Let us put the final nail in the coffin of the neurotransmitter myth of big Pharma and the APA. The idea that psychiatric issues come from some quantitative soup of neurotransmitters in the synapses of the brain is completely wrong.
My daughter Lily was at a party at a friend’s house. The friend had two black cats that Lily knew quite well. Everybody was outside in the backyard for a barbecue. Lily’s cell phone rang, and she went over to a far corner of the property for privacy and to get better reception. While she was talking, she spied one of the black cats in the bushes. She kneeled down, stretched out her hand and signaled the cat to come to her. It approached her. As it came out from under the bushes, she noticed a white patch of fur on the cat’s head that continued right down its back and onto its tail. My daughter felt a sudden wave of fear without immediately knowing why. Then it hit her—skunk! With her heart beating fast, she turned and walked slowly away without getting sprayed.
Lily had been living in kitty world, one of her favorite worlds. Being partially preoccupied on the phone, she experienced “cat.” The skunk, possibly rabid, did not behave like a wild animal. It came to her, much like a cat. The white stripe of fur was the visual trigger that didn’t fit with a black cat. Lily remained in the kitty drama for a few moments before the discordant information registered. When the white stripe took on the meaning of skunk and its skunk-story meaning, she had a fear reaction. Then she fled. Notice that her fear reaction actually preceded her conscious recognition.
This wasn’t just a correction of cat to skunk. It was a drama shift from kitty world to skunk world. From her immersion in kitty world, Lily was tender, warm, and maternal. Oxytocin and vasopressin were secreted from her hypothalamus, generating a feeling of love, tenderness, and warmth. Her autonomic nervous system created this mood state in the context of reading safety, trust, and love from her internal kitty world, triggered by seeing a cat.
When she saw the telltale white stripe, she shifted from kitty drama to skunk drama. In skunk world, she went in the other direction—into fight or flight. She went into a state of fear and, in this case, flight from danger. Her hypothalamus was stimulated to start the fight/flight response, secreting corticotrophin-releasing hormone and stimulating the sympathetic nervous system. Her autonomic nervous system, through the vagus nerve, stimulated an increased heart rate. In concert with other brain nuclei, it stimulated the adrenals to secrete cortisol. This went back to the hippocampus and amygdala, the feeling centers. Her fight-or-flight response, with all its necessary aggression, followed. These reactions were regulated by neurotransmitters, particularly serotonin.
Here’s the important point: both of Lily’s responses—the tender response and the fight-or-flight response—followed from the meaning of two separate brain plays (kitty world and skunk world). The biochemical, hormonal, neurological processes were not the progenitor of her responses. They merely were the mechanisms that mediated and made manifest her response. Her response to reality was through a top-down processed story that was generated by her cortical mappings. The meaning from perceived sensory data was purely through an activated cortical play. This then determined the biological, biochemical, neurological, hormonal, muscle, thinking, and feeling responses that followed. It was a specific cortical story that determined her state of mind-body.
Neither animal was a stand-alone fact, independent of story. Each elicited a limbic-cortical drama—one for cat, one for skunk. The state of feeling response was consonant with the meaning of the internal story of each animal. Lily has a long history of kitty love. Her internal story of cats elicited the feeling states that comprise this story. The meaning of white stripe was skunk story—danger from overpowering olfactory assault. It is the top-down cortical story that determined the biochemical, hormonal, and neurological responses. Each story reflected the mapping. The state of feeling and action response followed from the internal story of persona, plot, and feeling relatedness.
Yes there are neurotransmitters in the brain. There are thought to be a hundred, with ten of them doing the lion’s share of the work. Between two neurons there is a synapse, a gap of .02 microns. Neurotransmitters generate a chemical neurotransmission between neurons. This is a mechanical linkage that functionally glues a sequence of neurons together. It is what allows a nerve impulse to create memory maps of our experience. It is the emotional memories mapped though our limbic system that coalesce into our very plays of consciousness. When our plays of consciousness are sufficiently infused with love, they foster our authentic being and loving relatedness. When we are subject to trauma, deprivation and abuse, our plays are infused with sadomasochistic aggression. This is so with our original play, as well as traumatic experience all the way through development. All problematic plays result from trauma and are mediated by serotonin. However, serotonin does not create symptoms, the sadomasochistic play does.
Lily’s kitty and skunk worlds are relatively simple stories with an uncomplicated plot. How does this compare to the more central and powerful dramas, like problematic plays of consciousness – when the primary story of an internal play is a relationship of cruelty between two personas. This drama becomes the prism through which one experiences the world. When the drama is sadomasochistic, it is not grounded in a loving engagement between a loving ‘other’ and one’s lovable Authentic Being (which would be analogous to Lily and the kitty). The currency of an ongoing sadomasochistic play is a fighting sadistic aggression between the two personas (analogous to Lily and the skunk). The characterological story is deeply held. It is not a momentary enactment, like a skunk scare. Consequently, the fight of sadomasochism in one’s cortical world is a continuous steady state of war. There is an endless internal rage between two personas. [See – “How did Captain Hook get into Eddie’s Closet?”]
There are two essential points to keep in mind: First, one’s literal internal play is invisibly and constantly in operation inside of us. And second, it is this actual story that determines what is activated in the brain-body circuits. Fighting anger between personas consumes serotonin. On an ongoing basis, the neurotransmitter serotonin feeds the fight throughout the salient regions of the brain where these characters are mapped, particularly the feeling centers—the amygdala and the hippocampus. The inner drama, as an ongoing and enduring play, is sucking up serotonin on an ongoing basis.
Here’s the way it works: As a neurotransmitter, serotonin regulates aggression in the mapped neuronal circuits. Aggression is not a dirty word. All of our functioning in daily life uses healthy aggression. Assertiveness and self-protection—our capacity for fight-or-flight—are necessary aggression that utilizes serotonin. However, the ongoing sadomasochistic war in one’s cortex between the other persona and the self persona is of a different order than the regular and routine aggression of daily life. It is sadistic aggression. This constant state of fighting, from the sadomasochistic play, is constantly feeding on and overtaxing the serotonin supply.
When a personality is subject to a steady state of war, at some point the supply of serotonin will cross a threshold and become insufficient. This is purely in the context of a sadomasochistic play of ongoing fighting created by abuse and deprivation, i.e., trauma. At this point psychiatric symptoms are generated. Serotonin depletion is not the cause of psychiatric conditions; it is merely a mediator. The problematic play is the thing. Serotonin is specifically employed in the extensive mappings of ‘self’ and ‘other’ engaged in sadistic aggression. This is what is stored in the specific memory loops. This is where the fighting can’t be sustained. It isn’t some general pool of ‘not enough serotonin’.
People come to a therapist because they are suffering, due to the pain created by their symptoms. A psychiatric symptom is the signal that the sadomasochism of the cortical drama has crossed the threshold into serotonin depletion. Symptoms are the consequence of a diminished supply, like a fighting army whose supply lines have been cut off. Replenishing the serotonin allows the warring parties to fight on, which escalates and fosters the pernicious internal war. Symptoms comprise the built-in crisis of problematic characterological worlds. “Crisis” in Chinese ideograms is drawn as the intersection of danger and opportunity. The patient’s crisis provides an opportunity to address the real issue. The real issue is the problematic characterological play. Therapy is about dismantling the internal war and the recovery of the authentic self and the ability to love.
Psychotherapy is not about the signal that something is wrong, but about the something that is wrong. The real work of therapy is with the characterological world, the Authentic Being, and relatedness. In actuality, symptom relief is not so difficult, and never needs drugs. Character is the heart of the matter. Symptoms signify two things: First, that the characterological world has actually been in an unsustainable state of internal war, and second, it is the signal that the play has broken down. In the context of an ongoing problematic internal play, it is not a question of if but only when the system will get overtaxed. A characterological world with problematic fault lines will break down in characteristic ways.
If I am an auto mechanic, and you bring your car to me because the engine is overheating due to a cracked radiator, I can give your car symptom relief by feeding the radiator more fluid. This fix might work in the short run, but the structural problem has not been addressed. Just feeding the radiator will not fix the problem but will actually make it worse. There will be more leaks and more overheating due to the extra water, that will damage the engine even more. As the auto mechanic, I had better understand the organization of the engine in order to address the real problem—a cracked radiator—and how and why that happened. I need to understand the real issues and not mask them.
Sadomasochistic aggression is the primary manifestation of problematic characterological reality. It is the ongoing war between two internal personas. Sadistic anger is the currency and intoxicant of sadomasochistic relating. Anger is not a feeling or impulse that exists on its own. The anger is enacted between the two deeply held personas in the characterological play. Problematic plays are composed of these fighting personas, living on a projection screen imposed on reality. The aggression, in all its overt and subtle forms—whether a physical beating, sexual abuse, resentment, envy, simple disdain, or self-criticism—is an enactment between these two personas.
In the absence of love between two Authentic Beings, pain becomes the problematic solution to utter aloneness and emptiness. Hurting or being hurt and its accompanying anger gives the sensation of pseudo-vitality. Because pain feels real, one always becomes attached to this substitute relatedness. But it is a substitute that can never really work, and so the sensation gradually ceases to be effective and there has to be a constant escalation of attack to create the sensation of being alive. Built into this enactment is that the aggression will continue to increase. The sadistic judge will punish the bad attackee but cannot be satiated. Feeding the internal fight with extra serotonin escalates the war and generates a greater hunger for more and more serotonin.
