When the Tail Wags the Dog, Eventually the Dog Bites

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International events related to emotional health issues continue to shock the world, and call into question the value of the mental health industry. Recently, many people around the globe have felt devastated by the suicide of Robin Williams and shocked by the downing of the plane by Andreas Lubitz. Numerous incidents of violence have been shown to involve the mental health industry with some link to mental disorders or psychiatric medication. The important issue to understand is what do these connections mean.

Clearly mental health services are failing many individuals and society. All research on treatment modalities and outcome show poor results, with chronicity and frequent recurrences the norm. Many practitioners have come to accept this as all one can expect and have stopped truly listening to people’s pain. This leads to poor practice, with superficial diagnoses and multiple medications to control symptoms. Symptom control, whether by medication or simplistic approaches to therapy have become the main interest of mental health services.

This approach seems to suit managed care models, corporate needs, big pharma and the mental health industry in general. Emotional health is being redefined by special interests, in a manner that is actually changing the way people think of themselves. It is a case of the tail wagging the dog. It can be argued that it is precisely this orientation that is leading to catastrophic results.

To be up front, I prescribe psychiatric medication frequently, though usually as an adjunct to psychotherapy. Psychiatric medication can play an important role in relieving some symptoms, that may allow some people to feel better quickly and to work in therapy better. We should not be depriving people of relief from emotional pain by adhering rigidly to any kind of doctrine. What is crucial is that we listen to people carefully and with empathy to be able to figure out what can help them and what may hinder their emotional well­-being. We need to understand that DSM Axis I diagnoses are made up and do not generally describe disease processes, and that psychiatric medications do not cure diseases.

What psychiatric medications do is to change the functioning of brain pathways. There is no evidence that they make abnormal pathways normal. There is no evidence that even if there might be a brain abnormality in certain conditions that the medications work at the particular site of the abnormality. All they do is either block or accentuate some pathways somewhere along the route of certain nerve transmissions that in some ways alter the appearance of certain symptoms.

In other words; for the most part, psychiatric medications make normally functioning pathways act abnormally. This may have a beneficial effect, or it may lead to side effects, or it may make things worse.

For example, from a clinical perspective, most antidepressants act as emotion dampeners, though Peter Breggin prefers the name ‘zombifiers.” This effect may be helpful, with some people describing this as having a thicker skin, though for other people this feeling is very uncomfortable. From this point of view, let’s examine the situations of Robin Williams and Andreas Lubitz.

The death of Robin Williams saddened the world. Many of us will never watch one of his movies again with quite the same feeling of joy. There were clearly many aspects to his final decision, including a fear of his physical condition. He is also reported to have had bipolar disorder. While making this diagnosis on many people with emotional ups and downs has become a fad, I do not wish to dispute this possible diagnosis in Robin Williams. It does not appear that this diagnosis was a predominant factor in his death, though it is likely that his being seen and treated as if his main problem was a psychiatric disorder may have contributed to his suicide. The most important issue, involved in significant depressed and hopeless feelings, appears to be Robin’s vulnerability to decreased applause. This narcissistic vulnerability, as it is called in psychiatry, appears to have haunted him throughout his life. This is something that is treatable, but only if one recognizes the depth of the problem and doesn’t revert to just treating symptoms. It is likely then that Robin William’s death is an example of a DSM Axis I diagnosis contributing to a suicide. The issue of whether psychiatric medication may also have played a contributing role is highly uncertain in the case, though anyone who does receive a diagnosis and medication may end up feeling more hopeless when the medication does not take away one’s most painful feelings.

The life of Andreas Lubitz may be more germane to the issue of diagnoses and medication. What we know so far about him is that he deliberately planned to crash the plane, had been exploring ways to commit suicide, had a previous history of depressed moods, had seen numerous doctors over the previous months — including a psychiatrist, was preoccupied with worries about his vision, and was taking mirtazapine, an antidepressant, for insomnia.

We know that laws in Germany may have made it difficult for the doctors who saw him to report their concerns. This aspect rests in the hands of German society. What is clear is that Andreas Lubitz never received appropriate treatment for his emotional problems. We cannot necessarily blame the mental health system in Germany for this, nor the individual doctors. It is very possible that he was not amenable to receiving treatment. This is common in individuals with somatic preoccupations who look for a physical cause of their distress and refuse to accept the need for proper therapy. However, every attempt should have been made to engage him in proper psychotherapy and to work with him so that he would understand that agreeing to take time off work would help ensure his ability to maintain his career.

Ideally, the proper psychiatric approach to help him with his emotional distress should have occurred from his first appearance for depressed feelings. Suicide frequently is not the result of an acute appearance of a depressed mood, but happens after a person has struggled with repeated or chronic feelings of distress for years. Just treating symptoms rarely resolves the underlying emotional issues that lead to the depression in the first place, and often, as is shown in research, leads to frequent recurrences and accompanying hopelessness.

The use of mirtazapine in Lubitz is also concerning. Mirtazapine is a fairly poor antidepressant and as a sleeping aid frequently leads to daytime drowsiness. Any antidepressant can leave someone more detached from their feelings or actions. As one patient recently expressed “when I was on the antidepressant I didn’t think or have feelings about my actions. I just did things with little awareness of what I was doing.” As the dose of mirtazapine Lubitz was on was relatively low, one can’t be sure of whether it had any impact on his actions, though it did not appear to have relieved his insomnia or help his mood. As a sleep disturbance seemed to be a major aspect of Lubitz’s distress, there is the issue of why a more reliable sleep aid with less possible side effects possibly wasn’t used.

The most crucial issue, in these tragic situations and in the general mental health field, is the lack of attention to the complex emotional issues that lead to distress in many individuals. The overuse of DSM Axis I diagnoses and the over-reliance on medication and symptom control leaves many people with chronic distress and hopelessness. Doctors are being trained to not listen to people, but to rely on simplistic tools and symptom checklists to determine treatment.

