Mental Health Concerns Not “Brain Disorders,” Say Researchers

The latest issue of the journal Behavioral and Brain Sciences features several prominent researchers arguing that mental health concerns are not “brain disorders.”

Peter Simons
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The journal Behavioral and Brain Sciences features several prominent researchers in its latest issue debunking the notion that mental health concerns are “brain disorders.” It begins with a paper by researchers in the Netherlands arguing that neurobiology will never convincingly explain any mental health concerns. The rest of the issue includes dozens of commentaries by influential researchers, some supporting the initial premise, and others attempting to argue against it. In response, the initial study authors point out that none of the responses can provide any convincing evidence that neurobiological reductionism has succeeded in a meaningful way.

The lead article and response to the commentaries were written by Denny Borsboom at the University of Amsterdam, Angélique Cramer at Tilburg University, and Annemarie Kalis, at Utrecht University, all in the Netherlands.

“None of the commentators appears able to point to convincing evidence that, generically speaking, mental disorders are brain disorders,” they write, “in fact, it seems that most commentators do not even bother. This brings us to the first important conclusion of this response to commentaries: The thesis that mental disorders are brain disorders enjoys no appreciable support.”

The gyri of the thinker’s brain as a maze of choices in biomedical ethics. Scraperboard drawing by Bill Sanderson, 1997. (Wikipedia Commons)

The researchers present a thought experiment that ably delineates just how poorly the idea of brain disorders has fared: Imagine a world in which biological reductionism had succeeded. The neurobiology of mental disorders is understood, and treatments are tailored to that biology and have a high success rate. And now imagine that in this world researchers write a peer-reviewed article in a high-profile journal arguing that brain disorders do not exist.

In that world, we can only imagine that researchers would muster piles of scientific evidence to show that brain changes are responsible for mental health concerns. Every commentary would simply point to numerous studies demonstrating that point. There would be no debate. Instead, in response to this argument, no commentator is able to point to such evidence, and “most do not even bother” to try to produce such evidence.

“The reductionist position on mental disorders as brain disorders does not represent a scientifically justified conclusion, as is often supposed in the popular and scientific literatures, but instead is a hypothesis.”

Borsboom and colleagues argue, in a high-profile journal, that the hypothesis of biological reductionism does not sufficiently explain the human experience. Instead, a variety of other explanations work just as well, if not better.

Borsboom and his co-authors suggest that psychiatry should focus on intentionality—the meaning of experiences—as it is the unique defining feature of all human explanation of mental and emotional problems. Focusing on neurobiology has been, according to the researchers, a failure, which ignores the phenomenological aspects of the human experience and, thus, essentially misses the point of mental health concerns.

According to Borsboom, Cramer, and Kalis:

“It is highly unlikely that the symptomatology associated with psychopathology can ever be conclusively explained in terms of neurobiology. Therefore, sticking to the idea that mental disorders are brain disorders may be counterproductive and can lead to a myopic research program.”

The researchers argue that simple explanations are never going to be found to reduce mental states to biological differences, for several reasons. Mental health diagnoses are based on clusters of “symptoms,” which are culture-bound and change over time (as with each new edition of the DSM, the “bible” of psychiatry) which makes it impossible to assume that we would find a biological correlate to an arbitrary list of very different symptoms. For instance, depression may include weight gain, weight loss, insomnia, fatigue, oversleeping, as well as a number of emotional states that may or may not be present. To assume that all these contradictory features could be due to the same biological substrates is flawed.

Additionally, because correlation cannot prove causation, it is just as likely that any neurobiological changes detected are the result of a mental state, rather than the cause. That is, changes in a person’s neurotransmitter levels would actually be expected after drastic changes in sleep, eating, and mood states—biological changes could be caused by routine changes such as this, or they could both be part of some other process.

Further, the researchers argue that identifying the “symptoms” of psychiatric diagnoses requires attention to the environmental context and the person’s experience. That is, symptoms are described in the DSM using contextual, experiential language, rather than objective language. For instance, the criteria for depression “feelings of excessive or inappropriate guilt” requires the clinician to contextually examine the source of guilt and decide whether it is inappropriate given the content of the guilty feelings.

Influential Stanford scientist John Ioannidis wrote one of the commentaries published with this article. Ioannidis discusses how research on mental health concerns should proceed, given what he calls the “dead end” of the neurobiological research agenda.

