Open Letter Re: This Morning‘s Feature on Depression

Julie Leonovs
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Dear Dr Chris Steele

RE: This Morning Feature on Depression – 18th of March 2014

We would like to express our grave concern over the information and advice you gave several of your participants on the programme including Dee, and then Nicola and Dan specifically, during the phone-in.

On the majority of occasions whilst imparting your medical knowledge (and personal experience) on depression, you clearly stated that this condition was due to a ‘chemical imbalance’ in the brain caused through a depletion of serotonin. You stated quite categorically that anti-depressants (ADs) would be the main answer to help people get back on track (like they continue to help you). You even stated a person might need to be on anti-depressants for life and that this would be ok.

It was clear Dee has major social difficulties and this is having an impact on her ability to manage and cope. Although you stated Dee’s circumstances caused a depletion of serotonin in her brain and that drugs would correct this, there is no scientific evidence to support your assertion that Dee actually has a “depletion” or chemical imbalance and that ADs correct any imbalance.  What is the proper level of serotonin?  What medically established, peer reviewed test, measures serotonin in the brain?  What region is this serotonin being sampled?

It was also very clear to us that Dan was suffering from bereavement due to the recent loss of his father. He said he was feeling tired, grumpy, couldn’t sleep and was crying all the time. Yet again you said Dan had all the symptoms of clinical depression and therefore it would be better for him to see his practitioner, who would hopefully prescribe anti-depressants. Can I ask you: If Dan’s above reactions are ‘symptoms’ of clinical depression, then what would you say are the signs of understandable grief? Grief is not an illness and feeling overwhelming emotions is a natural human response. In fact, there can be a number of stages someone will go through like shock, sadness and anger to name a few. Doctors are supposed to use the least intrusive method possible first, and recommending he begin taking a brain-altering drug was unhelpful and potentially harmful considering the main effects of taking ADs such as aggression, suicidal ideation, and suicide itself. Bereavement cannot be ‘medicalised’ in this way and to suggest this is sending out the wrong message to a person having to accept loss and work through the grieving process.

Regarding Nicola, you again pushed the use of long-term drugs, saying it ‘gets you back to normal.’ Drugs cannot make you ‘normal’, as their very mode of action is to impair true normal brain functioning.  You are making yet another recommendation for drugs to correct an imbalance that has never been consistently found and shown to cause depression. Quite the opposite in fact: Research has shown that psychiatric drugs do indeed create ‘perturbations in neurotransmitter functioning’ thereby affecting normal homeostatic mechanisms that exist in the brain, which in the long term can cause permanent neural dysfunction (Hyman 1996). As a result, we feel Nicola would clearly have benefitted more from intensive talking therapy to explore her underlying fears and anxiety, and certainly from the support of caring friends and family rather than resort to long term ADs.

The notion of a ‘chemical imbalance’ is now a fairly outdated view, and it is irresponsible and unethical to continue to indicate to the public they suffer from an imbalance where non has ever been consistently found and replicated within the peer reviewed professional journals.

“There is no scientific evidence whatsoever that clinical depression is due to any kind of biological deficit state.” (Ross 1995, Associate Professor of Psychiatry)

Stanford Psychiatrist Dr. David Burns has stated:

“I spent the first several years of my career doing full time research on brain serotonin metabolism, but I never saw convincing evidence that any psychiatric disorder, including depression, results from a deficiency of brain serotonin.” (Lacasse, J. 2005)

In fact the American Psychiatric Association has openly admitted for a long time now that this theory of a chemical imbalance was all just a metaphor, a myth invented by the pharmaceutical companies to generate drug sales!

“The psychiatric profession has finally come clean and confessed on a national media outlet that there is no evidence to support the Serotonin Theory of Depression . . . However, according to Pies, it was the pharmaceutical companies who espoused the theory, and not well-informed, practicing clinicians, because the psychiatry community has known all along that the theory is not true.” (Leo, J. and Lacasse, J., 2012)

There are many more academic papers and journals highlighting these findings. We feel to ignore such evidence is unprofessional, naïve and unethical.

To imply to viewers there is known scientific evidence to support the ‘chemical imbalance’ theory is misleading and could potentially do more harm than good. If a person is led to believe they have a ‘chemical deficiency’ then this can affect how they perceive themselves, how other perceive them, cause them to take drugs thereby masking the main external difficulties, affect ‘treatment’ plans and more so, create a prolonged road to healing. Instead of focusing on how they can sort their external life out, they resolve themselves to believing there is nothing they can do due to their ‘illness’. To suggest a person needs anti-depressants only reinforces that they are ‘ill’, with ‘a magic bullet’ being the only solution.

The chemical imbalance theory of depression can affect a person’s perception of himself or herself. Compared to a bio-psychosocial explanation, the chemical imbalance explanation was less credible and led to decreased personal and moral responsibility for depression, a worse expected prognosis, and the perception that psychosocial interventions are largely ineffective. (Deacon and Baird 2009) 

To suggest that a person has a depletion of chemicals in their brain actually leaves the problem at the person’s door. So, as in the cases of Dee, Dan and Nicola it implies that suffering is caused by an internal biological abnormality, which can be treated with drug intervention. So who helps to support Dee with her social problems, Dan with his grief and Nicola with her deep rooted fears? Detracting from their external predicaments and suggesting a physiological internal cause, is equivalent to using people as scapegoats and ignoring the moral and social responsibilities we all have as people to support the vulnerable and to challenge the wrongs that reside within society.

This also brings us to the point that during your TV appearance, the advice you gave placed the greatest emphasis on psychiatric drug interventions.  We felt that ‘talking therapies’, social work or carer support – not to mention support and love from family and friends, participation in external activities etc was gravely omitted from your advice. We felt these options would have been far more effective for Dee, Dan and Nicola enabling them to explore and manage their life circumstances. Yet, you instantly jumped to drugs as the remedy without consideration for their extenuating circumstances.

Research has actually shown that ‘antidepressants’ are no more effective than placebo and clearly have unwanted side effects like agitation and anxiety.

The problem is not that people do not improve on medication. They do, and on average the degree of improvement is clinically significant. But people also improve on placebos. This suggests it is not the drug that is making people better (Kirsch 2009)

Even more alarmingly, it’s now recognised by the medical profession that suicidal thoughts and feelings can increase, whilst starting and during the first few weeks and even months of taking an anti-depressant.

To suggest also that someone should be on them for life ‘which is ok’, we find even more shocking considering the long term physical damage that can occur. We also find it quite sad that you actually feel you need to be on anti-depressants for life yourself. Based on the research, we would question your claim and wonder if you too, have actually bought into the myth of the chemical cure or if your own drug usage is the reason for such recommendations? If this is the case then using yourself as an example, is not evidence-based interventions based on peer reviewed long term data but rather personalised marketing. In some circumstances medical professionals also have vested interests in the pharmaceutical industry and patients deserve to know if this is the case, although we are not suggesting this here with you.

Dr Steele, bearing in mind the findings from the research we have highlighted above and the ever growing publication of research on this subject matter, we trust you will take our concerns onboard and refrain from using information that cannot be substantiated scientifically. To continue to do so is not only misleading but also grossly unethical. Making claims via the media that cannot be proven scientifically we feel actually has serious implications for the health and well being of This Morning’s viewing audience and therefore the programme could be an infringement of broadcasting legislation.

We would appreciate a response from yourself or producers of This Morning as soon as possible.

Regards

Julie Leonovs (with contributions by Nick Redman)

Cc:

Julie Leonovs: BSc (Hons), MSc Psychological Research Methods, Mental Health Advocate

Nick Redman: Bristol Hearing Voices Network

References:

Deacon, J. B and Baird, L. G. (2009) “The Chemical Imbalance Explanation of Depression: Reducing Blame at what Cost? Journal of Social and Clinical Psychology, Vol 28, No. 4: pp. 415-435

Hyman, S. (1996) “Initiation and adaptationA paradigm for understanding psychotropic drug action”. American Journal of Psychiatry 153 151-61

Kirsch, I. (2009) The Emperor’s New Drugs: Exploding the Antidepressant Myth. The Bodley Head, London.

Lacasse, J. (2005) ‘Serotonin and Depression: a disconnect between the advertisements and the scientific literature’. PloS Medicine  Vol 2.: 1211-16

Leo, J and Lacasse, J (2012) Psychiatry’s Grand Confession [online] Available from: https://www.madinamerica.com/2012/01/psychiatrys-grand-confession/ [Accessed March 2014]

Ross, C (1995) ‘Pseudoscience in Biological Psychiatry’. (New York: John Wiley & Sons) 111

In support of this letter:

Rachel Waddingham: London Hearing Voices Project Manager, Mind in Camden

Patrice Campion: BSc (Hons), MSc Psychological Research

Mental Health North East (MHNE) England.

Dr R Huws: Consultant Psychiatrist, Sheffield

Hugh Middleton: Hon. Consultant Psychiatrist Nottinghamshire Healthcare NHS Trust & Associate Professor, University of Nottingham. Co-Chair, UK Critical Psychiatry Network.

Dr James Davies: Senior Lecturer in Psychology and Social Anthropology, University of Roehampton

Suman Fernando: Visiting Professor, Faculty of Social Sciences & Humanities, London Metropolitan University. Former Consultant Psychiatrist

Philip Thomas: Honorary Visiting Professor, Social Science and Humanities, University of Bradford. Formerly Consultant Psychiatrist Bradford District Care Trust

Sami Timimi: Consultant child and Adolescent Psychiatrist, Director of Medical Education Lincolnshire Partnership Foundation NHS Trust

Paula J. Caplan: Ph.D., clinical and research psychologist, Associate, DuBois Institute, Harvard University, former member of two DSM committees, and author of They Say You’re Crazy: How the World’s Most Powerful Psychiatrists Decide Who’s Normal.

Mary Maddock: Board Member MindFreedom International/Co-author Soul Survivor – A Personal Encounter with Psychiatry.

Katie Mottram: Development Group Member UK Spiritual Crisis Network

Marian B. Goldstein: Counsellor, Co-char Danish Hearing Voices Network

Olga Runciman: Psychologist and Chair of the Danish Hearing Voices Network.

Speak Out Against Psychiatry (SOAP)

Cheryl Prax

Bernadette Bushe

Susan Kingsley-Smith: IC – Contributing Author: Coming off Psychiatric Drugs 2014 by Peter Lehmann Speaker: Proactive Planning – Reducing Reliance on and Considering Safe Withdrawal from Psychiatric Drugs, Companion Guide to the PACE Manual: Creating Your Own Proactive Plan; Founder Empowering Solutions project.

Nancy Rubenstein Del Giudice: Director of Public Education and Volunteer Coordinator The Law Project for Psychiatric Rights (PsychRights.org)

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Julie Leonovs

After a masters in Psychological Research Methods and a degree in psychology, Julie’s main focus has now switched to the myth of psychiatric diagnosis and how labelling can harm those suffering emotional distress. She strongly feels there is an over-reliance on the disease-based model which can ultimately detract from an individual’s personal suffering. As, a consequence Julie is a strong believer in the non-drug approach towards healing and would prefer professionals to recognise and utilise the many alternative ways for supporting those going through trauma and crisis. What is needed is a complete paradigm shift in how we view those experiencing emotional overwhelm and subsequently how we then support and enable individuals to heal. Consequently, through her own experiences she is now a strong advocate in promoting the rights of those engaged within mental health services and similar environments based in the UK.

(Thank you to Nick Redman for his support in compiling this letter.)

55 COMMENTS

  1. Great article. The only thing I would add is that, in describing the idea of an imbalance as some kind of “metaphor,” I would suspect that the establishment is trying to head off suits for malpractice. There is, after all, nothing about the idea of an imbalance that is metaphorical. “My luv is like a red, red rose” — that’s metaphorical. Putting the idea out there, — a quite specific, detailed, and scientifically based idea — that the chemicals in your brain are out of balance is not metaphorical in any way. The problem is not the use of poetic language. It is the theory itself, and the actions that followed, using that theory as justification. Letting them call it a metaphor is to let them wriggle out of responsibility.

  2. The fact that I’m such a lousy librarian and secretary is getting on my last nerve right now. If anyone has a link to an article that includes a quote from a psychiatrist acknowledging that there is no evidence for the “chemical imbalance” theory (hypothesis) and saying that it’s something that the patient can “understand”, please link to it here. With the chemical imbalance charade, the other metaphor— that an antidepressant for depression is just like insulin for diabetes— comes into play and likely wins.

    With this bio-belief, psychological intervention is rendered useless, therefore, the psychiatrist wins the race and the jackpot that comes with it. People also are led to believe that SSRIs only act on serotonin, correcting the imbalance, and have no other effects. While under the influence of an SSRI, the patient may not be able to tell that something is an effect of the drug, and not them or their “disease” that is responsible for any behavior or thoughts that are induced by the drug.

  3. How much ignorance is feigned I do not know, but I suspect many psychiatrists realize they are phonies and that they are really no different from the witchdoctors their ancestor laughed about. Still there are bills to pay and miles in an expensive car to go. Without the drugs many of these men and women would be out of a job. So there you are.

    In my opinion depression and mental illness in general are a matter of two things: identification and agency. If I do not know who I am how can I claim to be the negative emotions I experience? If I drive through a dark and dismal slum I do not immediately conclude I am a dark and dismal slum. Why not? If I see a cat, I do not conclude I am a cat. Again why not? When I perceive a negative emotion and a negative thought why must I conclude that is me? So the important thing is to get a self certifying answer to the question, who am I.

    Secondly, who is the doer? Can anyone give a certain answer to that one? Clearly when a loud unexpected sound goes off nearby, and I jump, my agency is not apparent at all. At what stage do I become the genuine doer? The German philosopher Schopenhauer gave this answer regarding our actions: Doing comes from essence. That was a medieval answer to the question. Thus the thoughts and emotions that come into my mind are in some sense a reflection of who I am as a unique person. I have not simply been thrown into the environment. But almost all of the time thoughts and impulses simply arrive unannounced are acting upon or not. It is with great difficult that anyone can make any sense out of the notion of free will other than the legal definition–involving sanity and not being coerced at the time.

    Depression is often a long journey through the subconscious slums like a journalist living for months or years in a war torn country. Destroyed edifices, smoke, hungry people, wounded and dead, torn trees and cloudy skies and the sounds of gun fire and motar shells.

  4. Excellent article; thank you for your community service!

    It’s wrong to prescribe medicine to “cure” normal biology; depression is the natural, normal response to depressing experiences. My biggest criticism of psychotropic drugs is that the drugs cause fatigue that reduce the ability to work through the real problems that cause emotional distress.

    Best wishes, Steve

  5. Great read, good argument. I wonder whether with the medical approach drugs could be done away with and placebos be prescribed instead? After all, if placebos are effective (as effective as drugs laden with harmful effects) wouldn’t it be beneficial to take them? The bind here of course is that you’d have to believe you’re taking ‘medication’, which means that somebody has to lie about what they’re giving you and at the same time they’d presumably profit from the lie! Also, I’ve found in my case an ‘extended’ or ‘extra’ placebo effect occurs, whereby particular people buy the ‘chemical imbalance’ line, I’m guessing because it invariably comes from a doctor, and somehow, miraculously, when I’ve taken prescribed medication it’s had an instantaneous effect. They believe they’ve done something positive when I take the drug, their behaviour changes instantaneously to a state of relaxation and, in this now non-confrontational environment, I’m able to relax myself. To the other party, this easing of tension in the room is evidence of the efficacy of the medication! Pointing out that nobody in the medical world claims so-called medications act instantaneously never helps. So, love the letter posted above, it highlights some of the arguments which one would hope might persuade more people to question medicine’s ‘biological fix’ approach.

    • It’s interesting that people would ask for what they know is a placebo. In this case, the added benefit would be that the placebo does not have other unwanted effects, that antidepressants certainly have.

      It’s not unusual for transplant recipients to feel so good on their anti-rejection medication (steroids) that they stop taking them. They don’t start to feel bad until a significant amount of time after their body starts rejecting the organ. The good feelings are a drug induced state that don’t work in their favor. A lot of drugs do work for what they’re supposed to work for and the failure to take those drugs has life-threatening consequences.

      The fact that the placebo effect is so significant in antidepressants is a side effect of the fact that for most people these drugs don’t really do much for “depression”. When all the data is properly collected and analyzed, the effectiveness is not much different from placebo. That doesn’t mean that an antidepressant doesn’t have a significant and positive effect on some people— way over placebo— ,but that they’re not effective on the whole and should stop being promoted as a likely solution to the problems of “depression” for anyone who anyone thinks is suffering from it, whatever “depression” means.

      • The problem with giving a placebo to a distressed person is that it implies there is a “medical” problem.
        If we want to change the paradigm from a medical model to a psychological one, we shouldn’t even “pretend” pills of any kind are helpful.

  6. @ Julie Leonovs @ Nick Redman

    Thank you for the clear wording and the call for a response on why psychiatrists still give recommendations that are clearly biased towards neuroleptic drugs. The late confession that ‘the psychiatry community has known all along that the theory (on Serotonin depletion) is not true.” (Leo, J. and Lacasse, J., 2012) can make a rather cynical read with regards to guidelines and practices, and primarily, to harm done to patients.

    In my view it is important to support a paradigm shift from ‘treatment’ to ‘reciprocal learning’ using diverse sources of insight, experience, embodied, psychological and social factors in mental health disturbance and step-wise subjective recovery (based on respect for a person defined relation to her unusual experiences). Therefore exploration and evaluation of the social, emotional, developmental, growth processes, the pocesses of change through dialogue and learning in different ‘talk therapies’, peer-run or co-facilitated support groups, peer-run and co-facilitated recovery education programs is needed. It is needed exactly to be able to evaluate the beneficial and possible distressing effects in face-to-face and group-based exchange, learning, growth and empowerment processes vs processes that can lead to distress and rejection. In my view a much better understanding of beneficial and challenging social learning processes in facilitated peer support groups as safe spaces (sic) has shamefully been neglected in research. This may be due to the public opinion, and I am afraid many mh professionals’ view, that peer support is only self-help and the real effective treatment must be conducted by psychiatrists and psychologists.

    The research and evaluation into consumer-led/user-led/co-produced experience-based support groups which make use of psychological and social learning processes, using experienced based planning of subjective recovery (with respect to ongoing vulnerability or unusual perceptions whilst supporting constructive meaning-making and self-empowerment, more personal control over distressing experiences and support for the up-take of social, educational, vocational activities) has only been expanding over the last years and funding is still scarce. However, in parallel to social and political activism, it is decisive, in my opinion, to build systematic and broad evidence on the potentials, processes, benefits, but also challenges and potential harms to be addressed, inherent to experienced-based, reciprocal learning and social empowerment in peer support and recovery group programs.

    I agree, the notion of subjective recovery needs be nuanced and critically discussed. I here refer to a fundamental right to socially mediated recovery of self in a subjectively meaningful and active life highly dependent on social opportunities for many people. Social mediating refers to the necessity for most people to be heard and listened and answered in order to listen to themselves, give more hopeful responses to thoughts, voices, roles of self. Facilitated peer support & recovery group programs have unique experiential knowledge, real social diversity and therefore safety to offer which has been too little explored and evaluated.