My niece, who recently graduated medical school described what she learned in psychiatry as “elicit a list of symptoms, pick any diagnosis that seems to fit, and write a prescription for any SSRI.” The industry is defining what it means to be an emotional being and dictating how people should see themselves and their emotions, rather than the other way around. Sometimes when the tail wags the dog, the dog bites.  -Norman Hoffman MD, FRCPC

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54 COMMENTS

  1. “My niece, who recently graduated medical school described what she learned in psychiatry as ‘elicit a list of symptoms, pick any diagnosis that seems to fit, and write a prescription for any SSRI.'”
    Gee, what could possibly go wrong under that haphazard methodology!? To top it off, there is no blood test, urine test, brain scan–no objective laboratory measure to confirm anything whatsoever!

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    • This is what the psycho / pharmaceutical industries are teaching the PCP’s to do, too. Only some of the PCPs are lying to their patients and claiming the dangerous SNRIs are “safe smoking cessation meds,” so the patient doesn’t even know they were put on a mind altering, psychotropic drug. Then the doctors claim their “safe … med” couldn’t possibly have caused the known ADRs and withdrawal effects of the dangerous antidepressants. And ships the patient off to a psychiatrist, who further misdiagnoses the patient, as “bipolar.” And then the psychiatrist creates the symptoms of “bipolar” via the central symptoms of neuroleptic induced anticholinergic intoxication syndrome. “Gee, what could possibly go wrong under that haphazard methodology!?”

      This is how the psychiatric industry covers up easily recognized, and complex, iatrogenesis for the incompetent and unethical mainstream doctors. It’s called “the dirty little secret of the two original educated professions,” since it’s also, historically, how psychiatrists cover up child molestations for the religions.

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  2. The main thrust of your article is well-taken, crystallized in your phrase, “The most crucial issue, in these tragic situations and in the general mental health field, is the lack of attention to the complex emotional issues that lead to distress in many individuals.”

    I’d like to critique one thing.

    The article stated, “All research on treatment modalities and outcome show poor results, with chronicity and frequent recurrences the norm.” While I agree that in the big picture mental health treatments are very poor, saying that all research shows poor results is false. A limited amount of research shows quite good results, e.g. Barry Duncan’s research (e.g. The Heart and Soul of Change) on how helpful outpatient psychotherapy is to many, many people.

    Perhaps what you say is closer to the truth if only studies of zombification and brief therapies at hospitals is considered, but even then it’s not accurate. The Open Dialogue studies in Finland, the Need Adapted studies in Finland, and the recent RAISE studies by Dixon are some examples of approaches with relatively good results for severe emotional distress.

    There is also much qualitative research about extra-psychiatric approaches that is hopeful, e.g. Paris Williams’ Rethinking Madness and Marius Romme’s writing on recovery from hearing voices.

    We should highlight the limited amount of research that is hopeful, because this can encourage people.

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    • I stand corrected on that point. I agree with you in that there is good therapy and some good research. I was referring mostly to the simplistic diagnosis and symptom based research with standardized models of therapy. We do need to show that both research and therapy can be done in ways that address complex issues.

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      • Have many serious questions now regarding on the one hand, a clear anti-med bias expressed publically here…versus…my experience…of being left on, without question, so many, too many drugs, for so many years…assuming, that the doctor was doing what was best for me.

        I do believe my brain was ruined by that.

        All other issues aside. I struggle mightily with this. Within a very excellent system which I am lucky to have found.

        So far, I have taken myself off of three of these essentially life-long brain cripplers. I have such big questions about how my experience was so non-reflective of your views here. I was not a young student, I guess…I was too old and too far gone?

        Hesitated here but at least I put this out there. But out there it is.

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  3. I don’t want to seem contrary, but do we really want to deduce the end of a life down to DSM Axis 1 Diagnosis? Durkheim’s study of suicide presented them as unique… A totality of life experiences culminating in a final act. It bothers me that society feels the need to generalize them down to a handful of diagnosis and words like selfish, coward, and narcissist. This is where psychiatry fails its patients. This is how it loses its humanity. He spent his life making others laugh. What is narcissistic about that? And once event, does not make a suicide. That would diminish the totality of experiences leading to these deaths to simple over reaction.

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    • I totally agree with you. What I was referring to ias what psychiatry calls “narcissism”. Robin was vulnerable to feeling badly about himself at times, but in my mind was an amazing person. The point is that life can not be put down to a DSM diagnosis. It is dangerous to do so on many levels. We need to see people as whole complex people. I just wish that someone could have helped Robin Williams with his demons whatever they were. He is sorely missed, especially in a world with not enough humour.

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      • It isn’t my intention to argue especially as both of us are making assumptions about Robin’s mental state and perception anyway . however, you noted in your last paragraph that the industry was defining us through the overuse of dsm labels and over medicating. My main problem was that it was exactly what you seemed to be doing. Narcissism is the first thing you think of, but to me, the simpler answer is that, considering history of drug use, the stage and characters presented an escape from your own life. That wouldn’t support narcissism, but it would support poor coping skils and trauma. Psychiatry had got to start allowing patients to define themselves. After all, people rarely fold neatly into labeled drawers.

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  4. Dear Dr. Hoffman,

    If I understand things correctly, Peter Gotzsche and his collaborators have shown that antidepressant drugs barely beat placebo at best for treating depression. That means that every single one of the following treatments: exercise, meditation, dietary improvement, yoga, acupuncture, light therapy, various talk therapies, behavioral activation, EMDR, hypnosis, acupuncture,… are at least as good as antidepressants, just because antidepressants apparently do almost nothing good. Antidepressants are tied for last place in effectiveness, but they are also clearly in last place in terms of safety to the patient. From this, I would conclude that antidepressants should only be used in rare situations at most when everything else has failed. However, you seem to use them frequently:

    “To be up front, I prescribe psychiatric medication frequently, though usually as an adjunct to psychotherapy.”