He suggests that mental health interventions should focus on environmental changes, rather than the neurobiological correlates of mental health. That is, the context of a person’s life has much more impact on their mental health than does their neurobiology. According to Ioannidis:

“Our societies may need to consider more seriously the potential impact on mental health outcomes when making labor, education, financial and other social/political decisions at the workplace, state, country, and global levels.”

Borsboom and his co-authors go even farther:

“In the current scheme of things, explanatory reductionism is a remote possibility, not a realistic research target. We do not have biomarkers that are sufficiently reliable and predictive for diagnostic use. We have not identified genes that are specific to disorders and explain an appreciable amount of variance. We have not obtained insight into pathogenetic pathways in the brain that are sufficiently secure to inform treatment. If anything, we should wonder why the massive investments in research, that should have uncovered these factors, have not pushed back the prevalence of common mental disorders by a single percentage point.”

They write that the reductionistic biological explanations of mental health “should not be understood as science but as science fiction.”

 

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Borsboom, D., Cramer, A. O. J., Kalis, A. (2019) Brain disorders? Not really: Why network structures block reductionism in psychopathology research. Behavioral and Brain Sciences, 42(e2), 1–11. doi:10.1017/ S0140525X17002266

Ioannidis, J. P. A. (2019). Therapy and prevention for mental health: What if mental diseases are mostly not brain disorders? Behavioral and Brain Sciences, 42(e13), 23-24. doi:10.1017/S0140525X1800105X

Borsboom, D., Cramer, A. O. J., Kalis, A. (2019) Author’s response: Reductionism in retreat. Behavioral and Brain Sciences, 42(e32), 44–63. doi:10.1017/S0140525X18002091.

50 COMMENTS

  1. The idea of mental symptomology being caused by conditions other than brain diseases seems to have eluded mental health professionals, despite the existence of the classic dietary deficiency diseases- scurvy, beriberi and pellagra, all of which can induce depression (also notice that all three have different treatments).

    • It begins and ends with the environment: traumas (ACEs, poverty, chronic stress, etc), dietary deficiencies, microbial imbalance, infectious diseases, it isn’t a competition. But the one thing that keeps eluding researchers is a bad gene that could be altered or eliminated.

      To think we could fix human dissatisfaction and deep distress over the ills of the world with drugs was folly to start with. That researchers ever seriously thought they could pinpoint a gene to finger as the culprit of human distress while the world literally burns around us was hubris on a grand scale.

        • Great example, Rachel777. Pernicious anemia is another example of a biological *cause* for a mental *disorder*. Just because the problem started in the gut, however, doesn’t mean that downstream it isn’t causing a mental illness (depression in this case). Long-term B12 deficiency leads to serious neurological degeneration via demyelination, which is certainly a brain disease. Pernicious anemia has many causes, yet it frequently results in clinical depression. Kate, Natasha et al. “Does B12 deficiency lead to lack of treatment response to conventional antidepressants?” Psychiatry (Edgmont (Pa. : Township)) vol. 7,11 (2010): 42-4. and Syed, Ehsan Ullah et al. “Vitamin B12 supplementation in treating major depressive disorder: a randomized controlled trial” open neurology journal vol. 7 44-8. 15 Nov. 2013, doi:10.2174/1874205X01307010044

          • However, the story appears to be a bit more complex, because the biological cause does not materialize suddenly in a vacuum.

            I think what Borsboom et al are suggesting is to look for feedback loops in a kind of circular causality. Thus, pointing to one cause only makes partial sense, because you could partition the stream of events differently.

            In the short example by Rachel777, theories about the cause and treatment of ‘depression’ leads to an intervention with antidepressants, which leads to a new dynamic for maintaining the ‘depressive state’ by influencing processes in the gut. This, however, could not have been the initial cause for the ‘depression’ simply because it must be assumed the ‘depression’ preceded the antidepressants.

            Thus, the *cause* of the ‘depression’ could equally validly be processes resulting in the initial symptoms, the idea of treating ‘depression’ with antidepressants, the side effects of the antidepressant or the B12 deficiency.

            More correctly, I think, the whole sequence of events could be considered, and one or more strategic points of intervention pursued in a necessary collaboration with the person experiencing the difficulties.

            The work of Borsboom et al is very interesting, I think, and part of a renewed interest in using (holistic) systems thinking in the context of mental health, which could actually make a sensible difference.

