The Biological Evidence for “Mental Illness”


On January 2, 2017, I published a short post titled Carrie Fisher Dead at Age 60 on Behaviorism and Mental Health.  The article was published simultaneously on Mad in America.

On January 4, a response from Carolina Partners was entered into the comments string on both sites.

Carolina Partners in Mental Healthcare, PLLC, is a large psychiatric group practice based in North Carolina.  According to their website, they comprise 14 psychiatrists, 7 psychologists, 34 Advanced Practice Nurse Practitioners/Physicians Assistants, and 43 Therapists and Counselors.  They have 27 North Carolina locations.

Partners’ comment consists essentially of unsubstantiated assertions, non sequiturs, and appeals to psychiatric authority.  As such, it is fairly typical of the kind of “rebuttals” that psychiatry’s adherents routinely direct towards those of us on this side of the issue.  For this reason, and also because it comes from, and presumably represents the views of, an extremely large psychiatric practice, it warrants a close look.

I will discuss each paragraph in turn.

“We strongly disagree with this article, which neglects a lot of important information and uses selective hearing to distort what Carrie Fisher was about and also to distort the evidence for mental illness as a real disorder.”

My Carrie Fisher article was brief (566 words), and was intended as a counterpoint to the very widespread obituaries that lionized her as a champion of “bipolar disorder.”  The essential point of my article was that Ms. Fisher had been a victim of psychiatry, and like a great many such victims, died prematurely.  Obviously I neglected a lot of important information.  I could have gone into great length as to the recklessness of psychiatry assigning the bipolar label, with all its implications of helplessness, disempowerment, and “chemical imbalance” to a young woman who by her own account was, at the time, using any drugs she could get her hands on.  But I felt that a brief and respectful statement of the facts was all that was needed.

. . . . .

“Mental illnesses have a long history of biological evidence. For example, researchers have demonstrated that people with depression have an overactive area of the brain, called Brodmann area 25. Schizophrenia has been linked to specific genes, as PTSD and autism have been linked to specific brain abnormalities. Suicide has been linked to a decreased concentration of serotonin in the brain. OCD has been linked to increased activity in the basal ganglia region of the brain.”

Brodmann area 25 (BA25)

Partners did not provide a specific reference in support of this contention, but my best guess is that the reference is Mayberg, HS, et al (1999) Reciprocal Limbic-Cortical Function and Negative Mood: Converging PET Findings in Depression and Normal Sadness (Am J Psychiatry 1999; 156:675–682).  Here’s the study’s primary conclusion:

“Reciprocal changes involving subgenual cingulate [which includes Brodmann area 25] and right prefrontal cortex occur with both transient and chronic changes in negative mood.”

What this means essentially is that negative mood, whether transient or enduring, is correlated with changes in both the subgenual cingulate (Brodmann area 25) and the right pre-frontal cortex, and that when the depression is relieved, the changes are reversed.

This, of course, is an interesting finding, but provides no evidence that depression, mild or severe, transient or enduring, is caused by a biological pathology.

The reality is that all human activity is triggered by brain activity.  Every thought, every feeling, every action has its origins in the brain.  I cannot lift a finger, blink an eye, scratch my head, or recall my childhood home without a characteristic brain function initiating and maintaining the action in question.  Without stimuli from the brain, my heart will stop beating, my respiratory apparatus will shut down, and I will die, unless these functions are maintained by machines.

So there is absolutely no surprise in the discovery that sadness and despondency have similar neural triggers and maintainers.  It would be amazing if they didn’t.  But — and this is the critical point — this does not warrant the conclusion that sadness which crosses arbitrary and vaguely-defined thresholds of severity, duration, and frequency is best conceptualized as an illness caused by pathological or excessive activity in BA 25.

Depression is a normal state.  It is the normal human reaction to significant loss and/or living in sub-optimal conditions/circumstances.  It is also an adaptive mechanism, the purpose of which is to encourage us to take action to restore the loss and/or improve the conditions.

All consciously-felt human drives stem from unpleasant feelings.  Thirst drives us to seek water; hunger, food; hypothermia, warmth; hyperthermia, coolness; danger, safety, etc.  Sadness and despondency are no exceptions.  They drive us to seek change, and have been serving the species well since prehistoric times.

But — as is the case with all the above examples — when a drive is not acted upon, for whatever reason, the unpleasant feelings worsen.  Just as unrequited hunger and thirst increase in strength, so the depression drive when not requited deepens.

The reality is that most people deal with depression in appropriate, naturalistic, and time-honored ways.  If the source of the depression is the loss of a job, they start job-hunting.  If the source is an abusive relationship, they seek ways to exit or remediate the situation.  If the source is a shortage of money, they seek ways to budget more sensibly, or increase their earnings; etc.

Depression, either mild or severe, transient or lasting, is not a pathological condition.  It is the natural, appropriate, and adaptive response when a feeling-capable organism confronts an adverse event or circumstance.  And the only sensible and effective way to ameliorate depression is to deal appropriately and constructively with the depressing situation.  Misguided tampering with the person’s feeling apparatus is analogous to deliberately damaging a person’s hearing because he is upset by the noise pollution in his neighborhood, or damaging his eyesight because of complaints about litter in the street.

Our feeling apparatus is as valuable and adaptive as our other senses.  But psychiatry routinely numbs, and in many cases permanently damages, this apparatus to sell drugs and to promote the fiction that they are real doctors.  Their justification for this blatantly destructive activity hinges on the false notion that depression becomes a diagnosable illness when its severity crosses arbitrary and vaguely-defined thresholds.  But deep despondency is no more an illness than mild despondency.  The latter is the appropriate and adaptive response to minor losses and adversity.  The former is the appropriate and natural response to more profound or more enduring adversity.  Though, of course, what constitutes profound adversity will vary enormously from person to person.  An individual, for instance, raised to the expectation of stable and permanent employment may be truly heartbroken at the loss of a job.  Another individual, raised to the notion that there’s always another job “around the corner” will, other things being equal, be less affected.  And so on.

In this regard, it’s noteworthy that Partners’ comment refers to overactivity in BA 25.  The use of the prefix over implies pathology, but in reality there is no yardstick to determine what would be a correct amount of activity for BA 25.  All that can be said, on the basis of Mayberg et al’s findings, and subsequent BA 25 research, is that when a person is sad, there is more activity than when he is happy.  So the use of the term “overactivity” is deceptive — sneaking in the notion of pathology without any genuine or valid reasons to consider it so.  The “reasoning” here is:

–  depression is an illness
–  depression is correlated with high activity in BA 25
–  therefore high activity in BA 25 is pathological

In other words, the contention of pathology rests on the assumption that depression is an illness.  To turn around and use this falsely inferred pathology to prove that depression is an illness is obviously fallacious.  It is also typical of the kind of circular reasoning that permeates psychiatric contentions.  In reality, there is nothing in Mayberg et al or in subsequent research that warrants the conclusion that the increased activity in BA 25 is pathological or excessive.

. . . . .

Schizophrenia linked to specific genes

This assertion, that schizophrenia is linked to specific genes, is frequently adduced in these debates, as evidence that “schizophrenia” is a real illness with a biological pathology.  Here again, Partners do not provide any references in support of this assertion, but there have been a number of studies in the past fifteen years or so that have found links of this kind.  However, in all cases, the correlations have been small.  In other words, there are always a great many individuals who have been assigned the “schizophrenia” label, but who do not have the gene variant in question; and there are a great many who have the gene variant, but who do not acquire the label “schizophrenia.”  To date, no genetic test has been found helpful in confirming or refuting a “diagnosis of schizophrenia.”

An additional problem arises here, in that the assertion that “schizophrenia has been linked to specific genes” is often interpreted as meaning that “schizophrenia” is a genetic disease, which it emphatically is not.  To illustrate this, let’s look briefly at a real genetic illness:  polycystic kidney disease (PKD).  This is a well established genetic illness caused by cysts in the kidneys.  The cysts progressively block the flow of blood through the kidneys, causing tissue death.

Most cases of PKD are caused by the defective gene (PKD-1).  In polycystic kidney disease, the pathology occurs because the PKD-1 gene causes the nephrons to be made from cyst wall epithelium rather than nephron epithelium.  And cyst wall epithelium produces fluid which accumulates in, and ultimately destroys, the nephrons and the kidney.

So the gene determines the structure of the nephron wall.  This is the primary genetic effect.  This structure causes the wall to produce fluid.  As the nephrons become increasingly blocked, the kidneys produce less urine.  So, reduced urination is a secondary effect of the gene PKD-1.  Symptoms of PKD don’t usually emerge until adulthood, but about 25% of children with PKD1 experience pain and other symptoms.  So a child growing up with polycystic kidney disease may feel sick much of the time.  Such a child, other things being equal, is likely to be fussier and more distressed than other children, and it is entirely possible that one could find a weak correlational link between gene PKD-1 and childhood fussiness, though, of course, any search for such a correlation will be confounded by the obvious fact that children can be habitually fussy for other reasons.  The fussiness would be a tertiary effect of the gene PKD1.

And from there the causal chain could continue in various ever-weakening directions.  For instance, the child might become somewhat sad and despondent.  Or it could be that the child received extra attention and comforting from his parents and was fairly content, and so on.  Ultimately the outcome is impossible to predict with any kind of precision, and the best we can expect from genes vs. subsequent behavior studies are weak, tenuous correlations.

Cleft palate is another example of a pathology that is caused by a gene defect; actually a gene deletion.  This condition results in a characteristically strained and nasal speech quality which can be quite stigmatizing.  The nasal speech is a secondary effect of the gene deletion.

Children with this kind of speech are sometimes mocked and bullied by their peers.  The child might react to this kind of stigmatizing by speaking as little as possible, by withdrawing socially, or in various other ways.  These reactions would be considered tertiary effects of the defect.  And so on.  As with the PKD, each step in the chain takes us further from the genetic defect, and the statistical associations grow proportionally weaker, and it would be stretching the matter to say that the lack of speech was caused by the gene deletion.  Nor would one conclude that the child’s social withdrawal was a symptom of a genetic disease.  And this is true even though the link between the deletion and the cleft palate is clear-cut and direct.

In the same way, it is simply not tenable to claim that “schizophrenic” behaviors (e.g. disorganized speech) are symptoms of a genetic disease.  This is particularly the case in that correlations between the “diagnosis” and genetic anomalies are typically very small.  The effects of any minor genetic anomalies that might exist have had ample opportunity to be shaped by social and environmental factors, and these are more credible causal constructs.

“Schizophrenia” is not a unified condition.  Rather, it is a loose collection of vaguely defined behaviors.  For this reason, any genetic research done on this condition will inevitably result in conflicting and confusing results.  It’s like looking for genetic similarities in all the people who play bridge, or read romance novels, visit libraries, play football, or whatever.  If the sample sizes are large enough, and in genetic research sample sizes are often enormous, one could probably find small effects in all or most of these areas, but no one would conclude from this that these are genetically determined activities, much less illnesses.

A person’s ability to learn depends on two general factors:  a) the structure of his brain, as determined by his DNA, and b) his experiences since birth.

One can’t learn to play the piano, for instance, unless one has appropriate neural apparatus, and fingers, both of which require appropriate DNA.  But even a person with good genetic endowment in these regards, will never learn to play unless he is exposed to certain environmental factors.  He must, at the very least, encounter a piano.  In the same way, a person whose genetic endowment might be relatively marginal might become an excellent pianist, if he were to receive persistent environmental encouragement and support.

Similar reasoning can be applied to the behavior of not-being-“schizophrenic.”  This behavior involves navigating the pitfalls of late adolescence/early adulthood, and establishing functional habits in interpersonal, occupational, and other important life areas.  Obviously it requires appropriate neural apparatus, hence the weak correlations with genetic material, but equally clearly it calls for a nurturing childhood environment, with opportunities for emotional growth and acquisition of social, occupational, and other skills.

Given all of this, it’s not surprising that researchers are finding correlations between DNA variations and a “diagnosis” of schizophrenia, but given the number of links in the causal chain and the multiplicity of possible pathways at each link, it is also not surprising that the correlations are always found to be weak, and of little or no practical consequence.

Nor is it surprising that the correlations between being labeled “schizophrenic” and various psychosocial factors are by contrast generally strong.  Having a schizophrenia label is correlated with childhood social adversity, childhood abuse and maltreatment, poverty, and a family history of migration.

. . . . . 

Generally similar considerations apply to Partners contentions with regards to “PTSD,” “autism,” suicide, and “OCD,” but space precludes a detailed discussion here.

. . . . .

“Eric Kandel, MD, a Nobel Prize laureate and professor of brain science at Columbia University, says, ‘All mental processes are brain processes, and therefore all disorders of mental functioning are biological diseases…The brain is the organ of the mind. Where else could [mental illness] be if not in the brain?'”

Dr. Kandel (now 87 years old) is an eminent neuroscience researcher at Columbia University.  There’s an extensive biography in Wikipedia.  His early research focused on the neurophysiology of memory.  He has received numerous awards, including the Nobel Prize in Physiology/Medicine (2000), and is widely published.  His record of research achievements is enormous, and his knowledge and expertise are vast, but in the statement quoted by Partners, and, incidentally, by other psychiatry adherents, he is simply wrong.

Let’s take a closer look.  Logically, the Kandel quote can be stated symbolically as:  A is identical to B; therefore malfunctions or aberrations in A are malfunctions or aberrations in B.

On the face of it, this seems sound, and indeed, it is a valid inference in some situations.  For instance, the furnace in a person’s home is the primary heating appliance; therefore, malfunctions in the furnace are malfunctions in the primary heating appliance.  Indeed, in a simple example of this sort, the statement is tautological.  We are simply substituting the synonyms furnace and primary heating appliance, and the inference contains no new information or insights.  But the inference is fallacious in more complex matters.

Let’s concede, for the sake of discussion, that the premise of the Kandel quote is true, i.e., that all mental processes are brain processes.  The term mental processes embraces a wide range of activities, including sensations, perceptions, thoughts, choices, positive feelings, negative feelings, hopes, beliefs, speaking, singing, general behavior, etc.

The term “disorders of mental functioning” is harder to define, but, again for the purposes of discussion, let’s accept the APA’s catalog as definitive in this regard.  Let’s accept that anything listed in the DSM is a “disorder of mental functioning.”

It’s immediately obvious that some of the DSM entries are indeed the result of brain malfunctioning.  In the text these are referred to as disorders due to a general medical condition or to the effects of a substance.  But in the great majority of DSM labels, no such biological cause is identified, and so the conclusion in the Kandel quote would appear to call for some kind of evidence or proof.  However, in the Kandel quote, the conclusion is not presented as something that has been, or even needs to be, proven.  Rather, it is presented as a logical conclusion inherent in, and stemming directly from, the premise.  And it is from this perspective that the Kandel quote needs to be evaluated.

