The Psychiatric Times (November 2016) honors Robert Whitaker on the front page. Well, not directly. The lead article, written by Ronald Pies MD is entitled, “The Astonishing Non-Epidemic of Mental Illness.” The article is an attempt to refute a central premise of Whitaker’s well-known book, Anatomy of an Epidemic, that mental illness is on the rise because of adverse medication effects.
The article makes an argument that rates of mental illness have been unchanged over the last decade, and argues against Whitaker’s assertion that more people are ill with mental illness due to misguided and harmful psychiatric treatment.
Assessing actual rates of mental illness in the population is difficult, but for the sake of argument I want to agree with Pies that the rates of mental illness have been constant over time. Unaddressed in Pies’ article are the well-known statistics on the dramatic increases in the percentage of the population that are taking a psychiatric medication.
If the incidence of mental illness has remained the same, but there is an ever-increasing percentage of the population that take psychiatric medications, then these drugs are being over-prescribed to people without mental illness.
I am surprised that Dr. Pies and the Psychiatric Times would want to headline the issue with this article. While I realize that Whitaker and Pies have had their disagreements, this article seems inappropriate for a leading psychiatric publication. Anatomy of an Epidemic, while popular among the public, is not popular at all with psychiatrists, many of whom make their living by doing the overprescribing.
Who is the intended audience? I can’t know exactly why this article was written, but obviously, Dr. Pies has been affected by Robert Whitaker’s well-written book and the entire Mad in America movement. My guess is that he needed to write the article for himself, because the psychiatric epidemic spawned by overprescribing and prescribing without concerns for side effects is so obvious. Congratulations, Bob.
Meanwhile, there is another epidemic of mental illness. It is the epidemic of people trying to stop SSRI antidepressants that they have taken for many years. Put on a SSRI 20 years ago, often for trivial problems, the patient believes that they can stop the drug whenever they want. When they do stop, the depression and akathisia are crippling, and reinstatement sometimes makes it all worse. In my practice I am seeing people with severe tardive akathisia after stopping their SSRI and they don’t know that it is a side-effect of withdrawal. Such patients must be commonly showing up in every psychiatrist’s practice. Unfortunately, the long-term withdrawal effects of SSRIs are not recognized by organized psychiatry.
On the other hand, I have a strong suspicion that the pharmaceutical industry is looking to capitalize on SSRI withdrawal. The FDA has just approved a drug to treat pseudobulbar affect. There is a push to declare pseudobulbar affect a common and often unrecognized condition. Pseudobulbar affect is a state where the patient’s mood is very labile, and they are easily moved to tears or laughter. It is an uncommon clinical finding, best known as a result of strokes or other neurological conditions. It is pretty rare and it is difficult to see why the profit driven pharmaceutical companies would focus on this. However, it is a very common symptom in patients who are withdrawing from SSRIs. Education courses are showing up, to teach the doctor to recognize what is described as a common and under diagnosed problem. So, when the patient who doesn’t realize that they are in withdrawal shows up with pseudobulbar affect, the psychiatrist is going to be able to make a diagnosis and prescribe another drug – anything as long as the withdrawal syndrome remains disguised as new illnesses.
The good news is that Mad in America is widely circulated and the message has been entering the collective unconscious. Even Dr. Pies’.
I administrate a group on Facebook – Cymbalta Hurts Worse – with over 7,000 members. Where do we send these people with horrific post taper withdrawal effects? Doctors are sadly clueless? And they often tell the patient that a new disease has come to town (wanting to prescribe more damaging meds) when it is clearly just the residual effect of getting off the chemical Cymbalta.
Report comment
Funny you should say that. As a psychiatrist, I find it very difficult to convince people that drugs are often not the best solution, and not without harm. I try to convince people not to hop on the psychotropic bandwagon but it’s an uphill battle, to put it mildly. Sometimes, rarely, they’re necessary, at times they’re helpful, often they’re not necessary and more harm then benefit. Anyway, I don’t know of any specific way to help withdrawal except for a slow taper, possibly some temporary medications for symptomatic relief and lots of support. There’s no one medication that I know of that ‘fixes’ the withdrawal, and if there is, I’d be happy to hear of it. There are some workarounds but I don’t think this issue has been addressed in psychiatry.
Report comment
NWWell you sound like one of the better psychiatrists. The problem you describe probably stems from the mass marketing efforts of massive pharmaceutical companies.
Are you sad? Are you angry? Are you tired? Does your life stink? Not to worry! Follow the dancing pills.
Drugs will make it all better….