            In a later comment you write, that it is untrue that ‘mental health concerns are not brain disorders’ because biological causation may lead to mental health concerns. However, from a systemic process point of view it is still true, I think, that ‘mental disorders’ cannot primary be understood as brain disorders, because the causality involved is much more complex and traverses different levels of description.

            Unfortunately this flies in the face of hopes for a ‘simple’, one-domain solution to mental health problem, which is what many are hoping for (and which would be nice if true). The Borsboom et al perspective paints a differently complex picture.

          • Jonathan, I was always dieting in my teens. Anorexic eighties.
            My mom, my aunt and every other female friend told me it was impossible to be too thin. All the boys wanted us to look like Callista Flockhart or Kate Moss.

            I went off to college desperate to find a husband. I wasn’t fat but far from that lean and hungry supermodel all guys demanded. In my religious subculture you only have a narrow window of time to marry if you’re female. Between 18 and 22. On your 23rd birthday you’e well past your prime since all the guys are taken and you might as well be 46. The colleges are 70% female and female curves make guys think you’re a slut I suppose.

            I never could become thin and pretty enough. But I’m sure all those laxatives and crash diets and 3 day fasts for the beautiful body my rotten genes denied me messed me up long before I started SSRIs at 21.

            Morbidly obese now, hopelessly alone and middle aged I stay at home and cry with my cat. Still less depressed than on those darn drugs. Tears feel better than that undead zombie state psychiatrists call “good mental health.”

          • “… far from that lean and hungry supermodel all guys demanded.”

            I hope it has become clearer by now that not all guys demand a lean and hungry supermodel look. I personally find such a look unattractive and sometimes a little disturbing, as it seems to represent a desire to punish women for looking like, well, like WOMEN!

          • Things are certainly different now. Even though most guys don’t find obesity attractive they are happy with healthy looking women. Glad that part of the eighties is over! 🙂

          • Yeah, the 80s was kind of a nightmare from a dating perspective, wasn’t it? I remember avoiding discos at all costs because I didn’t want everyone judging my dancing or my clothing as “not cool enough.” Plus the music I grew up with was all about protest and revolution and fun and love, not about money, sex and drugs! OK, well, there was a lot about drugs in there, too, but you get my point.

  2. good discussion here….the big problem imo
    is mental health treatment….we are not
    treating the cause.. only symptoms and signs…
    we need treatment of the cause of mental suffering…
    whatever the cause may be…for that person….
    and we need to think of true prevention…

  3. This article is reductionistic and polarized. Mental health is affected by physical health. This article is basically insinuating the brain has nothing to do with the mind. Reading the cited sources, it sounds like the original intention of the articles he cites is to integrate psychology, biology, and environment together into a holistic system… not to completely cut out the biological component as this article tries to do. A quote from the abstract of the first article cited: “instead of being reducible to a biological basis, mental disorders feature biological and psychological factors that are deeply intertwined in feedback loops. This suggests that neither psychological nor biological levels can claim causal or explanatory priority, and that a holistic research strategy is necessary for progress in the study of mental disorders.” That statement I can agree with. However, it’s completely untrue to say that “mental health concerns are not brain disorders.” As a biochemist, I can point to literally thousands of articles showing biological CAUSATION of mental disorders.

      • Steve McCrea, Where do I start? The biological causes of mental disorders are LEGION and OBVIOUS to trained clinicians. Think Hashimoto’s thyroiditis (look it up) as one simple example.
        Bocchetta, Alberto et al. “Affective psychosis, Hashimoto’s thyroiditis, and brain perfusion abnormalities: case report” Clinical practice and epidemiology in mental health : CP & EMH vol. 3 31. 20 Dec. 2007, doi:10.1186/1745-0179-3-31
        For more pieces of the mountain of facts about biological causes of mental disorders, see:
        Infectious Behavior by Paul H Patterson (shows the infectious causes of schizophrenia and autism)
        A Promise of Hope by Autumn Stringham (more of a personal case history of nutritional causes of bipolar disorder) for an intro to nutritional causes.
        The movie Brain on Fire (for an intro to autoimmune causes of mental health disorders).
        The mental effects of hypoglycemia. Books such as Nutrition and Your Mind by George Watson discuss this.
        Just a few of the many papers on Iron and ADHD:
        Chen, Mu-Hong et al. “Association between psychiatric disorders and iron deficiency anemia among children and adolescents: a nationwide population-based study” BMC psychiatry vol. 13 161. 4 Jun. 2013
        Konofal, Eric and Samuele Cortese. “Lead and neuroprotection by iron in ADHD” Environmental health perspectives vol. 115,8 (2007): A398-9; author reply A399.
        Effectiveness of Iron Supplementation in a Young Child With Attention-Deficit/Hyperactivity Disorder

        A few more papers to read about biological causes and associations with mental disorders:
        Niederhofer, Helmut. “Association of attention-deficit/hyperactivity disorder and celiac disease: a brief report” primary care companion for CNS disorders vol. 13,3 (2011): PCC.10br01104.
        Li Y et al. Dietary patterns and depression risk: A meta-analysis. Psychiatry Res. 2017 Jul;253:373-382.
        Howard AL et al. ADHD is associated with a “Western” dietary pattern in adolescents. J Attention Disorders 2011;15(5):403-411.
        Lopresti AL, Jacka FN. Diet and bipolar disorder. J Altern Complement Med. 2015 Dec;;21(12):733-739.
        Peet M. Nutrition and schizophrenia: an epidemiological and clinical perspective. Nutr Health. 2003;17(3):211-219.
        Logan AC, Jacka FN. Nutritional psychiatry research: an emerging discipline and its intersection with global urbanization, environmental challenges and the evolutionary mismatch. J Physiol Anthropol. 2014;33:22.
        Jacka F et al. A randomised controlled trial of dietary improvement for adults with major depression (the ‘SMILES’ trial). BMC Medicine1. 2017;5:23.
        Parletta N et al. A Mediterranean-style dietary intervention supplemented with fish oil improves diet quality and mental health in people with depression: a randomized controlled trial (HELFIMED). Nutr Neuro 2017 Dec;7:1-14.
        Serafini G et al. The role of inflammatory cytokines in suicidal behavior: a systematic review. Eur Neuropsychopharmacology 2013;23(12):1672-1686.
        Goldstein BI et al. Inflammation and the phenomenology, pathophysiology, comorbidity, and treatment of bipolar disorder: a systematic review. J Clin Psychiatry. 2009;70:1078-1090.
        Najjar S et al. Neuroinflammation and psychiatric illness. Journal of Neuroinflammation. 2013;10:43.
        Politi P et al. Randomized placebo-controlled trials of omega-3 polyunsaturated fatty acids in psychiatric disorders: a review of the current literature. Curr Drug Discov Technol. 2013 Sep;10(3):245-253.
        Benton D. Carbohydrate ingestion, blood glucose and mood. Neurosci Biobehav Rev 2002;26:293-308.;
        Daly ME et al. Acute effects on insulin sensitivity and diurnal metabolic profiles of a high-sucrose compared with a high-starch diet. Am J Clin Nutr. 1998; 67:1186-96.
        Jones TW. Enhanced adrenomedullary response and increased susceptibility to neuroglycopenia: mechanisms underlying the adverse effects of sugar ingestion in healthy children. J Pediatr. 1995;126(2):171-7.
        Pearson S et al. Depression and insulin resistance: cross-sectional associations in young adults. Diabetes Care 2010;33:1128–1133.
        Hajek T et al. Type 2 diabetes mellitus: a potentially modifiable risk factor for neurochemical brain changes in bipolar disorders. Biological Psychiatry. 2015;77:295–303.
        Kim B, Feldman EL. Insulin resistance as a key link for the increased risk of cognitive impairment in the metabolic syndrome. Exp Mol Med. 2015;47(3):e149
        Calkin CV et al. Insulin resistance in bipolar disorder: relevance to routine clinical care. Bipolar Disorders. 2015;17:683-688.
        de la Monte SM, Wands JR. Alzheimer’s disease is type 3 diabetes—evidence reviewed. Journal of Diabetes Science and Technology. 2008;2(6):1101-1113.
        Colle R et al. PPAR-γ agonists for the treatment of major depression: a review. Pharmacopsychiatry. 2017 Mar;50(2):49-55.
        Iranpour N et al. The effects of pioglitazone adjuvant therapy on negative symptoms of patients with chronic schizophrenia: a double-blind and placebo-controlled trial. Hum Psychopharmacol. 2016 Mar;31;(2):103-12.
        Villagomez A, Ramtekkar U. Iron, magnesium, vitamin d, and zinc deficiencies in children presenting with symptoms of Attention-Deficit/Hyperactivity Disorder. Children. 2014;1:261-279.
        WHO. Is it true that lack of iodine really causes brain damage? WHO website. Updated May 2013
        Mazahery H et al. Relationship between Long chain n-3 polyunsaturated fatty acids and Autism Spectrum Disorder: systematic review and meta-analysis of case-control and randomised controlled trials. Nutrients. 2017 Feb;9(2).
        Sathe N et al. Nutritional and dietary interventions for autism spectrum disorder: a systematic review. Pediatrics. 2017 Jun;139(6).
        Erhart M et al. Examining the relationship between ADHD and overweight in children and adolescents. Eur Child Adolesc Psychiatry 2012; 21:39–49.
        Lange, KW et al. The role of nutritional supplements in the treatment of ADHD: what the evidence says. Curr Psychiatry Rep 2017;19: 8.
        Pelsser LM et al. Diet and ADHD; reviewing the evidence: a systematic review. PLoS One. 2017 Jan 25;12(1):e0169277.
        Wassef A, Nguyen QD, St-André M. Anaemia and depletion of iron stores as risk factors for postpartum depression: a literature review. J Psychosom Obstet Gynaecol. 2018 Jan 24:1-10. PubMed PMID: 29363366.
        Smith KA, Fairburn CG, Cowen PJ. Relapse of depression after rapid depletion of tryptophan. Lancet. 1997;349(9056):915–919.

        These are just the tip of the iceberg. I’m excited for you to discover them, though!
        Talk therapy can be great, but no amount of talk therapy is going to increase someone’s iron levels unless it’s focused on telling them how to get more iron (for example). We need a multi-disciplinary approach. The paradigm I see here in Mad in America is pitting talk therapy against psychiatric drugs, which is a valid debate. However, we do need to keep in mind there are more than just those two factors or approaches to addressing the multitude of factors affecting mental health.
        But don’t get me wrong. I love Mad in America and am aligned with its mission. The issue you’re rightly fighting is our current system of seeking and prescribing a one size fits all drug to fix a mental health problem that may have any number of causes that are totally irrelevant to the drug’s effects. That’s why psychiatric drugs don’t usually work. It’s not that mental illness doesn’t have any biological basis. To say there’s no biological cause for psychiatric conditions is patently false. I get annoyed with Mad in America when writers conflate psychiatric drugs with all biological contributors to mental illness. That’s why I commented here.

        • Thanks for sharing, Nic. Dr. Brogan has written a book supporting this. A Mind of Your Own.

          It’s worth noting psychiatrists who work at “mental health” centers do not treat thyroid conditions or other endocrine problems nor nutrient deficiencies. I suffer anemia and thyroid problems but seek help elsewhere. The same with proven brain issues like Lyme disease.

          SOME psych doctors may check people with depression for thyroid levels or the other conditions you mention. I have been to a number of health centers and clinics and not one ever mentioned checking for these. Even GPs frequently overlook these concerns if you bear an SMI label. 🙁

        • Well, THAT was an impressive list! Perhaps we’re missing each other a bit because of what is defined as “mental illnesses.” I have never had any interest in denying that there are biological causes of mental DISTRESS or CONFUSION. What I have a problem with is when the DSM creates a “disorder” like “ADHD” or “bipolar disorder” and claim that ALL people with these ill-defined and subjective “diagnoses” have the SAME biological cause! What you said toward the end is what I believe also – that each case is different and no one-size-fits-all approach will suffice for any “disorder,” especially those defined by behavioral observation rather than any kind of scientific measurement and analysis. In fact, one of psychiatry’s great crimes (and there are many) is their insistence on “diagnosing” people without even bothering to do a physical workup to see what might be causing their “symptoms.” This doesn’t even get into environmental stresses (both physiological and psychological) that contribute beyond a person’s own biological variables.

          So sure, there are biological causes of mental/emotional distress, and you’ve documented a ton of them here, which is appreciated. The question I pose is, can anyone name one DSM-defined disorder that is reliably caused by any specific biological problem? I think we all know the answer to that one.