    Why do you do that? Am I missing something here? – Saul

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      • Maybe using them frequently gives the therapist and client more to talk about… Feeling emotionally numb, yet agitated; becoming fat and asexual, just for starters. It’s a good way to turn short-term counseling into long- term therapy, especially when a person tries to get off the drugs, leading to a flood of potentially life-threatening emotions.

        Again, I friggin give up!

        Duane

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        • Hi Duane,

          I know where you’re coming from. The Onion always helps

          http://www.theonion.com/article/new-study-finds-therapy-antidepressants-equally-ef-38026

          It’s relatively easy for me to be nice as I haven’t been harmed myself, but I have seen some amazing stories on the psychcentral web site like (paraphrasing)…

          I’m 18 years old and just broke up with my girlfriend. My doctor gave me Zoloft. Should I take it?

          Someone who suddenly can’t get their prescriptions refilled and is in trouble. Why? Because her M.D. just lost his medical license. It turned out that her MD was both a physician and a pharmacist and was taking money from drug companies and too many of his patients were dying.

          Many people with prescriptions for multiple psych drugs who literally decide what drug to take when on an hourly basis depending on how they are feeling.

          Many, many people are proud of their diagnosis and proudly display their DSM categories and their meds and doses in their signature line, even as they suffer through severe side effects. Many people very strongly want to believe the chemical imbalance story and will automatically discount anything that contradicts that or points out long term harms.

          – Saul

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    • (I hope I’m not distracting)
      My experience is that the non drug methods work where as the antidepressants don’t.

      I believe the Cochrane ‘collaboratorion’ carried out a study on tricyclics and found they were mostly ineffective. I’ve been on the tricyclics and I found that they made no difference to my mood.
      But I learnt and practised Buddhist breathing meditation
      and this worked and my sadness never returned.

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  5. Dear Saul, Duane et al,

    I understand and appreciate your comments and confusion. Certainly psychiatric medications are grossly overused, often dangerous, and corrupt our society’s attitudes towards emotional pain. I hope to be able to with time, explain that there can be certain benifits from cautious use of certain medications in appropriate circumstances, but for now let me say this:

    In a perfect world people wouldn’t come to me in severe emotional distress with no money for proper therapy or even an adequate diet.
    In a perfect world, I would be able to spend 3-4 hours a week with each of them ,helping them with their emotional issues, and then spend the rest of my time fighting poverty, social dysfunction, child abuse, work place abuse, and corporate power.
    In a pefect world, people would have the incentive to seek proper help, do exercise, yoga, meditation, or anything necessary rather than take psychiatric medications.
    In a perfect world, I would be able to convince people that “chemical imbalances” don’t exist and that psychiatric diagnoses are made up.
    In a perfect world, I wouldn’t be prescribing modest amounts of medication to stop people from seeking it elsewhere from doctors who will overprescribe with no concern for more complex issues.
    In a perfect world, I wouldn’t have to prescribe any medication to help people with some aspects of their emotional pain, but then, in a perfect world, there wouldn’t be any emotional pain.
    In this world, I am asking you to not judge me too harshly for having to take some shortcuts to deal with reality while trying to provide people with some relief from their pain.

    Sincerely,

    Norm Hoffman

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    • Dear Norm,

      Your honesty and willingness to consider alternatives is a breath of fresh air. I think that posting it here shows courage and shows that you care about your patients. I once asked an MD a similar question on another web site and he said the following:

      “Try treating someone who comes in with severe depression. They can’t or won’t commit to exercise (depression has sapped their motivation, their living area isn’t conducive to exercise, injury, climate whatever) they’ve had a bad experience with therapy and refuse to go. Supplements to treat holistically will run over 50 dollars a month compared to a 5 or 10 dollar copay for medication. And this isn’t an extreme case I describe. In certain areas, this is a typical patient profile”

      I don’t actually agree with this, but I think it’s an honestly held belief that was perhaps reasonable to hold a few years ago (basically before MIA) when anyone could be forgiven for believing research literature and treatment guidelines which are now just widely known to be grossly corrupted.

      My impression is that the vast majority of M.D.s (even psychiatrists) sincerely do want to help their patients, but many are now in a crisis as it has become clear how bad things really are. There has been lots of discussion at MIA and elsewhere about the DSM and how that should be changed and what the roles of the various existing professions should have. I think it might be more helpful to first try to construct new treatment guidelines and protocols for people having various problems and then try to see how the existing professions fit in afterwards. I say “new” because current guidelines like this one

      http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf

      seem to me to be very bad and more likely to be leading to harms than ridiculous DSM categories that M.D.s probably don’t pay much attention to anyway.

      Take depression, for instance. I’m not a medical professional, but it’s clear to me that the basic existing plan is very simple and it goes like this:

      1. Have patient’s PCP check for purely medical conditions that might be causing a problem (Sometimes skipped).

      2. Start the patient on some antidepressant, optionally recommend therapy, mention that exercise might help.

      3. When new symptoms appear, add new corresponding meds. When depression reappears, change to a new antidepressant, searching for the “right cocktail.”

      This is a life-destroyingly horrible plan and leads many people into deep trouble. If anyone wants a visceral view of this, I suggest that you visit the “psychiatric medications” section of the psychcentral web site. This plan is so incredibly bad that I spend some of my time advising that people not do this and, instead, to follow the obviously much better:

      1. Deal with any physical/nutritional issues first.

      This should be MUCH more extensively done than what usually happens since many common conditions (Vitamin B, D deficiencies, Omega 3 deficiency, hypothyroidism, heavy metal toxicity, pre-diabetes, infection, gluten allergy,…) can contribute to mental problems. [I just learned yesterday at MIA, that a urinary tract infection, for example, can apparently cause psychosis!]. As a layman, I’m impressed by the “Functional Medicine” view of this.