    To abstain from exploring and evidencing the complexity of processes and benefits as well as challenges in facilitated peer support & recovery learning programs does, in my view, serve traditional treatment policies at the dispense of these ‘new’, experienced-based, facilitated support and recovery group programs.
    The issue of ‘brain imbalance’ is far too complex, in my view, to be debated in dichotomous injections of yes or no, for or against, which miss and distort how the brain and bodily cns work in super-complex ‘imbalance regulations’ being informed by embodied interactions, intentional thoughts and expectations related to social interactions, values, norm and power disparities or structural and interpersonal violence. It is because people know that their brains, bodies, emotions and thoughts (all organically and socially mediated) function in regulated and structurally shaped ‘flows of imbalances’ that nearly everybody, professionals and clients, gives some credibility to the ‘brain imbalance’ claims. Fundamentally, what has been shown through knowledge of brain and embodied functioning is that the brain is not a causal actor and that drug consumption easily and most often result in harmful effects because psychotropic drugs non-specifically target striatal, meso-limbic and neocortical neurological circuits and significantly interfere with the necessary ‘grades of freedom’ for regulation of body-cns-brain. However, this discussion exceeds my knowledge. My contribution is to caution not to get trapped in ‘brain imbalance, true or false’ – debates which by their very over-simplistic wording seem misleading and unhelpful to me. I welcome all research evidencing how the neuroleptic over-dosing of the whole living organ-cns-brain leads to extreme and enduring physiological harms, emotional and psychological impairments, etc.
    Research into activities which support restauring embodied and neurological complexity and flexibility of functioning has been far too little undertaken. This is only partly due to the complexity, dynamics, inter-connectedness and inter-activity to be accounted for. Nevertheless, there may be promising developments in embodiment and inter-action research, and one day more ‘robust and rigorous’ evidence on the healing emotional and organismic and mental (complex inter-regulations restauring) effects of yoga, animal contact, multi-layered processes in music making, and many more.

    In my view building a scientific research paradigm for embodied, emotional, intention and interaction supporting ‘holistic’ activities has been badly neglected. I mention this to emphasize that the ‘brain-gaze’ needs be opened up to a perspective on a more ‘socio-ecological’ research paradigm. This will enhance our knowledge on dialogical, embodied, inter-actional and socially supported healing, recovery and empowerment processes, plus how these can be supported by ‘healthy lifestyle’ activities. The usefulness of these approaches for drug withdrawal, with only minimal use of neuroleptic drugs in the beginning of truly severe organismic, affective and mental ‘terror-disturbance’, is part of my thinking. I hope it becomes clear to the reader why I chose to offer broader questions and perspectives and not respond in a more targeted way.

    • I agree. Thinking of mental/emotional distress as homeostatic imbalance (rather than dysfunction) that likely involves every system of the human brain/mind/culture would embrace the complexity of our lives, minds, and problems.

      For nicotine addicts, for instance, the relapses that occur up to a year after quitting are often interpreted as psychological problems or a failure of will, but are really a sort of wig-out, a temporary physiological state in which the pleasure/pain center of the brain appears to be going haywire in an effort to reach balance. It’s a necessary step that is uncomfortable to tortuous— it can feel like mania or depression; but is really just a wild swing of the pendulum in its effort to reach homeostatic balance. It will pass, and efforts to analyze oneself psychologically during these times are a waste.

      It takes a full year for a brain to return to normal functioning after quitting smoking. This is true for a whole lot of drugs that pass the blood/brain barrier and alter the chemical functioning of the brain. Could mental habits or responses such as those that result in learned helplessness also affect the chemical functioning of the brain in the same way some drugs do? How could they not? The thoughts are inseparable from the chemical phenomena. Could changing habits do as much to contribute to homeostatic balance in the brain as well as other interventions?

      The mind/brain is inseparable and the individual/social being is inseparable. We are social animals with a highly developed and very sensitive brain living in a highly-developed world that demands a lot from us. Many of those making the demands are nameless and faceless and appear to have no obligations to us. Our culture expects a lot from us, expects us to feel individually responsible for fulfilling it’s expectations, and discourages us from thinking of ourselves as the communal animals that we are.

      Divide and conquer is a tried and true method of social control. Othering people who suffer from the effects of pathological social behavior as if they were the pathology itself is a mean tactic and more effective and powerful when denied than it would be if it were seen for what it is.

      • “Divide and conquer is a tried and true method of social control. Othering people who suffer from the effects of pathological social behavior as if they were the pathology itself is a mean tactic and more powerful when denied than if it were seen for what it is.” This is how I’ve been told the religions have been covering up child abuse for decades, if not longer. And it’s what my family dealt with, I agree it’s pure evil.