          • Actually psychiatry’s crime is assigning the emotional/behavioral manifestations of PHYSICAL illness to symptoms of a discreet mental disorder.

            Using myself as an example, Lyme disease mimics every label in the DSM. Treat the lyme infection and you will also treat the inflammation that causes the depression, anxiety, depersonalization and psychosis that can present either as primary symptoms or alongside physical symptoms of Lyme such as arthritis and carditis. But at no point are those emotional and behavioral symptoms a discreet “mental illness”. It’s a physical illness that can have emotional and behavioral manifestations.

            The DSM-V also introduced Somatic Disorder which is just a new way to dismiss women’s medical illnesses since the old wastebasket diagnosis of fibromyalgia has been generally accepted by medicine due largely to patient pressure and the validation of pharmaceutical approval for it.

          • Steve, you’ve got to remember that those alleged diagnoses in the DSM’s are actually behavioral descriptions that say nothing about their origins or treatments, unlike the conditions that Nic has catalogued.

          • Quite so, and that is my point. What is called “major depressive disorder” could be caused by childhood trauma, iron deficiency, low thyroid, chemotherapy, finding out about a serious life-changing diagnosis, having a dead-end job, being in a domestic abuse relationship, not knowing the meaning of life, having Lyme Disease, or a long, long list of other possibilities. As Kindred Spirit points out, they don’t even bother to check for well-known biological causes. All of which tells us that “mental disorders” AS DEFINED IN THE DSM are nonsensical entities that have no meaningful value, and that claiming any such “disorder” is caused in the main by a “brain disorder” is rank idiocy without a shred of scientific evidence.

            If we ditch the DSM, we might actually find out what IS causing the problem, be it biological, psychological, social, or spiritual in nature.

          • Steve, one more point is that you can have more than one cause. You could have ACEs, be in an abusive relationship, be poor and homeless, and also have an infectious illness (or any other combination of factors.) The current system doesn’t bother to take any of the potential causes into account. It just labels the patient crazy and drugs him. If he’s very lucky he also gets a decent therapist. And if the patient objects to the treatment or doesn’t improve, the system doubles down on more of the same and becomes ever more coercive and abusive. This is what’s wrong with psychiatry and the DSM. It’s not that there are no physical causes of emotional or behavioral issues, it’s that the known physical causes are largely ignored in favor of creating the ruse of a lifelong patient with a heritable “mental disease” treatable by pharmaceuticals.

          • Very true. The main effect and probably the main purpose of these “diagnoses” is to keep anyone from looking into what’s really going on. Calling “depression” a disease is absolute idiocy! Unless you’re trying to bilk people out of a lot of money, of course.

          • Scientific studies should be careful about suggesting CAUSATION given obvious limitations and confounding criteria (including bias). Unless there has been a plethora of replication (which is largely absent) the best a scientific study can do is suggest a relationship of variable strength depending on the study design and participant characteristics. Science, at its core must continue to be open to scrutiny and given the current SCIENCE as MARKETING approach, it behooves us all to be very wary of studies of any kind that suggest an “answer” to a “question” . The definition of the “question” or the “answer” are products of ……FILL in the Blank here….

          • Very true. The first thing a scientist should do when presented with evidence that a particular hypothesis is true is to generate any other possible explanation that might also be valid and start testing those, too, while setting up to have others try to replicate the experiment you did. Apparently, something like 50% or or more of recent accepted studies fail when replication efforts are made. We would be much better off being a lot more humble about what we “know,” especially in a “soft” science like psychology. Unless, as you say, our purpose is marketing, in which case we spin every “positive” study to make it seem better than it is, and either spin “negative” studies to sound positive, or make sure they are never published. That’s Marketing as Science, and it seems to be how business is done these days.

  4. Yeah, yeah. I am sure that without Szasz critique and Hillman’s empathy, wisdom/phenomenology we will soon find the answer.

    We won’t find the truth without having wisdom.
    ————————————————————————————————————
    James Hillman – “Re-Visioning psychology”.

  5. Once a person is diagnosed with the “illness” of “Schizophrenia” the medical idea is that the only suitable treatment is “medication” (major tranquillizers) – lifetime disability being the best that could then be expected.

    Whereas if people were seen as having individual situations then these could be helped without “drugs”, with the person regaining their place in life. I switched from long-term disability with this approach,

    (..though I never regained my sleeping pattern).