      2. Try all of the safe healthy ways to overcome depression next.

      There are many good things to try and many, like exercise, diet, meditation, breathing exercises, talk therapy,… (listed in the link below). Many have zero cost and/or are great for your health anyway.

      3. If 1 and 2 really fail and you are still feeling really bad, discuss the next steps with your M.D.

      (details listed here http://forums.psychcentral.com/4262681-post105.html ).

      I think it would be good for well-meaning professionals to get together and try to construct better guidelines and protocols for people with depression symptoms, people hearing voices, people with panic attacks, people with sleep problems, people who are angry all the time, people who are afraid all the time, people who have “brain fog” or memory problems, people who are addicted to drugs, people who have suffered sexual abuse, people who are already on psych meds and are having problems, people with mental problems who are in prison, etc. I think that if well meaning professionals can agree on a protocol, just thinking of a patient’s benefit, that’s a good starting point for forming new organizations, organizing how the various existing professions fit in, finding areas where more resources are needed, and getting to better outcomes.

      – Saul

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      • Hi Saul,

        you call yourself a layman, but you clearly have a better view of the issues than many professionals. The points that you raise are excellent, and we really do need reasonable protocols in the field. As you point out, and as is evident in the link you provide, most protocols at the present time largely presume a biological cause of depressed feelings. Many practitioners are encouraged to use screening tools that are only validated ( and poorly at that) for Major Depression which as we know is a made up diagnosis to begin with. The common protocol is then exactly as you pointed out, with lip service being paid to alternatives to medication and prescriptions being written quickly, often with poor follow-up. One of the reasons why these type of approaches and protocols continue is that doctors want to feel their treatments are successful, and as antidepressants are primarily emotion dampeners, patients initially often report not feeling quite as bad. Without further investigations of the person’s happiness or functioning, and with infrequent follow-up appointments, the doctor then feels comfortable in the perception that the patient is doing better. From the viewpoint of many doctors, if the patient initially wasn’t feeling quite as bad after being started on meds and then months later describes feeling worse, then the problem is biological and more meds are needed. These perceptions need to be challenged. We do need a whole new approach to treatment.

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        • I’d also like to point out that the gold standard treatment for so called “bipolar” patients tends to be a combination of psych drugs, often lithium and an antipsychotic, plus often times more drugs. And lithium and antipsychotics have moderate drug interaction warnings:

          “MONITOR: The concomitant administration of lithium with neuroleptic agents may increase the risk of extrapyramidal reactions and neurotoxicity. In addition, central nervous system-depressant effects may be additively or synergistically increased in patients taking multiple drugs….”

          I’m quite certain this is why the so called “bipolar” patients are doing so poorly. Perhaps the psychiatric industry should come up with a gold standard treatment for “bipolar” that doesn’t have moderate drug interaction warnings, too? Or better yet, just admit that “bipolar” is a made up disease, and stop claiming being justifiably irritated or having mood swings, is a “life long, incurable, genetic mental illness” / “chemical imbalance” that must be treated with drugs.

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    • Hi Norm
      It might be enough to let a person know that there are better solutions available other than tranquillisers and antidepressants (and that these solutions work better for the “psychoses” as well).

      The bio model exists on the back of misinformation.

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    • Hi Dr. Hoffman, as opposed as I am to psychiatric medications — I believe they should be banned for minors and given to others only upon a full disclosure, and the patient’s meaningful, freely given and informed consent — I do not believe it is ultimately about drugs, but about trust. Trust in the competence, wisdom, motivation, integrity and humanity of the psychiatrist. You come across as a rare psychiatrist who warrants this trust and I am glad that you are posting at MIA.

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      • Thank-you for your comment. I totally agree with you that it is about trust, and you point out some of the crucial issues in trust: competency, wisdom, integrity and humanity. Too few psychiatrists possess these attributes. As psychiatrists, we do need to have a strong understanding of our field and a wise understanding of research. Most of all, we need to have an open mind and to listen to our patients primarily for concern for their feelings and needs. Sometimes this means meeting them halfway; for example, while trying to educate them about various aspects of emotional care,, at their request, using medications, though cautiously, to help engage them in a therapeutic process. I’ve called this “back-door therapy”; first meeting their request for medications, with full disclosure, but then once engaged to begin a real therapeutic process. Everyone is entitled to their own comfort level about treatment, and one can start to build trust in many ways, as long as the patient’s own perspective and needs remain central. I also want to make it clear that I tend to use the word “patient” despite the shortcomings of that term to denote a recognition of my responsibility to attend to the person, and of the power imbalance that exists regardless of all respect given to the person. It is not a term that I use to denote that the person has an inherent illness, that they are a victim, or that they need to collude with a particular role. I don’t like the term client which can imply a business arrangement rather than a caring relationship.

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  6. Of course, I’m no fan of psych drugs, but I think this doctor is being pretty straight with us. Yes, this is far from a perfect world. There are a lot of non-drug resources, but spread out over the US population of 320 million, it is very hard to find them.

    And a lot of people are ready to do anything not to feel the emotional pain they are experiencing. I can see how it might not be so bad to give someone the least dose of the safest psych drug possible as a temporary crutch to get them through what they are experiencing.

    Someone very close to me considers herself to be bipolar, and the fact is that her huge mood swings, especially her occasional mania, has really gotten her in trouble. She takes lithium. She hates it, but her mood swings have nearly ruined her life.

    I have a strong feeling some of the people who know me are really going to go after me for this, but at the very least I think this particular psychiatrist is sincerely trying to have an honest dialogue here.