To pursue this, let’s consider the example of “oppositional defiant disorder.”  This is a disorder of mental functioning as defined above, because it is listed in the DSM.  And according to Dr. Kandel’s “logic,” it is also therefore a “biological disease.”  The “symptoms” of oppositional defiant disorder as listed in DSM-5 are:

  1. Often loses temper.
  2. Is often touchy or easily annoyed.
  3. Is often angry and resentful.
  4. Often argues with authority figures or, for children and adolescents, with adults.
  5. Often actively defies or refuses to comply with requests from authority figures or with rules.
  6. Often deliberately annoys others.
  7. Often blames others for his or her mistakes or misbehavior.
  8. Has been spiteful or vindictive at least twice within the past 6 months. (p 462)

Obviously for any of these behaviors to occur, there has to be corresponding neural activity. But there is no necessity that the neural activity is diseased or malfunctioning in any way.  A child learning from his environment, developing his behavioral repertoire in accordance with the ordinary principles of learning, could acquire any or all of these behavioral habits without any malfunctioning in his neural apparatus.  We acquire counterproductive habits as readily, and by essentially the same processes, as we acquire productive ones.  In general, if a child discovers that he can acquire power and control in his environment by throwing temper tantrums, he will, other things being equal, acquire the habit of throwing temper tantrums.  Similarly, if arguing with parents and other authority figures yields positive results, there is a good chance that this also will become habitual.  And this is not because there is anything wrong with the child’s brain.  Rather, it’s because his brain is functioning correctly.  He is internalizing as habits those decisions and actions that pay off.  It is often observed in child-raising practice that if you’re not training your children, they’re training you.

Similar observations can be made about the other seven “symptoms” of oppositional defiant disorder, and indeed all the DSM labels.  A person with a perfectly normal-functioning brain can acquire the habits in question if the circumstances are conducive to this learning.

So to return to the question in the Kandel quote:  “Where else could [mental illness] be if not in the brain?”, the answer is clear:  In the self-serving and unwarranted perception of psychiatrists.  Mental illness is the distorting lens through which psychiatrists view all problems of thinking, feeling, and behaving.  It is the device they use to legitimize their drug-pushing and to maintain the fiction that they are practicing medicine.

. . . . . 

“You’re right that mental illness is also affected by social and environmental conditions–by a person’s disposition, or upbringing, or current environment. It’s also true that mental illness is affected by drug use (both prescribed and not prescribed). So are other medical conditions, such as heart disease and cancer.”

I’m not sure where Partners are coming from here, because I never made any such statement.  In my view, which I have stated clearly on numerous occasions, “mental illness” is a psychiatric invention, self-servingly created to promote the spurious notion that all problematic thoughts, feelings, and/or behaviors are illnesses.  And not just illnesses in some vague allegorical sense, but real illnesses “just like diabetes,” which need to be treated by medically trained psychiatrists with mood-altering drugs and high voltage electric shocks to the brain.

Partners’ vague concessions concerning environment, child-rearing, and drug effects is a fairly standard psychiatric sop, but doesn’t mitigate their earlier contentions on the “long history of biological evidence” and their uncritical endorsement of the logically spurious Kandel quote.

. . . . . 

“And it’s true that mental illness is often difficult to diagnose because of
1) the current limitations of the field of research. Thomas R. Insel, MD, director of the National Institute of Mental Health, for example, talks about how the diagnosis and treatment of mental illness today is where cardiology was 100 years ago, concluding that we need to continue scientific research of mental illnesses.  (There’s a longer quote on this below.)”

And (from later in the comment)

“Longer aforementioned quote:
Take cardiology, Insel says. A century ago, doctors had little knowledge of the biological basis of heart disease. They could merely observe a patient’s physical presentation and listen to the patient’s subjective complaints. Today they can measure cholesterol levels, examine the heart’s electrical impulses with EKG, and take detailed CT images of blood vessels and arteries to deliver a precise diagnosis. As a result, Insel says, mortality from heart attacks has dropped dramatically in recent decades. ‘In most areas of medicine, we now have a whole toolkit to help us know what’s going on, from the behavioral level to the molecular level. That has really led to enormous changes in most areas of medicine,’ he says.

Insel believes the diagnosis and treatment of mental illness is today where cardiology was 100 years ago. And like cardiology of yesteryear, the field is poised for dramatic transformation, he says. ‘We are really at the cusp of a revolution in the way we think about the brain and behavior, partly because of technological breakthroughs. We’re finally able to answer some of the fundamental questions.'”

It is at least forty years since I started hearing about psychiatry’s great biological breakthroughs that were just around the proverbial corner, and the promise, if my readers will pardon the pun, is getting a little old.

What’s noteworthy, however, is that in other disciplines, where there is hope or expectation of breakthroughs, the proponents of these endeavors generally wait until the evidence is in before implementing practices based on these hopes.  In fact, to the best of my knowledge, psychiatry is the only profession whose entire work, indeed, whose entire conceptual framework, is based on “evidence” and “breakthroughs” that are not yet to hand.

Note also the truly exquisite contrast between Partners’ earlier and confident contention that “mental illnesses have a long history of biological evidence” with the assertion here that the “diagnosis” and “treatment” of “mental illness” today is where cardiology was 100 year ago.

Incidentally, Dr. Insel, former Director of the NIMH, also said:

“While DSM has been described as a ‘Bible’ for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been ‘reliability’ — each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever. Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment.” (Transforming Diagnosis, 2013)

And let us be quite clear.  “Lack of validity” in this context means that the “diagnoses” don’t actually correspond to any disease entities in the real world.  Note also that Dr. Insel didn’t say poor validity, or low validity.  He said lack of validity — meaning none.

. . . . .

Back to the Carolina Partners comment:

“2) mental illness symptoms often overlap with symptoms caused by other illnesses, for example, someone with cancer may also become depressed after diagnosis. Or someone’s fatigue may be caused by a vitamin deficiency, rather than by depression.

While considering all these factors, it is still completely inaccurate to state that there is no biological foundation for mental illnesses. They are not ‘make-believe’ diseases, but rather are caused by a variety of factors, including biological ones. As we understand more about mental illness through research we will (as we have with cardiology, for example) gain more precise vehicles for measuring and understanding the biological implications of these disorders.”

This is a little rambling, but let’s see if we can unravel it.

“… someone with cancer may also become depressed after diagnosis.”

This is true.  In fact, I would say that most people who contract serious illness become somewhat sad and despondent.  But this in no way establishes the notion that the sadness should be considered an additional illness.

“…someone’s fatigue may be caused by a vitamin deficiency, rather than by depression.”

This quote contains one of psychiatry’s core fallacies:  that the various “mental illnesses” are the causes of their respective symptoms (as is the case in real illness).  To illustrate the fallacy, consider the hypothetical conversation:

Client’s wife:  Why is my husband so tired all the time?
Psychiatrist:  Because he has an illness called major depressive disorder.
Client’s wife:  How do you know he has this illness?
Psychiatrist:  Because he is tired all the time.

Psychiatry defines major depression (the so-called illness) by the presence of five “symptoms” from a list of nine, one of which is fatigue, and then routinely adduces the “illness” to explain the symptoms.  In reality, the “symptoms” are entailed in the definition of the “illness,” and the explanation is entirely spurious.  There are many valid reasons why a person might feel fatigued, but none of these is because he “has a mental illness.”  Mental illnesses are merely labels with no explanatory significance.  And because of the inherent vagueness in the criteria, they’re not even good labels.

“…it is still completely inaccurate to state that there is no biological foundation for mental illnesses.”

As stressed above, there is a biological foundation to everything we do — every thought, every feeling, every eye blink, every action.  But — and this is the point that seems to evade psychiatry — there is no good reason to believe that the various problems catalogued in the DSM are underlain by pathological biological processes.  And there are lots of very good reasons to believe that they are not.

“They are not ‘make-believe’ diseases, but rather are caused by a variety of factors, including biological ones.”

I don’t think I’ve ever used the term “make-believe” to describe psychiatric “illnesses,” though I do routinely describe psychiatric labels as invented.  The two terms are not synonymous.  What psychiatry calls mental illnesses are actually nothing more than loose collections of vaguely-defined problems of thinking, feeling, and/or behaving.  In most cases the “diagnosis” is polythetic (five out of nine, four out of six, etc.), so the labels aren’t coherent entities of any sort, let alone illnesses.

But the problems set out in the so-called symptom lists are real problems.  That’s not the issue.  I refer to these labels as inventions, because of psychiatry’s assertion that the loose clusters of problems are real diseases.  In reality, they are not genuine diseases; they are inventions.  They are not discovered in nature, but rather are voted into existence by APA committees.

“As we understand more about mental illness through research we will (as we have with cardiology, for example) gain more precise vehicles for measuring and understanding the biological implications of these disorders.”

But meanwhile psychiatry has made up its mind.  Within psychiatric dogma, all significant human problems of thinking, feeling, and behaving are illnesses that need to be “treated” with drugs and electric shocks.

. . . . . 


All of this is interesting, and I suppose it’s important to refute the more or less steady stream of unsubstantiated assertions, fallacious reasoning, and spin that flows from the psychiatric strongholds.

But meanwhile the carnage continues.  There is abundant prima facie evidence that psychiatric drugs are causally implicated in the suicide/murders that have become almost daily occurrences here in the US.  My challenge to organized psychiatry is simple: call publicly for an independent, definitive study to explore this relationship.  And my challenge to rank and file psychiatrists is equally simple: pressure the APA to call for such a study. If what you are doing is unqualifiedly wholesome, safe, and effective, then what do you have to fear?


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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  1. Phil,
    Thanks for taking time to break this down.

    We can assume now that Carolina healthcare partners will disappear, since they will presumably not have any real counterarguments to your breakdown of the myths that “schizophrenia” is a valid illness caused by biogenetic malfunctions, etc. And they won’t want to embarrass themselves further.

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      • Thanks, “markps2”! I used Internet Explorer, and got a warning from IE that the site’s security certificate was not yet valid, and advising me NOT to follow the link. I’m a stupid, ex-mental patient, so I followed the link. Only secure content was displayed, but I didn’t click on the box to display the insecure content. I may be insecure, but I’m content. Looks like “Carolina Partners” is a PLLC – Public Limited Liability Corporation – and not a 501(c)3 CMHC – Community Mental Health Center.
        And THANK-YOU, Dr. Hickey, for promoting an idea that occurred to me a while back. ALL so-called “mental illnesses”, as listed in the DSM, were INVENTED, **not** discovered…. They are exactly as real as presents from Santa Claus, but not more real. Hey, Santa Claus employs literally 10,000’s of old guys every year. Santa Claus is real, and so are so-called “mental illnesses”.
        The DSM is ONLY a catalog of billing codes, but that’s for another comment!
        (Probably the comment I posted yesterday, that was taken down by one of Putin’s Russian hackers….Hmmm….)….
        Seriously, Phil, that’s some VERY clear and concise writing. I’d like to see what CaroPart has to say in response, besides crickets….

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    • Carolina Partners in Health Care is certainly not going to disappear. The counterarguments are embodied in the studies used to support their claim. The same studies Phil critiques in his article. Business interests supersede any sort of embarrassment. Their response to Phil’s piece was not defensive so much as it was offensive. I don’t think non-substantial arguments have ever been a problem in psychiatry.

      Phil Hickey’s challenge to organized psychiatry, such as CPHC, still holds. He calls for an independent study of the relationship between psychiatric drugs and suicide. You know they are not going to go there. Why? Because if they did, it would show what we know to be true already. Psychiatric drug use is not safe and effective and, in fact, such use is undoubtedly an impediment to positive outcomes. We’re challenging the panacea of psychiatry, and the panacea of psychiatry is what it makes it’s business from, in essence, drugs and the negative outcomes that come of their use.

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      • Frank, of course I did not mean disappear literally or stop doing business. I meant stop engaging Phil in arguments within that they are bound to eventually be exposed as lacking evidence and data.

        And their arguments were indeed weak and unevidenced – they did not even cite specific studies to support their claims, counter to what you say – but nevertheless Phil broke them down comprehensively above. Nonsubstantial arguments are indeed a “problem” for psychiatry in terms of making sense and having logical, well-thought out models of human suffering and what to do about it, just not a problem in terms of continuing to deny criticism and keep doing what they do.

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      • Great article Phil. I agree, Frank. Psychiaty’s no 1 priority is not the welfare of the public – it is their own position and status. They mask this in an apparent primary concern for the public. Ultimately, I do not see psychiatry “volunteering” to be independently examined. In my country at least, turkeys dont generally vote for Christmas.
        Those ultimately charged with the welfare of the people – governments – need to wake up or be woken up to the truth, and impose a thorough examination of mental health, of psychiatry, their substances, and perhaps most important, their hollow and deceitful beliefs and belief system, from which all else emerges.

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        • Hi Terry Lynch,

          Your books offer hope. This is what depressed people need, and psychiatry doesn’t offer hope, because it says your are physically flawed instead, and so can never get truly well, that is, not without their medications. But the medications don’t work for long, and neuroplasticity means they could make the situation worse.

          I went out with my girlfriend’s Depressive Alliance, Friends in Need, group the other day and they were all on lots of medication. I felt sorry for them because no doubt dosages needed to be increased, and new medicines tried. How can doctors be happy with this? And what happens when all medicines stop working. One woman was too depressed to come out, despite all the medication.

          Philip Hickey’s article offers hope. There is nothing wrong with the brains of people like me, it’s just a neuroplasticity problem, and the functioning of the brain can change for the better. I can learn new ways of being, over time.

          Hope is what depressives need. The science is so good now; years ago I would have thought this was how I was born (shy – nervous), but now I know it was my upbringing (in poverty – in relation to others- causing low self esteem). And so now I have hope. Hope I can change how my brain works through neuroplasticity and epigenetics. I’m not fixed, or stuck, for life. So I work hard at my CBT, and Acceptance and Commitment Therapy. It might take a long time, but I’m working for change. I will eventually get into Buddhism and mindfulness.

          Thank you Phil Hickey for your excellent article and Terry Lynch for giving hope.

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  2. Thanks Phillip. You wiped the floor with them with your first point – with what I assume was practically Psychology 101.

    I hope they do literally disappear – the whole cancerous node of activity so clearly outlined as their clinic.

    All the best for a New Year.

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  3. Thanks Phil for taking the time to refute.
    In 1982, I heard the old sawhorse description of Psychiatry being 100 years behind Cardiology. Exact wording!
    Back then the docs were bewildered and frustrated because the so called existing bio markers were not appearing in any sound scientific way.
    My guess is with all the chemicals being thrown at and on folks like ECT there is a pathway of false positives.
    I did see one person really improve with ECT. One.
    And I have had family members improve on medication after trying to stay away.
    My own experience with medication and treatment has been less than positive down to horrorific.
    Placebo effect and other things were are not even yet aware of play a role.
    Research has been so badly designed and executed along with the co opting of BigPharma that it’s seems like a huge can of worms for all of medicine
    The other factor is the co-opting of patients” group by Big Pharma and other monied groups.
    One almost has to read every detail on the group’s website including board of director or advisors to be able to get a good peek st the true nature of the group and even then it can be hard.
    Medicine lost the do no harm ethic a long time ago.

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      • I would say as person who worked as a MSW on a urban city hospital’s general medical floor decades ago and as a parent with many children with many medical special needs, as a caregiver and support of friend, sister, husband, mother with Stage 3 to 4 Cancers, and as a person who was in the underbelly of psychiatry – the downward drift of all medicine has taken place at all levels. I would also include and consider other professions as well. As with teachers, government officials, police officers, therapists, there are still people who somehow survive the barriers and burnout factors to deliver. quality care. However in different ways and on different levels there are both small frustrating gaps and large overwhelming gaps. Some are systemic like the racism that is intertwined almost invisible in the systems, and then there is ennui enforced by paperwork and profiteering. All hail the bottom line of profit and greed to the one percent. Even medical professionals have become cogwheels and we all are less because of this.
        If you look at the complaints and problems of side effects for psycho trophic drugs which you have so often written about the — obesity, the Stage II diabetes, they are the exact same problems that have been growing in the general population and worse of all – in our children!. Our community has just been the canaries in the coal mine.
        Something has been lost in our communities, in our nation , and in our world. I can’t put my finger on it, but the loss is real and dangerous. Maybe it is the experience that African Americans and other minorities have always felt. I don’t know. Maybe it is my white status and privilege. Or maybe we all have been affected by something negative that still has no name.

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        • CatNight

          I think part of what you are describing and talking about here is that fact that we don’t really have communities anymore. We don’t have many real and life-giving relationships with many people on a broader level. We confine ourselves to the nuclear family and I believe that this is very limiting. At one time this country had families that were extended with three generations living in the same house. We had neighborhoods where all the mothers looked out for the welfare of the kids living in those neighborhoods. If one mother say you doing something you shouldn’t be rest assured that your mother would know about it shortly. We lived and worked in neighborhoods where people knew one another and watched out for one another. I think that this experience is pretty much dead and gone now. Once these things begin breaking down everything else begins to follow.

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          • Thanks Stephan I definitely feel that is a part of the problem. When I did field placement in graduate school I worked in a public school district where desegregation had. taken place. The problems was the students were bussed from the urban areas then to the suburban areas and visa versa. The faculty and staff remained behind. That effectively cut off the relationships the school faculty and staff had with the community and students.
            A Black principal could no longer pull out an irascible boy in the hallway and give him a lecture stating that she knew his grandparents and had taught his father. Her eyes and the community’s eyes would be on him. No more. I am not sure if this was a planned or unplanned consequence of this school district’s desegregation plan.
            I also miss the concept of front porches. So much has been lost in terms of the history and threads of community.

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        • CatNight,

          “Something has been lost in our communities, in our nation, and in our world.”

          I think this is very true, and I believe that psychiatry is responsible for at least some of this shift. The notion that all human problems are illnesses that can be banished with pills is not only destructive to the individuals, but also undermines our cultural resilience. Notions of self-denial, sacrifice, and striving to overcome adversity are being swept away by the psychiatric pill-pushers.

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          • Self control as well. Some folks with SMI labels truly are jerks. They’re not above using these labels to get what they want.

            I admit I used my “bipolar” label to shirk some adult responsibilities and throw tantrums in public. Looking back I feel embarrassed. I no longer want to act this way. Was it all those drugs I took? Or did I just possess such “good insight” I believed I was mad and adopted the role assigned me of madwoman?

            I still have very rare meltdowns in front of my parents. The last one occurred when they brought up my MI label and accused me of manipulative behavior.

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    • psychiatry is not a pseudoscience and I disagree with this article. they now have fMRI scans and other scans that show abnormalities in the brain with disorders and these are real because these are new and very accurate types of scanning and I have an illness that I know for sure is real by my own experience.
      scans don’t diagnose disorders but these fMRIs can show certain abnormalities of brain function and there are certain characteristics with each different illness.

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      • Lisa, the logical problem in your statement:

        “(they have) scans that show abnormalities in the brain with disorders and these are real…”

        is that the existence of the “disorders” is presumed a priori, and how to define “abnormal” depends entirely on the opinion of the doctor. Different feelings, thoughts, and behaviors always correlate to changed brain chemistry. Indeed our brain is constantly changing its chemistry as we respond to the environment for better or worse. But that does not make our brain’s responses to adverse psychosocial factors an illness caused by biogenetic factors.

        By psychiatric logic, if you took a brain scan of a person taking a piano lesson that they did not enjoy and felt upset about, and their brain chemistry changed (which it inevitably would), that would be evidence of Piano Playing Disorder. The problem is that the notion of Piano Playing Disorder would be an invention or projection from the mind of the psychiatrist, not something real in the (admittedly) altered biochemistry of the person taking the piano lesson.

        As to this: “these fMRIs can show certain abnormalities of brain function and there are certain characteristics with each different illness.”

        The problem with this is that the “illnesses” and judgments of “abnormality” are creations of men sitting around a table, not anything reliably identified by blood or brain scans. The doctors view the brain scans first, then decide arbitrarily what is “normal” or “abnormal”. There’s nothing scientific about it.

        And Lisa, consider what the leading American psychiatrists say about the validity of these “disorders”:

        In 2013, discussing psychiatric diagnosis, the psychiatrist and former National Institute of Mental Health director Steven Hyman stated:

        “The underlying science remains immature…The molecular and cellular underpinnings of psychiatric disorders remain unknown… psychiatric diagnoses seem arbitrary and lack objective tests; and there are no validated biomarkers with which to judge the success of clinical trials.” (emphasis mine)

        Hyman went on to call the DSM model of diagnosis, which includes labels like “schizophrenia,” “Totally wrong… an absolute scientific nightmare.”

        Hyman’s successor at NIMH, psychiatrist Thomas Insel, followed up this criticism by saying:

        “At best, [the DSM is] a dictionary, creating a set of labels and defining each. The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever.” (emphasis mine)

        David Kupfer, the DSM 5 chair, while trying to defend the new DSM, admitted that the discovery of biomarkers for supposed illnesses like schizophrenia remains “(D)isappointingly distant… unable to serve us in the here and now.”

        And former DSM-IV head Allen Frances went so far as saying, “There is no definition of a mental disorder. It’s bullshit… these concepts are virtually impossible to define precisely.”

        What other field of medicine talks like this about its own labels?

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        • By psychiatric logic, if you took a brain scan of a person taking a piano lesson that they did not enjoy and felt upset about, and their brain chemistry changed (which it inevitably would), that would be evidence of Piano Playing Disorder.


          Of course they wouldn’t usually do that, but the fact that they don’t illustrates the subjective nature of what behavior, etc. constitutes a disorder and what constitutes genius. Though I guess some also consider genius a disorder.

          Actually I guess at first I read this wrong; I thought you were referring to an enjoyable piano-playing session being labeled a disorder. But I think the same reasoning applies.

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      • This is a reply to “lisa v”, above. I’ve been thinking about your comment here, and what your experience might be, that would lead you to write it. Obviously, we don’t know each other, so no, I can’t say for sure that you do, or don’t have any particular “illness”. And I don’t want to disrespect, or take away, from YOUR EXPERIENCE. I’m guessing you’re new here at MiA, and there’s a LOT of information on this site, that might not agree with the stories you’ve been told. I’ve seen a lot of those (supposed) fMRI scans, which (wrongly) “claim” to show some “biological evidence” of some supposedly “real” “illness”. *IF* there ARE any actual structural abnormalities in your brain, then that would be PHYSICAL, not “mental”, and you should be seen by a good neurologist, NOT a psychiatrist.
        I can assure you that psychiatry indeed *IS* A PSEUDOSCIENCE. ALL of the so-called “diagnoses” in the DSM were INVENTED to serve as excuses to sell expensive drugs, and make money for the drug companies. Please read Mr. Robert Whitaker’s book, “Anatomy of an Epidemic”, and Dr. Peter Breggin’s “Toxic Psychiatry”, for a start. And, look at the Wikipedia entry for “phrenology”. Psychiatry is nothing more than 21st Century phrenology, with toxic drugs. Yes, sometimes, some folks do better on some drugs, for some short length of time. But long-term use of “polypharmacy” – more than 1, or several drugs at a time, – ALWAYS results in worse outcomes. Except for the bank accounts of the drug companies. So-called “mental illnesses” are exactly as real as presents from Santa Claus, but not more real.
        Now, I’m sure your distress is real. Your pain, and whatever, is REAL. But, that does NOT mean that you really have a real “illness”. Yes, sometimes, it can be helpful to see yourself as having an “illness”, if that helps you move forward to a healthier place. And, sometimes, when we’ve suffered a long time, things can SEEM to get worse, at first, especially, when we go for “help”. And sadly, too often, the local “community mental health center” does more harm than good.
        But I want you to know, that we’re glad you’re here, we hope you keep coming back and reading, and learning. You might also look at ><, and some other sites linked to here. For you to take charge of your own life and situation, and hopefully get some good support, is a good thing. But, yes, psychiatry is a pseudoscience, a drug racket, and a means of social control. That's ALL it is. That some folks still believe in psychiatry shows the power of greed and ignorance, and propaganda. (There actually are a few "good" psychs, you might have found one. I hops so.) I'm rooting for ya', my friend!

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      • You need to read more carefully. The author clearly states that there are ASSOCIATIONS of particular brain states with particular identified psychiatric “conditions” or “disorders”, but a) there is no real evidence that such brain states are in any way abnormal, and more importantly b) there are many people showing the same brain state who do NOT qualify as “disordered,” even by the DSM’s own subjective rules, and there are many people who qualify as “disordered” who don’t have the brain condition. EVERYONE who has malaria has a malaria virus, and almost everyone who gets infected gets malaria. Saying that 15% of “schizophrenia” cases are associated with a handful or more likely an armload of genes leaves 85% of schizophrenia sufferers with no such influence. Any REAL scientist would recognize that this is a dishonest attempt to get a result when no result exists. Hence, “pseudoscience” is most definitely an applicable term.

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          • I’m not Lisa and can’t speak for her. But I think a lot of people like the idea of being mentally ill. Instead of having to work to better yourself or improve your situation, all you have to do is wallow in self pity, coddle yourself and pop happy pills. I have friends like this, and psychiatry encourages this passive, helpless behavior! If I suggest Daisy get up and go for a walk or figure out why her life stinks so she can cure or endure it better, Daisy accuses me of being a meany. How dare I try to help her get over depression? Her psychiatrist told her she has an incurable brain disease. Boo hoo. Boo hoo. It’s hopeless.

            And I guess it is, if Daisy truly wants to stay depressed.

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  4. Now THERE’S the kind of volume I’m used to in a Phil Hickey article. 🙂

    When I saw the “partners'” first post I assumed it was largely a cut & pasted corporate promo statement not worthy of a serious response, and my reply (which I don’t think is there anymore) reflected my irritation with this. However I guess maybe I was wrong and it was written as a literal response to Phil.

    I can only absorb this is small pieces today. To start,

    In other words, the contention of pathology rests on the assumption that depression is an illness. To turn around and use this falsely inferred pathology to prove that depression is an illness is obviously fallacious. It is also typical of the kind of circular reasoning that permeates psychiatric contentions.

    This is the crux of the matter to me, and pretty much says it all.

    “Schizophrenia” is not a unified condition. Rather, it is a loose collection of vaguely defined behaviors.

    I try to take this further, and emphasize that there IS no “it,” not just that “it” is mislabeled, which using the term in quotation marks could imply. In fact, the history of humanity itself could be described as “a loose collection of vaguely defined behaviors.” (Point for discussion.)

    The reality is that all human activity is triggered by brain activity. Every thought, every feeling, every action has its origins in the brain.

    I think this is a western rationalistic assumption which cannot really be proven. I think it would be safer to say that every thought, feeling or action is correlated with a unique biochemical/electrical variation in brain activity. I personally tend to see the brain as a mediator, not the source, of consciousness, which is not strictly physical and exists beyond the material, 3D, time/space-bound parameters to which we cling. This is the borderline area between material science and spirituality.

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  5. Human hormones are biological reason for havoc in brains,which 21 st century science still name as
    mental illness or disorders.Any anyone with basic knowledge of biology,will agree with me.Sadly anyone
    who will want to bring more biology to medicine and science as academic,will be killed.If he/she will stood,
    for what I wrote.I hate Psychology and Psychiatry,because they want to manipulate all crazies and normals.
    With psychotheraphy and psychotropic meds.This is war on human mind.Indeed Mental Health System is
    death sentence with up to 20 years shorter life span,for us trapped in normals designs,because of global
    control and security issues.Psychology and Psychiatry classifications created STIGMA and also unbiological
    explains for our problems,help to their cause for continued existence of the worst part of health care system,
    everywhere in this world.

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  6. Yes, thank you for this article. I had already noticed that it varies across the country, how strongly people are committed to the concept of mental illness. Mostly I think it just comes down to their commitment to social conformity.

    As I see it, all the concept of mental illness does is marginalize people, and mostly it is to cover up for familial child abuse.


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  7. “…someone’s fatigue may be caused by a vitamin deficiency, rather than by depression.”
    Now how many of the patients that North Carolina Partners diagnoses with “mental illness” and “treats” with drugs are ever tested for any vitamin or mineral deficiency, toxic metals, thyroid abnormality or other medical conditions well-known to produce the same symptoms psychiatrists call “mental illness”?

    My own eminent psychopharacologist, who later rose to presidency of the APA and amassed a huge fortune from consulting for Big Pharma and his investments in psychiatric drug stocks, refused to even look at the tissue mineral analysis I had done on myself at my own expense, and wrote for the record that my remission was “spontaneous”. The great “scientist” ignored the confounding variable of my following a strict diet and taking forty-five supplements a day for several months prior to that spontaneous remission.

    But suppose he had picked up on it (what he called “The Hoffer Thing”) and used it to help many others have similar remissions? He would have been demonized by his peers and probably have to practice out of the back of some chiropractor’s office rather from a prestigious chair at a great medical school. Such are the choices that life offers us, but we know that businesses that will not learn from their customers eventually always fail.

    Isn’t it strange that Abram Hoffer, MD is one of the most revered of all doctors and most beloved of his many patients, and he was a psychiatrist?

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    • He wasn’t a psychiatrist by training, but sent to various early 1950’s psychiatric training institutes for short stays, after the government of Saskatchewan gave him a billet as Director of Psychiatric Research for the province in order to give him experience in what was going on in the psychiatry of the day. He was as unimpressed with these observed psychiatric activities as psychiatrists were unimpressed with him, after he and Humphry Osmond devised the original megavitamin therapy just prior to the arrival of the neuroleptics. Consequently, I don’t reveal to mainstream shrinks my own vitamin consumption, and stay in good shape, in order to avoid them.

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  8. This is one of your best blogs, Phil, out of a very strong field.
    I sometimes put it like this: All human experience has biological correlates – but not all human suffering is best described as a disease process. The ‘grief’ analogy can be useful. Someone whose partner has just died might well be highly agitated, anxious, distressed, weepy, unable to concentrate or sleep, perhaps seeing or hearing the dead person – in other words, meeting the criteria for a range of ‘mental illnesses’ – but most sensible people don’t call this a ‘mental illness’, because we know there is a causal link to a very traumatic event. If we were sophisticated enough to make this kind of link in every case (with obvious exceptions like dementia), it would be equally apparent that the ‘diagnosis’ is completely redundant. There is a mountain of research encouraging us to do this, and none at all supporting the current paradigm, as you have so powerfully demonstrated. The current case for psychiatry is resting entirely on a series of tautologies and logical errors. Lucy Johnstone

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  9. Hey…I want to write about an interesting case study written by Priti Arun, MD, of Govt Medical College and Hospital, Chandigarh; and Sudarshan Chavan, titled “Antipsychiatry Movement and Non-compliance with Therapy”. This is from India, where I live. It was published in 2004 in the Hong Kong Journal of Psychiatry.

    The case study, which deals with how the antipsychiatry movement negatively influenced a patient’s life, and goes as follows (I have broken it down into parts):

    1.) The patient was a 35-year-old unmarried man presenting with complaints of suspiciousness and aggressive behaviour towards his family.

    2.) Initially, the patient felt that someone was following him with the intention of harming him. He started believing that people were being introduced to him for some purpose. He also believed that advertisements in magazines and movies were intended to send messages to him, to hurt and frighten him. He went to Moscow in July 1995 for employment, but returned after 1 month as he felt that people in Russia were denying him his rights on the instructions of his family members. He thought that micro-phones were placed in his house and that his thoughts were known to everybody. He also thought that the government of the USA was watching his activities. He became upset and destroyed his green card and passport. His e-mails showed persecutory delusions and formal thought disorders.

    3.)There was no history suggestive of organicity, substance abuse, mood disorder, anxiety disorders, or suicidal ideas.

    4.) Premorbidly, he was affectionate and had many friends, but was sensitive to criticism. He had been a national-level hockey player and had won awards for essay writing.

    5.) After a detailed history was taken and the Mental State Examination performed, he was diagnosed with paranoid schizophrenia. Since then, he had been admitted to the psychiatry ward 3 times because of relapse due to non-compliance with therapy.

    6.) The patient had shown a good response to treatment with risperidone 6 mg during the first 2 admissions.

    7.) Prior to the third admission, the patient received 8 books from the USA that were published by the Church of Scientology. The books contained interviews with psychiatrists, patients, and their relatives. These books also depicted pictures of patients with tardive dyskinesia and described legal action taken against psychiatrists.

    8.) They patient’s e-mails, which were downloaded by his brother,revealed that he was in constant contact with people propagating the antipsychiatry movement. This group called themselves psychiatric survivors.

    9.) They praised the patient for his creative writing skills and reassured him that he did not have a mental illness. To win him over to their side, they acknowledged that he may be having ‘oddities of thought’ and suggested ways to ‘keep his mind from racing’ by spending time with art, poetry, and music.

    10.) This group guided the patient as to how to enter the USA after duping his parents. They also educated him about certain foods that slow down drug absorption. With the help of this group, the patient succeeded in avoiding taking any medications despite the best efforts of the ward team. He was advised by the group to paste labels of injection haloperidol decanoate on water for injection ampoules and received the water instead of the drug therapy until this was suspected by the ward sister.

    11.) To divert his family’s attention, the patient administered haloperidol drops to his father on the advice of the psychiatric survivors.

    12.) In a confrontation about his involvement with the antipsychiatry movement, the patient denied any involvement. E-mail and other correspondence was not shown to him because his parents feared a violent reaction and thought he may leave home forever. The issue was not discussed further with the patient. However, his parents became more vigilant regarding his medication as well as money being given to him. A contract was made whereby his parents agreed to set up a separate business for him provided he did not leave the town and took his medication under supervision.

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    • Extremely curious as to what supposed “anti-psychiatry group” is being referred to here. I wasn’t paying attention to this stuff in 2004 but don’t know of any active AP groups in existence then unless they’re referring to Mindfreedom, which is decidedly NOT an anti-psychiatry group.

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      • Steve, I’ve spoken to several folks over the years, who’ve been given Risperdal. They ALL say they don’t like it. They don’t like the “side effects”, or the effects-effects.
        (If a given “effect” is NOT a “side effect”, does that mean it’s a front effect? Back effect?
        Top effect? Bottom effect? Why am I having so much trouble making sense out of psychiatry, when I try to analyze it logically?….. 😉
        But seriously, NOBODY likes Risperdal….
        (If Risperdal “works” so well, why is there no street, or illicit market for it?…..etc.,

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  10. The case study begins with a passage titled “Antipsychiatry movement or Inhumane movement?” and goes on to say:

    1.) In Europe and America, the antipsychiatry movement has been very active, with articles in magazines, chat shows on television, and information on the Internet. Various antipsychiatry organisations such as Network Against Psychiatric Abuse (NAPA) and the Church of Scientology are very vocal. In the book Schizophrenia – the sacred symbol of psychiatry ,Szasz said that there is no such thing as schizophrenia.

    2.) Another book, Schizophrenia: medical diagnosis or moral verdict by Sarbin and Mancuso concluded that schizophrenia is a myth.

    3.) Payer wrote that hospital admissions are made only for monetary gains and are no use to the patient or family.

    4.) Breggin concluded that antidepressants do not have any specificity, disturb normal brainfunctioning, and are prescribed for the benefit of the pharmaceutical industry.

    5.) This author went on to say that electroconvulsive therapy does not have any role in psychiatric treatment and is given only to intimidate patients. In India, despite firm belief in faith healers and social stigma attached to mental disorders, there has been no active campaign against the treatment of mental disorders. However, with the advent of the Internet, the world has shrunk and information has become readily available. The barriers of distance and cost are no longer important. In addition to these advantages, information technology (IT) has threatened the religious and cultural values of various communities. This report is of a patient with paranoid schizophrenia whose treatment was influenced by propagators of the antipsychiatry movement through misuse of IT.

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  11. The above case study is very interesting and gives us all food for thought. The day is not far off when Mad In America becomes a topic in case studies done by people in the MH profession from various countries, as part of the “antipsychiatry movement”. And naturally, I do not think any of us would want to be a part of influencing someone in such a way that it is damaging to their lives.

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  12. The case study ends by saying:

    If the antipsychiatry movement becomes popular in India, many more patients will be discouraged from seeking professional help. Therefore, preventive measures need to be initiated by the professionals who believe in the safety and efficacy of psychiatric treatments. Preventive measures could include ensuring easy availability of scientific literature relating to various mental disorders, documenting positive results of treatment, keeping patients and their families involved in the treatment process, and increasing awareness among mental health professionals. It is necessary for psychiatrists, mental health professionals, and policymakers to question how best to deal with the virtual explosion of information on the Internet, where such unscientific, biased, and unethical information is readily available.

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  13. “It is necessary for psychiatrists, mental health professionals, and policymakers to question how best to deal with the virtual explosion of information on the Internet, where such unscientific, biased, and unethical information is readily available.”

    I find this quote extremely interesting. If the drugs are so effective, why aren’t all trial data published? Why can’t we see what percentages of patients have side effects and to what extent. Why can’t we see redacted data from trials every time a drug is mentioned? Can it be that data and real data could be formulated? How about lawsuits on drugs, can we outlaw non-disclosure agreements if psychotropics are so effective?

    Why do these situations exist if the drug companies have nothing to hide? If these medicines are so great, why do we never hear about the percentages of people that are relieved of symptoms?

    We don’t even see practical evidence in the marketing. we are inundated with commercials. Don’t you think they have paid for enough avenues? It’s nice to hear another side since it seems to be common belief among many. It’s not really clear cut even in diagnosis, I mean the DSM is opinion based and voted on. That’s not really clear cut and dry by any form of the imagination.

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    • Here’s an idea. They could get their pals in Big Pharma to come up with a new drug to create “insight” through blinding people so they can’t read anymore. And now that they claim they can diagnose bipolar in infants they can make it illegal to teach “bipolar” children basic reading skills. Woohoo! Problem solved! 😛

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  14. Psychiatrists are among the most damaging elements to ever exist in any society. I have no more patience for these quacks. Dealing with them and their idiocy is, ironically, making my own depression worse.

    I am probably going to take an indefinite break from arguing with their type. I have no more energy for such stupidity.

    Good luck with everything to all you activists and I hope the beast gets what it deserves soon.

    P.S.: To any of you “doctors” who might be reading this, hear this and remember it: I do not know which circle of Hell you are going to, but it’s probably a deep one. It’s no less than you deserve.

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    • Explorer 86,
      Thank you so much for your P.S. above. I was able to get my psychiatrist office notes through an attorney and when I was almost off all my drugs he had written he couldn’t understand why there was nothing wrong with me? He couldn’t (and wouldn’t) accept that his polypharmacy had made me totally incoherent even with the truth right in front of him. Like you I hope the Beast gets what it deserves.

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    • Before bowing out of these commentaries I urge you to consider that by posting here you are helping to educate people about psychiatric oppression. I don’t see myself as here to argue with shrinks, but I will engage with them as “straight men” to help expose the manipulative pseudoscientific pronouncements they make in the guise of presenting “information.” I could care less if they agree with me, it’s not in their interest, and I don’t see why it matters. The objective is to strip them of their power to impose their beliefs on others. It takes a critical mass of public consensus and I think this website is helping us get to that point.

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      • “It takes a critical mass of public consensus and I think this website is helping us get to that point.”

        I agree with this statement. However, what I’m trying to say is, if the site and the writings of the members here end up causing negative repercussions on people’s lives, it will lose its ability to reach that critical mass.

        Merely our intentions, which are good, are not enough. Many of these psychiatrists do their jobs with good intentions from their point of view, but look what ends up happening.

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        • Speaking truth to power does not cause negative repercussions, nor does writing about it. But it’s important to protect one another from retaliation by those who don’t appreciate being exposed, if that’s what you mean by repercussions.

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          • It can certainly make one a bit of a social pariah, all things considered. Especially among those “progressive” types who see the belief in biological mental illness as a sign of englightenment (and i’m afraid to say that I was one of them for most of my life) and its “denial” as some kind of cruelty…Which is ironic, considering the profile of the majority of the “deniers”. It’s like they don’t even take two seconds to find out what exactly is going on.

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    • According to Dante’s Inferno, the last 3 rings of Hell are where the treacherous get their just deserts. Since I can’t think of anything more treacherous than a branch of “medicine” devoted to disable (sometimes kill) people while pretending to help them, the shrinks should wind up in the last circle embedded in ice. I hope they get Haldol injections first.

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  15. We should be grateful to registeredforthissite and his/her/its outrageous posts. Reminds me of an old joke about two Catholic schoolboys.

    They went to confession together. The first boy went into the confessional and soon came out to do his penance at the alter.

    Then the second boy went in and hesitantly told the priest about a sin that he said was on his conscience.

    “I was walking a girl home from school yesterday when she led me into the bushes where we were soon doing terrible, filthy stuff with each other.”

    “You are doing the right thing by confessing this my son,” said the priest, “but for your penance you must say a hundred Our Fathers and two hundred Hail Marys. Now tell me, who was the girl? Was it Molly O’Mally?”
    “No Father.” said the boy
    “Was it Kathy Gallagher?” asked the priest.
    “No Father.” said the boy.
    “Was it Jennifer O’Donnell?” asked the priest angrily.
    “No Father, she’s a new girl and I don’t know her name.” answered the boy.

    His friend was waiting for him outside the church and asked,
    “You were in there a long time doing penance. What did you get?”
    “Three good leads.” his friend chuckled.

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  16. Like our famous American jazz musician, Dizzy Gillespie, once said “Man,if you have to ask “What’s that?” you ain’t never gonna know.” But here’s a clue. If you have a herd of cattle in a pen with a hole in it, through which they can escape, don’t draw attention to it until you close it. Keep their food and water by the gate and let them believe that is the only way out.

    You and your mentors or handlers have an IT problem, but it is not abuse, it is the freedom of speech, expression and ideas we enjoy where the Internet is available. They fear our ability to independently verify the facts in the poisonous “food for thought” they provide, and which you parrot in your transparent posts. So when you mention doctors like Szasz, Breggin, Sarbin, Mancuso, etc. and attempt to discredit them, you only point your readers in the direction of the hole in the fence. People are naturally curious and they are bound to investigate for themselves, especially if they find themselves in desperate circumstances.

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    • See the last comment on this page and the time stamp on it.

      Before you go on your little rant, it is good for you to follow your own advice and verify your facts.

      While I have my own views which some may disagree with me on here, and am afforded the freedom (which I presume you believe in) to air them, there is a reason I am here, just like the rest of you.

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    • I think “registered’s” motives in posting this are sincere, however misguided his/her conclusions may be. I actually think this article is good to know about, it shows how paranoid the term “anti-psychiatry” made them even “back” in 2004.

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      • So do I, Oldhead. I don’t what his motives are, but I find it strange that registeredforthissite links to the article about Thomas Szasz by John Breeding. Isn’t John Breeding a Scientologist? Scientology’s motive for getting people off psychiatric drugs and out of therapy is to divert the funds spent on those modalities into their own coffers. They have even wormed their way into VA “Mental Health Care”.

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        • Once again, I did not merely link you to the article. I provided a link to you and specifically asked you to read my comment which has nothing to do with Scientology nor John Breeding, just like Thomas Szasz had nothing to do with Scientology except using their resources. Since it is difficult for you to separate both those things (the article from my comment) I will republish the comment here:

          There are many people who fraudulently call Thomas Szasz a Scientologist. This is an absolute lie. Szasz was an atheist. In an interview aired by the Australian Broadcasting Corporation, Szasz clearly states:

          “Well I got affiliated with an organisation long after I was established as a critic of psychiatry, called Citizens Commission for Human Rights, because they were then the only organisation and they still are the only organisation who had money and had some access to lawyers and were active in trying to free mental patients who were incarcerated in mental hospitals with whom there was nothing wrong, who had committed no crimes, who wanted to get out of the hospital. And that to me was a very worthwhile cause; it’s still a very worthwhile cause. I no more believe in their religion or their beliefs than I believe in the beliefs of any other religion. I am an atheist, I don’t believe in Christianity, in Judaism, in Islam, in Buddhism and I don’t believe in Scientology. I have nothing to do with Scientology.”

          Link to the interview:

          If you have been introduced to Thomas Szasz by way of his over-the-top videos created by CCHR, a Scientology backed group, please ignore them, and actually read his published works.

          The mental health workers that I was exposed to belonged to an organisation based on and funded by Christian groups (there and many such hospitals, schools and other institutes like that in my country. Hell, I studied in a Christian school, but that has nothing to do with my beliefs). Should I dismiss them as Christian groups? No. Their financial backing and what they do are two independent things. Similarly with Szasz.

          When you read Szasz’s works (and not CCHR videos, or RationalWiki entires, or rubbish written by random people, psychiatrists and “skeptics” online that ascribe nonsense and falsities like “mind-brain duality” to Szasz), likely you will agree with certain things, and disagree with others, i.e. you may be ambivalent. However, there is good to be absorbed from his works.

          I am publishing a few short passages from his books (like The Theology of Medicine etc.):

          1.) Inexorably, efforts to combat disease or stave off death conflict with the need to maintain dignity. The currently popular phrase death with dignity is therefore quite misleading: it is not just that people want to die with dignity, but rather that they want to live with it. After all, dying is a part of life, not of death. It is precisely because many people live without dignity that they also die without it. Determined and dignified persons, whether soldiers or surgeons, have always wanted to die with their boots on. Military men have traditionally preferred death on the battlefield or even suicide to surrender and loss of face; medical men prefer a sudden death from a myocardial infarct to a lingering demise from generalized carcinomatosis.

          These examples illustrate my contention that there is often an irreconcilable antagonism between preserving and promoting dignity and preserving and promoting health.

          2.) We can influence others in two radically different ways-with the sword or the pen, the stick or the carrot. Coercion is the threat or use of force to compel the other’s submission. If it is legally authorized, we call it “law enforcement”; if it is not, we call it “crime.” Shunning coercion,we can employ verbal, sexual, financial, and other enticements to secure the other’s cooperation. We call these modes of influence by a variety of names, such as advertising, persuasion, psychotherapy, treatment, brainwashing, seduction, payment for services, and so forth.

          We assume that people influence others to improve their own lives.The self-interest of the person who coerces is manifest: He compels the other to do his bidding. The self-interest of the person who eschews coercion is more subtle: Albeit the merchant’s business is to satisfy his customers’ needs, his basic motivation, as Adam Smith acknowledged, is still self-interest.

          Nevertheless, people often claim that they are coercing the other to satisfy his needs. Parents, priests, politicians, and psychiatrists typically assume this paternalistic posture vis-a-vis their beneficiaries. As the term implies, the prototype of avowedly altruistic domination-coercion is the relationship between parent and young child. Acknowledging that parents must sometimes use force to control and protect their children, and that the use of such force is therefore morally justified, does not compel us to believe that parents act this way solely in the best interest of their children. In the first place, they might be satisfying their own needs (as well). Or the interests of parent and child may be so intertwined that the distinction is irrelevant. Indeed, ideally the child’s dependence on his parents, and the parents’ attachment to him, mesh so well that their interests largely coincide. If the child suffers, the parents suffer by proxy. However, if the child misbehaves, he may enjoy his rebellion, whereas the parents are likely to be angered and embarrassed by it. Thus, what appears to be the parents’ altruistic behavior must, in part, be based on self-interest.

          3.) Since the seventeenth century, it has been mainly the scientist, and especially the so-called medical scientist or physician, who has claimed to owe his allegiance, not to his profession or nation or religion, but to all of mankind. But if I am right in insisting that such a claim is always and of necessity a sham- that mankind is so large and heterogeneous a group, consisting of members with inherently contradicting values and interests, that it is meaningless to claim allegiance to it or to its interests- then it behooves us as independent thinkers to ask ourselves, “Whose agent is the expert?”

          4.) John Donaldson and James Davis, the authors of a chapter titled “Evaluating the Suicidal Adolescent,” present the case history of a “17-year-old adolescent male,” whose problem they describe thus: “Current Complaints. Recent suicidal gestures.” This cannot be true: No one calls his own suicide attempts “gestures.” The authors’ final diagnoses of their patient are “Adjustment reaction with depressed mood. 2) Personality disorder 3) Homosexuality.” The book I cite was copyrighted in 1980, seven years after the APA abolished the diagnosis of homosexuality. Nine years after the authors’ treatment ended, the patient committed suicide. I am not faulting the authors for the suicide. I am faulting them for using this case as support for psychiatric coercion as a rational method of suicide prevention.

          Anyone familiar with the mental health industry knows that suicide is now the single most effective tool for promoting, justifying, and selling psychiatry. The threat of suicide, fear of suicide, gesture of committing suicide, attribution of wanting to commit suicide, promise of preventing suicide, claim of having successfully prevented suicide, each of these fears, threats, and promises stokes the furnaces of the madhouse industry, especially of its children’s division.

          5.) Everywhere, children, and even many adults, take it for granted not only that there is a god but that he can understand their prayers because he speaks their language. Likewise, children assume that their parents are good, and if their experiences are unbearably inconsistent with that image, they prefer to believe that they themselves are bad rather than that their parents are. The belief that doctors are their patients’ agents-serving their patients’ interests and needs above all others–seems to me to be of a piece with mankind’s basic religious and familial myths. Nor are its roots particularly mysterious: when a person is young, old, or sick, he is handicapped compared with those who are mature and healthy; in the struggle for survival, he will thus inevitably come to depend on his fellows who are relatively unhandicapped.

          Such a relationship of dependency is implicit in all situations where clients and experts interact. Because in the case of illness the client fears for his health and for his life, it is especially dramatic and troublesome in medicine. In general, the more dependent a person is on another, the greater will be his need to aggrandize his helper, and the more he aggrandizes his helper, the more dependent he will be on him. The result is that the weak person easily becomes doubly endangered: first, by his weakness and, second, by his dependence on a protector who may choose to harm him. These are the brutal but basic facts of human relationships of which we must never lose sight in considering the ethical problems of biology, medicine, and the healing professions. As helplessness engenders belief in the goodness of the helper, and as utter helplessness engenders belief in his unlimited goodness, those thrust into the roles of helpers whether as deities or doctors, as priests or politicians have been only too willing to assent to these characterizations of themselves.

          This imagery of total virtue and impartial goodness serves not only to mitigate the helplessness of the weak, but also to obscure the conflicts of loyalty to which the protector is subject. Hence, the perennial appeal of the selfless, disinterested helper professing to be the impartial servant of mankind’s needs and interests.

          Do these sound like the ravings of a crank? Give me a break.

          If John Breeding is a Scientologist, naturally I have nothing to do with his Scientology positions. I found that article on Szasz and wrote a comment there.

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  17. I recently pointed out somewhere that if a Scientologist says the sky is blue that doesn’t make everyone who says the sky is blue a Scientologist. When people bring up Scientology out of the blue a good response is to ask them why they’re changing the subject.

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    • Furthermore, most folks who criticize Scientology have never read L. Ron Hubbards’ “Dianetics”. No, I’m not trying to defend “Scientology”, per se. But, most folks really DO NOT KNOW the unpleasant history that L. Ron Hubbard had with the pseudoscience of psychiatry & psych drugs. The excesses of psychiatry are mirrored in Scientology. What little good either extreme might have once had, has long since been lost to excesses and extremes of all kinds. Scientology has gone for money, power, and social control, in the guise of a “religion”.
      Psychiatry has gone for money, power, DRUGS, and social control, in the guise of a bogus “medical specialty”, which is in fact much more like a religion. Psychiatry and Scientology are both just different sides of the same coin. They both rely on recruiting younger members, and keeping them hooked for life. They both are deluded as to the very real harm and damage they inflict on folks. A person might be safe deep within either psychiatry or Scientology, but both will, and have before, *KILL*. If it was within my power to do so, I would make BOTH Scientology and psychiatry cease to exist…..(but I’d keep *SOME* of the drugs…. You never know when you might need to tranquilize a psychiatric drug zombie*….)….
      *psychiatric drug zombie: n., a person who has been on too many psychiatric drugs for too long, and exhibits typical symptoms of psych drug toxicity, including akathisia, and tardive dyskinesia….

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      • Did L. Ron Hubbard have some sort of personal vendetta against psychiatry that had nothing to do with their human rights abuses? I think I heard about Scientology’s lawsuits against Prozac when I first started it.

        My favorite psych drug. No noticeable effects at all! Sugar pills are the only thing better. For me, at least. 🙂

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        • I believe it was the other way around. Dianetics was wildly popular in the 50s and the psychiatric field saw it as a big threat to their hegemony. The AMA and the APA attacked Scientology viciously and consistently all through the 50s and 60s and the IRS continued to pursue them even into the 80s, until George HW Bush decided to change the tenor of the IRS and told them to accept that Scientology was a religion. I think it’s fair to say that Hubbard decided that the answer to being attacked was to attack back. I suppose you could say a vendetta developed, but from what I understand, psychiatry threw the first punches. Scientology also very strongly believes that drug use is damaging to the human spirit in severe ways, and so as psychiatry has relied more and more on drugs, the antipathy has become greater in both directions.

          That’s what I know about it.

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          • Wish we could get Psychiatry legally declared a religion. Then we could get the ACLU and the ACLJ to take them on. And no more Zoloft commercials in church.

            I know. But we are all entitled to our little fantasies. I’ll take the above scenario over 50 Shades any day! 😀

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          • Steve: I just finished a book about the history of Scientology, the first one I’ve actually read! I read NOTHING about HW Bush calling off the IRS. The IRS finally settled the “non-profit/501(c)3” status of Church of Scientology after a NASTY campaign against the IRS, by Scientology’s well-paid lawyers, and plenty of Church-sponsored “dirty tricks.” And, while Hubbard DID “attack back”, he also attacked first. The whole story is so convoluted. And there is MUCH misinformation, disinformation, lies, rumors, etc., from ALL sides of the story. Apparently, much of L.Rons’ “official” biography was invented by himself. For example, the Scientology Church claims the Navy covered up Hubbard’s “secret” WW2 actions by a more prosaic record. Highly doubtful, to say the least. But now, as well-written as the book was, I need to read at least 2 or 3 more, just to get the WHOLE story, from ALL sides! At least the CCHR is reliably anti-psychiatry!….

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    • This discussion reminds me a bit of this forum called “crazymeds” forum. You can find it online.

      I remember some thread in which I was told sternly “Go ahead and reinvent the wheel! Our goal is to make sure mentally ill people stay on their meds!”

      People there were very touchy if things contrary to psychiatry were questioned and you asked for a certain level of specificity regarding certain issues.

      It’s the same here in an opposite manner (and that’s understandable, given what people here might’ve experienced in their lives, having experienced [and still experiencing]some of things in my life as well). If you even think that there might be some truth to what a psychiatrist might be saying (not to say that they don’t do things which can be disastrous) and voice it out loud, you will be put in the line of fire.

      However, I understand both points of view and place them in the context in which I feel they are supposed to be placed.

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  18. In relation to this article this lady named Priti Arun, MD, and her colleague BS Chavan have also done a study on “Comparative efficacy of methylphenidate and atomoxetine in oppositional defiant disorder comorbid with attention deficit hyperactivity disorder”

    Even if you want to take some drugs for something, it is better to take a disclosure form and have it signed by the doctor which includes criteria like no labelling etc.

    This is difficult for those in the west, because insurance will not cover you without a label. Your systems have become shackles.

    Fortunately for me, since my country is not a “developed” country, the waffle is not so “developed” either, and medicine is far cheaper, and I can do without any insurance.

    I can have my kidneys transplanted here (and done well) for the price of a root canal in the west.

    The abstract reads as follows:

    Oppositional defiant disorder (ODD) is frequently comorbid with attention deficit hyperactivity disorder (ADHD) and is associated with substantial functional impairments. Methylphenidate and atomoxetine are well-established drugs for the management of ADHD. Some studies from Western countries have reported these drugs to be effective in the management of ODD comorbid with ADHD. This study aimed to assess if methylphenidate and atomoxetine are efficacious in treating Indian children with ODD comorbid with ADHD.

    The Vanderbilt Assessment Scale (to label someone with ADHD) mentioned in the study looks like this.

    The introduction of the study:

    Oppositional defiant disorder (ODD) consists of recurrent uncooperative, disobedient, and hostile behavior which is not accounted for by the developmental stage of the child. It is defined in DSM-IV-TR as an enduring pattern of negativistic, defiant, and disruptive behavior toward authority figures. It must be present for more than 6 months and must not be caused by psychosis or a mood disorder, and the behavior must negatively impact the child’s social, academic, or occupational functioning. It does not include the most aggressive aspects of conduct disorder which is directed toward people, animals and property.[1] Negativistic and defiant behaviors are expressed by persistent stubbornness, resistance to directions, and unwillingness to compromise, give in or negotiate with adults and peers. It may also involve deliberate and persistent testing of limits, usually by ignoring orders, arguing, and failing to accept blame for misbehavior. ODD is among the most common mental health conditions in childhood. The prevalence of ODD in the general population has been reported to be between 2% and 16%. It has been estimated that around 60% of patients with ODD will develop conduct disorder and will have high risk for substance abuse.[2] Children with ODD have substantially impaired relationships with parents, teachers, and peers. These children are not only impaired in comparison with their peers, but they also show greater social impairment than do children with bipolar disorder, depression, and anxiety disorders.

    Good god. If I go to one more of these people they will label me with something else. I can forsee ADHD, Borderline Personality Disorder and all kinds of other junk which thankfully, I have managed to not be labelled with, and will certainly do my best to sue the doctor for defamation if I’m labelled with.

    So much waffle wrapped up in sciency sounding jargon.

    It’s be much better if they simply said, “Hey, not able to concentrate? Take this drug, it may help you, but be warned, it may also cause mania, psychosis, tremors etc. If you have such effects, we can give you even more drugs to curb them.”

    It would not be wise to go to any of these guys even for a prescription without having them sign a disclosure form which has pre-set criteria like “no labels” etc. In the west, medical charges have to be covered by insurance, which makes it even harder for people there. At least, I am somewhat happy that I live in a “developing country” as opposed to a “developed” country because thankfully, the waffle is not very “developed” here either (though I fear for the future). I don’t need to sell a kidney and an arm to pay for medical expenses here even without insurance (depending upon the nature of the condition of course). In the west, I’d be forced to be labelled, because otherwise, medicine is so expensive and I wouldn’t be able to pay for it. I could have my kidneys transplanted here (and done well) for what they charge in the west for a root canal.

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    • Sorry for the double writing.

      The downside of living where I do is, I will never be able to find a doctor like some of the ones here on MIA who would be happy to provide services without labelling and have a lot more knowledge about the flaws of their profession and how it can end up damaging lives and families.

      Most of the doctors will unfortunately be like Priti Arun and the rest of her colleagues.

      Families and people are also quite illiterate about these things, and some will blindly believe these guys because they are…well…”professionals”.

      I have had to struggle with some of these things.

      It is necessary for more people to know these things, especially people who are young.

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      • Those of us who have been through this junk, are familiar with this sort of language…medical-ish jargon…our files are full of them. These psychiatry guys do their jobs, their systematic reviews, their statistics etc., improve their own research profiles whilst at the same time what they do helps some people, doesn’t do anything for others and harms some people…but no one knows what ends up happening to the people who were a part of these studies, what problems they actually had as opposed to the junk they were labelled with, whether or not those interventions helped them in any way or if they were harmed in the process, what they are doing now with their lives, what they thought of this whole psychiatry phase of their lives…etc.

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    • The prevalence of ODD is estimated between 2 and 16%? Any scientist would be filled with shame at such a massive range for a prevalence estimate! It’s like saying your IQ is between 100 and 110 with 45% accuracy. An 8x variance in prevalence might as well be admitting that you don’t know what you’re talking about or are just plain making it up from whole cloth. Which pretty much describes the DSM.

      — Steve

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  19. If we translate the abstract to truer and clearer language, it would go as follows:

    People who are uncooperative, disobedient and hostile frequently are also unable to concentrate on things which they are supposed to be doing, are restless, inattentive, disorganised, procrastinate etc.

    C14H19NO2 and C17H21NO are well established chemicals in dealing with children who are inattentive and unable to concentrate. Some studies in western countries have reported that children who are inattentive and disobedient benefit from using these chemicals. This study aims to find out if Indian children who are inattentive, disobedient etc. benefit from the use of these drugs.

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  20. It would also be interesting to know how many of these children with “ADHD comorbid with ODD” were who were prescribed Ritalin(C14H19NO2), ended up experiencing mania and were subsequently labelled as bipolar.

    It would also be interesting to know how many of these children behaved the way they did due to prior life experiences and person-on-person experiences.

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      • Don’t be naïve, Subvet416! The potential Indian market is well over a BILLION people! That’s several times bigger than the American market! Follow the money! And, given literally dozens of languages and sub-cultures in India, they won’t know what hit them, until it’s too late. Just like here in the U.S. And, Hinduism, with it’s many Gods & beliefs, is fertile ground for the pseudoscience lies of the drug racket known as “psychiatry”. And, bogus “mental illnesses”, like in the DSM, can always be created!
        Too bad “Western Medicine” doesn’t understand the early scientific learning behind Ayurvedic medicine, and the chakras!….

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          • I saw this comment back in January, and thought about responding then, but I didn’t. So I’ll do it now. “Chakras” comes from an old Sanskrit word, and it basically means “energy center”. Something like that. Chakras are an early, scientific-for-the-time-and-culture way of both describing and understanding human anatomy. In short, Chakras are real. For example, the heart Chakra corresponds to the vagus nerve. The “3rd eye” Chakra denotes the pineal gland. Sure, there’s some nonsense and pseudoscience in Ayurvedic medicine, but hey, look at *psychiatry*! And if you don’t think Prana is real, how long can you hold your breath, before you either breathe, or die? You don’t have to “believe” in Chakras, but that doesn’t make them not real. And c’mon, you KNOW I was being facetious in my comment above, don’t you? The pseudoscience of psychiatry infected India long ago….

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  21. You seem to have no trouble finding studies and articles that promote your viewpoint. Why don’t you look for yourself? Here’s a start.
    I’m not naive Bradford. You are quite correct but I doubt registeredforthissite is ready to face the truth.

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  22. Dear Philip,
    I enjoyed your article immensely, but I couldn’t help but voice some counterarguments. I am not a psychiatrist, but I am a believer in biological psychiatry that is not based on drugs and electroshocks, as you put it. I would place myself in the “critical psychiatry” camp and am in favor of abolishing all coercive psychiatric practices.

    Here are my counterpoints:
    1. The official psychiatric definition or threshold of “illness” versus “normal distress” is not completely arbitrary and invented. For a mental problem to be considered a “disorder” it must cause substantial distress to the sufferer and to impair social functioning (e.g., work productivity). In other words the definition of “mental illness” is subjective, yes, but it is subjective on the part of the “patient” or “client” if you will. If the sufferer decides that he/she lost the ability to function normally and that mental suffering is bad enough that he/she needs some kind of help, then psychiatrists would agree that we are dealing with a “mental illness.” I am not using exact quotes from the DSM, but this is what it says more or less.

    2. Biological psychiatry is based on hard scientific evidence, not a vague set of beliefs (although these are also present there). I will list the effects and provide some references (I can provide a hundred references and many more effects if you need them):
    a) different diets and even different types of meals have various effects on mental state.
    b) cooling or heating of the body have effects on mental state.
    c) hyperventilation alters mental state
    d) breath-holding alters mental state
    e) physical exercise alters mental state
    f) colon cleansing has effects on mental state
    g) probiotic supplements have effects on mental state
    h) bright light and darkness affect mental state
    i) sleep deprivation affects mental state
    j) exposure to low doses or radiation affects mental state
    k) fasting affects mental state
    l) and to state the obvious, ingestion of chemicals and brain trauma change mental state

    3. Some people need psychological help (e.g., couples counseling) and others need psychiatric help (e.g., insomnia, mania, poor attention, hearing voices, etc.). Some kind of organization or individuals need to provide this help. Inevitably, the question will arise about licensing and proven practices versus unproven claims and practices. The government and law enforcement will get involved. There will be abuses, and I don’t have all the answers, but someone needs to provide psychiatric care according to proven practices because some part of the population needs this kind of help. I am not saying that a label has to be attached to a sufferer and I am against psychiatric drugs, but someone has to deal with severe disability and suffering of the mental kind. For example, the government could publish a set of self-help interventions and certify them as valid and proven and some people, let’s call them “mental health counselors” would manage this system by advising those who need help on how they can help themselves. For example, physical exercise is now scientifically proven as a treatment of anxiety and depression. Some diets can help with insomnia (scientific proof is currently lacking, but the government or somebody else could fund this kind of research).

    4. There is plenty of good evidence now that ADHD is caused by poor digestion or insufficient consumption of meat. This is biological psychiatry, but it involves self-management, no drugs are needed.

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  23. Wallenfan,

    Thanks for coming in. I will respond to your points as you have numbered them.

    1. “If the sufferer decides that he/she lost the ability to function normally and that mental suffering is bad enough that he/she needs some kind of help, then psychiatrists would agree that we are dealing with a “mental illness.”

    I think your concepts here are a bit vague. “Lost the ability to function normally” cannot be applied in any kind of reliable or consistent fashion.

    The arbitrariness is also evident in the actual criteria items. The DSM-5 “diagnostic” criteria for major depressive disorder, for instance, include:

    “A. Five (or more) of the following symptoms have been present during the same two-week period and represent change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.”

    Five is arbitrary (why not four or six?). There is no actual evidence that the presence of five of the items indicates the presence of an illness. It’s just a decision that psychiatrists have made in one of their committees.

    Two week period is arbitrary. Why not three or four?

    The requirement that either (1) or (2) be present is arbitrary; why not number (8) or number (9)?

    These criteria are decided, and even voted on, by committees. There is no solid research to support these decisions. The notion that the DSM checklists are the symptoms of illness in the way that real medicine has lists of symptoms is simply false.

    Similar considerations apply to all psychiatric diagnoses, with the exception of those that are clearly identified as being due to a substance or to a general medical condition.

    2. The fundamental principle of biological psychiatry is that all significant problems of thinking, feeling, and behaving are biological illnesses that need to be treated with psychiatric drugs.

    Nobody disputes that biological factors such as diet, temperature, oxygen levels, etc., can affect people’s thoughts, feelings, and actions, but this does not establish the general principle that all problems of thinking, feeling, and behaving stem from biological malfunctions. Earthquakes cause buildings to collapse, but the presence of a collapsed building is not proof that an earthquake has occurred.

    All thoughts, feelings, and actions have neural underpinning. Again, nobody denies this. But a person with a perfectly normal functioning brain can acquire counterproductive habits.

    Depression is not an illness. Rather, it is the normal adaptive response to loss or to enduring adverse circumstances. It is essentially a message from the most primitive core of our consciousness, that some changes are needed; just as hunger is a message to eat. Depression is no more an illness than hunger.

    3. Here, I think, we just have to agree to differ. In my experience, psychiatry is essentially drug-pushing, just like the street variety. What psychiatry offers is a temporary feeling of comfort/well-being/control, but always at the expense of long-term damage.

    Tragically at this point, the government (NIMH) is mostly funding research on brain pathology and the quest for “new and improved” drugs.

    4. We’ve seen over the past 30 years, lots of “evidence” that ADHD is caused by this or that, but the claims never seem to survive close scrutiny.

    In my view, there is no such entity as ADHD. Children focus their attention to differing degrees, of course, but that, in my experience, is largely a function of discipline and training. But the notion that once some arbitrary threshold of severity is passed, the problem becomes an illness is not warranted.

    Again, thanks for coming in. Although I don’t agree with the positions that you present, I do appreciate your comment and the opportunity for dialogue. My responses here are necessarily brief, but I have discussed all of these issues at great length on my website, Behaviorism and Mental Health ( Feel free to browse around.

    Best wishes.

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  24. Thank you for the detailed response.

    1. Sorry, but I find your refutation of mental illness unconvincing. Diagnostic criteria for almost any physical illness involve some arbitrariness, and they are defined by physicians and voted on by committees. You can take issue with every word and find vagueness in every sentence. Take a look at the diagnostic criteria of diabetes:

    1. Diabetes symptoms (e.g. polyuria, polydipsia, and unexplained weight loss for Type 1) plus:
    a random venous plasma glucose concentration ≥ 11.1 mmol/l or
    a fasting plasma glucose concentration ≥ 7.0 mmol/l (whole blood ≥ 6.1 mmol/l) or
    two hour plasma glucose concentration ≥ 11.1 mmol/l two hours after 75g anhydrous glucose in an oral glucose tolerance test (OGTT).
    2. With no symptoms diagnosis should not be based on a single glucose determination but requires confirmatory plasma venous determination. At least one additional glucose test result on another day with a value in the diabetic range is essential, either fasting, from a random sample or from the two hour post glucose load. If the fasting random values are not diagnostic the two hour value should be used.

    Why 11.1 mmol/l and not 11.0 mmol/l? The polyuria definition is also vague and arbitrary. All these definitions were created by physicians. If we apply your logic to diabetes, then it does not exist either and should not be treated.

    Your basic assumption is that psychiatrists have no right to define illnesses and are not to be trusted, but MDs of non-psychiatric kind have a right to define illnesses and should be trusted.

    Your position that mental suffering and mental disability do not exist because the threshold is vague is unjustified. A more rational position would be to admit that yes, the threshold is vague, but we have good functioning and “happiness” on one side, and poor functioning and unhappiness on the other side. The threshold is necessary in our imperfect world, otherwise nobody would be able to claim disability or qualify for free medical care or for payment for the care by an insurance company. People with poor functioning and unhappiness really need help and seek help, and those with more severe problems are more likely to seek help. Psychiatrists try to define a mental illness statistically, in order to decide who qualifies for treatment and who does not. Society’s resources are limited and some arbitrary thresholds have to be set. To answer your question “why two weeks and not three”: psychiatrists use statistics to try to define the category of depressed people who are likely to seek help and who are depressed badly enough to need help. Statistics are vague and based on probabilities rather than hard, well-defined limits. Statistics also change with time. It’s called “Diagnostic and statistical manual…”

    To give another example, the definition of statutory rape is vague and arbitrary, but most people would agree that we need such laws despite the arbitrariness and vagueness. Why can’t a 19-year-old guy make love to a 15-year-old girl, but a 16-year-old guy can? Where is the logic?

    I agree that psychiatry is profoundly perverted by the pharmaceutical industry, but I disagree with the idea that mental illnesses do not exist. Your assertion that psychiatrists claim that an arbitrary threshold causes a mental illness to suddenly appear is also incorrect. They admit that there is a spectrum from normalcy to disorder, and they admit that there is some arbitrariness in diagnostic criteria.

    I am sorry, but the logic behind the notion that mental illness does not exist is circular:
    1. Mental illness does not exist because psychiatrists have no right to define what is or is not a mental illness.
    2. Psychiatrists are not real doctors and should not be trusted because mental illnesses do not exist.

    The same reasoning can be applied to internal medicine, with the conclusion that heart attacks or strokes do not exist. Accordingly, every deviation from the physiological “norm” or average is to be disregarded and should not be treated.

    Antipsychiatry people claim that mental illnesses cannot be traced to biological problems, aside from those organic mental disorders that are caused by measurable brain damage, by medication, or by a physical illness. My position is that so-called functional mental disorders (such as major depressive disorder) do exist and have a biological cause, but this biological cause is ignored by both psychiatrists and antipsychiatrists. This cause is the lifestyle. A bad or unsuitable lifestyle produces subtle physical problems in the brain, which are not statistically significant but they still cause mental suffering or disability. For instance, it is known that cortisol levels in blood are somewhat higher in depressed people on average, but this change is not statistically significant and cannot be used for diagnosis because the depression-associated range of concentrations substantially overlaps with the no-depression-associated range of concentrations. Nonetheless, this subtle physical problem in the brain does exist and causes somewhat higher cortisol levels on average.
    Bad nutrition or a lack of physical exercise can make a person depressed because the brain is not functioning well and this suboptimal functioning leads to various personal problems, which make the person feel depressed. Antipsychiatrists here would say that the low mood is a response to personal problems and no biological problem exists, whereas modern psychiatrists (DSM) would say that low mood is a functional mental disorder caused by a chemical imbalance in the brain, which appeared out of nowhere. On the other hand, critical psychiatrists who believe in biological psychiatry (such as myself) would say that the low mood is caused by the bad lifestyle, and correction of the lifestyle will improve functioning of the brain, and thus resolve personal problems, and the mood will improve when the problems are gone.

    I can cite my own experience. I was depressed through most of my teen years and often had suicidal thoughts. This depressed mood (I did not have an official diagnosis) cannot be traced to negative life events and it was not “an adaptive response to loss or to enduring adverse circumstances.” I went to a good school, and my family was not poor. I had many tiny personal problems, none of them serious, but the whole collection was depressing. Looking back, I can say with certainty that my depressed mood was caused by cigarette smoking and bad nutrition (mostly junk food): biological causes.

    2. You said “The fundamental principle of biological psychiatry is that all significant problems of thinking, feeling, and behaving are biological illnesses that need to be treated with psychiatric drugs.”

    This is not the definition of biological psychiatry. Please see

    3. I completely agree with your statements here. Psychiatry (and medicine in general) is distorted and perverted beyond recognition by the pharmaceutical industry.

    4. ADHD is a valid diagnosis if we agree that psychiatrists have a right to define mental illnesses (as discussed above) and that some people, including adults, complain of distractibility. My claim about meat consumption and ADHD is supported by numerous studies: ADHD patients consume 50% less animal protein on average. ADHD patients are more likely to have iron deficiency. Iron levels in blood strongly depend on meat consumption. Children with ADHD show biometric signs of protein malnutrition. Anorexic people are very likely to have symptoms of ADHD.

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    • Peer review does not filter out flawed studies effectively. If you apply enough funding to biased research, then you can impose widely accepted but false theories on science because you can get hundreds of bad studies published with enough money. “Bad studies” of which you’ve given us 8 examples. Even pubmed prints PhRMA PROPAGANDA.
      Psychiatry is a pseudoscience, a drug racket, and a means of social control. It’s 21st Century Phrenology with potent neuro-toxins. The DSM is a catalog of billing codes. All of the bogus “mental illnesses” in it were invented, not discovered. So-called “ADHD” is exactly as real as a present from Santa Claus. It’s primary cause is unrealistic expectations for school children, and America’s drug culture.
      (BTW, I hope you recognize the original source author of the first 2 sentences in this comment….)….~B./

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    • The difference between your diabetes example and psych diagnosis is that at least for diabetes, there is a MEASUREMENT of something that is out of range, even if the range is arbitrary, and treatment can be gauged by whether the measurement moves in the right direction. The “measurements” for psych diagnoses are completely invented based solely on social/behavioral criteria. There is no actual measurement of something “out of balance,” nor is there any way to determine if the situation has been corrected, as there is zero attempt to discover or differentiate cause. Hence, totally heterogeneous groups are lumped together. To take ADHD as an example, a kid could meet the criteria due to low iron, sleep apnea, poor parenting at home, poor classroom structure or a rigid teacher, understandable boredom, prior or ongoing trauma, or lack of sleep, to name only a few. The range of potential solutions for diabetes is pretty narrow – improve diet and exercise, or alter insulin levels in some way. The range of potential solutions for ADHD is huge and totally variable depending on the situation. If you alter the diet of a kid whose mom is being beaten up, it will have little to no impact. If you assign parenting instruction for a kid whose teacher is a poor classroom manager or who bores the kids to tears, it’s not going to help. So calling “ADHD” a diagnosis isn’t just unhelpful, it’s destructive. It is like saying that a “rash” is a diagnosis. A rash can be caused by poison ivy, measles, or syphilis. You MIGHT want to know which is which before you start treatment, eh? A rash is not a diagnosis, it’s a sign. ADHD is not a diagnosis. It’s a sign that needs to be interpreted.

      — Steve

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      • I know you mean well, but your statements are not supported by evidence. Of course you can measure mood scientifically, and you can use various questionnaires such as Hamilton Depression Scale, which have been validated scientifically, both for diagnosis of depression and for monitoring the effects of treatment.
        Symptoms are subjective but they are as real as our conversation right now. If you ask me, my mood is more real than my insulin level, because I can feel and describe my mood, but I can neither see nor feel my insulin. Psychometrics is a valid scientific field and if you believe that nothing mental is real or measurable then you are rejecting not only psychiatry, but also psychology, the field of pain medicine, and education. Knowledge is not something you can touch, it’s a mental construct. Exams in school attempt to measure knowledge.
        Whether something was invented has no bearing on whether it is real or not. An airplane was invented and airplanes exist. The transistor was invented, and transistors are real.

        I agree with you that psychiatric nosology is not based on etiology and lumps together people who have different causes but similar symptoms, but your assumption that all psychiatrists are evil heartless A-holes who don’t care about patients and do not try to investigate a cause of the problem is incorrect. In any case, diagnosis based on symptoms is a start, and further differential diagnosis and stratification based on causes is possible for ADHD, depression, and other entities. For example, there is the official caused-based entity “substance-induced mood disorder”. Nothing stops a psychiatrist who arrived at the diagnosis of ADHD to investigate further, to ask the patient how things are in the family, etc. You need to start somewhere. A patient that seeks psychiatric help does not come to a psychiatrist with a well-defined cause. He or she has a list of complaints that are symptoms. You cannot disregard symptoms if you want to find a cause.

        Diabetes is also a sign-and-symptom based entity and includes several types based on etiology. To arrive at etiology, you need to first detect diabetes on the basis of signs and symptoms. Incidentally, diabetes was invented by doctors, as you put it, and did not exist before the discovery of insulin. In contrast, depression and melancholy are the concepts that were not invented by MDs.

        Let’s say a 40-year-old person complains of distractibility, i.e. poor attention control and impulsivity and wants to see a psychiatrist. How do you propose this person can receive free medical care (multiple visits and thorough investigation of causes) without some kind of diagnosis?

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        • I have no problem with diagnosis as a means of getting insurance reimbursement. When I had to do psych diagnosis, I told the clients exactly what the diagnosis meant – essentially a description of what seemed to be happening on the outside, chosen for the purpose of getting the insurance company to pay for the needed services. I assured them that I was not in the least concerned with this label, which had to do with payment, and was very much more interested in what the client has to say about what’s going on, when it started, when it stops, what THEY thought it was related to, what has helped in the past, what has made it worse, etc.

          As for psychometrics, sure, you can give someone the HAM-D and count up points and some will have higher scores than others, but what does it mean? I never, ever bothered with such silly nonsense, but instead simply asked the person the kind of questions that might be on such a questionnaire in the context of a normal conversation. As to whether they improved or not, well, they were of course the best and in many ways the only way to make that determination. I feel the same way about IQ tests (somewhat more reliable, but still, what the heck are you really measuring?) and any other psychometric tests. They are mostly very unscientific, because they measure undefined and undefinable entities. To compare a HAM-D scale score to a blood sugar measurement is absurd. One measures a physically determinable quantity. The other “measures” a concept. Measuring depression is as ridiculous as measuring courage or shyness or integrity. They are not measurable entities – they are social constructs that have meaning that varies widely based on both the reporter and the “measurer,” and can’t ever be standardized. They can be “normed,” but of course, “norming” makes the assumption that the average of scores on a questionnaire establish how things ought to be. There is no objective norm possible.

          Diabetes is of course BASED on signs and symptoms, but it is not itself a SIGN or SYMPTOM – it is a concept or model that EXPLAINS why low blood sugar and other signs and symptoms are happening, and PREDICTS with some accuracy what kind of intervention will help. As I outlined very clearly above, an “ADHD” diagnosis does neither of these things – it provides no explanation as to cause, nor does it accurately predict what will help, because of course the same thing will not help all members of an utterly heterogeneous group. So what’s the point of saying someone “has ADHD” when it tells you neither the cause nor the treatment for the “disorder?”

          As for psychiatrists, I defy you to name where I said they were all evil bastards. I believe there ARE some evil bastards at the higher levels of the hierarchy, and a smattering of evil bastards lower in the ranks, but most are simply grossly misinformed, and are committed (as you appear to be) to believing in these subjective and misleading categories of “disorders” which don’t serve them or their clients well.

          I could go on all night, but I’ll stop here. You’re simply stating things without addressing my clearly expressed concerns with the system. You admit that psych diagnosis creates heterogeneous categories, and yet still feel the diabetes-insulin analogy is appropriate? It’s very hard to fathom how an obviously bright person as you appear to be can’t see how very different answering a questionnaire is from having one’s blood sugar measured. I’ll leave it at that.

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          • For what it’s worth, I like your avatar 🙂

            >>>So what’s the point of saying someone “has ADHD” when it tells you neither the cause nor the treatment for the “disorder?”

            Well, this is what the term “syndrome” is for. It’s an umbrella term for a collection of signs and symptoms that can have varied causes. The notion of syndromes is not entirely pointless, it helps a doctor to narrow down the list of suspected causes. Under the current system, the label of ADHD of course is believed to be caused by a chemical imbalance: “dysfunction of the dopaminergic system in the prefrontal cortex” and “necessitates” specific treatment, methylphenidate. The chemical imbalance is assumed to be the ultimate primary cause not caused by anything else. I disagree.

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          • I agree. However, these syndromes should be called syndromes, not “disorders.” And the explanations given for them claim that they are something a lot more than syndromes. Clients are frequently told that they “have a chemical imbalance” or “their brain doesn’t work quite right” or “I know you want to pay attention, but your brain won’t let you” or “mental illness is a neurobiological disorder of the brain.” I could riff off half a dozen more “explanations” that are simply lies, given out of ignorance or malfeasance, it doesn’t matter. I have no objection to people using shortcut terms to communicate, but syndromes are syndromes, and when they’re treated as if they are something else, you get idiocy and destruction as a result.

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    • Wallenfan,

      Thanks for coming back.

      In my view, you’re confusing the essence of an illness with the measurement of its severity. The essence of diabetes is damage/malfunction of the pancreas, of which the excess sugar in the blood is a symptom. Similarly, the essence of pneumonia is the successful colonization of lung tissue by germs. The essence of peritonitis is infection of the peritoneum by germs. Etc.

      All illnesses admit of degrees of severity. In former times, simple severity scales were used, e.g. prodromal, mild, moderate, severe, terminal. Today, more formal measures are usually found. These measures, and their administratively delineated cut-offs, are provided by the specialties concerned to clarify the point at which an illness becomes treat-worthy, and perhaps more to the point, reimbursable. They involve a measure of arbitrariness to be sure, but not entirely. Progressive kidney failure, for instance, is often measured in terms of percentage of kidney function remaining. Around fifteen percent is generally accepted as the point where active treatment interventions begin. This is because, above 15%, an individual can get by, but below that level, the adverse effects become more pronounced, and active treatment becomes warranted and, again, reimbursable.

      The difference between this and psychiatry is profound, in that, apart from those DSM entries labeled as due to a general medical condition or due to a substance, there is no DSM label that has an identified essence or biological pathology.

      In general medicine, there is a straightforward causal relationship between the essence of the illness and its symptoms. This is actually the meaning of the word symptom – the visible, testable, tangible manifestation of the essence of the illness – of the biological pathology.

      In psychiatry, all we get are the symptoms – there’s nothing behind the symptom to even warrant calling them such. The delineations and cutoffs used in general medicine draw their meaning and their validity by reference to the biological pathologies that constitute the true definitions of the illnesses. In contrast, the delineations and cutoffs in psychiatry have no validity. There is nothing to which psychiatry can point to justify one month rather than two; three “symptoms” rather than four; etc.

      But it’s actually much worse than even that. Because in psychiatry, it’s not just the “symptoms” that contain arbitrariness, it’s the very “diagnoses” themselves. Psychiatrists, through the votes of their committees, made childhood inattention an illness without the slightest evidence of an underlying biological pathology. Similarly, shyness became social anxiety disorder; criminality became conduct disorder; childhood disobedience became oppositional defiant disorder; road rage has become intermittent explosive disorder; habitual childhood bad-temperedness has become disruptive mood dysregulation disorder. The list goes on and on: arbitrary, and incidentally self-serving, transformation of non-medical human problems into illnesses, with no statement of the essential underlying biological pathology. You assert, in response to Steve McCrea, that “diabetes was invented by doctors…” This, I suggest, is not true. Diabetes was discovered by doctors, but has existed as a disease entity that sickened and killed people, probably since prehistoric times.

      . . . . . . . . . . . . . . . .

      “Your basic assumption is that psychiatrists have no right to define illnesses and are not to be trusted, but MDs of non-psychiatric kind have a right to define illnesses and should be trusted.”

      I have never written anything remotely like this. I don’t think psychiatrists can be trusted because they routinely lie to their customers, the public, other doctors, the media, politicians, etc. As a recent example, see Columbia University Psychiatry Department’s press release of May 12, 2017.

      It contains the statement:

      “An international group of experts has concluded that, for patients with schizophrenia and related psychotic disorders, antipsychotic medications do not have negative long-term effects on patients’ outcomes or the brain.”

      Neuroleptics do not have negative long-term effects on the brain!

      . . . . . . . . . . . . . . . .

      I have never said or written that mental suffering and mental disability do not exist.

      . . . . . . . . . . . . . . . .

      I have never said or written anything like the circular argument that you attribute to me.

      . . . . . . . . . . . . . . . .

      I find your introduction of the concept of psychiatrists’ right to define mental illnesses puzzling. I have the right to stand on a street corner and proclaim that the Earth is being taken over by Martians, but that doesn’t make it true. Similarly, psychiatrists have I suppose the right to sit in their committees and assert that childhood bad-temperedness is an illness; but that does not make it so.

      I do indeed say that there are no mental illnesses. My reasoning is that the “symptoms” of the so-called mental illnesses do not arise from biological pathology. And if it were ever established that they did,
      the illness in question would become a neurological or endocrinological illness.

      . . . . . . . . . . . . . . . .

      Your theory of “subtle physical problems in the brain” which cause mental suffering or disability is, in my view, problematic because of the averaging and overlapping issues that you yourself concede.

      My own position, which I sketched out in my earlier response, is that depression is not a pathological state, but is rather a signal from the deepest core of our consciousness that something is amiss – either in our lifestyle, context, relationships, safety, etc. just as hunger is a message to eat, depression is a message to make some changes. I think your quest for a pathological underpinning, interesting as it may be, is a wild goose chase. There is no pathological underpinning! Or at least several decades of highly motivated and lavishly funded research have yielded nothing. The chemical imbalance hoax is long discredited, and psychiatry has nothing to put in its place. This is not to say that our “feeling –apparatus” cannot malfunction. Obviously it can. Every organ can malfunction. But this does not establish the general principle that all negative feelings spring from neurological malfunction.

      In addition, recognizing depression as essentially normal and adaptive is more parsimonious than insisting, without evidence, that it is pathological.

      . . . . . . . . . . . . . . . .

      “…all significant problems of thinking, feeling, and behaving…” is a paraphrase of the APA’s definition of a mental disorder in DSM-III, IV, and 5. The definition in DSM-5 has some additional verbiage, but the content is essentially the same.

      . . . . . . . . . . . . . . . .

      “Bad nutrition or a lack of physical exercise can make a person depressed because the brain is not functioning well and this suboptimal functioning leads to various personal problems, which make the person feel depressed. Antipsychiatrists here would say that the low mood is a response to personal problems and no biological problem exists, whereas modern psychiatrists (DSM) would say that low mood is a functional mental disorder caused by a chemical imbalance in the brain, which appeared out of nowhere. On the other hand, critical psychiatrists who believe in biological psychiatry (such as myself) would say that the low mood is caused by the bad lifestyle, and correction of the lifestyle will improve functioning of the brain, and thus resolve personal problems, and the mood will improve when the problems are gone.”

      There is, I suggest, an interesting fallacy here. The opening statement is true: “Bad nutrition or a lack of physical exercise can make a person depressed…” The fallacy is in the next phrase: “…because the brain is not functioning well…” You don’t have evidence to support the causal assertion. My position is that the human organism thrives on physical activity, especially purposeful activity. And when this doesn’t occur, our “feeling apparatus” sends us negative messages using the only “language” at its disposal. Inactivity-induced depression is not an indication of neurological malfunction, but rather the opposite – the brain and other feeling-related organs working in harmony to encourage us to get moving. It’s an adaptive response, no more pathological than the experience of a fear response if confronted with a lion rampant.