When a patient feels psychiatric symptoms, it is analogous to putting your hand on a hot stove. You receive a pain signal, which signifies harm. The temperature triggers a pain response that travels up your afferent nerves. You send an impulse down your efferent nerves to your muscles to get your hand out of there. I could treat this problem by injecting a drug to numb the pain nerves of your hand. The upside to this solution is that it would take you out of pain and make you feel better. The downside is that you would keep your hand on the hot stove, feeling no pain. This solution would foster the pernicious situation and escalate the damage to your hand resulting in a bad burn. This is exactly how antidepressants operate.
By pouring more serotonin (radiator fluid) into the synapses, one might (and this is a considerable might, at best) temporarily relieve the symptoms. Old antidepressants such as Elavil put more serotonin in the synapses. New antidepressants such as Prozac accomplish the same function by preventing the re-uptake of serotonin in the synapses and creating a larger pool of serotonin on which to feed. However, what serotonin actually does is create a hardening of the self and an unconflicted selfishness. It intensifies an emotional hardening toward others. When fighting, you are hard and cruel. Your enemy is an “it,” not a person. There is an attitude of coldness and hatred toward your adversary. This amplifies the emotional reality of the invisible sadomasochistic personas. The escalated hardness and coldness from adding in extra fuel for aggression is often experienced as feeling good. This is due to the fact that there is no conflict over hurtfulness. This has been numbed. To heal from cruelty, you have to feel the appropriate remorse and regret.
Let me emphasize that antidepressants do not fix the sadomasochistic war. Instead they allow the destructive process to deepen, while the patient may temporarily feel better. Second and even more important, the extra serotonin specifically explains why people act on their suicidal and homicidal impulses. In the context of emotional numbness, hardening and drug-induced cruelty, people are less conflicted about murdering themselves or others. This explains the rash of horrendous mass murders committed almost exclusively by people on antidepressants. These kind of events were unheard of until antidepressants came on the scene.
Real recovery is achieved by mourning, in psychotherapy, and ending the war, and allowing for the possibility of authenticity and love. Don’t worry, a different cortical drama alters the chemical brain all by itself. The brain chemistry simply follows from the actuality of the internal drama. An antidepressant drug fix, through a numbing psychogenic drug, estranges you from the possibility of change in your problematic play, and consequently from your best humanity and your best self.
To review, the issue is not in the neurotransmitters, but the mappings of experience that generate problematic plays. Serotonin does not exist in some stand alone way. It is merely a substance that specifically glues sadomasochistic plays together. The only issue is, in fact, the problematic sadomasochistic plays which come from trauma. This is what creates psychiatric symptoms. The treatment for problematic plays is psychotherapy. When we mourn the trauma, the sadomasochistic play is deactivated. The neurotransmitter glue is also deactivated. A new and loving play replaces the problematic play. There is no such thing as a chemical imbalance which needs to be fixed with extra serotonin. There is a traumatic play that needs to be mourned. As we have seen; the antidepressants damage the patient, and may be a significant factor in suicides and mass murders.
Psychiatric symptoms are signals that need to be heard and felt to address the something that they signify. Adding serotonin to the system numbs out and overrides the signal. It is the sadomasochistic play in the theater of the brain that is the pernicious situation that damages the patient. This is what needs to be addressed. Our unique human story is the subject of psychiatry; the cortical top-down characterological drama in the theater of the brain. The subject of our psychiatric endeavors is phenomenological reality and its enduring play.
Again, if Mad In America wants to be a legitimate and effective voice in honest and concerning struggles in mental health care problems, publish articles that debate issues of general validity, not extremist and rigid attitudes and rare examples that dumb down true benefits as much as note the occasional risks.
Um, antibiotics can cause serious anaphylatic reactions, and cause bacterial resistance, but, is MIA going to call for the dissolution of antibiotic use in this country? Opiates can cause paradoxical reactions, but, let’s deny people with post op pain or broken bones access to meds that will responsibly impact on reducing terrible anguish.
In fact, let’s just make either all meds OTC or go on a campaign to claim that chemical interventions should be last ditch treatment options. After all, the world is black or white, the Force is either light or dark, and psychiatrists, well, we don’t even have a good side in the profession, hmm?
Again, I defy readers and the editors of this blog to tell us all, what do you offer for treatment for people who seem to have the signs and symptoms of Major Depression, who are suicidal, not eating or sleeping, can’t function at their jobs, and create anguish in their loved ones watching the depressed person wither away.
Still haven’t read anything of real substance from anyone associated with this site.
To finish back to this post, yes, antidepressants have a dark side, but, it starts with poor diagnostic assessment, excess prescribing, and not reinforcing outside supports besides medication use. Debate those points, and you might be seen as a contributor to the dialogue that can elevate MIA as a legitimate accuser of psychiatric misconduct.
Joel Hassman, MD
Board Certified Psychiatrist
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Joel,
Challenge accepted. First of all, data from Irving Kirsch and Joanna Moncrieff’s meta-analyses show that antidepressants suppress symptoms only at most about 15% better than sugar pills. So most people benefit hardly at all from the antidepressants themselves. You talked about “dumbing down true benefits”? But beyond anecdotal experience and opinion, do you have any data showing that the “true benefits” of antidepressants are greater than the research by Kirsch and Moncrieff suggests?
Second, the straw man argument about MIA calling for dissolution of antibiotic use is not going to work. As you know Joel, many commenters take a nuanced position on antidepressants stating that they can be helpful in specific situations. You aren’t doing yourself any favors by painting commenters here with such a broad brush.
Third, Major Depression is not an valid discrete illness, and its reliability in the DSM 5 field trials was almost chance as to whether psychiatrists could agree who had it or not. Of course, serious states of depression are very real, but that does not mean Major Depression is one illness with a known cause in biology.
As for treatments helping people who are severely depressed, many reports on this site and in the broader world of psychotherapy researched have addressed this. Research by Falk Leichsenring, Paul Knekt, Jonathan Shedler, Barry Duncan, and the Tavistock Clinic have shown that long-term psychotherapy can be very helpful for depressed people in reducing their distress, with or without adjunct drugs. Here is some data that was featured on MIA:
http://tavistockandportman.uk/about-us/research/current-research-projects/adult-depression-study-tads
http://www.centerforselfdevelopment.com/pdf/000004-effectiveness-of-long-term-psychodynamic-therapy.pdf
There’s some real substance for you, Joel.
Regarding poor diagnostic assessment, perhaps your profession would care to develop diagnoses that have real validity and a decent level of reliability.
If you can do that, you might be seen as a contributor to elevating your profession to being considered a real branch of science and medicine. Good luck with that, Joel.
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I would not consider you the first person to rebut me, BPDT. Your rhetoric from past experiences does not consistently speak volumes for moderation and genuine interest for debate, but, my interpretation.
Hey, your point of starting out less invasive is certainly correct, therapy is the mainstay of mental health care, but, are you going to reply further that honest and true severe Major Depression is going to be fully and completely impacted with talk therapy alone?
Just falling back to the disingenuous statement that there is no reliability or validity of psychiatric diagnosis is your projection of the straw man’s argument, BPDT. If you are going to dismiss the people I think I have had a genuine, effective, and safe impact in helping, well, tell them their outcomes were a sham and I should be indicted by the masses for being a fraud and not being a responsible service to the community.
Good luck with that path if you are considering it…
I have posted about this at my blog today per this post by Dr B, and if the folks who read there can provide legitimate, defensible examples of where I am wrong, then they will be printed and noted.
Been at this proposition before, lots of blank space in the comment sections of posts prior that asked for the same rebuttal………..
Again, I am genuinely sorry psychiatry either failed you or just abused you, but, psychiatry as a whole is not the enemy.
Sincerely,
Joel H Hassman, MD
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It’s nice to see you starting out your post my questioning my character Joel. Your arguments would be more convincing if you addressed them directly to what was being discussed.
Asserting that my questioning the validity and reliability of “Major Depression” is “disingenuous” is a little rich. Such a criticism is quite sincere and valid. Here are the reliability kappa ratings for Major Depression in DSM 5:
http://1boringoldman.com/index.php/2012/05/22/to-take-us-seriously/
As can be seen, it’s not much better than chance (0.32) whether psychiatrists can tell who “has” Major Depression or doesn’t. I don’t think it’s disingenuous to point that out; do you Joel? This lack of validity creates a real problem and vulnerability when one tries to make categorical arguments about given “illnesses.” Of course, you know that I’m not the only one making this type of criticism… much more prominent people than myself such as Tom Insel and Steven Hyman have asserted that DSM labels lack validity.
Further, in science the burden of proof for new concepts falls on the claimant, not critics. Major Depression is still a hypothesized concept with no known etiology or biomarkers. Therefore calling its usefulness and validity into question is justified, and makes all of these studies questionable in terms of replicability. Again, this is different from saying that people become seriously depressed and need help; of course they do.
Suggesting that I am dismissing the outcomes of depressed people that you have helped is another straw man; I have done no such thing. I am glad you helped these people and would never dismiss them. I don’t even known you and your work.
By the way, it’s correct that some evidence shows that people who report being the most severely depressed are helped by drugs significantly more than by sugar pills. They were the only group which stood out in Kirsch’s research, even though the difference there was still relatively modest. On the other hand, not everyone who is severely depressed wants drugs, nor should they have have to take them. Social support and time are enough to help some people with very severe depression get out of it. I have experience with this in my family.
Although it may not be you personally, psychiatry as a whole is doing a lot of damage with its massive overdrugging and its use of stigmatizing unscientific diagnoses, and we should not ignore these harms.