Report comment
you make it sound as if i am paid, i am not! Music does help, something like this does helps: https://www.youtube.com/watch?v=GKSRyLdjsPA, or: https://www.youtube.com/watch?v=S_xH7noaqTA
Report comment
Ekaterina, I was referring to American drug commercials. I wasn’t attacking you. And I know you aren’t getting paid; writing for MIA is a labor of love.
And you are right about music. It frequently has made me feel much better. 🙂
Report comment
@Nwwell.com, I find your comment disingenuous in this venue of all places. “Difficult to convince” people to not pop magic pills for themselves, their family members, their children? Possibly because the profession to which you belong, and its pharma partners, have spent billions of dollars and a few decades convincing people that they have brain diseases that will absolutely be repaired and rebalanced by little pills, perhaps? A little professional humility is in order. Maybe you’re one of the good guys, and maybe you’re not, but psychiatrists who take a removed, above-it-all tone like that give me serious pause. Liz Sydney
Report comment
Nwell.com,
You’ve got well prepared lines.
Report comment
After taking SSRIs and many other psych meds for 13 years I was left with what I might describe as my central nervous system fried while in withdrawal. I was extremely sensitive. I still am. I can only take all natural or vegan supplements. The most important part of recovery is sleep and SSRI withdrawal with leave you with crippling insomnia. Your brain desperately needs the restorative sleep to heal itself and vamp those neurons back up. Taking ambient only tricks the brain to make you think you slept when in reality you were in a temporary coma. The mechanism of action for that medication inhibits recovery in itself. When taking SSRIs your cortisol shoots up at nights making daytime sleeping a breeze. In withdrawal you’re left unable to sleep at anytime because your brain is firing on all stations trying to repair itself. It took me months to figure out that serotonin is necessary to create melatonin in my body and my serotonin has been depleted. Melatonin supplements don’t work because of this reason. So I had to literally add serotonin into my body. I took 5htp and my withdrawal symptoms disappeared entirely. I started sleeping like a baby and my chronic acne and bloating disappeared. After about two months I was able to stop taking the supplement with no ill effect. There are ways to go about this but they’re all from a nutritional standpoint. I’m happy to say I’ve successfully come out of this completely by myself even after reading all the horror stories on the internet. I did my own research and opened my mind to the clinical side of this. I also might add that a high quality, high value EPA fish oil stopped the initial brain zaps, tinnitus and lethargy.
Report comment
@mj92902mj, It is a sad fact that you and many like you know more about this subject than 99.999% of allopathic doctors out there. Glad you had the fortitude and insight to get out there and learn it on your own. Pity the poor folks who keep going back to the same old same old and expecting a different outcome. I’m extremely happy for you!
Report comment
A slow taper isn’t the panacea it’s made out to be. A taper is harmful in at least two ways. The person is still taking a drug that harmed their brain. That means only one thing: more harm. If there is suffering, it goes on for the length of the taper. If you look at everything that’s been published on tapering, you’ll find many studies that found it makes no difference.
Report comment
@Better Life. I strongly disagree as I admin a very large group regarding Cymbalta. A non-pharma influenced global group where people come in all ages and stages. It has been our observation over the years that a slow taper gives the brain time to adjust to the new chemical mix. It also often minimizes the distressing and often times disabling withdrawals. We have had people slow taper at rates around 2.5% where they were still able to have a career and a semblance of a life. Compared that to folks who went the fast taper/cold turkey rate and the results are astonishing dissimilar. Not always, but very much superior with slow tapering. In fact, cold turkey can cause psychosis in some cases and we have several stories of people hospitalized due to the body’s severe reaction to the chemical upheaval. Which, if you know anything about that, is really an added danger because doctors are often prone to give more drugs which is the worst thing to be done in these kinds of situations. I only comment here not thinking I am going to change your mind but for all the fence sitters that might take your comment as Gospel. Respectfully, it is not, and could be very dangerous advice.
Report comment
30 years ago, I had been on “Triavil 4/25’s”. that’s 4mg.s of Trilafon, & 25mg.s of Elavil, 3xday. I was developing tardive dyskinesia – facial tics – so I just stopped it cold turkey. Didn’t tell my shrink, because I didn’t think I needed to. The shrink never told me anything about tapering, *or* withdrawal…. Quickly, I went into a full-blown psychosis, worse than anything before or since. I was literally almost murdered by jail guards, then spent 6 months in prison, being tortured with 1000mg.s/day of Thorazine…. The shrink had her medical license yanked, but I didn’t learn that for years after. Moral? Except in very rare cases, with specific indications, ALWAYS TAPER! (A few years after the above episode, I was re-hospitalized, while on Trazadone, taken *as* *prescribed*, when I went toxic on it, because the local CMHC NEVER checked my blood level, like they were supposed to.)
