked on, cooking up stories for how the scene had played out. In one scenario, a bear with the ghost of Fishin' Jimmy riding sidesaddle on its woollen hide had lunged from the woods, knocking L into a troll-spike.

Finally we reached the van and drove 15 miles north to the hospital in Littleton, NH. A few miles into the drive my nose inexplicably started bleeding again, and I grabbed a beach towel to staunch the flow. In doing so I opened up the cut on the side of my nose again.That bled too, profusely. I drove one-handed, silently cursing. By the time we stumbled into the ultra-clean waiting room of the Littleton hospital ER, my face and hands were soaked in blood and my leg was bee-sting swollen and I had a rime of peanut butter around my mouth. We stank of the woods and of old cheese and probably a little bit of urine, as leaves don't wipe as well as they ought. The triage nurse opened her eyes wide and wondered who was the patient? Lucky for us, the waiting room was entirely empty, and L was whisked in for gluing and reparation faster than one would have hoped.

I left them there for rescue by the camp nurse and took the van back to collect the others, now waiting at the trailhead.  They would want ice cream, and would want to know: Was L all right? She was, and they would get their ice cream.  When I turned on the van's crusty old radio a song featuring the little girl's name was playing. What were the odds of that? (And I'd like to say her name aloud here, because she deserves honor for her bravery and her laughter, but one doesn't write about other people's children online, of course. But I'm saying her name to myself all the same.) The odds.

Maybe 10 years from now she will be on a trip herself, now bold and 18 and in love with something of the mountains and maybe with a boy, and she'll remember M and J and the way they glanced at each other over the stones. In 15 years, she will be 23 and I will be old and intolerable and maybe I will have forgotten how to skip--my parents, in their 80s, say that when you can't skip anymore that might mean that you are old. Does it? Maybe in 20 years, someone will ask: How did you get that scar? And she'll touch it lightly and remember the light on the water and the shiver of the lilypads in the wind when she was eight and high in the mountains  and far from home. And how when she fell she dove rather than faltered and engraved this instant on her memory.

Sunday, June 18, 2017

Themes of This Blog Seen In Newspaper Advice Columns – Part II


This is the second in series of posts showing how several of the issues I discuss in this blog show up in letters to newspaper advice columnists. Advice columnists must bring us problems that resonate with a fairly wide readership, and they therefore provide us with another source of information about human behavior and cultural trends.

I follow Jeanne Phillips (Dear Abby), Carolyn Hax, Amy Dickinson (Ask Amy), and Marcy Sugar & Kathy Mitchell (Annie’s Mailbox).

I will highlight each theme with a title preceding each letter to the columnist that I've reproduced, reflecting the blog subject that seems to be discussed. The title will also be a link to a related post. I am not including the columnist’s responses to the letters. 




"In relationships, if you always do what you always did, you'll always get what you always got." ~ Amy Dickinson.

Whenever a family member has somewhat compulsively behaved in a certain manner for a very long time, and then decides to change, the change often does not go over well with the rest of the family. The others seem determined to force the changer to go back to his or her old ways. 

In this post, I am emphasizing the above process rather than the particular role described in these letters, which I have not previously discussed directly as a separate entity. In the following three letters, the writers all had served in various incarnations of the same role, and complain about the reactions of the rest of their families when circumstances changed. The role might be called the “family support person,” or in a more extreme form, the “family servant” or even “the enabler.”

6/7/13.  Dear Carolyn: I’ve always been the one in my family to give whenever possible. When I went to college, I took on student loans so my sister wouldn’t have to. A few years later, when her car died, I purchased a new one and gave her mine. When family needed help, I was always there. Now I’m trying to purchase a house, and no one seems the least bit interested in helping me. I swallowed my pride and asked for financial assistance, even if it was a “loan,” and was told tough toenails. Would it be wrong for me to cut my family out of my life? I feel as if I was the great son whenever I went out of my way to help, but now I’m just some annoyance. - Always the Giver

6/18/13. Dear Amy: I've spent most of my life being a support system for various friends and relatives through one crisis or another. I've always been proud of the fact that I'm someone they can rely on when they need to. Recently, I learned that I may have a debilitating disease for which there is no cure. No firm diagnosis has been reached, but at this point it doesn't look great. Since I received the last batch of test results, I have witnessed my friends and relatives pull away from me, dismiss my symptoms and change the subject if I bring it up. I understand that everyone has their own lives and problems, but I desperately need some support right now. — Lost

June 24, 2013.  Dear Annie: My husband and I both work 18-hour days at a hospital. When we get home, we are exhausted. Since our schedules are irregular, however, our siblings seem to think it means we are always available for free babysitting. My husband's sister (a stay-at-home mom) is forever dropping off her toddler, saying she needs to "de-stress." She never calls ahead. We've tried locking the door, but she has a key. My brother has dropped off his young sons multiple times without warning and with no indication of when he'd be back. He stopped when I told him I was going to start charging him $12.50 an hour.  

The last straw was when my oldest brother's wife arrived one weekend in a van with seven little girls and stated that these kids were staying overnight with us because she and her girlfriend were going to a spa. I was just getting off a 24-hour shift, and I told her politely that since she hadn't checked with me beforehand, she'd have to make other arrangements because I was too exhausted to care for her girls and those of her friend. She became angry and told my nieces that I don't love them. Her girlfriend, whom I had never met, screamed at me from the passenger window. After they left, I got nasty phone calls from my brother and parents. The friend sent me an itemized bill and asked that I reimburse her for the spa trip they missed. Instead of responding, my husband and I sent our family members an email outlining that we love them and our nieces and nephews, but we would no longer be available for babysitting unless it was an emergency. We apologized for being rude or for causing them any trouble. The email was much kinder and more polite than they deserved, but we hoped it would allow us to start over. It was not received well. Currently, the only person speaking to us is my father-in-law. We considered moving in order to have boundaries, but I resent being forced out of a house I love.  I miss my family. What can we do? — Not the Nanny

Your Spouse’s Secret Mission 

Wherein one’s spouse plays the villain to take the heat off a husband or wife who cannot stand up to his or her own family.