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I want to ask, do you see a difference between treating the suffering of depression and the pain of depression?
I have long been able to treat my suffering with CBT and meditation, but it was not until I managed my neurotransmitters did I alleviate the pain.
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I have been dealing with the BPDTs for several years now at sites like this, and won’t get dragged into the folly that is the agenda of the extremist antipsychiatry folk that this site is well known for, hence why so few psychiatrists end up at these threads who are moderate and want to dialogue, not have to endure the soapbox tirades the authors of MIA inevitably allow.
But, for the sake of trying to answer another who seems to want a perspective and not just platitudes or mistaken efforts at debate, Krystn below asks, I assume to me, the difference between the suffering vs the pain of depression?
I honestly don’t understand the definitions you are expecting with those terms, aren’t pain and suffering synonymous? But, you allude you ended up on medication or some other biological intervention, and found relief? If so, I am glad for you, and hope those who are or did treat you continued the process and modulated your needs as time progressed, as did your health.
Again, Dr B seems to confuse those who worship at the alter of rigidity and inflexibility of the mistaken “biochemical imbalance” model, to be similar to those like me who see illness as multidimensional, or biopsychosocial.
Well, as my last comment here at this thread, to both MIA staff and your readers, illness is multifactorial or dimensional, and so is treatment, so I hope your crusade to try to end any medication interventions, if truly well intended and benefits the sizeable majority of the populace, plays out well.
It is easy to be critical and label, but as I have written endlessly to those who want answers and progress, watch out you are not in the crossfire of the extremists of both sides of this polluted aisle of “my way or no way”. Rigid and inflexible people do not serve the people, but just expect to be served.
This is not a personal attack, but an interpretation of what I have read in my travels with those who expect persecution and extermination at the end of the day. It is how MIA comes across to many who have read here, and then wisely chose to not comment.
Sadly, I was compelled to comment to what Dr B has written at the post, and realize once again, I am not an invited guest to debate, but either be repentant or repulsed. It is what it is folks, meds are part of the equation that is mental health disorders.
Be safe, be well, and be wise!
Joel Hassman, MD
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Joel,
If you have something to say regarding my comment, say it directly. In both my comments I spoke directly to what you said, including references and data. But you seem to think that use of diagnosis is validated simply by your saying so. It doesn’t work that way, my friend, nor is it an “extreme” position to challenge the validity of psychiatric diagnosis – not when many within your own profession, including Insel and Carlat, have publicly done so. It’s interesting how you avoided that vulnerable issue, Joel… characteristic of the other Joels I’ve been dealing with for years now.
Here’s the latest straw man argument from Joel: MIA readers and staff have a “crusade to try to end any medication interventions.”
Joel, please stop the lies! You’re getting almost to E. Fuller Torrey territory here… Robert Whitaker, myself, many other commenters have repeatedly said that there are instances where drugs are useful.
Unless Joel can provide a quote, readers can assume that he is fabricating and projecting the idea of “ending medication intervention” onto readers here. Joel, if you have actual quotes or evidence that MIA staff think all medications should be ended, let’s see it. If not, don’t make stuff up!
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It’s always interesting to me that you seem to spend an awful lot of time paying attention to what’s going on at MIA. I wonder why that is? I may get smacked for this and my response removed, but to me your responses always smack of such smugness. You always seem to be the “expert” about everything. This is the very thing that turned so many of us here at MIA against and away from psychiatry.
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Well, Dr Hassman,
You state categorically that this is not a personal attack yet you have managed to insult a fellow contributor, BPDT, Mad in America, the author, Dr B, MIA readers and all those who disagree with you. You have leapt to conclusions based on little evidence, that those who disagree with you are anti-psychiatry extremists, and `do not serve the people’, invoked a conspiracy argument that there is a campaign to `end medication interventions’ and that you, and those who agree with you are being victimised because of your beliefs.
You also seem to be putting Krystl in her place when you say there is no difference between pain and suffering. There is. Pain is a phenomenon, suffering is how you feel about it. A subtle difference but a real one. To call them synonymous is to miss the point. However you seem to allow her credence because she supports your position.
Shall we look at this. Even in this very restricted forum you appear hostile to criticism, The use of low grade evidence/assumptions making grandiose claims from very flimsy evidence regarding the motivations of others and invoke conspiracy arguments to explain a perceived lack of acceptance are some of the features of pseudoscience which is a pursuit of confirmation not truth. As you say, true discussion/debate should be an examination of the facts, it does not include insults, claims of persecution, denial and patronising of other debaters.
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Here’s the thing, BPD. In my view it’s a mistake to be schmoozing these people, at least on their terms and using their perspectives; it is naive to accept a “challenge” from someone with no credible interest or understanding of this struggle, and who is in fact openly opposed to it, is legitimate. A few examples:
I defy readers and the editors of this blog to tell us all, what do you offer for treatment for people who seem to have the signs and symptoms of Major Depression, who are suicidal, not eating or sleeping, can’t function at their jobs,
and create anguish in their loved ones
Uh, defy us? That sounds friendly & open to constructive discussion…
Just falling back to the disingenuous statement that there is no reliability or validity of psychiatric diagnosis is your projection of the straw man’s argument, BPDT.
Please, shouldn’t psychiatrists who come here, ostensibly because they wish to contribute something of value, at least be aware that people at this site are overwhelmingly opposed to “medical model” characterizations of thought, feeling and behavior? And that their attempting to dismiss this viewpoint as patently absurd will be seen as a “disingenuous” effort avoid addressing the essence of our collective consensus? Any psychiatrist who has not even considered the semantic contradictions of concepts such as “mental” illness to the degree of his/her being able to offer an informed argument should at least do some research before presuming to pontificate; to wit:
if Mad In America wants to be a legitimate and effective voice in honest and concerning struggles in mental health care problems, publish articles that debate issues of general validity,
Still haven’t read anything of real substance from anyone associated with this site.
Debate those points, and you might be seen as a contributor to the dialogue that can elevate MIA as a legitimate accuser of psychiatric misconduct.
See what I mean BPD (and all)? What we should be confronting here, if anything, is the pitifully arrogant attitude which underlies such declarations; to argue about irrelevant details is to fall into a diversionary framework and implicitly legitimize Mr. Hassman’s contention that there is some sort of genuine debate to be had.
I see as well that he wants to divert people to his own site rather than hold his own here; I for one won’t be taking the bait!
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Dr. Hassman, it is good to know that there are “those like [you] who see illness as multidimensional, or biopsychosocial.” and that your treatment is “truly well intended and benefits the sizeable majority of the populace” and that you are also happy that “those who are or did treat you continued the process and modulated your needs as time progressed, as did your health.”
Yes, and I am not being sarcastic. Dr. Berezin does make an important point, that psychotropic drugs are mediators which may lower the psychological feeling of distress, but problems in living are not solved by them alone (which is important to remember). However, sometimes modulating these mediating biological factors is a good thing if they achieve positive results where the positives outweigh the negatives (which include harmful/distressing side effects).
It took me a very long time to find a combination of drugs which have minimal side effects (which I achieved only sometime back, by altering dosages (mainly of the SSRI which is most problematic of the whole lot in terms of side effects, but also is the most efficient in providing relief from a feverishly low mood etc.), possibly eating better etc.). These help alleviate the psychological aspects of extreme pain. However, there is still pain because of life experiences. That is not something drugs can remove.
But I can understand in many respects where the readers and writers on this site come from and there are some important things they are trying to say.
It is true there are some extreme people on this side (as there are on the other side) but MIA and Whitaker genuinely have done some good work. And I also know that there are psychiatrists who do good work as well. I have had some bad experiences but I have also had good ones and I’m very grateful to some of the psychiatrists that I’ve had who have genuinely helped me from their side. But it is not a black and white thing, and not as simple as “good” and “bad”. It’s nuanced and complex.
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Would you mind defining “extreme” and identifying the extreme people on this site so we can make sure not to read any of their posts (and possibly get them access to the help they need)?
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This is one of the standard arguments conventional psychiatry uses to defend itself from criticism. Personally, and knowing the power and violence behind organized psychiatry, I don’t think it follows in the slightest. Allen Frances, when he isn’t brokering a deal with a pharmaceutical company, claims moderation for his position. Criticism is okay, but haul in the heavy artillery, only we defenders of our profession have the right to use such heavy artillery, and use it we do against our critics. Moderate your criticism, and ignore, to the best of your ability, the rising toll of human destruction, or you’re an extremist. Excuse me, did somebody say something about “the rising toll of human destruction”, that is, the inatrogenic (if anybody asks, physician caused) injury and mortality rate? Sheer mythology. I’m afraid psychiatric survivors must be behind that one. Really…
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Joel appears to have his mind made up and seems to want to criticize anyone who disagrees with him. To say that nothing of substance has ever been posted here is ridiculous in the extreme, and of course, he is disingenuous in claiming that Whitaker or most people here are categorically opposed to the use of psych drugs in any and all circumstances.
It is interesting that he “defies” us to come up with alternative approaches for the theoretical depressed person who can’t function, when there are dozens of alternative approaches that he, as a bio-psycho-social psychiatrist, should be very familiar with. So while on the one hand claiming that people here are rigid and don’t understand flexible and supportive psychiatrists like himself, on the other, he suggests that medication is the only solution for a person disabled by depression.
As for his dismissive wave at the questionable validity of DSM diagnosis, many of his own colleagues appear to disagree with him. To not even consider the importance of the validity argument doesn’t show much in terms of openness and flexibility.
Joel provides no substantive arguments to validate his points, and is probably not worthy of responding to unless he changes his style, which I find unlikely.
—- Steve
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Sorry, I did not mean to offend. Sometimes I have a hard time not being extreme myself as well. I just try to put myself in the shoes of the other person and see where they’re coming from (whether they happen to be critics or supporters). And I also consider the possibility that not all feel the same way as me or some others and that sometimes I can be wrong.
I know several here have had less than pleasant experiences (to put it very very mildly) and I do not disrespect what they’ve been through and I have stated that I totally understand where they’re coming from, having been in some unpleasant situations myself.
Best wishes.
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It seems to me you are missing the point, Joel. It seems the article is about claiming that adjusting serotonin is the ultimate treatment for depression, not that antidepressants do not have a positive effect in many cases. There are plenty of folks who have made similar arguments, and the response is almost always protective of the role of drugs/medication vs. acknowledging the lack of conceptual and scientific backing for the idea that depression is a primarily biologically caused phenomenon.
I’d be interesting hearing your comments on that point, rather than your rather generalizing put-downs regarding this particular website.
—- Steve
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Perhaps per the length of this post by Dr B I might have misinterpreted some things, but I think this paragraph in his post makes a point for me to read it as moreso an indictment than just a misunderstanding:
“Let me emphasize that antidepressants do not fix the sadomasochistic war. Instead they allow the destructive process to deepen, while the patient may temporarily feel better. Second and even more important, the extra serotonin specifically explains why people act on their suicidal and homicidal impulses. In the context of emotional numbness, hardening and drug-induced cruelty, people are less conflicted about murdering themselves or others. This explains the rash of horrendous mass murders committed almost exclusively by people on antidepressants. These kind of events were unheard of until antidepressants came on the scene.”
Rash of horrendous mass murders? Come on Steve, even you have to read that sentence alone and step back to ask, “a bit extreme, perhaps”.
Sorry I won’t be back to debate further, I have already noted my termination at this thread in just prior comment above.
Let others debate in the manner they are comfortable participating.
Joel Hassman, MD
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Re family and mass murders, caused by antidepressants
http://antidepaware.co.uk/homicides if you havent heard of Columbine, and all the others, where is your head shoved? How about Germanwings, gone blank? Or do you really not research, and keep up to date? Women jumping in front of trains with babies, men driving off bridges with kids in the car………………… these people, never ever shown violence until they go on these drugs……………. all hidden, all blamed on the pretend illness , never on the damn drugs….. Autopsy, nah, dont list the paxil, in their system, or the effexor, or the zoloft, as they are all withing the right medication dosage………….. If you dont, admit this damage being caused by these drugs, time you stopped being a damn psychiatrist.
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I suspect you’re still reading even if you are at a loss for how to respond.
So, what’s your explanation of so-many drug-correlated mass murders? If you have been unaware of this phenomenon to date don’t be embarrassed, check it out.
I
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Moral agency generally requires the full use of one’s faculties. Both drug madness and depression madness are used to deny moral agency, and so, in that sense, Joel Hassman, I see your point. What I’m saying is that drug madness isn’t the answer to depression madness, and a “rash of horrendous mass murders committed almost exclusively by people on antidepressants” kind of makes the same point. People get emotional about mass murder. I’d call mass murder extreme myself, and that leaves us to try to figure things out. What is the cause? Nobody can rule out anti-depressants as a contributing factor, especially before taking a good hard look at them.
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A typical response by someone making straw man arguments who is part of a vulnerable “medical” profession not based on real scientific diagnosis… “(I’m right and) I won’t be back to debate further.” Nice one, Joel.
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No doctor I ever went to said that SSRI’s would cure me nor was an ultimate treatment. None of them. They do not have a cure and they said that to me. They told me it was preventative, to help me cope. Neither did I hear them say that it was only a biological disorder. Neither did they say therapy was a cure.
But you know what? I did both. And they kept me stable to figure out what was going on with ME.
I am in no way supporting pharmaceuticals as an answer, but the fact that they provide some relief should be interesting to anyone looking for a cure. The fact that they help is a starting point. I agree that research has stalled on serotonin when, for depression, they could look at dopamine and endorphin receptors as genetic risks for the disorder as well.
But just as western medicine is not being holistic, neither is the author f this article. Since no one seems interested in how I cured my disabling anxiety and OCD all I can say is that you have blinders on. That you are looking to prove your own theories rather than find a cure.
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Hi Krystyn are you still on them?
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Where are my other comments? I can rewrite if you didnt get them.
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Am i still on what? No more pharmaceuticals, just Riboflavin and Biotin and I only eat fish as an animal protein.
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Oboy, fresh meat — looks like Mr. Hassman is feeling masochistic, otherwise he wouldn’t be setting himself up so blatantly. But before jumping into the fray let me comment on the article itself, because I don’t want this guy’s silliness and ad hominem approach to divert us from the actual issues Dr. Berezin raises.
So — I’m glad to have this biochemical info. I wish though that it had been explained in a way that would be more comprehensible to those who find themselves bedazzled and overwhelmed by medical/scientific terminology, the cat/skunk analogy aside. After reading the title the average reader is most concerned with the antidepressant/violence connection, which isn’t really even mentioned till close to the end. Still, I’ll be referring people to this.
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I hope you’re aware that depression is just a syndrome, not an illness of itself (the writer doesn’t seem to), and doesn’t have one all-effective treatment for its every manifestation. As a nobody, I can still think of several- some forms of liver and thyroid disease; deficiencies/dependencies of/on B vitamins, particularly B1, B3 and B12; zinc deficiency (identified by loss of senses of taste and smell); incorrectly diagnosed schizophrenia-type illnesses.
There’s nothing necessarily wrong with medical treatments, if you know which one to use,
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That’s sort of the point, “depression” is a false category to begin with. “It” can be associated with innumerable different causes from individual to individual, whether physiological (i.e. despondence over an illness) or otherwise.
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Hi Robert,
Thanks for this interesting essay. The story about the cat/skunk really brought it alive as an interesting metaphor.
I like this sentence, “Psychiatric symptoms are signals that need to be heard and felt to address the something that they signify.”
Exactly, distress is a sign that something meaningful is wrong, usually something to do with the environment and our relationships and how we conceptualize the environment, and needs to be addressed, not a symptom of an illness caused by misfiring neurons. Thank you!
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Robert,
What you say seems intuitively right to me, and I appreciate the artful attention you give to your writing. Could you comment on the degree of confidence you have in your description of the neurochemistry involved? I read in these pages and elsewhere that there is virtually no evidence for the idea that a serotonin deficiency or imbalance causes depression. Is there clearer evidence for the more nuanced processes you describe?
To my ear, the psychological dynamics you outline sound very much right, but I’m not sure if the details you offer are simply known and correct or if they are more speculative, and I wonder what the implications of that question may be for people for whom extensive therapy has not alleviated severe depression. Personally, I think that most people in that situation have not had very good or the right sort of or enough therapy, but I also think (as much as I hate to agree on anything with the remarkably rude and clearly very angry Dr. Hassman above) that we need to pay close attention to cases where therapy has not worked. I am especially concerned about people who had intense early trauma that inscribed especially deeply those warring synaptic pathways you describe and affected brain development in other ways–what some have considered a form of brain injury. This raises, I think, questions regarding the potential limits of talk therapy; the role of faith and religion (which I think can help some people transcend these questions but opening up higher realms of consciousness); and whether we should be completely closed to the possibility of chemical or neurological approaches.
Thank you for your response and for your writing,
Daniel
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Daniel,
This explanation covers all the bases. This is a paradigm that that actually explains ‘depression’. (I didn’t get into how different temperaments generate different symptoms.) As I said, serotonin affects the mappings of problematic plays. Yes, it can get depleted. This is generated by the endless internal war, not some biochemical flaw that creates some imbalance. It is the war that generates symptoms. Antidepressants don’t correct an imbalance, they temporarily feed the internally created hunger. The over feeding creates an imbalance. In the article I didn’t address how addictive antidepressants are. When they cease to feed the war hunger, more and more serotonin is demanded. If one ties to stop, they believe the imbalance is recreated. As if more serotonin fixes the imbalance again. Often pharmacological psychiatrists expertly add one or two more antidepressants to the mix. And then when that doesn’t work they go to antipsychotics and even shock treatments.
I also didn’t address how problematic it is to discontinue (unnecessary and destructive) antidepressants. They create all kinds of debilitating symptoms. People often believe that their brain is truly damaged and the drugs are saving them. This is confusing, and is not true. MIA can tell you about these horrendous problems. Users commonly have horrific withdrawal symptoms that are almost never publicized. An array of frightening neurological symptoms appear when trying to detox off this psycho-active brain drug—vertigo, lightheadedness, burning or tingling sensations in the skin, difficulty with gait and balance, blurred vision, tremors, twitches and restlessness. Sometimes there are hallucinations. Often to discontinue antidepressants takes a year under careful supervision. And symptoms can continue for years after.
Believe me I understand that there is not a lot of good psychotherapy out there. But insufficient therapy does not mean the understanding of how it all works is not correct. I feel so strongly that we need to promote good psychotherapy. I’m sorry to suggest my book, but this is where I fully address psychotherapy, which is not a simple subject. “Psychotherapy of Character, the Play of Consciousness in the Theater of the Brain.” In it I do address faith and religion, but in a very different context. I hope you read it and we can talk further.
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Dr. Berezin — Thanks for the article. In Freudian/psychoanalytic terms would it be fair in your estimation to describe the effect of antidepressants (as related to violent behavior) as one of unleashing and potentiating the contents of the id?
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Thanks oldhead,
Since I long ago stopped using Freudian/psychoanalytic terms I’m not capable of resuming now. I’m not being persnickety here, because I think it’s important to speak from a new and inclusive paradigm, where the language is simple, clear, meaningful, and understandable. I’ve lost patience years ago with theoretical ideas like ‘id’ that has no reference to actuality, but is a Freudian fantasy construct, and isn’t meaningful to me. I’d prefer to say it the way I did, that “However, what serotonin actually does is create a hardening of the self and an unconflicted selfishness. It intensifies an emotional hardening toward others. When fighting, you are hard and cruel. Your enemy is an “it,” not a person. There is an attitude of coldness and hatred toward your adversary. This amplifies the emotional reality of the invisible sadomasochistic personas. The escalated hardness and coldness from adding in extra fuel for aggression is often experienced as feeling good. This is due to the fact that there is no conflict over hurtfulness. This has been numbed. To heal from cruelty, you have to feel the appropriate remorse and regret.” Such a state has the potential, in certain people, to tend toward violence.
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Yeah I get that, it’s a good start. Still, if you don’t like using words like “id” (though nobody seems to take issue with “ego”), I can rephrase; what I’m alluding to comes from reading Dr. Breggin’s comments regarding Columbine, Aurora, etc. Perhaps you don’t go for the whole notion that we all have “dark” unconscious fantasies or sub-fantasies which remain repressed for good reasons; the way I read Dr. Breggin though, these drugs act to encourage at least some people to manifest such impulses in material reality rather than keeping them confined to the “unconscious.” Am I assuming too much?
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oldhead
(I can’t reply directly, except under my own comment.) I am in total agreement with you and Dr. Breggin.
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Thank you for this response, Robert. Your account certainly resonates with me, and in fact I have my own experience of SSRI-withdrawal very similar to what you describe. I’m afraid, however, that the thrust of my question seems not to have quite come through. I am especially interested, as someone with only a cursory understanding of the science involved, in how certain we can be of the dynamic neuro-chemical aspects of the model you present. My understanding has been that we simply do not understand with any great clarity how serotonin operates in the brain with regard to mood and emotion. I believe you are suggesting otherwise, that, in fact, it is very clear how it operates. Is this right?
This seems a very important question to me. If it really is this clear, it would help to know how and why, to know something of the scientific basis of your account. If it is not that clear, I would think we should maintain more flexibility and openness and still consider other accounts, as compelling as yours is.
Best,
Daniel
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Daniel,
I don’t think it’s possible to get scientific clarity on how serotonin actually operates on the brain with regard to mood and emotion, past a certain point. What I am suggesting is an explanation which covers the known facts, not just some of them. On this basis I feel reasonably clear. The theories that I have come across don’t even pretend to answer the various issues that have been addressed.
If you find that there are other understandings that seem more accurate, I of course would be open to that. Knowledge is not a personal possession but a link in the ongoing chain of our collective understanding. If something else is more accurate than throw out what I saw and go with the truth.
For sure simple chemical imbalance is just a joke. I haven’t seen anything else that addresses how ‘depression’ actually relates to a neurotransmitter and describes a feasible mechanism. This explanation incorporates the relation between the neurological and the human. Again, this is very fully developed in the book, through brain development and embryonic morphogenesis and how they relate to consciousness.
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Dr. Berezin, You are starting of with a flawed assumption; that low serotonin or serotonin receptor activity is the only cause of depression AND that researchers actually know why SSRI’s help some people. And on that basis you say that neurotransmitters are not the cause of depression? Do you see the flawed logic there? You can’t say that just because medical science has not found out how to effectively manage neurotransmitters that they are not the root cause of the illness. If I do not know WHERE my radiator is leaking, the BEST ACTION is for me to dump in coolant so I can drive home to take a better look at it.
But the very fact that we can mimic depressive or manic symptoms with other drugs should prove the issue regardless.
I have no doubt that doctors and researchers have no idea what is going on because I have been dealing with them for 20 years. But the fact that that SSRI’s have limited effectiveness does not mean that mental health issues are not derived from a combination of the effect of nature AND nurture on neurotransmitters. (It still frustrates me that people want to think that mental health has to be rooted in only one of these.)
Just handing out prozac, and not looking at peoples diets and environment will lead to this wide range of results and will bring the results closer to placebo. How much tryptophan and Omega 6 a person eats will alone change the amount of serotonin produced and serotonin receptor sensitivity.
I had OCD and Anxiety, clinical, hospitalized, on disability. Prozac helped my OCD but caused a range of other issues. I also practiced years of meditation, which helped some as well. But now that I know my genetics (yes, I have my genome) I can see why Prozac worked and why it did not. You see, I have slow MAOA enzymes and long form serotonin receptors. By limiting the serotonin that re-entered the nerve it put less demand on the MAOA enzyme so the cell could rid the cell of O2 and not form superoxides. It also kept a lot of serotoinin around as well.
Since MAOA uses a form of Riboflavin (FAD) as a cofactor, I have been taking very high doses of Riboflavin (Flavin mononucleiotide) as well as eating a low protein, fish only diet. And guess what? No more OCD, no more anxiety, and no more medication.
It might be that some people’s illness is caused mostly by nature, but it is not the truth for me.
So I am afraid you, nor anyone else, can convince me that neurotransmitters do not play a role in mental illness. It was my understanding of myself, and neurotransmitters, that I have been able to recover in spite of the horrible treatment I had from my doctors.
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The burden of proof is on the claimant, no the critic. In other words, it is up to psychiatrists and researchers to provide evidence that serotonin has any causal role in leading to feelings of depression, not up to critics to disprove this unevidenced hypothesis. So far, there is no evidence that neurotransmitters cause so-called mental illness, period. Until such proof appears, no one should be told that biology causes mental illness, as horribly a simplistic an idea as that is anyway.
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Does biology cause cancer?
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Science is not about proof, it is about direction. Until there is prrof you cannot say that biology doe NOT cause mental illness.
I agree that serotonin is not THE neurotransmitter that causes depression. It might just be a marker of disease where the real culprit could be dopamine, epinephrine, or endorphin. Or even fatty acid metabolism, or just s crappy life.
But the author jumped from the lack of efficacy of SSRI to cure depression to “it is not caused by neurotransmitters”. That is a huge leap even as he admits that there are hundreds of other neurotransmitters.
And the fact that you said “so-called” mental illness really gets under my skin. Where where you when I could not eat because I was certain all the food in the supermarket was tampered with? Why did that happen to me? Can you prove that was because of some sadomasochistic war.?
The fact I am better now seems to have gone right through your head, and if you are not interested in why and how I am better shows me you are blinded by your ideas.
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You asked where I was when you were worried about the supermarket food. There’s about a 30% chance I was sleeping, a 45% chance I was at work, or a 25% chance I was watching a movie, hanging out with friends, or with a girlfriend. I hope that answer satisfies you.
My point is that proof is required before one speaks about a valid mental illness of known etiology. Yet no proof has been discovered that brain chemical imbalances cause mental illness, despite decades of effort. That is one reason why “mental illness” is “so-called mental illness”, and I do not apologize for that usage. I do not mean to imply that suffering is not real; I am a survivor of much horrendous experience myself. What I am saying is that there is no evidence that biology is causing feelings of depression or unreality, nor evidence that emotional suffering breaks down into discrete illness categories.
One thing you said did make sense to me. “A crappy life” could certainly be enough to cause feelings of depression or delusions. Research such as the Adverse Childhood Experiences study is piling up showing that stress and trauma are strongly linked to being labeled with one of these so-called mental illnesses. It makes sense to me that poor diet is a factor also, as you initial post noted.
I am glad you got better; I did read your post about diet and nutrients, and I think that can be very helpful.
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No proof that chemical imbalances cause mental illness, correct. But there is substantial evidence. There is not proof that man created global warming either.
You said that diet and nutrition can be helpful, well why do you think that is? Because things like tryptopahn turn into serotonin and tytosine into dopamine. We know that when we limit these nutrients people get mood disorders. We also know that omega 3 effects the serotion receptors. Is that “proof’? No. Is it compelling? Yes.
The ONLY way I got better was understanding my genetic bias toward keeping catecholamines around a lot longer than other people (look up monoamine oxidase deficiency). It was not beacuse I had friends, no, they all left me. It was not because I mourned, and I mourned. No, it was because I saw my genetics and took very specific cofactors and changed my diet. Period. So your theory is missing something. It is incomplete.
Are you saying my recovery was a fluke? A fake? Or what? I noticed that you used a turn of phrase that doctors use with me when I told them how I helped my self: “Glad it worked for YOU”. As if it could not possible help anyone else, because maybe I am crazy?
But if you think serotoinin plays no role in mood disorders, do you think it plays a role in any other health issues? Like migraines or parkinson’s or nausea or IBS? You see, you are like everyone else, you do not see the possibility that mood disorders can arise organically (nature) and insist they must come from social causes (nurture). When it is a fact that they can arise from BOTH.
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Kyrstyn,
You have made a lot of assertive statements, but haven’t listed any actual data. If you have any real evidence that is even suggestive that chemical imbalances cause feelings of depression, let’s see it… and if you have evidence that “mood disorders” can arise purely from nature, let’s see that too. I don’t think you do.
I don’t think about nature and nurture in this way as discrete or separate entities. Nature/nurture are constantly interpenetrating dynamic influences which require each other. That is what epigenetics and neuroplasticity is about; the fact that our genes are nothing without the environment to give them cues…. the environment actively modifies and influences our genes throughout life. Genes only provide a number of potential scripts awaiting environmental triggering. What are called “mental disorders” are distressing feelings and experiences that are modifiable in positive or negative directions via different interactions with the environment. Brian Koehler recently wrote a very good essay about this on MIA, which I encourage you to check out for a more complex view on the nature-nurture issue.
And do not assume you know my mind by projecting onto me. I didn’t say anything about your recovery vis a vis other people. I said I’m glad for you, period. Leave it at that. I’m sure it could help other people too, but I wasn’t even thinking about that. And I’m not your doctor. Get some clear ego boundaries!
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BPD Transformation- I find your comments generally insightful, and they often they give me a lot to think about, but there’s one here that bothers me a lot. I don’t write much and this is a pretty good example of why sometimes I feel intimidated to do so, should my perspective be different from yours or one of the other frequent commenters.
Before you said you were glad for Kyrstyn, you said, “You asked where I was when you were worried about the supermarket food. There’s about a 30% chance I was sleeping, a 45% chance I was at work, or a 25% chance I was watching a movie, hanging out with friends, or with a girlfriend. I hope that answer satisfies you”? To me that kind of smartass is no different than the cold smartass attitude many people here complain about in their experiences with psychiatry. I thought we were here to get away from that…
She’s a new poster, and not everyone feels the same way you do about “so-called” mental illness. Those who “rethink psychiatry” (mission of this website) but are not necessarily staunchly antipsychiatry like yourself, may be offended. (for the record, I’ve said “so-called” too, so it doesn’t bother me) But if someone got offended, and even if you don’t feel you should apologize, I still don’t understand why you needed to kick back with snark as you did above.
Kyrstyn- post on the nutrition threads and you’ll probably get more of a discussion.
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Surviving,
Thank you for your comment. I can see it may have come over as a bit mean of me, although with my twisted sense of humor, I actually intended it be flippant and humorous in a ridiculous way, not mean. Often these things do not translate well in online interactions without the visual/voice tone cues of real interactions. I will try to be more aware of that.
In my defense I will say that the commenter had already made negative assumptions about me and what I was thinking that were way off base and that she couldn’t have possibly known without asking. So I didn’t feel the need to hold myself back that much.
At this point, I’ve had enough with the “mental illness as an illness like any other” thing and am not going to apologize or be careful about what I say with that. If a few people get upset by that, so be it.
I encourage you to post more often because I enjoy your posts and want to hear more of you. In an online forum, people are always going to say some weird things and one will always occasionally be upset by what gets said. I hope you won’t take these things personally to the degree that they inhibit you from posting… remember these people here don’t even know you.
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Keep putting in the coolant fixes the problem, but isnt fixing the engine. As for blaming genetics, for the failure of prozac et al, that is like blaming vaccines for not working, because we have the wrong genes to match the vaccine. Or blaming antibiotics for not working, because we are somehow defective in our body chemistry. Why do people feel they have to somehow apologise, by finding a genetic marker so they can explain why a drug doesnt work. Do psychiatrists manipulate our minds to that ridiculous extent????? The biggest pharma scam in history, if our drug doesnt work, or our vaccine doesnt work, it is actually YOUR fault?????
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You have a misunderstanding about what I am saying. Search for Nutritional Genomics.
But we can say the same about psychotherapy, if it does not work…who’s fault is it?
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Hi Krystin if psychotherapy doesnt work, I would just say it doesnt work. I wouldnt feel the need to get genetic, to have to prove a theory as to why it doesnt work. I absolutely think diet has so much to do with this, as does vaccine damage, toxins and pollutants. In my case, I thought my father, myself and my son, were very different, in that valium sends opposite, to what it should do, according to the doctors. I now find that at least 20% of people that use ANY DRUG, have the opposite effect as to what that drug should do……….. We dont have defective genetics, we are just all different. It seems that the one drug fits all, ie Viva Zypexa, cures everything from acne to menopause, is an absolute pharma scam……….. All psych drugs, are proving to be in the same basket, major pharma scams.. When an actual study into GSK paxil for children sends 10 out of 98 kids suicidal in only 21 days, and another wanting to go home and murder his parents, comes back as PAXIL Is SAFE AND EFFECTIVE>>>>>>>>> how could that happen? 14 billion profit, on deaths, and disabilities caused by paxil, for a 3 billion fine. Crime does pay if you are a pharmaceutical company.
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I will look up Nutritional Genomics….. but think we are agreeing anyway.
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Dear Dr Berezin,
I find your descriptions about the potential drama going on in a persons mind very interesting. This makes a lot of sense to me, and this was mostly what I was looking at in your article.
My own suicidal hospitalizations were caused by “antipsychotic” depot injection. They were definitely accompanied by neurological reactions but the most most dangerous part was a type of “terror” that I had never experienced before, and that I didn’t know would end.
I went on to make complete recovery when I stopped taking this medication.
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“I could treat this problem by injecting a drug to numb the pain nerves of your hand. The upside to this solution is that it would take you out of pain and make you feel better. The downside is that you would keep your hand on the hot stove, feeling no pain. This solution would foster the pernicious situation and escalate the damage to your hand resulting in a bad burn. This is exactly how antidepressants operate.”
This was a very good comparison – if we will suppose that the antidepressants will work for a while.
However, they may be unable to help the patient find relief; not even for a second…
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Hi chrissponias,
You’re right. I wouldn’t say that I wouldn’t take an antidepressant ever in my life but like a tranquilliser I would hope to recognise it for what it was.
I’ve found lots of non chemical things that help me and make me happier and less worried in the normal world and I’ve got the most extreme diagnoses (because I initially refused the medication).
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It’s ironic that just after Joel Hassman pontificated that there is “(nothing) of real substance from anyone” on MIA, that “meds are part of the equation that is mental health disorders”, and he defied readers to tell us “what do you offer for treatment for people who seem to have the signs and symptoms of Major Depression?”…. after all of that, this article suddenly appeared at the top of MIA homepage:
http://www.madinamerica.com/2016/01/therapy-effective-and-efficient-long-term-for-depression/
And after speaking about the long-term efficacy of psychotherapy for depression, it said, in part: “An analysis published in JAMA in September, however, found that “patients with more severe depression were no more likely to require medications to improve than patients with less severe depression. The same study also suggested that CBT may be used an effective first-line treatment for severely depressed patients.”
So there is data playing into one of Hassman’s issues, that for many of the severely depressed, drugs are not absolutely necessary. This doesn’t mean that for others drugs cannot be helpful. But given that antidepressants are only barely more effective than sugar pills in the randomized studies by Kirsch and Moncrieff, it does suggest that therapy is more helpful and more effective in the long term than drugs.
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Absolutely brilliant article (bit long winded?) but spot on……….. “”””By pouring more serotonin (radiator fluid) into the synapses, one might (and this is a considerable might, at best) temporarily relieve the symptoms. Old antidepressants such as Elavil put more serotonin in the synapses. New antidepressants such as Prozac accomplish the same function by preventing the re-uptake of serotonin in the synapses and creating a larger pool of serotonin on which to feed. However, what serotonin actually does is create a hardening of the self and an unconflicted selfishness. It intensifies an emotional hardening toward others. When fighting, you are hard and cruel. Your enemy is an “it,” not a person. There is an attitude of coldness and hatred toward your adversary. This amplifies the emotional reality of the invisible sadomasochistic personas. The escalated hardness and coldness from adding in extra fuel for aggression is often experienced as feeling good. This is due to the fact that there is no conflict over hurtfulness. This has been numbed. To heal from cruelty, you have to feel the appropriate remorse and regret.””” Summarises everything so wonderfully. I have been there, I have been that suddenly demanding arrogant selfish bitch, and yes felt a sense of power for that, instead of the normal me that actually had some sort of guilt and compassion………………… I have been that woman, that suddenly blamed everything on a small little baby, and could have quite callously drowned him………….. luckily, I still had a bit of brain left! Thankyou so much, this is spot on…….. It also explains to my why people suicide going on the drug (their brain hasnt managed to self regulate down the flood of serotonin, yet)… and also why those going through horrific withdrawals, and suicidal thoughts when coming off the drugs, rarely suicide………. the thoughts are there, but more balanced serotonin, means they are compassionate enough to themselves, not to do it. My observations only, thanks for the great article……..
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Folks, the comment section is for discussing the issues raised in the blog posts, not for ad hominem arguments (no matter how true they might be) and slinging insults at other commenters. I realize the discussion started out with something of a provocation, but we need to keep it clean and stick to the issues. It’s unfortunate that some comments making valid and important points also contained personal attacks and had to be removed.
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“To review, the issue is not in the neurotransmitters, but the mappings of experience that generate problematic plays. Serotonin does not exist in some stand alone way. It is merely a substance that specifically glues sadomasochistic plays together. The only issue is, in fact, the problematic sadomasochistic plays which come from trauma. This is what creates psychiatric symptoms. The treatment for problematic plays is psychotherapy. When we mourn the trauma, the sadomasochistic play is deactivated. The neurotransmitter glue is also deactivated. A new and loving play replaces the problematic play. There is no such thing as a chemical imbalance which needs to be fixed with extra serotonin. There is a traumatic play that needs to be mourned.”
This is excellent–and true, to my mind.
