Should Physicians Read Journals? Given Current Standards, Maybe Not

The image is so familiar it is a stereotype: The physician’s desk, piled high with copies of medical journals, where she or he reads the latest research updates between patients. Medical science, it is said, progresses so quickly that if practitioners do not keep up their knowledge base will be obsolete within five years. But is the reading of journals useful? Can it potentially inculcate misinformation as much as progress? Is the knowledge gained worthwhile?
Full Article

Categorized In:

Lithium and Suicide: What Does the Evidence Show?

There appears to be increasing acceptance of the idea that lithium prevents suicide, and even that it can reduce mortality rates. For a toxic drug that makes most people feel rather depressed, this seems curious. I did wonder whether it might be having this effect on suicide by sapping people of the will to act, but the proposed effect on mortality seems completely inexplicable. A closer look at the evidence, however, suggests the idea is simply not justified.
Full Article

Categorized In:

Stimulate Your Vagus Nerve and Thus Chill Out: Simple, Natural, Uninvasive Methods

The Low Histamine Chef published a post yesterday: The vagus nerve inflammation connection. I was tickled to get a list of various self-hacks on how to stimulate the vagus nerve. Once the vagus nerve is stimulated we calm down! It’s like magic. The vagus nerve is implicated in all sorts of stress.
Full Article

Categorized In:

Five Strikes Against Assisted Outpatient Treatment Laws

Only five states remain in which Assisted Outpatient Treatment (AOT) laws have not yet gone into effect — Massachusetts, Maryland, New Mexico, Connecticut and Tennessee — and the pressure to start these programs in CO and NM is now very heavy. This article will address the push towards forced treatment for vulnerable populations who are at a high risk of being re-traumatized by these laws. It will also attempt to put a human face on the issues of stigma, labeling and the downward spiral that distressed individuals can get locked into when positive rather than punitive pathways are not made available to them.
Full Article

Categorized In:

#ADA25 Birthday, Mental Health, Justin Dart and My Crazy Hashtags

This weekend I am celebrating the twenty-fifth anniversary of the Americans with Disabilities Act. Let us get a little bit crazy now! I am introducing a new segment where I boycott so-called normality. Our choice, our only choice, and we always have a choice, is what kind of madness we want.
Full Article

Categorized In:

Revised UN Prison Rules

While the outcome is disappointing, the revised UN prison rules reflect the stage we are currently in with regard to the incorporation of the CRPD standards elsewhere in the UN system. Some premises derived from the CRPD are brought forward, but the bottom line remains the same, to the detriment of people labeled with psychiatric diagnoses.
Full Article

Categorized In:

ADHD: A Destructive and Disempowering Label; Not an Illness

In recent years, we’ve seen an increasing number of articles and papers from psychiatrists in which they seem to be accepting at least some of the antipsychiatry criticisms, and appear interested in reforms. It is tempting to see this development as an indication of progress, but as in many aspects of life, things aren’t always what they seem.
Full Article

Categorized In:

Survey on Emotional Distress and Mental Health Diagnosis: An International Campaign to Include “Regular People” in the Conversation

As researchers and practitioners, we are deeply troubled by the continuous narrowing of options available to people experiencing emotional difficulty. We believe that a variety of mental health approaches should be available to people from all walks of life and that we need to involve ordinary people in new kinds of conversation on this topic.
Full Article

Categorized In:

Teen Bipolar Disorder and the Abnormal Brain: Making Sense of New Research

Maltreatment is broadly defined as being “characterized by sustained or repeated exposure to events that usually involve a betrayal of trust.” It includes not only physical and sexual abuse, but also emotional abuse, including exposure to domestic violence, humiliation and shaming, as well as emotional and physical neglect. The way maltreatment is defined has great significance in the way we think about the connection between childhood experiences and adult mental illness. The word “trauma” itself may convey a kind of “not me” response, but when the term is defined in this way, we see that these experiences are, in fact, ubiquitous.
Full Article

Categorized In:

Why the DSM Differential Diagnosis is So Disappointing

For many clinicians like myself, families come to us with insurance that they seek to use in addressing psychological issues. As most know, in order to utilize the insurance benefits, a diagnostic code has to be billed that is specifically assigned to the identified patient, who in my case is a child or adolescent. As has been widely documented on MIA and other venues, this presents many challenges/controversies, both of an ethical and etiological origin. But this article is about a very specific concern, one that is inherent in the categorical, disease-based model, but also one that continues to depict the human person as a set of parts, not a dynamic, holistic being constantly interfacing with his or her environment.
Full Article

Categorized In:

Gut Microbiota & Mental Health

The importance of the gut microbiota for physical health, mood, and perhaps cognitive capacity is a recent discovery. There are still plenty of unknowns. Given that so much of the American diet is based on processed foods, each food additive needs to be interrogated to determine its impact on the microbes in the gut, general inflammation, and mood and behavior. It might be easier to eat lots of nut, fruits and vegetables and avoid the processed foods and artificial sweeteners and start enjoying yogurt (the stuff without the high fructose corn syrup).
Full Article

Categorized In:

The Sweet Spot Between Ignorance and Certainty: A Place Where Dialogue and Healing Can Happen

It’s now widely known that a good relationship between helper and person to be helped is one of the very most important factors determining the outcome from many different types of mental health treatment. But when people are in an extreme state such as the kind we call “psychosis,” forming a good relationship is not an easy thing to do. And unfortunately, the typical interaction between professionals and clients seen as psychotic in our current mental health system has characteristics which make a positive human relationship almost impossible.
Full Article

Categorized In:

One Family’s Encounter with Modern Psychiatry and a Call for Social Change

Asking the psychiatrist to discontinue medication was one of our bravest moments. It went against everything doctors had told us over the past twelve months—against Rebecka’s regular psychiatrist’s vehement opposition (“You can come back when it doesn’t work.”). It went against what we heard repeatedly in the media and in pop culture. It went against what we saw in the advertisements during the evening news. And it was the turning point in Rebecka’s journey toward optimal mental health.

Full Article

Categorized In:

Benzodiazepines: Miracle Drugs?

The first benzodiazepine – chlordiazepoxide – became available, from Hoffman-La Roche, in 1960. Benzodiazepines largely replaced the earlier barbiturates, which had received a great deal of negative publicity because of their much-publicized role in lethal overdoses, both accidental and intentional. Initially, there was a good measure of skepticism among the general public with regards to benzos, and indeed, with regards to psychotropic drugs generally. The dominant philosophy in those days was that transient, drug-induced states of consciousness were not only ineffective in addressing human problems, but were also dangerous. But pharma-psychiatry systematically, deliberately, and self-servingly undermined this skepticism.
Full Article

Categorized In:

Rx Resilience: Cultivating the Ability to Bounce Back

In many respects, resilience is the most important sign of health. This is true in physical health, and even more so in mental health. Resilience is what I spend my working hours trying to help others achieve. Resilience is what I have spent my own life discovering, harnessing, and finally thriving with. Quite simply stated, resilience is the ability to bounce back or recover from the trials and tribulations that living as a human being inevitably comes with.
Full Article

Categorized In:

The Lonely Way: Reflections from a Young Psychologist

Psychotherapy (I’m still searching for a better term, since the word ‘therapy’ involves thinking that there is sickness somewhere) is not about knowing everything. It’s about humanity, doubts and uncertainty. It’s about reaching out and reaching in, authenticity and honesty. It’s the most demanding thing I have ever done, because I’ve fully involved myself in this work; I use my own feelings, scratch away at my existential issues and try to care as deeply as I can for people who choose to enter my office. Sometimes, I know exactly what helps and what doesn’t. Sometimes, I have no idea. In a very odd way, it’s the most professional attitude I can think of. But it is also the lonely way.
Full Article

Categorized In:

The Disease Loop – Mental Health Infographics

I have been creating graphics to explain some of the work we do. Infographics have a lot of power. This one is a rough draft, there are still too many words on it. It needs more pictures and less words, …
Full Article

Categorized In:

Dialogues as a Way of Transforming Consciousness: Results from Three Teleconference Dialogues of Discovery held in 2015

Dialogues are an effective process in bridging an illusionary divide. Any group anywhere can follow a dialogue format and propose questions for inquiry and reflection. Dialogues are relatively easy to convene and they typically result in participants establishing deep connections with one another, having new insights and enhancing one’s knowledge and skills about how to be or work in partnership with others.
Full Article

Categorized In:

Always a Mystery: Why do Drugs Come and Go?