Psychiatry is a pseudoscience, and a drug racket, and a means of social control. That’s ALL. It is NOT a legitimate “medical specialty”. ALL of the DSM is only a catalog of billing codes. ALL so-called “mental illnesses” were INVENTED, as excuses to $ell drug$….
The psychs continue to INVENT new “disorders”, and “pseudobulbar effect”, in the absence of actual, documented cause such as stroke, is yet more proof of what I’m saying…. But, thankfully, my experience with “antidepressants” was more benign. They were useless for me…. Thank God I’m still alive, and DRUG FREE. That’s in spite of all the “medical care” I *suffered*. Now, with hindsight, I can see that the WORST of my so-called “symptoms” were ALL IATROGENIC!….
(c)2016, Tom Clancy, Jr., *NON-fiction
Report comment
Completely agree Lost. Cold turkeying a med or tapering too quickly is like putting the breaks on the car at 60 miles per hour.
And anyone who advocates this should be willing to support users 24 hours per day who suffer horrific withdrawal symptoms because of this advice.
Report comment
Even smokers often find tapering off cigarettes easier than quitting suddenly. Their relatives may find it easier too–the smoker is less irritable because the withdrawal symptoms are less severe.
Smoking is definitely unhealthy, but if a taper is what it takes to quit altogether it beats a smoker who says he will quit smoking (cold turkey) but can’t make it through the first day without a cigarette because of overwhelming cravings for nicotine.
Report comment
Exactly!
Report comment
Sorry for the late reply, especially because I’m disagreeing with and correcting some of the statements made in replies to my original comment.
I didn’t recommend against tapering. I said it isn’t a panacea, and it unduly improves the image of antidepressants. The mainstream media has caught on, and now mentions tapering as if it addresses the problem of antidepressant withdrawal so completely that withdrawal is a non-issue. Now, anyone who has problems after they go off an antidepressant brought those problems on themselves by not tapering slowly enough.
How slow is slow enough? Well, if you had problems, you’re told your taper wasn’t slow enough. The Theory of Tapering therefore cannot be falsified.
It is true: There are studies that conclude there’s no difference between tapering and not tapering. (I know: their tapers weren’t slow enough.)
I’ve been a member of SurvivingAntidepressants.com long enough to have read countless stories of people suffering all through tapering. There are people who were doing fine until the last dose reduction, from minuscule to nothing. That last step isn’t a quantitative change like all the previous ones. It’s a state change, from one a drug to not on a drug, and it can bring on withdrawal symptoms in full force.
The implication that I don’t know what I’m talking about is an attack-the-messenger strategy. I’ve gone off more psych drugs than most people have been on, and it wasn’t because there was anything wrong with me when I first took a dose of Effexor IR.
Regarding smoking, some people might prefer tapering to quitting cold turkey, but that”s because, as I implied, tapering is the opposite of quitting. Using is the opposite of quitting. Cold turkey was the method used by the majority of former smokers because of the simple fact that you either smoke, or you don’t. Quitting isn’t a process. Quit is a status.
Smoking and antidepressant use are apples and oranges, anyway. Smokers crave nicotine, and AD users do not crave ADs. Physical complaints and mood changes in withdrawal from nicotine are negligible in comparison to those complaints and changes in withdrawal from ADs.
I don’t recommend tapering or cold turkey. I recommend thinking long and hard, doing a lot of reading, and questioning experts, users and former users before taking an antidepressant drug for any reason.
Report comment
I read the Pies article and there is definitely some sort of blindness at work there. He’s put himself forward as a defender of organized psychiatry, and as such, he’s going to be blind to its faults. He dismisses medicalization, though who knows why, while focusing on “serious mental disorders”. I think there is always a certain form of shell game involved in this kind of maneuver as well. Bi-polar disorder passed schizophrenia as the most popular form of “serious mental disorder” label awhile back, but he is still fixated on the “schizophrenia” label. I don’t think you’re going to see psychiatrists stop taking patients because their complaints aren’t serious enough. I’d imagine that the labeling rate must have come close to reaching a saturation point with the last decade. 1 in 5 with a “mental illness” label, 1 in 6 on psych-drugs, talk about a successful marketing campaign? Where was Dr. Pies while this was happening? I recently read Kenneth Donaldson’s Insanity Inside Out. He mentions 1 in 7 as the number of people with a “mental illness” label, and so the incidence of labeling has certainly gone up since the mid-1970s. I don’t know that Ronald Pies has seriously dealt with outcomes. If he had, maybe he would be singing a different tune, but then if you’re just out of be a hatchet man for authoritarian psychiatry, you don’t go there. Not going there certainly isn’t going to make any sort of critique less valid.