      The nutrition issue is more complicated, and I would concede that poor nutrition could deprive the brain or other organs of materials they need, which could cause the “feeling-apparatus” to malfunction and the individual to feel depressed. But wouldn’t this fall under the category that psychiatrists call depression due to a general medical condition? It is well established that various genuine medical conditions (e.g. hypothyroidism) can have these kinds of effects, but as stated earlier, this does not establish the general position that all, or even most, depression is caused by biological malfunction.

      . . . . . . . . . . . . . . . .

      Your references to functional mental disorder are interesting and nostalgic. I haven’t heard the term used since psychiatry started going cause-neutral in the late 70’s. The idea here is that a person who is depressed because his wife of fifty years has just died “has the same illness” as a person who is depressed because his feeling apparatus has malfunctioned for whatever reason. And this assertion is considered warranted because – and this is psychiatry’s supreme inanity – the two presentations meet the inherently vague and arbitrary criteria set out in the DSM checklist. This is about on a par with the assertion that all small bright objects in the night sky are stars!

      . . . . . . . . . . . . . . . .

      Concerning ADHD, here again, my position is, I suggest, more parsimonious. Children are born distractible. We train them to focus on the things that we consider attention-worthy. This is an integral part of parenting. When we encounter a child – or for that matter an adult – who doesn’t display an age-appropriate level of focusing, it is reasonable to conclude – in the absence of any other obvious causal factor – that the training didn’t occur or was insufficient. And incidentally, parents who are neglecting to train their children to focus and sit still when required may also be neglecting to train them in other areas.

      If the “symptoms” of ADHD are caused by brain malfunction, I think the onus is on psychiatry to state the nature of this malfunction and diagnose it by brain test. Until then, it’s just another unsubstantiated, self-serving assertion.

      Best wishes.

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      • >>>The fallacy is in the next phrase: “…because the brain is not functioning well…” You don’t have evidence to support the causal assertion.

        There is plenty of evidence. In my first post, I showed several studies on the relation between brain function and nutrition and between mental health and nutrition. Here are some more:
        And this argument is not difficult to grasp even without evidence. For example, chimps living in nature consume 100% raw diet without any artificial chemicals. You are saying that if we give them plenty of human junk food, so that their diet becomes completely unnatural, the chimp brain will keep functioning as well as on their natural diet. Pardon me, but your position is ridiculous. The same can be said about physical exercise. Unfortunately, your explanation about physical exercise is not supported by any evidence (feel free to post links to scientific studies) and resembles magical thinking. When you said that we are dealing with “a mental disorder due to a general medical condition”, this is closer to the truth, but a bad lifestyle may not necessarily cause a diagnosable physical disease, perhaps a borderline medical condition. What I am saying is that depending on genetics, in some people, the brain will malfunction because of the bad lifestyle. Some people will develop symptoms of schizophrenia, others symptoms of depression, etc. There is a world of evidence showing that patients with schizophrenia on average consume an unhealthy diet. If this theory is correct, then switching to a healthier diet and/or starting a regimen of physical exercise should be beneficial for patients with a mental disorder. Scientific studies show that this is exactly what happens:

        There are many other lifestyle interventions that can be used, they are listed in my first post.
        People with some genotypes will not develop a brain disorder, but will present with a disease of some other organ, because of the bad lifestyle.

        >>>The difference between this and psychiatry is profound, in that, apart from those DSM entries labeled as due to a general medical condition or due to a substance, there is no DSM label that has an identified essence or biological pathology.

        There is plenty of evidence of subtle brain abnormalities for many DSM labels, including depression and schizophrenia. These deviations are not statistically significant, but they exist, for example, greater levels of blood cortisol and inflammation markers in depression. Note that you can’t say that these subtle differences do not exist. They are small and cannot be used for diagnosis, but they do exist. You COULD say that they don’t exist if the average values did not differ between depression and no depression, but the average values differ consistently, in many studies. We can call it “a mental disorder caused by a subclinical general deterioration of health”. My position is that this subclinical general medical condition is caused by a bad lifestyle. Most modern psychiatrists are saying that the primary cause is a “chemical imbalance” which has some small physical manifestations. This is the influence of the pharmaceutical industry and their cronies.

        Now, your assertion that mental disorders do not exist is not helpful for patients who have a mental disorder due to a general medical condition or due to some medication because they will never find out the cause if they don’t see a psychiatrist. Your activism *maybe* helpful for people who have a mental disorder due to a bad lifestyle because they won’t be harmed by psychiatric drugs. But you are denying the subtle physical manifestations of mental disorders (despite plentiful evidence), and you don’t tell these people that they need to review their lifestyle. These patients won’t get worse if they listen to you, but they won’t get better either. You offer them nothing useful and they will end up going to a psychiatrist, partly because they do believe that they have a mental disorder (e.g. unexplained panic attacks), and they will find your claims simply unbelievable.

        I have a friend who has a “schizophrenia” label. He hears voices constantly and has some bizarre delusions (he thinks that he has a telepathic connection with Putin) and is currently living on disability payments with his parents. Your claim that he does not have a mental disorder is preposterous to say the least. Your position must be especially laughable for psychiatrists who see patients everyday. Some people, perhaps, 2% to 5% of the population, actively seek psychiatric help because their life is unbearable because of psychiatric symptoms. That’s tens of millions of people going to psychiatrists with various complaints every year.

        >>>If the “symptoms” of ADHD are caused by brain malfunction, I think the onus is on psychiatry to state the nature of this malfunction and diagnose it by brain test. Until then, it’s just another unsubstantiated, self-serving assertion.

        There are many self-serving and venal psychiatrists to be sure, but there are also those who say that neuroleptics harm patients, e.g., David Healy and Bruce Charlton. Regarding ADHD, there are tests, e.g. sustained attention test, which show deficiencies in patients with ADHD. There are numerous physical signs of protein malnutrition among patients with ADHD, including smaller brain size. I posted those links above. If you still cannot see the physical manifestations of ADHD, then you are in denial.
        You are correct in that these physical deviations cannot be used for diagnosis because they overlap with the normal range, but a small change is not the same as no change.

        >>>Your theory of “subtle physical problems in the brain” which cause mental suffering or disability is, in my view, problematic because of the averaging and overlapping issues that you yourself concede.

        There is no problem with “averaging”. Average values show differences consistently in many studies.

        In this conversation, you never support your claims with references to peer-reviewed studies, unfortunately, it seems like you are preaching. I am sorry, but your concepts of “feeling apparatus” and “adaptive response” seem like personal opinions unsupported by scientific evidence. As I mentioned above, I was depressed for many years in my teens. It was not an “adaptive response” to a bad social environment. It was a boring, unpleasant, and pointless existence associated with many small personal problems without any big negative life events, in a GOOD social environment. Therefore, your theory of depression is incorrect or requires a major revision.

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        • Wallenfan,

          Thank you for coming back.

          You write:

          “You are saying that if we give them plenty of human junk food, so that their diet becomes completely unnatural, the chimp brain will keep functioning as well as on their natural diet. Pardon me, but your position is ridiculous.”

          What I actually wrote was the opposite:

          “The nutrition issue is more complicated, and I would concede that poor nutrition could deprive the brain or other organs of materials they need, which could cause the ‘feeling-apparatus’ to malfunction and the individual to feel depressed.”

          This is the exact opposite of what you attribute to me. In your earlier comment, you had combined “bad nutrition” and “lack of physical exercise” and had made statements about this combination of factors. In my response, I separated these, because I felt they were different kinds of issues. I accepted your position concerning nutrition, but disagreed with you concerning the lack of physical exercise.

          . . . . . . . . . . . . . . . .

          “There is plenty of evidence of subtle brain abnormalities for many DSM labels, including depression and schizophrenia. These deviations are not statistically significant, but they exist, for example, greater levels of blood cortisol and inflammation markers in depression. Note that you can’t say that these subtle differences do not exist. They are small and cannot be used for diagnosis, but they do exist. You COULD say that they don’t exist if the average values did not differ between depression and no depression, but the average values differ consistently, in many studies. We can call it ‘a mental disorder caused by a subclinical general deterioration of health’. My position is that this subclinical general medical condition is caused by a bad lifestyle. Most modern psychiatrists are saying that the primary cause is a ‘chemical imbalance’ which has some small physical manifestations. This is the influence of the pharmaceutical industry and their cronies.”

          Subtle brain abnormalities sounds a lot like chemical imbalances with the difference that they are too small to detect reliably. Psychiatry has been pushing the chemical imbalance notion for decades and telling us that the nature of these imbalances will be discovered soon. Of course, this is now discredited, but what you’re doing is unassailable – asserting that the imbalances are too small to ever be reliably identified.

          . . . . . . . . . . . . . . . .

          “But you are denying the subtle physical manifestations of mental disorders (despite plentiful evidence), and you don’t tell these people that they need to review their lifestyle.”

          In the previous paragraph you had presented these subtle brain abnormalities as the causes of mental disorders. Now you’re describing them as manifestations (i.e. effects) of mental disorders. Roget gives symptom as one of the synonyms of manifestation. So are the subtle brain abnormalities the causes of “mental disorders” as you had indicated earlier, or the effects?

          . . . . . . . . . . . . . . . .

          “Your claim that he [your friend] does not have a mental disorder is preposterous to say the least. Your position must be especially laughable for psychiatrists who see patients everyday.”

          You’re missing the point. The individual concerned may indeed have some problems, but it is dangerous to assume brain pathology based only on the vague and arbitrary DSM checklist. My position is eminently simple: assertions of brain pathology should be based on evidence of brain pathology in every case. Perhaps your psychiatric colleagues would find this laughable. I don’t know. But I don’t find their readiness to dispense with this safeguard at all funny. I think it’s a tragic and destructive hoax.

          . . . . . . . . . . . . . . . .

          “Regarding ADHD, there are tests, e.g. sustained attention test, which show deficiencies in patients with ADHD. There are numerous physical signs of protein malnutrition among patients with ADHD, including smaller brain size.”

          Here again, you’re missing the point. The assertion that people whom psychiatry labels as ADHD do poorly on sustained attention tests is not surprising, because habitually low sustained attention is the primary gateway to that label! Nor is protein malnutrition surprising, since stimulant drugs, which are prescribed extensively for this so-called illness, are known to suppress appetite.

          . . . . . . . . . . . . . . . .

          “I am sorry, but your concepts of ‘feeling apparatus’ and ‘adaptive response’ seem like personal opinions unsupported by scientific evidence.”

          I’m not sure what kind of evidence you have in mind. Can you provide evidence that the hunger response is adaptive? Or the sensation of pain on touching a hot stove? Or the unpleasant sensation when exposed to extreme cold? Or the urge to flee when confronted by extreme danger?

          There’s not much wasted space in the human organism, and in my view, it is reasonable to regard a response as adaptive unless there is good evidence to the contrary. Why should the human feeling-apparatus be exempt from the general rule that every organ serves an adaptive purpose?

          . . . . . . . . . . . . . . . .

          “As I mentioned above, I was depressed for many years in my teens. It was not an ‘adaptive response’ to a bad social environment. It was a boring, unpleasant, and pointless existence associated with many small personal problems without any big negative life events, in a GOOD social environment. Therefore, your theory of depression is incorrect or requires a major revision.”

          Actually, your personal account provides support for my ideas. Firstly, let me clarify my position. I have never stated that depression stems exclusively from “a bad social environment” or “big negative life events.” The phrase I used in my first response to you was “…an adaptive response to loss or to enduring adverse circumstances.” And you quoted this phrase back to me earlier in your reply. But now you morph this into “bad social environment” or “big negative life events”. Social difficulties and major negative life events would be included in my phrase, but so would “…”a boring, unpleasant, and pointless existence, associated with many small personal problems”, which is how you described the situation that brought on your teenage sadness.

          It is not possible in the limited space here to go into this in detail. But in 2009, I wrote a post title Depression Is Not An Illness: It is An Adaptive Mechanism.

          If you have time to read it, I would be interested in your thoughts/feedback.

          . . . . . . . . . . . . . . . .

          Earlier in your response you expressed the belief that people go to a psychiatrist partly because they believe they have a mental disorder. And this is undoubtedly true. But if we ask the more basic question: why go to anyone at all, the answer is clearly because they are motivated by the negative feelings to initiate some changes. Which is precisely the point of my position. The actual changes that people pursue is highly individualized – some start going to a gym; others might change their diet; others might take long walks; and others, as you point out, go to see a psychiatrist. In my view, learning is the primary determinant of the precise form that the changes take. But the basic drive to pursue change is a direct product of the unpleasant feelings, and is adaptive. Pleasant feelings, of course, are the opposite: a signal that all is well, and that we should stay on our present course.

          Or, to address the matter from another direction, can you suggest any other function that our feeling-apparatus might serve?

          Incidentally, I’m sorry to learn that my writing comes across to you as preaching. This is emphatically no part of my agenda, but I appreciate the feedback, and will certainly try to avoid such pitfalls in the future.

          Best wishes.

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  25. Uh, where does Phil claim “mental suffering does not exist”? If he said anything that ridiculous a lot of us would take issue.

    As far as nutritional deficiencies causing emotional and cognitive problems, we can all agree on that. But no psychiatrist I have ever seen takes those things into account. They often failed to test my thyroid levels, and I’m hypothyroid. This has brought on bouts of depression the shrinks treated with brain drugs–not simply raising my thyroid supplements.

    If you feel depressed or can’t function properly despite other things going great in your life, you might want to see a dietitian. Most GPs and other doctors are ignorant about nutrition. (My current doctor told me to go on a carb free diet. “No grains. Just lots of fruits and vegetables!” Oh boy. And I’m looking to him for preserving my health and life? Scary!)

    I have been anemic and deficient in many vitamins lately. Especially B3, B6 and D3. Since coming off my neuroleptic drug–Abilify–my red blood cell count is much better. Coincidence? Perhaps….

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  26. >>>>Uh, where does Phil claim “mental suffering does not exist”?

    Perhaps I misunderstood, but he disregarded my statement that some people need and seek psychiatric help and he seems to think that there is no such thing as severe mental suffering because definitions are vague and arbitrary: if everyone is suffering then no one is really suffering, it’s all normal.

    >>>My current doctor told me to go on a carb free diet. “No grains. Just lots of fruits and vegetables!”

    Well, fruits and veggies are carbs, so technically, this is a grain-free, not a carb-free diet. Actually, there are several studies showing that a real low-carb (ketogenic) diet is beneficial for patients with schizophrenia and bipolar disorder:

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    • Yes, you did misread him. Who would argue that people suffer emotionally or seek psychiatrists out in hopes that they will feel better? That’s how I got started. My problem is the psychiatrist was ignorant or deceitful. He put me on an SSRI that kept me from sleeping for 3 weeks…and my life went drastically downhill from there.

      Fruit certainly contains carbohydrates. My point about the doctor calling a grain-free diet a carb-free diet was to show how ignorant he was. I agree with the rest of what you say.

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