I’ve been teaching a course on substance abuse for about 30 years now. In this course, I cover a new drug class each week and always review the history of the drug. All of the drugs of abuse, cocaine, alcohol, marijuana, opiates are not new on the human scene. They date back to the Sumerians and the Greeks. The question for me is what accounts for epidemics? I have come to believe that epidemics are supplier driven rather than a function of consumer demand. For the current opiate epidemic, the suppliers were the pharmaceutical houses.
Full Article

Categorized In:

Women, ECT, and Memory

Imagine you wake up tomorrow with your past missing… You may not be able to recognize your home or know where your banks accounts are….You can’t remember your wedding or your college education. Eventually you realize that years of your life have been erased, never to return. Worse, you find that your daily memory and mental abilities aren’t what they were before. Now generally the memory loss that besets ECT recipients is spoken of with little or no explicit reference made to gender. In this article as in certain of the literature, on the other hand, gender is highlighted. My intent in this article is to hone in on gender per se; more specifically to shed light on how ECT, memory loss, and women’s lives come together.
Full Article

Categorized In:

Tearing Apart the DSM-5 in Social Work Class

I’m currently a student at the Silberman School of Social Work. This was the final paper for “Human Behavior 3.” HB3 is a required class which is basically a crash course in understanding and using the DSM-5 (The Diagnostic and Statistical Manual of Mental Disorders). In Human Behavior 1 and 2 they cover all kinds of ideas from psychodynamics to systems theory, and have the students practice writing biopsychosocial evaluations. I’m not sure what it looked like in the past but in recent years HB3 has become a DSM memorization class, so much so that we did most of the 5 week class online with modules that looked like the image I’m posting below. I don’t know what other people’s papers looked like, but here is what I turned in to my professor last week.
Full Article

Categorized In:

For a Well Mind, Try Revolution? Creative Maladjustment Week 2015

Your mental wellness requires a global revolution. In fact, your physical wellness requires one, too. For many years, I have noticed that there are people doing good social change work for mild reform. That is nice, but during my work in what we affectionately call the “mad movement,” I have often called for revolution, because the change we need is so big! We have the technology, a solution is affordable, but we need to act urgently and the main question is, “Do we have the collective will?”
Full Article

Categorized In:

Psychiatric Drugs are False Prophets with Big Profits. Psychiatry Has Been Hijacked

Once again, I just finished another consultation with someone from out of state who was desperate to find a therapist who he could talk to. He didn’t want to be pigeon-holed into some DSM-5 reductionistic diagnosis. He didn’t want psychiatric drugs. He was desperate to find a psychiatrist who would understand him, who he could relate to, and could treat him with real psychotherapy. There should never have been a reason for me to consult with anyone from out of state. Unfortunately, the cynical and fraudulent takeover of psychiatry is all but complete. How many real psychiatrists are left?
Full Article

Categorized In:

Medical Education: Psychiatry and Reductionism as a First-year Medical Student

I sat down in the auditorium for another lecture. The psychiatrist-turned-professor wrote the names of atypical antipsychotic drugs on the white board in front of 200 first-year medical students. I wondered if any of my classmates saw the disconnect. The first-year course, endearingly named “Behavioral Sciences,” is essentially a mandatory run-through of the major diagnoses present in the DSM and their corresponding pharmaceutical agents. Understandably, many of my intelligent classmates wanted to know why psychiatry was using certain drugs for certain disorders. However, they were often satisfied by the professor drawing a bunch of synapses on the board with some little bubbles floating towards an up-regulated or down-regulated receptor system.
Full Article

Categorized In:

Who Needs Radicalisation?

Where is the evidence base to support the assertion that the millions of people in our “civilised society,” that are defined as having a mental illness, are in fact ill at all? We know that the chemical imbalance theory has been disproven, we know that the geneticists have found nothing to validate a theory that people are vulnerable to inherent defects and that psychiatry remains the only stream of medicine that relies on the subjective assessment of a human being. What we also know is that there are severe consequences for many of those people as a result of these—at best—hypothetical assumptions about the causes of emotional distress.
Full Article

Categorized In: