On the 7th of November, Robert Whitaker was here in Copenhagen to officially launch the Danish translation of his book, Anatomy of an Epidemic and in conjunction with that, a conference had also been organized. Professor Peter Gøtzsche of the Cochrane Institute was also one of the speakers along with Ole Larsen, an Open Dialogue psychiatrist. Many of Whitaker’s books were sold that day, with many getting their copies signed, it was a great day and a sense of excitement prevailed. Even surprisingly, a psychiatrist who works in the closed wards and who promotes forced treatment had chosen to accept my invitation on behalf of the organizers to come, despite much skepticism. He told me afterwards how happy he was that he came and though he is unlikely to change his praxis overnight, perhaps the next time he meets someone who does not want treatment, he discovers, doubt has crept in and forced treatment will be just that much harder.
However, while we were celebrating the day, in another part of Denmark, psychiatry was preparing its attack. A professor of psychiatry Poul Videbech, one of our finest, specializing in depression with a particular emphasis on electroshock, was busy writing a review of the Danish version of Whitaker’s book for ‘Today’s Medicine’, an internet magazine for doctors in Denmark. ‘Today’s Medicine’ had asked the publishers for a copy so that Videbech could review it . . . only they had not yet received it as it was still waiting to be sent. However, that small detail did not deter Videbech who reviewed the book anyway, and on the 8th November, the day after the book was launched, Videbech’s review was published. The title of his review is “The Boy Has No Clothes On”. (Review is included as an appendix)
As you can imagine with such a title, the review is hardly going to be favorable, indeed it smacks of condescending paternalism framing the well-worn scenario for establishing psychiatric supremacy. Surprisingly, at least from my perspective, the review revealed more of the professor and by proxy psychiatry than it did anything else and certainly as reviews go, this is one that is difficult to take seriously. But precisely because it cannot be taken seriously it becomes a serious review, for we see psychiatry, as represented by professor Videbech, shooting itself in the proverbial foot.
What did professor Videbech as the psychiatric representative really expose? Psychiatric practice at its best! He states, “It is this assumption that (the author – Videbech’s words) psychiatry intends to prove and (he – Videbech’s words) it does so in such a way that all research in favour of this is included, and all that argues against it is systematically ignored.” Does anyone recognize this? Irving Kirsch, PhD certainly does as described in his book, ‘The Emperor’s New Drugs: Exploding the Antidepressant Myth’
What about his following statement, “Next, the author seeks to show that there is no evidence that depression is due to a lack of serotonin in the brain, and that nothing suggests that schizophrenia is due to too much dopamine. […] No one today who knows anything about neurobiology believes that depression or schizophrenia can be explained so simplistically.” That inspired me to take a peek at the Danish Psychiatric Foundation’s latest book ‘Schizophrenia and other Psychoses’ for sufferers of schizophrenia and their families, and low and behold from page 77 – 80 what did I see? The ‘too much dopamine hypothesis for schizophrenia’ explained.
Of course a review of this calibre would not be complete without some element of pathos, however here Videbech has pulled out all the stops. The “heart-breaking experiment concerning drug free treatment of schizophrenia, which is occurring right in front of him: the hundreds of thousands of untreated people with schizophrenia in the United States who are homeless, sleeping in parks and found in prisons. If Whitaker were to study their terrible fate: how they are being raped and killed, how they die of frost-bite and tuberculosis . . . ” This is a reprehensible attempt at using human misery to push psychiatry’s drug agenda to the extreme while, at the same time, attempting to discredit a man whose message is that Harrow’s study shows that people off drugs have better outcomes than those on drugs. As a matter of interest, here in Denmark according to the National Indicator Project’s 2011 figures, 94% of all ‘schizophrenics’ in Denmark are medicated. I never knew the USA was a potential haven for ‘schizophrenics’ who could be part of an experiment regarding drug free treatment albeit in utter misery according to Videbech. I believe Harrow’s results show something profoundly important for us all and I am just one of many who proves his and Whitaker’s point. I would still be on the highest pension reserved for those who were 100% incapacitated by mental illness if I had not gotten myself off the psychiatric drugs.
Videbech’s finale is, “One cannot help but think that here it is most definitely the boy who has no clothes on.” I disagree.
I found that by the time I had read the whole review I was staring at a stark naked and frightened psychiatry, a psychiatry desperately trying by any means possible to shut the boy up who keeps saying “psychiatry has no clothes on . . . psychiatry has no clothes on . . . ” and now this boy has come to Denmark and is saying it in Danish “psykiatri har ingen tøj på . . . psykiatri har ingen tøj på . . . ”
Gerlach, Jes; ‘Skizofreni og andre Psykoser’ published by Psykiatrifonden 2011
Kirsch, Irving, PhD; ‘The Emperor’s New Drugs: Exploding the Antidepressant Myth’ Basic Books; First Trade Paper Edition, 2011.
Baandrup, L, Voldsgaard, I, Cerqueira, C, Riis Jølving, L & Nordentoft, M; Den Nationale Skizofrenidatabase, Ugeskr Læger 174/42 15. oktober 2012
Whitaker, Robert; ‘Den Psykiatriske Epedemi, Illusionen om Mirakelpillen’ (2013) published by Psykovision
Here is Professor of Clinical Psychiatry, Poul Videbech’s review of Robert Whitakers Anatomy of an Epidemic translated.
The Boy Has No Clothes On
Today’s Medicine | 11.08.2013 | Page 32 | 1,105 words | Article ID: e413c4c2
The award-winning American science journalist Robert Whitaker’s book “Anatomy of an Epidemic” is published this week in Danish with the title “The Psychiatric Epidemic” The book is filled with rhetorical ploys and a selective choice of sources, writes guest reviewer Paul Videbech.
Author Robert Whitaker’s starting point is based on what he calls a modern plague. In 1955, he says, there were 566,000 people admitted to hospitals for the mentally ill in the United States, equivalent to 1 in 468 Americans. In contrast, in 1987, it was 1 in 184 who received a pension due to mental illness in the United States. The comparison is somewhat unconvincing, but let’s accept the premise.
Initially this appeals to a scholarly epidemiological, sociological and psychiatric discussion of the complex changes that have occurred in society during the same period: the demographic composition of the population has altered, our diagnostic practices have changed (and our threshold for defining mental illness has probably become too low), drug and alcohol abuse has exploded, family structures have changed. Moreover, exclusion from the labor market has also intensified: the tolerance towards people who do not perform 100 per cent has decreased. The pharmaceutical industry invents new diseases that has to be treated with medication, etc. All these things could conceivably increase the incidence of mental illness. However, this exciting and important discussion the author pretty much jumps over, for he knows, mirabile dictu, what the main cause of the plague is: It is the psychiatric treatments that make people sick! It is this assumption that the author intends to prove and he does so in such a way that all research in favour of this is included, and all that argues against it is systematically ignored.
Kicking down an already open door
However before he gets that far, we are introduced to the psychopharmacological history. How most ‘big’ psychiatric medications have been largely discovered mostly through coincidence. The story is true enough, but has been told better in other books.
Next, the author seeks to show that there is no evidence that depression is due to a lack of serotonin in the brain, and that nothing suggests that schizophrenia is due to too much dopamine.
Here the author is seized by his own enthusiasm and with great energy kicks down an already open door: No one today who knows anything about neurobiology believes that depression or schizophrenia can be explained so simplistically. It is an old rhetorical trick: A clearly ridiculous point of view is given to the opposition, which one then argues against and wins. It’s like reading Elliot Valentine’s book “Blame it on the Brain” from the eighties, a book the author frequently refers to.
There is something idealizing about the description of schizophrenia. In fact, it is even possible that schizophrenia does not exist, and that Kraepelin was wrong: his patients whom he believed suffered from dementia precox, had in fact encephalitis, which was the cause of their hallucinations and progressive disease.
Deja vu for 70s
At a time when studies document the benefits of early detection in adolescents with schizophrenia, for example, the OPUS project, and where people all over the world are aiming to make the period of untreated psychosis as short as possible to avoid chronicity and damage to the brain. It [therefore] becomes a deja vu from the previous anti- psychiatric era in the ’70s when one reads about how much healthier it is to live through one’s psychosis than be treated. Moreover, if you have the misfortune to get antipsychotic medication it increases one’s risk for relapse and becoming a chronic patient. The drug damages the brain, claims the author, yet all the studies with modern scanning techniques, which shows that people with schizophrenia who have never received medication have an increased propensity for shrinkage of certain brain regions, are quietly ignored. Granted – these cases are not easy to understand.
One could however wish that Whitaker had devoted more attention to the gigantic and heart-breaking experiment concerning drug free treatment of schizophrenia, which is occurring right in front of him: the hundreds of thousands of untreated people with schizophrenia in the United States who are homeless, sleeping in parks and found in prisons. If Whitaker were to study their terrible fate: how they are being raped and killed, how they die of frost-bite and tuberculosis, it would probably be a completely different book he wrote. Maybe even a book that was dangerous for the system?
One could go on: Depression that is created by antidepressants and, the reason for the explosion in bipolar illnesses is, according to the author, due to the use of antidepressants which makes them bipolar. That ‘switching’ exists, is true, but that it is very rare is not addressed by the author.
Notes that are worth noting
Whitaker’s Notes feature is remarkable. He cites many references, but very selectively, and those who find favour in his eyes, are from the 60s through to the 80s with few newer references.
There are not many references to scientific studies, instead quite a number [of references] citing newspaper articles and popular science books. The author, who is a journalist, cannot obviously be expected to comprehend in depth the original scientific literature, which has been published within just the last five years. But surely it is not unreasonable to expect that the most important and recent meta-analyses would have been read and understood? Especially when [he is] trying to peddle such a controversial message? It is also amazing that all the famous psycho-pharmacologists during this time that Whitaker quotes from, are out of context in such a way that it looks as if they are passionately against the use of medication for mental illness.
One could continue to describe this demagoguery, but space does not allow it.
Everyone in the whole world knows the story of “The Emperor’s New Clothes.” It tells about how the little boy revealed the emperor’s conceit, though everyone closed their eyes to the truth.
We love the little boys that reveal system errors and corruption.
However, when one has read this book, one cannot help but think that here it is most definitely the boy who has no clothes on.
It is an old rhetorical trick: a clearly ridiculous point of view is given to the opposition, which one then argues against and wins. If Whitaker were to study their terrible fate: how they are being raped and killed, how they die of frost-bite and tuberculosis, it would probably be a completely different book he wrote. Maybe even a book that was dangerous for the system?
Award-winning journalist comes to Denmark
The award-winning American science journalist Robert Whitaker’s book “Anatomy of an Epidemic” is published this week in the Danish under the title “The Psychiatric Epidemic.” Robert Whitaker has won several American awards for his articles and books on mental health care and pharmaceutical industries, and he was one of the nominated finalists for the Pulitzer Prize in 1998 for a series of articles about abuse of the mentally ill in scientific experiments. In 2011, he won the Investigate Reporters and Editors’ award for investigative journalism for “Anatomy of an Epidemic.”
In connection with his book which was published in Danish yesterday Thursday, he participated in a conference regarding the future of psychiatry, organized by PsychoVision. The conference was also attended by Professor Peter Gøtzsche, director of the Cochrane Institute, and psychiatrist Ole Larsen.
How exciting! I think this strong response to Bob’s visit to Denmark by the psychiatric establishment is a good thing. Here in America, with our 320 million people, the media ignore us. But in a small (and democratic) country like Denmark, psychiatrists like this one are just setting up an exciting controversy which your mass media are sure to want to cover. What excitement! What extremism! Covering it will sell lots of newspapers and bring out more viewers of television programs.
And since (in my experience) every time our views and the totally fraudulent claims of the psychiatric establishment appear together, our views always look better to the readers and viewers. Most people, when given a chance, can tell the difference between lies and truth. We have the truth, and even though I am not known as an optimist, I think the truth will eventually prevail.
So congratulations to our Danish comrades, and I wish I could be there to participate in your fight.
Go Denmark! I better stop, or I am going to run out of exclamation points, lol.
