I came through integrative medicine as a stepping-stone to holistic care. As someone who has always had an intellectual rebellious streak, I like to question, push, and think outside of the box. Alternative medicine had always been a circus curiosity for me until I sat in a lecture by Dr. Richard Brown, and learned about supplements and herbs like Rhodiola Rosea and S-adenosylmenthionine (SAMe) that could be added on to medications or used on their own to change mood and enhance wellness. I practiced in this way for a couple of years, prescribing and strategically augmenting, before understanding that true personalized, lifestyle medicine obviates the need for medication. It gets to the root. I no longer wanted to enhance psychotropics, I wanted to eliminate them.
It was around the time of this awakening that I began to read the work of a psychiatrist Peter Breggin MD, journalist Robert Whitaker, and psychologist Irving Kirsch PhD. Here are some highlights of what they taught me and how they changed my practice:
Peter Breggin MD – Dubbed the “conscience of psychiatry”, Dr. Breggin believes the use of psychotropics is not only insufficiently evidence-based, but it is dangerous. The experience of withdrawal from these medications highlights the extremity of these effects and should be assumed to represent the body’s efforts to requilibrate rather than relapse of the underlying illness. He highlights risks such as tardive dyskinesia, akathesia, and more subtle risk factors that accumulate over time that he terms: “medication spellbinding”, affective volatility, and chronic brain impairment. He promotes a compassionate model of family therapy and calls on evidence from Soteria House and the Finnish model of Open Dialogue to argue for the efficacy of non-pharmaceutical treatments for illnesses as severe as schizophrenia.
Irving Kirsch, PhD – Careful analysis of the role of the “active placebo” in available clinical trials (38 trials including 3,000 patients) on antidepressants reveals that the placebo effect is the driving force behind these agents (75% of the treatment effect). He discusses medical ghostwriting, the selective publication of positive data, suppression of negative data and the recirculation of data so as to create the impression of a greater evidence base. He explores the relationship between the FDA and pharmaceutical companies and the levels of enmeshment that preclude effective monitoring. He, also, like Breggin and Whitaker, debunks the chemical imbalance theory exposing that there is no evidence supportive of serotonin deficiency, and that, moreover, a placebo-controlled trial of reserpine – the medication that was stated to pivotally support the monoamine hypothesis of depression – didn’t make people depressed at all. And Stablon, a serotonin reuptake enhancer is also effective as an anti-depressant. SNRIs, SSRIs, TCAs and heterocyclics all work equally well (26% according to STAR-D), once again, arguing against a cohesive mechanism underlying the disease. He states:
“The biochemical theory of depression is in a state of crisis. The data just do not fit the theory. The neurotransmitter depletion studies… show that lowering serotonin or norepinephrine levels does not make people depressed. When administered as antidepressants, drugs that increase, decrease or have no effect on serotonin all relieve depression to about the same degree. And the effect of anti-depressants, which was the basis for proposing the chemical-imbalance theory in the first place, turns out to be largely a placebo effect.”
Robert Whitaker – Mental health disability rates are higher than they have ever been, and in many ways parallel the increased prescribing of psychotropics to the masses. Medication exposure, on the other hand, does exact meaningful perturbations to bodily systems that force the accommodation to the body over time. We no longer have an understanding of the natural course of mental illness, and if we look at naturalistic and observational data, it suggests that patients who are never treated have higher functioning in society. Medication plays a significant role in transforming what would otherwise be an episodic acute illness into an unremitting, recidivistic chronic one.
What was potentially more disturbing than insights into the corrupt nature of our regulatory agency around licensing of pharmaceuticals was the fact that I had never, in a decade of training, heard a whisper – not even to refute or criticize – of studies discussed by these thinkers. I was never introduced to a culture of caution around these agents, and certainly not introduced to any alternatives, or any consideration of what might truly be driving some of these states. I hope that the cards begin to fall in psychiatry’s house because people who are suffering deserve better.
None of these experts, however, speak to why so many people are suffering – to the role of lifestyle and a toxic environment. I believe my perspective dovetails nicely with the abandonment of psychiatry as a discipline and the awakening to a whole-body wellness discipline called functional medicine.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.
I don’t know if this is true or not, but it really makes me think.