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    • Hi Ted,

      Thanks for your kind response. I understand that this is a difficult issue. I see people every day whose lives have been deeply hurt by the psychiatric industry and psychiatric drugs. The present practice of psychiatry in North America is overall abysmal. I think that many people who have come out as totally against all psychiatric medication have had or heard of mostly bad experiences, and therefore don’t know that there are other possibilities. The lack of proper resources and the selling of the bio-psychiatry model is clearly a huge problem, that we need to fight against.
      I would like to keep the dialogue about medication use open, though for now, let me give a simple example of reasonable drug use. It has become a common practice, and major health hazard, for family doctors to prescribe quetiapine (or shutupapine as I prefer to call it) for sleep problems. People who have been prescribed this medication, even though it has many side effects, are often afraid to stop it as their insomnia caused severe problems. In this situation I will wean them off the quetiapine, using small doses of a benzodiazapine. This approach usually works and then allows the person to continue to function while we look at underlying issues and other solutions for the insomnia.

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    • Ted you do not ask “How did this bipolar person become bipolar?” Were they born bipolar? People are made into what they are.

      Psychiatry feasts on the fear of mental illness, in the subject/patient, and also in the family of the patient.

      If you look for disease you will find it, the same way when you are driving , if you look at the tree in the way, you tend to drive into the tree.
      Time is always flowing, a diagnosis written in Pen should be written in pencil so it can be erased one day.

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      • Lithium has a rebound syndrome. When I took myself off it I went straight “up”. They wanted to take me in, but my mother wouldn’t let them. I balanced off eventually though, of my own accord.

        Lithium can cause bipolar in a well person – I didn’t suffer from mood swings until I took this drug (and came off it again). Initially, I was put on lithium as part of a drug cocktail (ie for no valid ‘mood’ reason).

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        • Fiachra,

          “Lithium has a rebound syndrome. When I took myself off it I went straight ‘up.'” Lithium was the last drug I was weaned off of also, and boy, oh, boy did I dance. In other words, a lithium withdrawal induced super sensitivity manic reaction was my experience going off lithium, too, Fiachra.

          Wish my husband had behaved as intelligently and lovingly as your mother, although my doctors had defamed me to him and brainwashed him big time. And none of my doctors warned us that being weaned off the lithium could result in a manic reaction.

          So, of course, the hospital I was taken to misdiagnosed the issue, and “snowed” me, in an effort to cover up all the prior easily recognized, complex, and controversial iatrogenesis to which I’d been subjected.

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      • I agree, we all have polarities, and anyone at all can be pushed to the brink in a toxic, double-binding environment. That would be a matter of healing a culture, not scapegoating an individual. As you suggest–and again, I agree–that where we focus determines our experience, we have choices here.

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          • According to this:

            http://www.nimh.nih.gov/health/statistics/prevalence/bipolar-disorder-among-adults.shtml

            Approximately 15% of American adults have been stigmatized as bipolar. Although, at much higher rates among the young than the old – 6% for those 18-29, 4.5% for those 30-44, 3.5% for those 45-60, and only 1% for those over 60.

            And check out the statistics for children diagnosed as “bipolar,” NIMH doesn’t even give out that information! No doubt, since it’s such an embarrassment to the medical community.

            And “bipolar” was historically called manic depressive disorder, and was only known to affect 0.5% of the population, and it had historically been known to be a completely recoverable disorder.

            Until, the “evidence based medicine” recommendations of the APA in the last decades. Which recommended treatment of “bipolar” with the antipsychotics / neuroleptics and the “mood stabilizers,” which are known to have moderate drug interactions with each other. And due to the APA’s denial of the fact that the neuroleptics are known to cause both the negative and positive symptoms of ‘schizophrenia’ via both neuroleptic induced deficit syndrome and the central symptoms of anticholinergic intoxication syndrome.

            Truly, it’s amazing and staggeringly disgusting, to research and learn of today’s greed inspired, almost unfathomable in scope, iatrogenic crimes against humanity by today’s psycho / pharmaceutical industry.

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          • Bipolar disorder is clearly the latest fad diagnosis. It allows psychiatrists to stick a label on anyone with up and down moods, with no further investigation into the causes of these moods. Of course, if you medicate people enough, these moods may go away, but then so does thought, functioning and healthy emotions. Especially as this diagnosis is being applied to children, it represents one of the biggest health hazards being thrust upon people by the industry.

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    • Ted Chabasinski: “I have a strong feeling some of the people who know me are really going to go after me for this, but at the very least I think this particular psychiatrist is sincerely trying to have an honest dialogue here.”

      I’ve actually been on this page for over an hour now, completely dumbfounded. This guy is by and far the most reasonable, reality-facing psychiatrist I have ever come across, anywhere and in any way. If I had the power, I’d rise him to the top so the rest of them would be forced to listen to him.

      That’s coming from the same guy who advocates for nuremberg-esque trials of the whole psychiatric field.

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  7. I was very glad to read you wean people off quetiapine (Seroquel) who had it prescribed for sleep. However, it’s not only family doctors who prescribe this toxin for sleep.

    While I was in the process of weaning myself from 8-9 years on a noxious Paxil & Klonopin combo, a series of very stressful life events not of my own doing and totally outside of my control befell me. My psychiatrist, who has 40 years of experience in child, adolescent, and adult psychiatry, yet knows or cares nothing about withdrawal, or psychotherapy, or counseling, prescribed 40 mg Prozac, plus 1 mg Klonopin, plus 50 mg Seroquel as a sleep aid. I took this toxic concoction for almost 2 years, and it destroyed my mental and physical health, my judgement, and my life. This does not need to continue happening to others!

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  8. It is absolutely true that many psychiatrists are prescribing anti-psychotics for sleep and other problems. It is frightening that Abilify is now the top selling medication in the U.S.. On a good note, as reported on MIA, the Canadian Psychiatric Association has come out strongly against the use of anti-psychotics for sleep problems in all people, and for the use of these drugs in children. Maybe some reform is possible. The common practice of prescribing psychiatric medication, and then continuing increasing dosages and additional medications when the person doesn’t seem to improve has to stop.