Although I think it’ll take more than just psychotherapy to make this transformation from self-splitting/inner chaos to self-loving/inner peace. I’m thinking that some kind of multi-dimensional healing is required for such a radical shift; that’s a lot of parts changing and integrating, creating a whole different world and reality for ourselves, from cellular to psychic. There’s a lot to which to adjust in core way, whole new habits of being and relating.
I see it as a pole shift, in that our point of personal power does a 180, internally motivated, through humility, self-responsibility, and trust, rather than externally, via controlling others and cohersion.
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Oh, and also controlling others through deceit. I feel that’s also relevant, given the industry we’re talking about.
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I think the the word “mourn” is very strangely appropriate.
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Ha! Indeed!
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Being forced into a “fight or flight” situation, in the most inappropriate of places, a doctor’s office, then also a church, was quite unexpected. “The only issue is, in fact, the problematic sadomasochistic plays which come from trauma. This is what creates psychiatric symptoms. The treatment for problematic plays is psychotherapy. When we mourn the trauma, the sadomasochistic play is deactivated.” The mind altering psychiatric drugs also cause the psychiatric symptoms, despite doctors claiming ignorance of this reality.
And the problem with psychotherapy, from my experience, is some psychologists, just gas light people and railroad them off to the psychiatrists for the incompetent doctors and child abusing pastors. And such “psychotherapy” is counter productive, actually downright medical betrayal, rather than helpful. But reading medical records, and researching medicine enough to understand “the dirty little secret of the two original educated professions,” allows one to comprehend the “sadomasochistic play.”
“Although I think it’ll take more than just psychotherapy to make this transformation from self-splitting/inner chaos to self-loving/inner peace.” I agree, Alex, an inner spirituality helps one survive and heal. But I also believe, “To heal from cruelty, you have to feel the appropriate remorse and regret.” Which doctors and pastors, and bishops do not provide. They deny and cover up their sins and crimes via the white wall of silence, and all the way to the tippy top of their organizations.
https://books.google.com/books?id=xI01AlxH1uAC&printsec=frontcover#v=onepage&q&f=false
And the cops, judges, and lawyers, all also collude to cover up child abuse for the paternalistic religions. I do believe we need to move towards a world where the child molesters are arrested, it is acknowledged all people are created equal, and we have justice for all instead.
Especially now that 2/3’s of all so called “schizophrenics” are child abuse or ACE’s victims who were likely wrongly put on the neuroleptics by child abuse profiteering psychiatrists. And because the neuroleptics do indeed create both the negative and positive symptoms of “schizophrenia.” Via neuroleptic induced deficit syndrome and the central symptoms of neuroleptic induced anticholinergic intoxication syndrome. A reality the psychiatrists deny.
It is quite shocking that today’s medical community and historically Germanic religious leaders seemingly did not learn from WWII that making up “mental illnesses,” then defaming, torturing and poisoning people unjustly, was and still is, unacceptable human behavior. And even some Jews did not learn such behavior was unacceptable, as two of my anticholinergic toxidrome creating psychiatrists were Jewish, ironically named for the priestly classes of Jews, a Rabin and a Kohen. But at a certain point, one does acquire the wisdom to realize just how disgusting, unrepentant, thus also hypocritical, some “professionals” truly are.
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I agree, Someone Else, we’re definitely in an age of systemic abuse and monster bullying (as I’ve come to call it), and it has had devastating effects on our society, as well as all of us, individually.
Once I got out of all those situations for myself, I certainly did go through a period of grief as I was letting go of so much–not just people, but also what I had thought was my ‘identity,’ to take on others’ stuff, that it was my responsibility to do so. (Thanks to what I learned as habit in my own family).
In that process, felt my past melting away, like water colors running in the rain; and while it was definitely a relief and worthy of celebration, it was also a process of letting go, detaching, and making for myself appropriate separations from certain relationships and environments. Suddenly, I was in no person’s land–if I was not that overburdened victimized person, then who was I?
To fill in the blanks, I learned that if I were to stop staring at the shadows of my life and instead, to intend to come into present time and see the good in and around me–even as slight as it could appear to be at times, but still, there is always good somewhere in our vicinity, if we take a moment to focus–then I could amplify this and my body would fill with new light and better feelings to replace the old gunk. So I began to shift my focus and what I chronically thought about.
After practicing this tons and tons (had to break old negative thought patterns and habits, that took some work and diligent focus), my consciousness eventually shifted into what I would call ‘light,’ by which, in essence, I mean, to a more positive, open, relaxed feeling in my body, leading to a more positive self-image and a more positive experience of life–better outcomes and manifestations. Eventually, joy.
That is continuing to this day, expanding as I move forward, because I more and more train my mind to focus on light energy, as opposed to the extremely dense energy of abuse and other social crimes. That on which we dwell becomes energy in our bodies, from the feeling of it. It’s actually good medicine to dwell on good feeling thoughts and images, it totally impacts our internal vibration, which influences everything about us and our lives.
Indeed, like you I feel that these folks should be called out and brought to justice, and I believe this is starting to happen. Bill Cosby is not getting away with it, his life and career have been permanently tarnished and he’s being publically scolded and abandoned. I believe he is suffering from his own crimes and deceit upon certain individuals, and also to society at large. I believe this will happen more and more, which will be a tremendous relief in our society.
Although, indeed, it will cause many people quite a bit of grief to be so disillusioned with those whom we had respected and trusted to such a degree. But I think it helps to know that this is a very powerful sign of significant change happening, the kind we’ve been instigating ourselves, to a more compassionate and creative world, of equal justice.
In the meantime, we can still choose on what to focus predominantly, and I believe that will help us get there faster and with greater ease. I prefer feeling good to feeling badly, and I also prefer to create positive experiences in my life, rather than negative. So I think eventually this focus will outshine all the crap, while these spurious ‘kingdoms’ fall and go out of business, but it will take some time. They are in the shadows, can’t help that. It is catching up to them fast, I truly believe.
We are certainly in store for some mass grieving, first, however. As that clears, then, society will be able to transform, and the world will became a new stage for our personal theater of consciousness. That would be how I envision it, in any event, like a Renaissance . And I really think we could really use one of those about now!
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Alex, as always, very beautiful and inspiring.
Dr. B
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Thank you, humbly, Dr. B. The inspiration is definitely mutual, as evidenced by how I borrowed your metaphor to incorporate mine! I do believe you are so spot on about this, rings clear as a bell to me.
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Thanks, Alex. And I do largely agree with you, a positive attitude and living in the moment is very important, actually living in such a manner is what likely got me through all the anticholinergic toxidrome poisonings, defamation, and thievery, with which I dealt. Although, one does get to a point where one understands the “dirty little secret of the two original educated professions,” and the banking industry’s crimes, and just becomes so very disappointed in our current society.
And that’s where I am at this point, to some extent, but it is a transitional phase. And I’m not upset so much about what happened to me personally. It’s the totality of the psycho / pharmaceutical / medical / religious industries’ greed inspired crimes against so many, that’s really heartbreaking to me. It’s the never ending wars, the complete fiscal irresponsibility of our past several Federal Reserve chairmen, government, and our mainstream media’s propaganda to perpetuate such stupidity, coupled with the concern that today’s leaders do appear to be following the anti-Semitic “Protocols …” manifesto.
Plus I was left, after all the anticholinergic poisonings, with a semi lucid dreaming issue. Where I awake in the mornings lately feeling God is in the process of the final judgement. And I fear way more people will be going to the “lake of fire,” than I had thought. Actually, I didn’t used to think there was even a need for a “hell.” And I do believe this is a transitionary phase within my dreams, since the story of my dreams, does change over time. But, that’s what’s going on in my dreams right now, which is disheartening, but of course with the promise of a better future for all eventually. And it is just dreams, but my dreams are sometimes prophetic, as were my grandmother’s, so no one really knows. Except, of course, God, if He does exist, as I believe.
Robert, is it common for one dealing with crimes and injustices similar to the ones my family has dealt with, to have dreams the final judgement is in process? And I know you don’t know me, or my entire story, but it does seem lots online, other than just me, are seeing “signs of the end.” Although, I know such theories have been happening for thousands of years, too. Maybe that’s just how the Christian mind copes with the staggering societal betrayal and injustices we see happening in our country and world today?
Alex, I do agree, justice is brought about in God’s time, and by Him. And the fact that, that pastor wrote the above mentioned book, pointing out his disgust at today’s ELCA bishops, is evidence the truth is starting to come out. Dennis Hastert, our former IL speaker of the house, was also arrested, for financial crimes related to his child abuse hobby, which is progress. One of my doctors was arrested by the FBI for similar crimes against many other patients. The house of cards that is today’s psychiatric theology is also starting to crumble, which will hopefully end the medical and religious industries faith in the psychiatrists “dirty little secret” way of covering up the easily recognized iatrogenesis of the unethical and incompetent doctors, and the crimes of the child abusing pastors and priests.
I guess I’m still in the grieving, or mourning phase, and do want to exit it asap. But I don’t feel it can be exited without at least pointing out the crimes of today’s psychiatric industry, and the crimes of those who they are unjustly harming others, to protect. In the hopes all the “professionals” will some day realize they are just people, like everyone else. And we’d all be better off living in a world where all humans understood mutual respect of all others, is what will bring about a better society for all. I’ve also been lucky enough to find doctors wise enough to take the prior psychiatric stigmatization off my medical records, because they were capable of understanding my medical research, and realized that covering up child abuse for religions isn’t very classy. One doctor was even kind enough to claim I was “one in a million,” a state psychologist told me I should go back to school and study public health, and a religious scholar who interviewed me asked me, “how does it feel to know more than the doctors?”