  7. How many of these professionals, doctors, psychiatrists have actually suffered from depression themselves. Unless you have been through it personally you have no idea what it is like. Only the person who is suffering actually knows how they feel inside, the rest is speculation. Also, has it ever occurred to you that perhaps some people prefer to think that it is a chemical imbalance in their brain which makes them feel the way they do as opposed to thinking this is a normal part of life when very clearly it is not a normal part of life as those who have truly suffered would not wish the way you feel when suffering from depression on their worst enemies. I can’t stand these pompous academics who have nothing better to do in their lives but to speculate, comment and earn money from an illness they truly have no understanding of.

    • upanddown – I totally hear you and I think, have a good understanding of what you are expressing. Having experienced a full range of what psychiatry said was a “disease” what I have discovered personally is that 1. their problem focus and blaming my biology and genetics served only to keep me hopeless and helpless to change any of it. And 2. that there ARE solutions to the issues said to be a “disease” that must be managed with toxic chemicals “for the rest of my life”.

      At first – I appreciated the diagnosis. It gave me hope that if they could “find what was wrong” with me that they could offer me a solution. Yet after 15 years of this I was in worse shape than when I first asked for their help. And – I totally believed that this was my “illness”.

      I reached a point where I decided that if I could not find a way to “get better” that I no longer wanted to live that life that I called “the life of the living dead”. Yet – what I also discovered, quite accidentally, after an uninformed psychiatrist experimented on me by forcing me into a complete cold turkey withdrawal from multiple (polypharmacy) drugs including benzodiazapenes, mood stabilizers and anti depressants in 2007 – is that as I started going through the forced wd process is that it was the DRUGS that were making me sick. (I am NOT endorsing just “going off” psych drugs to ANYONE. For info on safe wd please visit http://www.beyondmeds.com). I slowly started to reclaim my brain, my health and my life.

      Even after going off the drugs though I realized there was more I could do to improve my “mental status”. The thing was – it was no “quick fix”. This process of healing the physical issues that influence my emotional well being and energy levels has taken quite some time and a lot of effort but – today I live drug free, I feel happy, have consistent good energy and I know that when I am not feeling well that by listening to my body and inner wisdom that I can right myself without chemical intervention. I also understand that life will have ups and downs, light and dark and have I learned how to “ride it out” vs thinking it would be “forever”.

      I am so sorry to hear that you still suffer and most compassionately hope that you find your way to what might set things right for you.

  8. Julie, thank you for writing this open letter, it is very thorough. The only thing I would personally add is mentioning that in addition to antidepressants increasing the risk of suicide and violence. They also can cause mania, which is frequently misdiagnosed as bipolar.

  9. Julie,
    ‘Chapeau’, thanks and applause for you responding to every single post. I have just up-dated my reading of today’s posts andyour answers. I find it enormously validating how you reflect all the main issues and arguments posted, share your thoughts and compassion about each. Awesome and very constructive. Is their a blog ‘author’ and ‘facilitator’ award somewhere out here for us to dedicate to you? So well merited!

  10. An intriguing question: if you were approached by someone who appeared to possess considerable power and given these choices which would you take?

    Alternative One: you are depressed and miserable because you are a sinner and unreformed. God is now punishing you in hopes that you will see the light. Give up your errant ways and do His will. Etc. You are not alone: there is God, his angel and the demons.

    Alternative Two: you are acutely depressed because you have a chemical imbalance. It may be genetic. We do not know. After all we are organic machines with lots of parts and perhaps some of yours are broken or badly formed. This drug may help. No guarantees of course, but we do have other drugs. And science is working away day and night to find others. Aside: yes, you are alone in the vastness of inner space.

    Alternative Three: There is some connection between the way you feel now and your past. It is not likely that you were born feeling miserable and depressed. It is not the natural condition of a human being. If you do a few healthful things though you might wonder why and find a good mentor to tell your stories to, you will recover and find some contentment and happiness. In the meantime you might find it useful to think of yourself as a traveler on a journey. Try to enjoy the journey. You can imagine yourself years from now feeling happy enough and looking back on now and wondering why you did not enjoy the scenes out the window . . . you might as well. It is a real part of being human to feel down in the dumps. It does not make you a freak. Great men and women have gone through lots of despair at times. Perhaps it is your greatness as a human being that is trying to get born; and birth can be painful. Don’t be misled. Have some faith in a flower or a tree; walk in a park and breath deeply. You are fine.