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    • “It is frightening that Abilify is now the top selling medication in the U.S.”

      http://www.askapatient.com/viewrating.asp?drug=21436&name=ABILIFY
      Granted it gets better ratings at the more corporate websites, but not even much, even though we know it’s probably that those other sites are corrupting the results, or drug companies are submitting false ratings by fake users, and yet still struggle to reach a 5/10 rating.

      What has concerned me more than anything over the years though is this:
      http://www.askapatient.com/viewrating.asp?drug=17854&name=REGLAN

      They give this drug to INFANTS, and to pregnant women for morning sickness! This drug has by and far the highest incidence of tardive dyskinesia and dystonia of any neuroleptic, and I know from experience how life-destroying even a mild-to-moderate case of TD can be. At least with “schizophrenia” and such, there was some understanding to how doctors could blind themselves to the serious harm of those drugs. But for nausea? Motion sickness? Vomiting? This drug has been becoming so popular that after I was hit with ulcerative colitis, I’ve had to go far out of my way to instruct doctors and nurses never to give it to me, because I’m already battling TD I got from forced neuroleptic drugging as a child, and even then they’ve come close to sticking me with it a couple of times at the emergency room!

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      • Hi Jeffrey.

        I’ve had a patient who had quite severe TD after being treated by anti-psychotics for trauma related problems. This is a devastating condition. I believe that the use of any anti-psychotic for non-psychotic conditions should be illegal. (one can debate how they are used for conditions called psychotic as well).

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  9. As I said earlier, I am not a fan of psychiatric drugs. As for my friend who considers herself bipolar, and does have severe mood swings, she was first locked up as a teenager, given drugs (of course), but then weaned herself off of them. Unlike a lot of survivors that I have connected with lately, she did NOT have a bad family history. She is still close to her mother, who I have met, and when I first met her, she was mourning the recent death of her father, who sounded like a loving parent and a very good influence in her life.

    For many years after her loony bin experience, everything was fine for her psychologically and emotionally. But when she reached middle age, her mood swings reappeared. They got her in a lot of trouble, badly affected her ability to keep making a living, and led her to give away much of her money and property. So as I said, she went on lithium to keep her life from falling apart.

    And if I were in her position, I would do that too. There should be better solutions, but there aren’t.

    Myself, I think my primary mental illness nowadays is to be willing to challenge the conventional wisdom, not just in most of our culture, which seems to worship psychiatry and its drugs, but in our little movement too. That gets me in trouble. I am sure there is a drug for it. In fact, I think any antipsychotic would work.

    I think it is very important for our movement for people to keep an open mind about everything. I have strong options about a lot of things, but I will change them when reality tells me that I’m wrong. I learned that in Rockland State Hospital where I grew up. If I had gone along with what I was told to believe, I would never have left. Now I experience pressure both from within the larger society, and within our tiny movement that tells me I must think a certain way, and only have opinions that appear on the (unwritten) list of two hundred approved thoughts.

    Sometimes both the larger society and our tiny movement both make me feel as if I am back in Rockland State Hospital. But I insist on making up my own mind, and I think everyone else should do that too.

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  10. if people insist on taking psychotropic drugs, and doctors insist on prescribing them, they should at least be honest about it. say, for example, ” i choose to take this drug to get buzzed, high or stoned. i understand i currently have no chemical imbalance but i will soon have one. there is no difference if i take these or if i go down to the street corner in a bad neighborhood and pop a pill or shoot up. or drink alcohol. the only reason these drugs are legal and those are not is because pharm companies convinced govt there is lots of money to be made. NO DIFFERENCE at all. i understand that i choose not to adjust my behaviors or my lifestyle. i’d like to not work at making positive changes. and i will take these pills” i think people can do waht they like as long as they are honest about it!

    erin

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    • Hi Erin,

      I agree with you. All the evidence is that psychiatric medications interfere with the normal functioning of the brain. They make a normal brain abnormal. That does not necessarily mean that blocking normal function may at times be helpful, just a marijuana may be helpful emotionally in some circumstances. I do prescribe the medications known as antidepressants at times, cautiously, in particular circumstances (more to come on this later, as I do intend to wade into the bog), but I always tell patients that these are emotion dampeners, that they do interfere with the normal functioning of the brain, and that they are likely to dampen or numb all emotions, not just the bad feelings. (one may wonder why anyone would want to take these medications after this description, but as I’ve said, there is more to come on this). So , certainly honesty is important, and I think that this is one aspect in which the psychiatric industry had failed miserably.

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      • You point out something that always bothers me and this is the fact that so many people choose to go ahead and take the toxic drugs even after being informed as to what they will do to a person.

        To me this is some kind of a disconnect that makes no sense to me. I have good friends who insist on taking the SSRI’s knowing what will probably happen due to their use. Do people really want all of their emotions numbed and dampened? Do they want their sexual lives turned upside down? Do they really want to run the risk of experiencing “mania”?

        I’m beginning to believe that our society in general wants to be numbed to any kind of pain or adversity, no matter what and this is worrisome to me since it’s been through experiencing pain and adversity that I’ve was given an opportunity to grow as a person. However, I also know that I can’t judge anyone else with my own life experience since each of us is so unique and individual. What is helpful to me may not be helpful at all to anyone else. But this search for numbness scares me to no end. Where will it eventually lead?

        Personally I will never touch any of these toxic drugs ever again, no matter what. But I can’t stand in the way of others using them even after being informed of the end results. But I sure do not understand it at all.

        Perhaps your future blogs will help me to understand all of this, so I’m looking forward to hearing what you have to say.