With such a hateful review he really has set things up it is going to be interesting to follow the next period of time and see what happens. I think it is safe to say that such writing by, after all, a prominent professor of psychiatry is as we say not very becoming…!
“As a matter of interest, here in Denmark according to the National Indicator Project’s 2011 figures, 94% of all ‘schizophrenics’ in Denmark are medicated. I never knew the USA was a potential haven for ‘schizophrenics’ who could be part of an experiment regarding drug free treatment albeit in utter misery according to Videbech.”
I hate to sound repetitive but people do not appreciate, to quote Ronald Reagan, “how lucky we are” :D. I could so called “escape to the US” to be free from psychiatry. If psychiatry in the US were to become more “European”, there would be no place to escape to, so to speak. Although this speech was meant to be political, it also applies to how different things are seen psychiatry-wise in Europe vs the US https://www.youtube.com/watch?v=qXBswFfh6AY . In the US, the idea of the primacy of the individual and his/her rights over government and collectivism is still very popular, which is why it is very important that we win our political battles against psychiatry here.
We have like many other countries what I call the apartheid laws, special laws for those deemed mad allowing force treatment and detainment which is a violation of human rights. You also have them 🙁 But I am curious because we also have this debate in Denmark that homeless people are untreated ‘mad’ people etc. yet they will not be registered in the statistics saying 94% of all ‘schizophrenics’ in Denmark are on drugs. These are the official registered ‘schizophrenics’ if you like. Do you have similar statistics in the US? I mean can you be known ‘schizophrenic’ in the system and not take drugs? Do you know what I mean?
These numbers are hard to come by and I haven’t seen a single authoritative source that I could trust to get an accurate picture. Torrey’s TAC always exaggerates numbers so it is difficult to give an accurate number.
What I will say is this: there is a basic requirement that all laws that force people into treatment must meet, namely, that the person for which a court order is sought must be shown to be dangerous with a legal standard known as “clear and convincing evidence” http://www.law.cornell.edu/wex/clear_and_convincing_evidence which is a technical name for something that protects people from some psychiatrist saying “I think that the guy is dangerous” as being the only valid reason for forced treatment/commitment. Typically, showing of past violent behavior is required. While this is not a panacea by any means -since in many cases it really protects those with the means to afford independent lawyers-, it makes you immune to abuse as long as you play by the rules, ie, do not do anything that could imply dangerousness. It is still unfair, because those who are not labelled as “mentally ill” are more protected but it is still a higher protection than the “need for treatment” standard that exists in may European countries, including Denmark http://bjp.rcpsych.org/content/184/2/163/T3.expansion.html .
BTW, that youtube video by Peter Gøtzsche was excellent!
Thanks! Super interesting links. I am happy to see that a lot of countries do not have that dreadful extra human rights abuse twist that we have. Namely ‘”you are not a danger to yourself or anyone else but… We think you are mad, in fact we have decided that you are mad so unless you come to the psychiatric hospital voluntarily and take our drugs for your own good, we will come and fetch you and force medicate you” yours sincerely your local psychiatric department’
For me it is despairing to read the same old, “just look at all them mentally ill schizophrenic homeless, if only they just took their meds”, in the review, it’s just cheap and trashy. Is Paul Videbech really E Fuller Torrey? I have a theory that many of those that may be considered mentally ill and are homeless would have been far better off if they had never in the first place been given neuroleptic drugs. Oh yeah, that’s the point!
I agree I thought it was particularly distasteful that shameful plug for drugs, as if that would help with poverty, violence, misery and homelessness.
I love the way you write from the heart.
Thank you Duane! For your support 🙂
Professor Poul Videbech is also the psychiatrist who introduced and promoted screening for depression for the general public including pregnant women. Ie. screening healthy people,
‘One million Danes are to be screened for depression” is the title and since Denmark has a population of a little over 5 million this has been an ambitious and lucrative project.
“‘at the same time general practitioners (GP) should treat depression much more aggressively than they do today’, says the chair of the Minister of Health work group professor Poul Videbech”
Since this screening went into action there has been, as one can imagine, a big jump in the number of people filling out prescriptions.
This is what Professor Peter Gøtzsche author of “Deadly medicines and organised crime: How big pharma has corrupted health care” discusses in this video which is in Danish but has English subtexts.
See the video here: http://www.youtube.com/watch?v=i1LQiow_ZIQ&feature=youtube_gdata_player
Professor Poul Videbech has it appears, also been called to task for breaking the law in 2011 for not informing, in fact keeping it a secret that he was paid by big pharma Eli Lilly regarding SSRI’s. This is as the article says a problem especially when he is the one who writes about antidepressants for the Internet portal ‘pro medicin’ used by doctors and the public.
Big Pharma paying a psychiatrist perceived as a “top expert” to promote Big Pharma goodies? That’s hardly news in the US :D. In fact, one of the biggest blows to psychiatry happened 5 years ago when a US Senate investigation uncovered several high profile cases of psychiatrists involved in doing precisely that. Sadly, nothing happened. The biggest offenders (Biederman, Nemeroff, Keller) received little to none reprimands. Nemeroff was even later given more research money by the NIH. The APA promised to change things but this year psychiatrists were again ranked the biggest recipients of Big Pharma money in the US.
Ray Moynihan, the guy who authored the hilarious video on Motivational Deficiency Disorder, has written extensively about this matter: http://www.bmj.com/content/336/7658/1402 . In many countries these payments go unnoticed. Glad to hear that in Denmark there is some control on them even though the end result seems to be no different than what happens here: a few empty words from the governing bodies, but no real change.
Your Professor Videbeck reminds me of the admiring description of one of the doctors in Molière’s Imaginary Invalid.
“He is firm in dispute, strong as a Turk in his principles, never changes his opinion, and pursues an argument to the last recesses of logic. But, above all things, what pleases me in him, and what I am glad to see him follow my example in, is that he is blindly attached to the opinions of the ancients, and that he would never understand nor listen to the reasons and the experiences of the pretended discoveries of our century concerning the circulation of the blood and other opinions of the same stamp.”
and then there is this one:
Arg. “Still, doctors must believe in their art, since they make use of it for themselves.”
Ber. “It is because some of them share the popular error by which they themselves profit, while others profit by it without sharing it. Your Mr. Purgon has no wish to deceive; he is a thorough doctor from head to foot, a man who believes in his rules more than in all the demonstrations of mathematics, and who would think it a crime to question them. He sees nothing obscure in physic, nothing doubtful, nothing difficult, and through an impetuous prepossession, an obstinate confidence, a coarse common sense and reason, orders right and left purgatives and bleedings, and hesitates at nothing. We must bear him no ill-will for the harm he does us; it is with the best intentions in the world that he will send you into the next world, and in killing you he will do no more than he has done to his wife and children, and than he would do to himself, if need be.”
What great – and apt quotes love ’em!! Thanks for sharing Rossa
Congratulations Olga! Thanks for being so aware and writing so well. I did not know until now that your were a psychiatric nurse also. What a life experience you have had! I hope we meet someday. Maybe you were at the WNUSP/ENUSP conference in Denmark many years ago. It was just before then that I got a copy of ‘Mad in America’! It is brilliant that Robert Whitaker has touched so many hearts. It is no wonder that psychiatry is afraid of him and the lies he exposes. Thanks so much for all you do! http://www.mindfreedomireland.com
I am sure our paths will cross, Mary! And thank you for all that you do!
Psychiatry has good reason to be afraid, more and more people are demanding to see proof of their wares and they cannot produce. Isn’t it great we can unite from all over the world in the virtual world and through that regain our voice and our power!
Thank you, Olga. Curious that Videbech (sp?) claims that “switching,” i.e. from depression to bipolar disorder after taking antidepressants is “very rare.” I know of many people this has happened to, including myself. It might be “rare” in the sense of not being acknowledged by psychiatry. Typically, when switching happens, this is just taken as “proof” that you were already bipolar or at least genetically susceptible to bipolar disorder. These clowns wouldn’t pass a first year philosophy course.
Philopsophy?? “Whats that” I hear them say, “a new diagnosis, wonder what drugs are needed…”
My publisher in Denmark asked that I write a response to the review. Here is what I wrote:
To: (Book editor):
I have read Poul Videbech’s review of my book, Anatomy of An Epidemic, in Today’s Medicine, and I have to confess, I am not sure I have ever read a more ill-informed—and just blatantly dishonest—review of any book in my life. It surely is not about the book I wrote.