8/19/12. Dear Annie: My daughter-in-law tends to go to her family. She says she is uncomfortable with my son's side. She has been rude to us since she married my son, and she controls him. She threatens him if he does not do what she wants. My daughter had a fight with my daughter-in-law four years ago, and I just woke up to the fact that my daughter-in-law blames us for my daughter's actions. My husband and I tried therapy with my son and daughter-in-law, but it made things worse. I left, saying that I am not happy with either of them and I just want to see my grandchildren. My son said that if I don't continue with therapy, I won't see the kids again. They are using the children as weapons to control us. I told her she didn't like us from Day One. She told me she doesn't trust me. My new granddaughter had a baptism, and my daughter-in-law told us it was an occasion only for her family. We were insulted and hurt. I'm thinking of going to court and suing for grandparents' rights. — Trustworthy


Tag, you’re it 

Despite the protestations of heritability study authors across the universe, parents do not treat all of their children the same.

9/21/13.  Dear Annie: I'd like to add my two cents about whether parents treat their children the same. Mom, Sis and I live equidistant from one another. Sis still lives near the place where we grew up. Mom moved to a warmer climate. We call each other every weekend to catch up and stay in touch. Sis and I fly to visit Mom about once a year. Mom visits Sis and her family a few times a year. But despite the many invitations I have extended, she will not visit me. When I had heart surgery five years ago, Mom did not come. When I was hospitalized for pancreatitis, Mom did not come. Of the 25 stage plays I've appeared in, Mom came to see exactly one. She will never see the home my wife and I remodeled. It seems the things that are important to me don't matter much to her. I suppose there is a certain amount of validity in her excuse that there's nothing that interests her in my city, but when we visit our son and his family, we don't care whether there is anything to do. We are simply glad to be with them. Does Mom love me? Certainly. Does she love me as much as my sister? Probably. Does she treat us the same? Judge for yourself. — That's My Lot in Life



Thursday, June 1, 2017

Dependency Conflicts in People Who Practically Raised Themselves





In my post of December 17, 2013, Older Siblings and Neglectful Parents, I described one interesting pattern of family dysfunction that I have been seeing in my practice. It developed in families in which the parents had abdicated their responsibilities as parents in one way or another. I showed how an older sibling would sometimes step into the void thusly created to take the parental reins, so to speak, and the younger siblings would later displace their anger at the parents on to the “substitute.”

This post is about a different (or at times additional) pattern that may develop in families in which the parents are not doing their job.

In this particular situation, the parents were emotionally unavailable to their kids most of the time as they grew up. To complicate matters further, they did not set any limits on their child’s behavior during his or her teenage years. Teens from such families would be allowed to come and go as they pleased. They might start skipping school or not doing homework - and the parents would do nothing about it. They might come home drunk or stoned, and the parents would not seem to even notice. They might start getting into minor trouble with the authorities.

One might say that children in this kind of environment pretty much raise themselves. Some continue to get into trouble and do poorly, while others may settle down and make something of themselves. In either event, when it comes to their romantic relationships, anyone who might be interested in them eventually finds themselves in a very specific damned if you do, damned if you don’t bind.

Children who had been neglected in this way are missing something important, and they want it. They secretly long for someone who will love them and show an interest in them and take care of them and even set limits with them in all the ways that their parents did not. And from the outside they seem to other people to need those things desperately. They often seem out of control in some way, and seem to be in need someone to give them the proper guidance.

So what happens when someone tries to take care of them? They get angry or even rageful! The logic behind this goes something like this. “I had no one in my life who parented me the way I needed. I had to take care of everything myself and make all of my own decisions. How dare you tell me how to live my life???"

In therapy speak, this is one form of a classic dependency conflict:  I desperately want someone to take care of me and guide me, but I resent it when anyone tries to do that. It’s like they are asking, “Where were you when I really needed  you? No Johnny-come-lately is going to question me about my own decisions!”

Add to this another and additional family system issue: The neglectful parents often had been neglectful because deep inside they felt themselves to be too inadequate to parent well. They secretly feel guilty about what their children had to do to survive. If their child seems to be independent and self-sufficient, they feel less guilty. 

On the other hand, seeing someone do for their child what they did not makes them feel even guiltier, so there is pressure on the child to be self-sufficient and to not depend on others. If they are not independent, their parents may become depressed on act out self-destructively.

Rather than having a “Dependent Personality Disorder,” as the DSM might suggest, these "adult children" are actually counter-dependent. They are deathly afraid of their own dependency needs, and continue to try to manage their lives all by themselves, just like they always had to.

In a way, this type of family situation is the polar opposite of the intrusive helicopter parenting which is also a common occurence in todays's American culture. Despite being the seeming opposite of neglectfulness, helicopter parenting can also lead to a situation in which its victims looks like they need someone to take care of them but then resent it when anyone tries. 

This follows from something I call the principle of opposite behaviors - opposite family behavior leads to the same or very similar result. It occurs because the extreme polarized behavior of the parents represents opposites poles of the exact same conflict - or two sides of the same coin if you will. 

In a future post, I will show how an internal conflict in parents such as these can lead to a situation in which two brothers or two sisters develop characteristics that seem like extreme opposites, or how one generation of family members can go to one extreme with a particular behavior, the next to the other extreme, and the third back to the first extreme. That phenomenon would be next to impossible to explain if behavior were primarily determined by ones's genetic propensities.