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        • Hi Stephen,

          Hi Stephen,

          My personal view is that it is better not to take these drugs, and for a person to be able to work with their emotions. A major problem these days is that many people, both treating and being treated, no longer believe that one can live through and work with emotional pain. It is very hard sometimes to convince people that emotions are a signal to ourselves that we need to listen to and respect. It is also not my way to force my thoughts on other, but to show respect for where they are in life, though I do try to educated. So I always try to emotionally respond to the patient, attempt to settle down their worries, educate them to the meaning of emotions, and try to reassure both patients and therapists that emotional work can take time, but that progress is possible. Sometimes though people feel too raw to be able to wait things out, or be able to work in therapy. In these cases, medication, in the short term, may be helpful, always starting with the least invasive, least dangerous, and smallest dose possible, and always trying first to use medication that can be taken on an as needed basis, rather than daily. While this may not be the ideal way of treating someone, it is at times the best choice for helping the person move forward in life. One has to always be aware of the downsides, and work with the person to help them tolerate painful feelings rather than letting them be numbed down. It can be a fine balance. Of course, one then wants to get the person off medication as soon as possible. More to come on this issue.

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  11. wow- thanks for the quick response. another important thing we activists do is use the word “drug” instead of “medication”- tell it like it is. in theory, i support adults doing whatever they want to themsleves as long as they are aware and honest. numbing, distracting oneself in theory are great tactics when life gets tough. but as long as people are given these mind drugs as “medicine”, by a doctor , they are being fed the lie that, just like antibiotics or insulin or aids drugs, they are being given the medical solution to a medical problem. and, just like the great peter gotzsche says in his classic 15-,min video, doctors cannot handle the duality. and patients certainly cannot. which is why the best place for all these drugs is the bottom of the ocean. much better to use marijuana or alcohol- no one will claim them as l “medications”. enjoy the weekend

    erin

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  12. Dear Norman, Thank you for a great article and very interesting and important discussion.
    It was so refreshing and yes actually healing to read your statements regarding the current state of mental health care in our country today.Yes/ even before I became enmeshed in the the patient role as a professional licensed post graduate Social Worker with multiple specialized trainings under my built I felt that the whole system in every aspect was crumbling at best and worst completely falling apart. I actively decided to distance myself from the profession and tried to make a change of careers for that reason along with trying to find a career that would be
    more friendly to a mother of multiples and other children including several with medical and other issues. So much for best laid plans. Sop many nonlocus of control issues kept crashing in and I did seek help but not one therapist or psychiatrist was able to get a really good picture of the extended and nuclear family and support system dysfunction(out of control stress, medical issues , terminal illness, boundary issues, substance abuse issues, verbal and emotional abuse driven more by dysfunction than actual true meanness.) that I was dealing with as a person with a cluster of LD issues( basically overcome but still lingering at certain points) with on a daily basis. Those dysfunctional systems caused a psychotic episode that was non-retractable. I could literally feel my rational mind disintegrate but had no professional that I trusted well enough or family member to describe – well my mom but she was at a complete loss due to several factors .Medication was the only way out and since I had worked on a psych unit I agreed to go in thinking it would be of help. But no it was horrific on multiple levels.
    Insurance benefits and money to spend on nonessentials essentials like treatment are a paramount problems that you seem refreshingly to be aware of.
    My father could have footed a huge bill for an excellent hospitalization and treatment and help in caretaking of children if he understood what was happening to me.. He had no idea and was sick himself.
    There also was a complete lack of research and curiosity on my family and friend’s part it was only through my research and past memories of graduate school in DC that I was able to come through with researching and leave my husband, be well without medication, and get back to the beginning stages of working in more than just work for work sake position.
    A really good clinician whether Md, MSW or whatever should have been able to perceive
    without my vomiting traumatic information that I was in big trouble and that medication would only be a small solution and that the goal would be to keep me “high functioning” without it and or hospitalization. I never developed a true therapeutic
    a true trusting relationship where I could feel safe in divulging my thinking issues.
    Someone should have asked what’s wrong with this picture for me instead of labeling Bipolar and all that.Your honesty is a great gift. I still have unresolved anger towards those professionals that failed me in both big and small ways. I can forgive my family and some friends since they were not being paid for any type of professional service.
    And still someone of my family members are on meds. They all claim to be helped.Some try alternative approaches but money is a huge issue! They are not being given your type of counsel. Two have been smart enough to see the ruse and one has chosen to continue on meds.
    Only a few friends are able to see that through trying to get help I lost 15 years of what should have been the most productive time in my life. Thanks again for your honesty and sharing.

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    • Dear Cat,

      and thank-you for sharing your story and thoughts. When one considers the use of medication with a patient, it has to be thought of as doing so in partnership with the patient. Medication should never be thought of as the solution to a problem, but only as an aid. The crucial aspects to focus on is well-being, functioning and emotional growth, rather than on symptoms. These days too many practitioners are only concerned with symptoms, which can lead to the many horror stories we are all aware of.