First, what is Anatomy of an Epidemic actually about?
In this book, I start by raising a basic question: Why, in this era of increased use of psychiatric medications, are we seeing such a sharp rise in the number of disabled mentally ill? For instance, in the United States, the number of adults receiving a disability payment due to mental illness rose from 1.25 million in 1987 (the year that Prozac was introduced) to 4 million in 2007. Similar rises in disability have been seen in country after country during the Prozac era—Australia, New Zealand, Iceland, U.K., and Denmark, for instance.
Once those numbers are presented, I state this: We know that many people are helped by psychiatric medications, particularly over the short term. But how do the medications shape the long-term outcomes of people diagnosed with major disorders like schizophrenia, anxiety, depression, and bipolar disorder? Do they improve the likelihood that people will recover and function well over the long term? Or do they, for some reason, increase the likelihood that a person will become chronically ill, and thus increase disability rates?
As I seek to answer those questions, I do so in a very simple way: What does a thorough review of the scientific literature reveal?
As part of that review of the scientific literature, I first look at the chemical imbalance theory of mental disorders. I review the reasons it arose, how it was investigated, and how, starting in the early 1980s, researchers began concluding that this was a hypothesis that wasn’t panning out. For instance, people diagnosed with depression were not found to have a deficiency in serotonin, at least not prior to their being medicated. I then reviewed research into how the brain is changed by psychiatric medications, and why that compensatory change might prove problematic over the long-term.
Next, I review the outcomes literature for the different diagnoses, from 1960 until today, and that literature tells a consistent story: on the whole, psychiatric medications do increase the chronicity of major mental disorders, and increase the risk of disability. This is even true in schizophrenia: in the only long-term prospective study conducted in the United States, the recovery rate for those who stopped taking antipsychotics was eight times higher over the long-term than for those who were medication compliant. A recent randomized study conducted in the Netherlands also found a higher long-term recovery rate for those who were tapered down to a very low dose or were able to stop taking the antipsychotic altogether.
Now, in response to a few specific points in Videbech’s review:
• Dr. Videbech says that it is old news that the chemical imbalance theory of mental disorders never panned out. In a sense, he is right: researchers were drawing that conclusion in the 1980s. But I am pretty sure that psychiatry, in the United States, in Denmark, and in numerous other countries, failed to tell that finding to the public. Instead, the public was informed that these drugs were “like insulin for diabetes.” For that reason, it is hardly “old news” to the public.
• Dr. Videbech suggests that I believe that it is “possible that schizophrenia does not exist.” Here, he is trying to tell readers I am writing from an “antipsychiatry” perspective, or that I believe that—a la Thomas Szasz—that I believe that mental illness is a “myth.” In fact, what I write about is how Emil Kraepelin’s initial conception of schizophrenia was confounded by the fact that many of the patients he studied were almost certainly ill with encephalitis lethargica, a viral illness that had yet to be identified. Once that illness was identified, the presenting symptoms of patients diagnosed with schizophrenia underwent a change, and thus, when we try to identify schizophrenia outcomes prior to the arrival of chlorpromazine into asylum medicine in 1955, we have to look at the reported outcomes for patients diagnosed from 1945 to 1955, as opposed to outcomes for Kraepelin’s patients.
• Dr. Videbech notes that medical programs in many countries emphasize the importance of getting young people with symptoms of schizophrenia into treatment quickly. I agree that is a good goal, and in the solutions section of my book, I write of a program in northern Finland that is very good at that. But the question remains, what should that early treatment be? In northern Finland, which has the best five-year outcomes in the Western world for psychotic patients, the emphasis is on psychosocial care, and minimizing use of antipsychotics.
• Dr. Videbech says I claim that antipsychotics “damage” the brain, and that I ignore all of the abundant evidence that people who don’t receive medication have a “propensity for shrinkage of certain brain regions.” Unfortunately, there is evidence that antipsychotics shrink the brain, with this happening apart from any brain shrinkage that can be attributed to the illness. For instance, Nancy Andreasen, the former editor of the American Journal of Psychiatry, has now reported on several occasions that antipsychotics reduce brain volumes.