Hope runs eternal, but we do need to end the white trash paternalistic crimes, and without pointing them out, we will not end them. I went to a play this afternoon called “Clybourne Park.” And, as a girl who married a guy who used to live on Clybourne Ave in Chicago, and lived through the re-gentrification of that part of the Lincoln Park neighborhood of Chicago in the late nineties, which is what the second act was fictionally seemingly about. I’ll mention a bad joke in the second act of that play. A black guy asked, “How many white men does it take to screw in a lightbulb?” His answer, “All of them. One to hold the bulb, and the rest to screw the rest of the world.” At some point, I hope the “white men” currently in charge, will rethink the wisdom of their appalling and inappropriate ways.
But I do share you’re hope “society will be able to transform, and the world will become a new stage for our personal theater of consciousness … a Renaissance. And I really think we could use one of those about now!”
And I am still living in the now as well, and working to help build hope and self confidence in children. Just yesterday I ran a “community art project” at a nearby library, and I work to build confidence and give joy to children with an art program I run, every week, as well. I’m just in a transitional phase right now, trying to figure out the best path for me to take, to help humanity evolve in a better manner in the future, given the many talents I was blessed with by God. And the fact our current society doesn’t want to actually pay those of us with a creative, as well as, analytic side.
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Do you know what I’ve read and heard a lot online, SE? That we are, indeed, in the early stages process of mass awakening and transformation, in that all you speak about here has come to light, and that is rippling. All systems are challenged now, and it seems they are at a dead end, backed up against a wall. People like you and others on here, I believe, have instigated this with your beautiful and courageous truth-speaking. I see this spreading.
I believe it IS the end days of our society as we know it now, it is happening all around us. The good news is that there are new things coming into place, and we will continue to create them. A new world is birthing.
My impression is that you are picking up a collective energy, as I am, too. We are sensitive to this, as are some others. And you’re right, some aren’t quite ready for this, they’re struggling with other issues.
From where I sit, you’re ahead of the game with the awareness you have. You’re tapped in. Personally, I don’t believe there is anything to fear, if we trust and go with it, like you are doing. Things lighten up as we let go, let go, let go.
We all have our processes to engage in this, and each one of us will make choices based on what we feel is right for us, moment to moment, based on what is happening at that or any time.
I think you’re aligned with truth, so you’ll be fine, and in fact, more than likely, one of the pioneers, as the smoke clears from radical change.
At least, this is how I’ve been thinking about all of this, from a broad perspective. I find it totally fascinating–and yes, disorienting at times. But hey, it’s radical change! It’s what we wanted, so let’s see where this takes us.
We are most definitely not standing still at this time, and in fact, are moving forward pretty quickly at this point, I think. Information is zooming.
I’m fascinated now with the changes I see on a day to day basis at this point. I’m pretty sure this is new territory for humanity, this level of consciousness on such a large scale, indiscriminately. At least, that’s the buzz I hear on the ‘net.
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Alex, I’ve read it too. It’s as if my dreams, and concerns, have gone from my brain, and it’s supposed internal web of connectivity within the collective unconscious, to the World Wide Web. Many are “awakening.”
And I agree, I, as well as others around me, have also mentioned they’ve felt “the power.” What you call “a collective energy.” And I do feel we are, at least supposed to be, in the process of collectively evolving. “The end” is nothing more than the beginning of a much better world.
But the psychiatrists seemingly want to maintain the current materialistic status quo, with the evil “banks and corporations that will grow up around them,” the psychopathic corporations who are killing millions for short term profits. And have these criminals take over the entire world, their so called New World Order.
But the Holy Bible forewarns us about this “synagogue of Satan” world takeover. And the paternalistic mainstream religions don’t see it, or at least my ex-religion has seemingly sold out. My new religion, also a mainstream one, isn’t as bad. My current pastor is talking about how the groom is calling his “bride,” which is where I am feeling we are now. And I feel I am “of the bride.”
Thus, I don’t feel I have anything to fear either, but I worry about those who worship the Almighty dollar and short run corporate profits, at the expense of humanity. I wish they’d wake up, too, and become aware. As I feel the goal is to save as many as possible.
As a “taylor who sings with the Lord, who is just an American girl,” a description of whom my former hometown supposedly considered me, from one of my awakenings. With a swift little tale about my “walk through the fire.” Taylor Swift does seem to utilize my dreams / concerns / thoughts as if I were some kind of muse within the collective unconscious.
“Don’t say I … didn’t warn you … So it’s gonna be forever … Or it’s gonna go down in flames … They’ll tell you I’m insane. Cause you know I love the players. And you love the game … But I got a blank space baby. And I’ll write your name.” I do think the goal is to write as many as possible into the book of life. But such does require one behave with common decency, and repent and make proper amends, if needed, exactly as Jesus taught.
Mine is a bizarre and very creative story. But I do believe we are to collectively evolve, rather than allow the current evil, to take total control. At least lots of others seem to share my concerns now.
I do appreciate your insights, Alex.
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I wonder if this video I’m posting here will speak to you, Someone Else. This is my new play of consciousness, applying Dr. Berezin’s framework, which allows for never-ending growth and evolution through one and only one thing: awareness. I learned this as I grew from my adversities, and I discovered that this is the thought and belief now, that we are ascending into this new consciousness.
For those of us who choose this direction, it is available en masse now, not just for ‘the masters,’ it is universal, in all of us. There are tons of videos and blogs out there that talk about this in a plethora of ways, but I happened to catch this one this morning, and it seemed very streamlined and accessible, straightforward, so I thought I’d post it here and see what happens. It’s not the kind of thing I would normally bring to a predominantly academic crowd, but everything you say resonates beautifully with me, SE, and when I saw this video this morning, made me think of this exact exchange we’re having.
https://www.youtube.com/watch?v=ZT-IgX8jzL0
From our expanded consciousness, we know our power to manifest. I believe this is how we change the world, by opening our hearts and minds, and at least striving for joy and inner peace. I believe that’s what is on the other side of that grief we feel from letting go of the old, which drains us from perpetual loopy struggle, conflict, and war.
We can’t expect ourselves to be always in joy and inner peace–we are, after all, human with myriad emotions, and we can enjoy the entirety of our humanity, shadow and light, that would be normal, to my mind. But if we make that our goal, then not only are we *practicing* joy, but we are also offering it as our contribution to the collective. Energy ripples outward, as if throwing a stone in a pond. I think we help ourselves and others tremendously, the more we can practice this, and influence others to feel these good feelings. That is healing, and definitely the opposite of suffering.
Dr. B., thank you for this opening. To springboard from your extremely deft conclusions, this is what happened next for me, what is depicted in this video, and a whole new world opened up.
Finally, it is a joy to heal and grow. That’s what made the difference, actually enjoying the process—finding wonderment in the exploration of energy, humanity, and consciousness, via my own experience and observation, because it felt good to experience. That’s how I found healing.
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Someone Else, your story is so epic and all that you say rings of such profound truth. I love how you connect the dots, and also your unwavering certainty. Very powerful.
I’d be first in line to read your book. I believe it would be a multi-dimensional teaching that would enlighten society at large. I mean this very sincerely.
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Oh, Alex, thanks so much for the kind words. I do need to get back to writing, and more so editing. I want it to be a book of hope, not disgust, so I need to try to get my disgust out in other places first.
And, of course, I get busy with life also, which distracts from my writing and editing. But I greatly thank you for your words of encouragement.
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Thanks for the article –really really good– I really like the way you explained it– mind you im not too clued up on the language– but I got the picture anyway– only realised recently its the serotonin they’re messing with– and how that causes neuroleptic withdrawal that gets called relapse–like a catch 22– the only way to fix it all, is to have in law– a right to withdraw with proper assistance- a right to investigate adversity in medication for the individual– which, in a way– would make what’s been happening wrong– and them wrong- and they’re not gonna make anything they’ve done or do wrong either– not without simply putting it down to evolving like the rest of society anyway–just like they’re starting to do, with the CBT/therapy– – push at the moment–the internet– the world waking up to– screaming for– “recovery” as opposed to “management”–more internet–nothing mainstream– but– they’re simply not giving up their government given “power” over others–the first and biggest drug– outside of “attention and money”, not in a hurry anyway. And not whilst the three tricks of psychiatry are still working too- 1/to baffle— with science–2/ to “manipulate words and meaning in science and people”–to suit the line or story of the imaginer– 3/ silence– what you usually get when you’ve got them. Thanks again–jb
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http://www.naturalnews.com/049921_psychiatric_medications_homicide_risk_drug_violence.html
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I checked the source articles this article cites and they don’t seem to support its premise.
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Natural News is not the best source of anything, he seems to read stuff, and go off on a ramble…………… here is the best information on homicides and suicides caused by antidepressants http://antidepaware.co.uk/homicides/ it is difficult to get the drug use listed on the autopsy.
Illegal drugs get listed
Legal drugs dont get listed…… needs to change. Just because they are within “legal dose levels”” doesnt mean they are not dangerous.
People kill usually within first 10 days going on these drugs. A 14 year old put on paxil for acne! Dead in three days. Man put on the stuff aged 58 for stress, stabs his wife, then stabs himself………. These are not isolated occurances, but how can you blame these out of character events on a mythical illness, when in reality this man just went on a mind bending drug? All legal.
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