“Recent research has reported that serotonin is linked with normal gastrointestinal (GI) functioning. Serotonin is a neurotransmitter that delivers messages from one part of your body to another. Ninety-five percent of the serotonin in your body is located in the GI tract and the other 5 percent is found in the brain. Cells that line the inside of the bowel work as transporters and carry the serotonin out of the GI tract. People with IBS have diminished receptor activity, causing abnormal levels of serotonin to exist in the GI tract. As a result, they experience problems with bowel movement, motility and sensation, having more sensitive pain receptors in their GI tract.”
Is that true? 95% of serotonin is in the bowels?
What if proper solution is a clean, healthy digestive system and excellent nutrition? What if poor nutrition and malnutrition cause signs and symptoms that are considered to be mental problems?
I think I once read that some psych drugs cause problems with bowels, rectum. Something like that.
I can’t resist. I simply HAVE to:
Dear Dr. Brogan,
I’m thrilled about this great article by you and your ongoing path away from toxic drugs and bogus biomedical paradigms pushed with Big Pharma.
I have read about functional medicine from Dr. Mark Hyman in his books, online videos and many articles including his most recent best selling book, The Blood Sugar Solution.
Dr. Peter Breggin is a great hero of mine because his courage in exposing the menace of Toxic Psychiatry in the early 1990’s ultimately helped me literally save the lives of loved ones. Robert Whitaker’s excellent work and many others along with Dr. Breggin give me great hope for a paradigm change. The title of Dr. Irving Kirsch’s book, The Emperor’s New Drugs, says it all about modern medicine and biopsychiatry in particular.
Reading your latest greatest post gives me all the more reason for hope when younger doctors like you wish to practice holistic, functional medicine that actually helps people. This is in contrast to much of current medicine creating illness through disease mongering with Big Pharma/Business/Government to make more global billions while blaming the victims with ongoing old, evil eugenics theories masked as science for the most nefarious social reasons.
I look forward to reading more posts from you on your journey to enlightenment about what really promotes health and well being.
Thank you so much for bringing this to MIA readers’ attention.
IMO, there is an *understandable* reluctance to consider *any* form of medicine on the part of those who have been so badly injured by conventional psychopharmacology.
This is sad, because an orthomolecular, functional or other holistic approach can often work wonders.
And there are ways to overcome trauma, besides talk therapy – neurofeedback, cranial osteopathy, hyperbaric oxygen therapy, to name a few.
Are you familiar with the work of psychiatrist Charles Parker, DO? You may find his latest presentation encouraging.
Sufism teaches that in the ancient language, faith and fate develop from the same root word. The implication is that if you have faith, your fate (salvation) is assured, or if you can master your fate, your faith will grow.
IMO, another currently available “Mind Science” is Vianna Stibal’s ThetaHealing.
Some “skeptics” accuse her and her method as being “quackery” and / or some form of fraud. Eh.
I have two of her books. I absolutely love what she does. The passage I quoted in my comment above is from one of her books, actually. My favorite part is when she offered to buy some kid’s warts, to make them go away – and it worked. Hilarious.
Apparently, faith and energy healing are belief-based. I can’t see that as being fundamentally wrong.
She even says that some children’s limbs have grown back, simply because they didn’t think it wasn’t possible.
What we BELIEVE maybe is more powerful than what we “know”.
In Southern Louisiana, among the Cajun people, there are still some healers that use belief as their method of treatment for things like warts, etc. I never met one but all of my Cajun friends I had in the seminary swore by them. People in the small towns where these healers live give them great respect, almost as much or probably more than the Catholic priest in the church parish. After all, isn’t the whole placebo thing just another version of believing that something will work?
This is not the same thing as voodoo, which also still has believers in the badkwoods bayous areas.
Kelly, thanks for your article. As a therapist and herbalist, I constantly see the need for an examination of lifestyle and one’s “toxic environment” as you put it. Unfortunately there are many barriers to working with people on this level. At a base level, insurance companies are geared to pay doctors for medication management, not for lifestyle counseling. Sadly, not only doctors, but patients as well, have a quick fix mentality.
I would love to see “mental illness” treated in the same way as obesity…as something that requires a lot of time, care and attention to treat. It requires attention to diet, sleep habits, relationships and inner belief systems. No simple fix.