• Dr. Videbech says that it is “very rare” that antidepressants cause a depressed patient to switch into mania, and thus move from a diagnosis of depression to a bipolar diagnosis. In fact, this is a well-recognized risk with antidepressants, and it is not “rare.” Researchers at Yale University of Medicine, in a review of the records of 87,290 patients diagnosed with depression or anxiety, determined that those treated with antidepressants converted to bipolar at the rate of 7.7 percent per year, which was three times greater than for those not exposed to the drugs. This is one reason for the sharp rise in the number of people diagnosed with bipolar illness, which in turn is one of the primary reasons that disability rates have skyrocketed in the United States and other countries where SSRI antidepressants are widely used.
• Finally, Dr. Videbech complains that “there are not many references to scientific studies (in Anatomy); instead quite a number cite newspaper articles and popular science books.” This is an instance where it is so easy to show that Dr. Videbech is just writing nonsense and making things up. For instance, in the seven chapters in Anatomy devoted to reviewing the scientific literature for outcomes, there are 422 citations, and probably 80% are for articles that were published in medical journals.
Beyond these few specific points raised by Dr. Videbech, most of the rest of his review is just rhetoric. Your readers can decide whether his words are informative, or whether they are—such as comparing me to a “little boy” with no clothes on—really rather juvenile in kind.
For someone criticizing you for not referring to scientific studies, his review was glaringly free of any references of his own. If this is the best that Danish psychiatry can do, they’re probably helping market your book by putting up such an incredibly lame rhetorical defense without so much as a single footnote.
Rock on, Bob!
Your great response has been passed on by PsykoVision to Todays Medicine. It would be very unusual if it was not published.
So as they say… watch this space!
I sure hope Bob’s response to one of Denmark’s leading psychiatrists gets picked up by the Danish media. And unlike what would happen here in the US, I think it will.
This chapter in the controversy is going to illustrate what I said earlier, that whenever our side and that of the psychiatric establishment are presented together, our side always looks better. Imagine the Danish newspaper reader comparing Bob’s clear and well-thought-out letter to Doctor Videbech’s semi-deranged rant.
I love it, I just love it! Go Denmark! lol
Oh the Danish media will pick up on it, are picking up on it, Peter Gotzsche said this is going to hit Videbech like a boomerang and as he is a prominent psychiatrist it will also hit psychiatry. Interesting times lie ahead!!
Just wanted to add that it’s entirely possible that “switching” (from unipolar to bipolar 3) is under-reported simply because it’s under-recognized.
Given my case history, switching is clearly what happened to me yet they persist in calling me bipolar 1 (you know, when I’m not schizoaffective or borderline or any of the other labels that have been applied to me).
I really want this phenomenon addressed. Many, many people have had the same experience that I have and their doctor has just done the “Aha, so you must been bipolar all along” thing. It’s just a way to deflect criticism, I think.
I’m just guessing from anecdotal reports (I am not a researcher) but I would think switching happens often enough that the FDA should do a black box warning. Being honest about bipolar 3 might vastly change psychiatry’s approach to mood disorders. As always, I dream of change for the better.
This is similar to the response of Doctor Bender, the one who gave me shock at the age of six. When the children who were shocked obviously were emotionally damaged, she said that this was a good thing, as now their underlying disease had come to the surface and could be treated more easily. I think, Francesca, that you really are bringing up an important point.
But didn’t Bob W bring this out in the case of children, that a lot of the newly diagnosed “bipolar” children had their brains’ regulatory mechanisms damaged by their earlier drugging. It would be good if Bob would chime in here, because he is so familiar with this stuff.
You’re quite right, Ted. Bob certainly did address this issue (although I can’t remember at the moment in which book). I just cannot believe that anybody would think drugging or shocking a child would be therapeutic. “Underlying disease”! These psychiatrists will twist and turn, anything to avoid taking responsibility. I actually quite like my current psychiatrist yet he still encourages me to “drink the Kool Aid” that he was clearly taught at medical school. I really don’t know what it’s going to take.