  11. Thank you so much for this open letter. It breaks my heart that these false narratives are still being propagated through our culture. Of course, I am angry at the professional institutions that perpetuate false information. But I am equally angered by the state of our media, which regularly colludes with big, powerful institutions rather than maintaining the skepticism and spirit if critical inquire essential to an informed public.

    In simpler language, its bad enough that doctors and psychiatrists regularly lie or regurgitate ignorance misinformation. It’s worse that our entire info-tainment culture consistently lets them get away with it. Thank you for calling that out.

  12. Excellent letter, thank you to all involved for composing it. I gave a lecture to some University academics the other day (from arts and humanities faculty), and they were shocked to hear that the chemical imbalance theory of depression has no scientific grounding. I just mention this just to illustrate how successful the marketing of the chemical imbalance has been. The general public just have no access to information debunking it, and as you point out, the media continue to propagate it. Leading psychiatrists know that the chemical imbalance theory of depression and justification for antidepressant use is unproven and ‘metaphorical.’ They do not want to challenge it publicly though because it helps to support disease-based theories of depression, which psychiatry is so fearful of losing.

    • I agree the pharma industry’s marketing models of ‘chemical imbalance’ are as vague and unspecific as the drug compounds’ effects on the scandalously broad target areas in the brain (and wider neuro-hormonal system).
      With regards to the implication of ‘chemical’ changes in the functional pathways in striatal-meso-limbic and inter-connectivity of ‘higher neo-cortical areas’ – preshaped in evolutionary circuits and adapted through behavioral plasticity – I would be interested in two main questions
      – specification of the useless and dangerous ‘chemical imbalance’ propaganda by context-behavior-related research into functional organic and neural pathways, using dynamic continuum models, and taking into account regulatory mechanisms of mind-body-context inter-connectedness
      – thereby exposing the falseness of an artificial disease model of un-located, non-pathway specific neuro-transmittor deficits or increases like in ‘chemical imbalance in the brain’
      However, my view only, I find it dangerous to promote an idea of there being no chemical imbalances in the brain as this is how it works, through regulated functional changes in transmittors and other compounds. My opinion is that a generalistic stance like ‘done with chemical imbalance theory’ – central and peripheral nervous system interregulation and enablement of organic, affective and mental states, through ‘functional chemical imbalances’ have no crucial role in major distress or fear/victimization/mental responses – can easily discredit the ‘naturalistic opinions’ (anti-medication, anti-chemical imbalance-based disease theory’ especially in the survivor/user/consumer movement. Most often, the critical and conventional psychiatric professionals and especially reseachers are at a much lesser risk to be ridiculed ‘ignorant’, exactly due to their knowledge of neurophysiology and interrelations between neurofunctional pathways and organisms ‘meaningful’ states (alert, attention, fight, freeze, flight etc) and their impact on behavior. In my view many in the survivor/user/consumer movement are vulnarable to ‘naturalistic anti-chemical-imbalance ideologies for two reasons – having suffered real harms by the overmedication with neuroleptic drugs and poly-pharmacy – lack of physiology and neurophysiology education related to organism’ enabled and cns interregulated experiences and behaviors.
      I just wish it is not the survivors/users/consumers who will be blamed of irrationality and extremism again for simplistic opposition to and rejection of the fraudulant abuse of chemical imbalance paradigm for sales of ‘overall’ brain-disease-related neuroleptic pharmaceuticals.
      PS My interest lies rather in the implication of neuronal pathways in central evolutionary circuits as possibly engaged – via organism in context – in fear/agitation/perception/mentalization in ‘delusions, paranoia, mania’. I am interested in possible relaxing and calming processes through embodied and contextualised, be it individual, be it social network, ‘interventions’ with as little use of carefully explained and agreeable neuroleptic medication as possible.