Report comment
I suggest you check out Ron Pies articles/rebuttals etc on Phil Hickey’s, as well as Robert Whitaker’s blogs. Pies has an absolute talent for involving himself in arguments that lead to him being shot down again and again with logic and good research. He appears to be immune to both. BUT he was the executive editor of Psychiatric Times so has a forum where he preaches to the other illogical, poorly educated, delusional members of his profession with, he believes, impunity.
Report comment
Preaching to the choir in other words. Though they stink at both sermonizing and singing! The blind leading the idiots–or is it the voluntarily blindfolded idiot leading the blind? Ha ha.
Report comment
In his article, Pies references Thomas Kuhn’s idea of “paradigm,” saying that psychiatry is not a failed paradigm since “there is no one paradigm the defines all of psychiatry or that dictates practice on the part of all psychiatrists.” But I wonder if he truly understood the implications to his comment. If you apply Kuhn’s notion of paradigm here with Pies’ application of the term to psychiatry, then you would have to conclude that psychiatry as it’s practiced, is NOT science. Rather, it would be what Kuhn calls a “pseudoscience.”
He also seems to be oblivious to the implied paradigm in psychiatric practice generated by DSM diagnosis—that it classifies a real “illness” or “disease.”
Report comment
According to what I learned about debating in high school, it actually helps you make your case more effectively if you immediately own up to any weaknesses in your own arguments and possible strengths in your opponent’s. Screaming, “I’m right and you’re wrong!” will not win the debate.
Report comment
MiA seems to me to be toning down their critique of the “Mental Health System” lately as evidenced by recent posts.
https://www.madinamerica.com/2016/12/prescribing-benzodiazepines-needed-leads-abuse/
and this PHD lady who recommends drugs to strangers in the comments section
https://www.madinamerica.com/2016/12/dialogue-psychiatrist/
If I wanted to read mainstream view on psychiatry/’medications’ I would read mainstream sites.
WTH?
Report comment
I have noticed this seemingly deliberate shift in the site’s message too.
Some articles are definitely giving credence to psychiatric labels and talking of mind altering psych drugs as if they are real medications for real illnesses.
Sad, really….but I am glad that comments are not being censored….however, the people who countered them may slowly drift away.
Report comment
I’m wavering…thanks for corroborating my ‘reality’! hah
Report comment
excuse me, but i don’t recommend drugs to anyone:) And my PhD is in philosophy:) But just so that we keep some suspicion and some paranoia thinking, how about that Russians are on board?
Just saying:)
(This PhD lady, well, i am not hiding beyond any identity), and if you read my article, then you would probably recognize that i am totally against categorizing people, insulting them, calling them names, and if anything think that madness is a gift from God- i have another article published on this site arguing for that.
Report comment
anyway, it was wrong to share my opinion about drugs, you are right. I shouldn’t have done it. In my case, seroquel helped, but i am not sure about its long-term effect, and as to lithium, i only shared what a friend of mine told me, but i am really not a specialist, only have personal experience with ‘mental illness’ which i believe is misunderstood. In my experience it is a beautiful thing for which I fight.
Report comment
if any reconciliation I reported my own comment where i give my opinion about drugs:) I am not a specialist on them! Just my own experience, that’s it.
Report comment
Ekaterina, I have no problem with you saying that you have experienced benefits from psychiatric drugs. I did twice myself–first on Stellazine and secondly on Zoloft. Unfortunately the benefits ended after taking the pills for a month or so.
After becoming familiar with Dr. Peter Breggin’s works I have come to realize that these “good” effects were actually worse–in the long run–than negative experiences would have been (they encouraged passive pill-popping rather than making necessary life changes.)
Still you know your own life experiences better than I do. Not being a psychiatrist I don’t claim to know your thoughts and feelings better than you do! 😀
Report comment
FeelingDiscouraged,
This is generally the way things turn out!
Report comment
Hello,
well, yes, everyone has different experiences, etc, we should respect that.
I replied to this blog only because of reference to PhD lady, which I figured out was me, ha-ha:)
As to this article, i heard from many people that anti-depressants are terrible with terrible withdrawal effects. Not sure i can get off seroquel myself, since it helps me to sleep and now i depend on it.
Report comment
Are you perhaps replying to the wrong blog (this is Dr. Shipko’s post, not yours)…just wondering.
And yeah, it’s the RUSSIANS:)
Report comment
Ekaterina: Please don’t let yourself get too defensive about posting YOUR views. I have written here before, that, “sometimes, some people do seem to do better for some short length of time, on some low dose of some “medication”. Most of us who post here at MiA have been grossly, and wrongly OVER-drugged. And, see what you think 6 months, or a year or 2 from now. I read Dr. peter Breggin’s “Toxic Psychiatry” over 20 years ago, and my views have changed slightly over the years. If anything, I’m even MORE opposed to the pseudoscience drug racket known as “psychiatry”. But, given all the drugs out there, again, “sometimes, some people do seem to do better on some small dose of some drug.” You’re entitled to your beliefs, and experiences. Maybe you’re an exception to the rule. BUT, the key is to be as fully informed and educated as possible…. That’s what you’re doing here!
Report comment
Don’t know if it’s a conscious pattern but I agree about these particular articles.
Report comment
What I’ve noticed and not been fond of are articles written by people who don’t know the subject matter well enough to avoid wording, lifted from what ever media article they’re re-writing, that hits the wrong note. It might be patient-blaming, pharmapologism, or diagnosis-validating, among others. They clearly mean well, but they clearly haven’t lived through it, or been around the loosely unorganized non-movement long enough to know in their bones that what they are (re-)writing comes from a pro-drug, pro-diagnosis, pro-psychiatrist stance.
Report comment
The most serious effect of mental illness, especially ‘mood disorders,’ must be suicide. While we devote a lot of discussion to extra-pyramidal side effects of psych meds, little attention seems to be devoted to the significant increase in suicides and the apparent contribution which medications appear to make to them (or to their inability to reduce the incidence of them). Is this a topic too hot to handle?
Report comment
It definitely is a taboo subject in mainstream news but not on the alt media such as Facebook. Many groups of peer to peer support have lots to say on this issue.
Report comment
I beg to disagree. I don’t see ‘taking one’s life by one’s own hand’ as an “effect of mental illness”. Perhaps it is an “effect” of a growing disrespect for life in general, but that’s another argument altogether. You yourself are indulging in a paternalistic argument that people should not have exclusive rights to their own bodies, and I find that one highly questionable.
Report comment
You have been told by a person or persons with the highest social status and the whitest coats, that you are ill, that you will never get well and that, in order to remain in mainstream society you must take medications for the balance of your life which have rendered you impotent, make you feel as if your skin was crawling, disturbed your sleep every night and leave you feeling hopeless. When you try to stop your medications your family/wife/staff/loved one sends you to the ER. If you’re a ward of the state you must take the medication. Now, what is your escape? Madness doesn’t make you commit suicide but a treatment which leaves you desolate and makes it difficult to resist, just might. I believe that people must have control of their own bodies including their minds.
Report comment
Good point!
Now that I have rejected my psychiatric diagnoses and am slowly tapering off my last poison I no longer want to commit suicide. Ever. No matter how unhappy I feel.
Hear that rubbish about how “Zoloft saved my life,” “Prozac saved my life,” “Abilify saved my life,” or “Psychiatry saved my life,” as told by drooling, brain-dead addicts.
Here’s my take. “Anasognosia saved my life!” And my IQ has gone up noticeably too.
Dr. Pies can take his fistfuls of pills and stick them somewhere–lying charlatan that he is!
Report comment
Here’s my take. “Anasognosia saved my life!” And my IQ has gone up noticeably too.
Love it! Would you have any interest in being the poster child for anosognosia? 🙂
Report comment
FeelingDiscouraged
I have to say that sticking fistfuls of pills somewhere is an improper use of drugs! Of course, they probably work as well taken that way as they do by mouth!
Report comment
No, “they” just can’t be bothered.
I remember seeing a WW2 foto with a group of genuinely disinterested soldiers standing around smoking and chatting while a beautiful lady (enemy fighter) hung from a rope. The same mentality applies here – only some responsible doctors will actually joke about drug induced suicide.
In Ireland I followed my former consultant Psychiatrist into the Medical Council (he was a member himself) – in his response to my complaint he made light of drug induced patient suicide (to the approval of the Council).
Report comment
howard j miller,
“…little attention seems to be devoted to the significant increase in suicides ..”
I think we need to focus on all deaths, and near misses within Psychiatry.
Report comment
The suicide comment assumes that people who feel badly enough to kill themselves feel worse than people enduring extra-pyramidal drug and withdrawal effects. If you haven’t talked to anyone in the latter group, and aren’t in it, it’s probably impossible to the guess the depth, breadth, and duration of the life-wrecking syndromes. There is such thing as suffering so badly you beg out loud to die, but not being willing to kill yourself. That should be recognized.
Some people do kill themselves to escape extra-pyramidal side effects, and anyone who has endured them or is enduring them knows why.
That the drugs induce suicide is not discussed here much mainly because no one who comments here has killed himself or herself, and there’s something of an ethic of sticking to topics you know something about.
There are people here mourning those who have killed themselves, and the gravity and atrocity of doctors having instructed them to take pills known to doctors, researchers, drug companies, and governments to put their lives at risk is not lost on anyone, author or commenter.
Report comment
I can’t discuss details because of a gag order but I was intimately involved in a pharma induced suicide via Cymbalta. The family member went to the doctor complaining of suicidality. This had been an issue throughout the course of pharma treatment for an old back injury. The doc keep prescribing psychotropics and the member kept having suicidal thoughts. Over time with multiple whack-a-mole style drug changes and each drug bringing a new set of effects/more drugs-cycle, on the last visit with the last complaint of suicidality the doctor double their dose. Tragedy ensued. It is a subject that needs to be discussed. That and the pharma connection to mass killings, automobile drive into crowd killings, pilot plane suicides via pharma, etc. It all needs to be talked about but we all know that in mainstream it won’t be because the discussion is steered by big Pharma dollars. Only with social media sites such as Facebook and Twitter is any truth coming out, mostly by peer to peer groups. I put more faith in thousands of anecdotal stories via people who are not in a “legitimate” clinical trial…another story illustrating my last point is the case regarding Traci Johnson by Jeanne Lenzer found on a Slate publication-Google it. Her suicide was deemed a trade secret. Yes, let’s get the conversation going.
Report comment
I’m sorry to hear about the death of your half-sister. it seems like nothing is considered too potentially harmful when it comes to psychiatrist’s patients. I thought the Germanwings suicide crash would do the trick and there’s be a mass awakening, but someone got to the media quickly and spawned the seeds of the depression story.
Report comment
very good, that this topic is addressed here.
please forgive me my english – i´m not a native speaker.
i suffered severe side effects from anti-psychotics including so extrem restlessness and tension, that i would have killed myself if it wouldnt have stopped – by changing to another anti-psychotic. it was the most horrible thing i ever experienced in my whole life. and its really like one cannot express it in words. no doctor would have told me, that it came from the drug. i had to find out all by myself.
even now i never talked to anyone who had that severe side effects. so it is sort of relieving to read here, that i am not alone in having such expierences.
Report comment
Stuart,
There are no “actual rates” of “mental illness” to measure; as subjectively judged distress based on spoken words, actions, and thought cannot be reliably measured in the way that one can measure, for example, the number of pounds of copper shipped through Los Angeles in a given year, or the number of sheep on a farm in Iowa in April 2016.
Of course, people’s distress – including very severe, long-term distress that gets labeled “schizophrenia” or “bipolar” – are real experiences, and these experiences are reflected in altered brain chemistry and epigenetics over time. But that does make these experiences illnesses, any more than it would be evidence of an illness if one’s brain chemistry changed in significant ways after taking a course of piano lessons, being held hostage by terrorists for months, losing a beloved spouse in a traffic accident, falling in love, or losing a job and becoming depressed. Inevitably, one’s brain chemistry would change profoundly in individualized ways through all of these experiences, and three out of the five might lead to a (spurious) diagnosis of “mental illness”.
Dr. Pies is in a Scylla and Charybdis position. If rates of (non)-illnesses have increased, then clinicians are “over-diagnosing” the people who come in to see them, and drugging is not making a big difference in reducing the number of people who supposedly fit a diagnostic category.
If rates of non-illnesses have not increased, as Pies asserts, then the continually increasing drugging of these people evidences a number of problems, most especially that the drugs do not work to improve long-term functional outcomes of distressed people.
In Dr. Pies’ fantasy world, “schizophrenia” is a chronic, long-term disorder that requires indefinite druging, but that’s not the world everyone lives in, including people such as myself who once experienced psychosis but found alternative ways out.
It’s hard to tell what is really going on in the smoke and mirrors world of psychiatric statistics.
But ab initio, the whole problem comes back to the lack of valid diagnoses in psychiatry and the lack of any biological treatment that can directly target a non-illness, let alone make a substantial long-term difference in the direction of most people’s lives.
To repeat, there is no knowable rate of “mental illness” – just how many treatment providers have given however many people a subjective label at a certain time. Pies talks around this problem, speaking about labels like “schizophrenia” as if they represented well-delineated concepts, but well-informed members of the public can now see through the charade.
Severe distress is real and the depth of distress in people’s lives may vary significantly due to a whole range of factors, but this doesn’t mean we should pretend that there are neatly reified mental illnesses out there that people “have”. Things are not going to get any easier for Pies, because there are no valid diagnoses coming to psychiatry anytime soon.
Report comment
Matt,
“Schizophrenia” could finish – with the recognition of availabile solutions outside of Psychiatry, for those that want them.
I’ve been reading through the ‘holistic’ approach to so called “schizophrenia” that the Hearing Voices Network and Psychologist (and ex client) Rufus May use, and these methods are very straightforward and are proven to work.
I have accessed similar services in the community myself which were inexpensive and selfsupporting, and very successful.
With holistic recovery widely available in the community a person cold theoretically shift to it, at any time (with the drugs eventually going of their own accord).
Report comment
Fiachra,
Thank you for this comment, and I agree with what you are saying. At any time one can begin to move away from the disempowering, unevidenced psychiatric myth that one has a chronic brain disease and has to settle for less in life than what most other people hope for.
Report comment
Thanks Matt,
I suppose it’s about having the information that “schizophrenia” is erroneous and that there are practical solutions.
Report comment
Actually I believe in psychiatric disorders in a manner of speaking. Before Oldhead and the rest tear me apart for this statement, let me clarify.
Take the constellation Leo, for example. No one would disagree that the stars making up this lion’s figure are real. What is far less real are the lines between the stars joining the constellation together.
It would actually be possible to tear apart the constellations as we know them and create new ones. I have heard of a Christian astronomer who did this because he didn’t like a sky full of pagan mythological characters.
If people insist on classifying symptoms of distress they really shouldn’t use the terms disease or disorder. These encourage helplessness and even worse attitudes and behaviors.
I would have a lot less trouble if after carefully examining a large amount of unhappy people they identified certain negative feelings, thoughts and actions that commonly accompanied one another. Instead of calling them diseases or disorders they would refer to them as negative behavioral patterns. No need for diagnosis–especially the life long kind. Since behavioral patterns can always be changed this would do away with “stigma” or discrimination.
Report comment
PBA is a real symptom of brain injuries, diseases and syndromes. My father, who had MS, my husband, who has MS, my brother in law, who died from ALS and a niece, who had CP all had it. It is not depression– it is inappropriate emotions that cannot be controlled. Nuedexta is a very effective drug that has very few side effects. My husband was in the drug study and we are very glad that it is available to us. Without it, he has inappropriate reactions that are embarrassing to him and his children.
Please educate yourself about PBA.
It is a real symptom with a real treatment available.
Yes, I wish it was not so expensive.
But having been in the study (which lasted for 10 years, thank you FDA) we understand some of the costs of bringing a drug to approval.
Arlene D.
Daughter, wife, sister in law, of those with PBA (not depression)
Report comment
You are right there are folks who experience emotion lability after a medical issue as a stroke or even pancreatic cancer.
It was a problem in the past because no one knew what to do since the standard medicines did not work.
So this is what good can come out of good research.
I don’t remember my in law relative with ALS being impacted but I was parenting a special needs toddler at the time.
I think the problem is that greed fuels so much of our medical/industrial/business complex.
Then there is denial if the negative impact of many medical treatments and medications across the board.
Medical schools many many times do not teach how to treat problems arriving due to treatment and medicines.
It is as if they are fearful to admit their humanity.
A good doc will always be humane and aware of the whole picture of a patient.
The trouble is so many decide not to pursue medicine and go of to more lucrative careers.
This is a problem getting worse rather than better.
Glad your relatives were able to receive comfort.
Report comment
I don’t think the author meant to belittle pseudobulbar affect. He meant to say that is’s another symptom of antidepressant damage that will not be attributed to antidepressants, as it should be. It will be a new diagnosis, and a reason to prescribe a new and no doubt expensive drug.
Ten bucks says they’ll call it “mini-bipolar’ or if they really put their shrinking caps on, “Bipolar with Limited, Attenuated Mood Events” (BLAME)
Report comment
I lost my 16yr old daughter 6 yrs ago. Doctors put me on anti depressants right away. I was going through enough grief and the anti depressants were making me suicidal. I got off of them and though the depression was not gone (how could it be), the suicidal thoughts were gone. I did seek help for someone to talk to, to help me with my grief and went to a good hospital to get evaluated for a counselor. I went for help and instead was told I could not leave the hospital cause I needed to be on anti depressants and I was too depressed. Instead of helping me they set me back so far and put me back on medication that works the opposite on me. I stopped the medicine after a year and again suicidal thoughts were gone. I gave up on seeking help even though I need it, because doctors only seem to think drugs is the cure for everything.