It will take nothing short of tens of thousands of people or more going on a spontaneous Bender with tasers in the so called civilized nations of the world, in an unannounced way shocking by surprise thousands of psychiatrists and taping protests and declarations on their clothes stating that Thy must stop shocking and drugging children .Psychiatrists are among the most cowardly people I’ve ever seen especially when they are inside a mental hospital.They are very skittish as if they understood the damage they are doing.
Oh, they understand very well what they’re responsible for. But no one, especially in the hospital, either “patients” or staff, ever call them on it.
In the hospital where I work very careful plans are being laid to ennable such questions to start being raised for discussion. Such discussions will probably be very ugly with much raving and ranting and frothing at the mouth by the psychiatrists. It should be very interesting.
Ted, yes that is in Anatomy of an Epidemic. It is quite clear that there is a risk that a child or adolescent treated with a stimulant or an antidepressant will show increased mood instability that will lead to a bipolar diagnosis. When Yale researchers investigated the risk that an antidepressant could stir a manic episode, they calculated that risk according to age, and it was highest for those around 13 years old. Anecdotally, I am now hearing of another risk, and that is how often youth admitted for a first psychotic episode have been on a stimulant for some time. There is a known risk that stimulants can cause a psychotic episode, but this seems to be another nuance to that risk, in which you have had someone on stimulants for many years, and then comes the psychotic episode. But the evidence for this, at this point, is anecdotal in kind, and I haven’t seen it reported on in a study.
There is a study in Canadian J Psych from the early 2000s where they retrospectively looked at records of kids who had been prescribed stimulants, and something like 6.8 % of the records showed some level of psychotic symptoms. It is not rare. It is reflected on the label of Ritalin at the least, and I think Adderall as well, so I have to think there is more evidence of this. Of course, it should be a no brainer that stimulants can cause psychosis, since that’s part of how the dopamine hypothisis got its start, based on meth or cocaine users becoming psychotic on high dosages.
I am sure I can dredge up the reference if anyone is interested in looking it over.
Interestingly France does not seem to have ADHD…
Excellent work as usual Bob. However, I must take issue with the Szasz statement because it does misrepresent his position. Szasz used the word ‘myth’ with it’s true academic meaning as defined by the philosopher Gilbert Ryle.
“A myth is, of course, not a fairy story. It is the presentation of facts belonging to one category in the idioms appropriate to another. To explode a myth is accordingly not to deny the facts but to re-allocate them.”
Szasz is saying, not that the conditions called ‘mental illness’ do not exist, but that unwanted or deviant social behaviour has been wrongly ‘medicalised’, defined as being caused by a ‘disease’ and thus needing medical treatment. A myth is a belief system that underpins a particular society and its views. And as Ryle would explain it – mental illness is a ‘category error’.
Sorry to derail the thread a little, but I am always concerned when I see Szasz’s work being misunderstood.
Steve, that Canadian study you are talking about (1999) found that 9 of 96 youth treated with a stimulant for an average of 21 months developed psychotic symptoms. And as you say, the dopamine hypothesis arose in part because of the fact that stimulants, which up dopamine levels, at least transiently, can stir psychosis. There is something more I am talking about here, which I am hearing more about, and that is how long-term stimulant use may carry the risk of not just triggering a psychotic event, but carry a risk of causing some long-term changes that in turn increases the risk of being diagnosed with schizophrenia. That is what I don’t think has been studied, the risk of that occurring over the long term.
ANd Nick, as for Szasz, I agree with what you write here about what a “myth” is. My point here, in responding to Videbech, is that he is trying to use Szasz as a way to immediately discredit me with readers, as if I am writing from that perspective. And here is the relevant point: What I do in Anatomy is basically go through the scientific literature with this understanding: okay, psychiatry says it can group psychiatric symptoms into these various categories (schizophrenia, depression, bipolar, etc.) Based on its own literature and its own outcome measures, do its treatment improve outcomes over the long term. And Videbech, by raising Szasz, is trying to avoid that essential fact about Anatomy, that it is a review of the story told in biological psychiatry’s own literature.