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  13. Some thoughts: Yes, heavens to betsy someone with the title psychiatrist who has common sense. A person who can be dialoged with ,Yes it seems so. But still the Nuremburg like trials are necessary for so many for so many crimes so many still ongoing crimes against humanity within the pharma-psych-government complex and also other cartels presently active along the Constantly Accelerating And Spreading Time Release Eugenic Trail of Tears .
    As far as the numbing effect of drug meds and suicide or worse. I’ve had an experience , it’s truly a miracle I came out of it , to be able to speak of it now. There is such a thing as a perfect negative storm that can happen to a person. The factors of the storm that came together in my life were …. exhaustion , sleep deprivation, colitis , unrecognized exposure for weeks to a carbon monoxide leak into the passenger compartment of a recently bought $600 car whenever I drove it, having been forced by circumstances to give up custody of my 4 1/2 year old daughter, I was as a 36 year old with 20 years of on again off again exposure to psychiatric torture all mainly caused but unidentified at the time by mercury poisoning from 15 mercury amalgam fillings installed by dentists trained by the pseudo scientific ADA the american dental association . One in six people have extra trouble excreting mercury from their body. The effect of all this was not of numbness, but a the sensation of actually being permanently dead inside feeling nothing and not able to put any coherent thoughts together . I was walking in the bicycle lane down a 2 lane highway toward oncoming traffic , it seemed my only option was to step in front of the next on coming semi truck . I did , but the semi went around me and after it did to my surprise I came to life again feeling alive for about 10 minutes then dead again I did it again , again the semi swerved around me and I felt alive again for some minutes. I walked 26 miles to where I lived, the police were waiting for me ( I couldn’t speak or put words or thoughts together) and took me to jail for days of observation and then to a mental institution. I was out after 2 weeks on 2mg. of haloperidol . At a hearing to commit me my dad who flew in from Arizona saved me from being sent away to the state institution where the movie One Flew Over The Coocoo’s Nest had been filmed .
    It would be 24 more years till the mercury fillings , root canals , all metals removed , cavitations checked for by Hal Huggins protocol dentistry was done and all symptoms disappeared immediately after , the voices, the insomnia, the sensation of as if visual dreaming while awake at times, the colitis ,everything, I was a live psychiatric and Therapeutic State survivor.
    And I ask you all for how many of you is mercury poisoning a factor to some degree in your life. It was the lynch pin that turned mine upside down for 44 years . And for how many who have tried to commit suicide and for how many that succeeded or worse has mercury been the unrecognized factor never spoken about .
    I was fortunate that family finally made funds available for me to pursue this advanced dental treatment. Governments around the world should provide funds for their citizens to have the option to get advanced dentistry done . And of course it should be banned as a dental material and as something inserted even in flu shots that are available for free and totally bogus . Such are only 2 of the strategies of modern day Shake Your Money Maker Time Released Eugenics “. I’ve written enough for now .

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  14. In …. A Special Interview with Dr. Christopher Shade with Dr. Joseph Mercola I excerpt one paragraph .
    Dr. Shade speaking on mercury , ” It’s got a very strong ability to dysregulate your system. This is part of why it’s hard to pin down often by the symptoms that it’s mercury toxicity, because it dysregulates you in so many different ways. In fact , it can take you one way or another .Neurologically , it can make you hyperactive, or it can give you chronic fatigue .” ( Sounds to me like stuff that fuels the psychiatric diagnosis Bi Polar etc .) The last sentence my statement not Dr. Shades
    For the trained scientists among you heres an excerpt of what he said first: “The heart of mercury’s toxicity is what I call inappropriate binding. Mercury is never a free ion out there. Like if you take table salt and drop it in water , that’s sodium chloride. Then it will split into sodium ions and chloride ions. But mercury is always bound in these covalent relationships with whats called the ligand. Mercury’s favorite ligand is sulfur , specifically a reduced form of sulfur called a thiol. This is what you have on cysteine, like N-acetyl cysteine or in glutathione. But these thiols are all throughout your body.
    In fact ,when you look at enzyme systems- enzymes are generally large organic molecules that house at their metal core. The metal might be something like zinc,copper,or iron. Those metals are held in place by thoil groups. Mercury has higher affinity for those thoil groups than the metals do. How much higher? Try for zinc, a billion times higher-10 to the ninth. When mercury comes by , it floats by, and it sees an enzyme that’s holding zinc in it , those cysteines are going to reach over and they’re going to grab on to the mercury. Thus , you’re going to inactivate the enzyme.
    Other places that mercury will bind to thoils are on cell membranes. This catalyzes the rearrangement of the cell membranes. In fact, new research is starting to look at how mercury down to membranes in your vasculature causes a shattering of membranes and eventually pulling of holes in the arteries, which leads to you then kind of spackling them up with cholesterol. Then you get into the neurological area, you’ve got enzymes there, and you’ve got membranes there that it could work on , and different forms of mercury will cross the blood brain barrier.
    Then you’ve got a lot of neuroprotective elements. There’s one called thioredoxin. Thioredoxin is probably the primary target for mercury or one of its favorite targets. Say, it’s get several thiols. It’s got special forms of selenium called selenols that it attaches to with even greater ferocity than it attaches to the thiols. It gets in and it disrupts so many crucial elements of your chemistry. Those are places where zinc is supposed to be, where copper is supposed to be, and it kicks them out of their spots .
    The full interview can be seen in the archives at http://www.Mercola.com also look up DAMS which stands for Dental Amalgam Mercury Solutions also look up the IAOMT which stands for International Academy of Oral Medicine and Toxicology.

    I would speculate there is nothing that makes more money for the Theraputic State then the pseudo science of delivering mercury into the human body through dental fillings number 1 and eating fish with mercury in it, also we have mercury compounds in for example the free flu shot and in some of the other injections even given to babies. we have coal burning and over 50% of packaged food in the grocery stores have mercury in them from the packing machines which are cleaned with mercury containing caustic soda. There is more. We also have Monsanto the diabolical monsters of the midway which give new meaning to the reality of crimes against humanity. Many countries have banned the use of mercury as a dental material including Finland home of open dialog.. The USA instead made during the present presidents administration in the beginning ,a board member of the largest mercury amalgam manufacturer the head of the FDA. Believe it or not. She stonewalled crucial anti mercury legislation and was highly rewarded for her “work”. The money maker and time release eugenic substance mercury is very important to the goals and cash flow of the elite wana be feudal masters of the planet . Thats not to say they don’t have other” useful chemicals Medicines and other substances and strategies available” to further their domination goals.( why do you think they have shark tanks I mean think tanks) Carniegie and Rockefeller that is and others.

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