Report comment
What I found, in my years as a hospital chaplain and as a grieving person, is that all that the so-called antidepressants do is mask the grief that people need to be able to work through. People need to be able to do this at their own speed. Antidepressants are detrimental to grieving people who need to be in touch with their emotions and feelings to be able to work through their loss.
The best thing that I ever found for grieving was having someone who was willing to listen when I needed to talk. As a hospital chaplain this is what I found to be of real help to those suffering a loss of someone important to them. Drugs, especially drugs that make people suicidal, are of no help in this process of grieving.
It is terrible that you had to go through this and it pains me. I humbly encourage you to find a good friend who will listen to you, no matter what; a person who will not try to tell you how to do your grieving but who will sit with you in your grieving.
Report comment
Thank you……….the only support I have found is other grieving parents on line. I did recently try once again when a friend that also lost a child recommended her psychiatrist to me. I went but I did not realize psychiatrists only prescribe medication. She said I need to see a therapist that she would give me and then the therapist would call her to tell her what meds I need to be on. LOL once again meds, I think not. Seems like doctors work for the pharmaceutical companies now.
Report comment
This reminds me of an experience I had a few years ago. I was going through some difficulty and ended up in the office of a psychiatrist that I knew vaguely from my stay in the “hospital”. She was an intern at the time I was there. I told her what was wrong and she asked me what kind of “meds” I wanted. I told her that I didn’t want any of the drugs, I just wanted someone to talk to who would not be judgmental. She sat there with this sad look on her face and then stated that she didn’t know how to help me if I didn’t want any “meds”. I could tell that she was truly sad and very sincere.
When I started my journey in the system almost eight years ago I was under the very mistaken impression that psychiatrists actually listened to people and struggled to help them with their issues. Boy did I ever get a rude awakening. I even asked one at one point why psychiatrists did actually nothing to help people and got a long lecture about how disrespectful I was! They are very good at lecturing and being very paternalistic and patronizing.
Yes, it seems like most doctors and not just psychiatrists, work for the drug companies. I can remember back to the days that doctors actually brought their little black bags and came to your house. And if you couldn’t pay in money they’d take chickens and eggs! Those were the good old days when they sat down, held your hand, and listened to what you had to say. Those days are long gone.
Report comment
Seems like Pies and those other quacks can’t keep their own stories straight. Someone needs to ask Dr. Pies where those 500,000 people in desperate need of psychiatric treatment vanished to. He will either not deign to answer or–much more amusing–will come up with some lame falsehood which only fools himself and his most devoted disciples. All the while exposing more and more of his sorry rump!
How he even knew those undiagnosed people existed since they had never been counted is beyond me. How many times do people knock on your office door when no one in your office hears them, Dr. Pies?
Report comment
Thanks to the author for this illuminating post. Psychiatry itself became ‘schizophrenic’ when it hitched its wagon to pharma and launched the DSM. Now it’s just the Discipline of the Absurd. Liz Sydney
Report comment
Good to see you back after last month’s debacle.
Just a note about “mental illness” — while I acknowledge the tactical logic in talking about “epidemics of mental illness” in Bob W’s book, I think at some point that “mental illness” needs to be called out by him and others as a concretized metaphor and nothing more, especially not something which can be measured.
Psychiatric drugs cause brain disease, not “mental illness.”
Report comment
Oldhead, I was undergoing acute suffering when I first went to see a shrink. Because I had been bullied and sexually harassed in high school I had developed depression and anxiety–no biochemical explanation necessary.
The quack put me on anafranil for obsessive thoughts. I had a reaction after not being able to sleep for 3 weeks. Wound up with schizo-affective label–later changed to bipolar 2. On a cocktail for 20+ years. They said I’d need it for life, but I’ve been off most of the crap for several months now. No one seems any wiser. 🙂
Report comment
This includes my pro-psychiatry parents I currently live with for financial reasons. If Kevin Earley ever quits drinking the psych koolaid and gets on this site I could give him some pointers! Ha ha. 🙂
Report comment
You do realize that the DSM is ONLY a catalog of billing codes, and ALL the so-called “diagnoses” in it were INVENTED as excuses to sell drugs? Oh, silly me! Of course you know that! This is madinamerica!…. 🙂
Report comment
I have read, “They Call You Crazy.” If you haven’t already read it, I recommend you do. Fascinating view at how they vote DSM manuals into existence through boards of upper-level psycho-bureaucrats. Almost entirely privileged white men.
Report comment