    • Going through life with a medicine head is pretty disabling.

      If someone were forced to go through life on “therapeutic” levels of Nyquil that kept them from thinking straight that would likely ruin relationships, prevent gainful employment and lead to early death.. Just call the narcotic syrup life saving medicine, claim it saves the lives of those you keep doped up, or prevents them from killing others (because you say it does.)

      Psychiatry in a nutshell. The only disability I had was the one they gave me.

  6. There is a cure for the non existent illness of “Schizophrenia”.

    I can explain in my own case how “psychotherapy” worked in dealing with the problems I developed when I stopped consuming drugs suitable for “Schizophrenia”; that my state sponsored disability ended at this time (1984); and that I never “relapsed”.

  7. “If anything, we should wonder why the massive investments in research, that should have uncovered these factors, have not pushed back the prevalence of common mental disorders by a single percentage point.”

    Not only has all this wasted research money not decreased the “prevalence of common mental disorders,” the prevalence has increased. But this is because the “serious mental illnesses” are created with the psychiatric drugs. And we live in a society where these neurotoxic drugs are being forced, and coerced with lies, onto millions and millions of people.

  8. We are talking here of many things – everyone area vitally important DSM abolishment, the human body and its synergy with the evionment, trauma and how the human body reacts in all its various systemic and mircrobiological ways, the professional medical establishment- including others.
    I would like to see a Timeline pre and post Industrial Age.
    This would help with focusing on public health issues that can lead or have led to psychiatric intervention.
    Pre industrial worlds didnot require literacy, many folks lived their entire lives in one place and human environmental interactions were less negative as they are now.
    The research presented so often is not that examplary. It was one of the reasons in the mid 1980’s I just stopped reading any academic journals between the topics and shoddy standards it was literally a waste of time. This of course led to Big Parma sales rep interventions. How very lucky for Big Pharma to have leading academic journals start losing its way. And every time a solid piece actually emerged, it was quashed.
    That in and of itself would be another interesting timeline graph.
    BTW anyone familiar with diabetes knows when a person is hyper or hypoglycemic behavior changes. It has been known for police to arrest a diabetic in actual medical crisis for drunken driving.
    We need to raze the Medical and Science houses to their foundations and start over.Keep any solid beams and throw out all the rotten wood and bent rusty nails.

  9. There is also brain tumors both benign and malignant mistaken for so called “ mental health behavioral conditions.”
    My one LISW friend had a lose relative who had mixed up days and nights and function completely sparely from the partner and family. An expert from a leading university was consulted and sorry no help available. It was only after a happenstance medical emergency that involved a brain MRI that the benign tumor was discovered. Fifteen years of loss of life and this family had many members in the medical professions.
    A patient on the unit I worked was considered “ borderline” because of chronic complaints of headaches then after a ER visit with nonstop vomiting ah! malignant brain tumor was discovered.
    And then there was the Ohd/ MD student working in rotation who was sent to Psychiatry for issues because his concerns about his heart – “ all in his head” – he dropped down in the psych unit floor unconscious no med cart available because psych unit – do they really need one? Thorastic surgeons were seen by Socisl Service Worker to be laughing at a Code Blue called on the psyh unit floor.
    It was the founder of the Burn zI it who ran down four or so flights of stairs who responded to the Code and opened up – literally the student’s chest to do open heart massage but it was too late the oxygen depravation had already caused too much damage.
    I had heard the burn unit surgeon speak at a college class- trauma – all the burn unit folks were facing trauma. One had to be very brave to work within the burn unit. Hard, hard treatment and life long disfiguration and adjustment to life before and life after.
    Later on after my psych unit experiences , I learned my father had mentored the burn unit surgeon.
    To think that there were actual physicians who went above and beyond medical duty and trained others into the realm of not only do no harm but do whatever you can when you can and to hold onto the memories of how I was treated, especially now this month when zI was told by an aide the plan was for me to go into a nursing home and then later to find upon reading my medical records there was Lithium Toxity and Iliterallt could have died but no told me.
    I live with the memories of that and other hospitalizations and the FEAR – ANY DAY the police could AGAIN come knocking and the fear I could not as The Hets in West Side Stiry sing to each other “ Kerp Cool, man Jero Cool.
    I have no gang. Silence in the family and no talk of anything but pretend. Life is Winderful. No Emotions- nada nada burn soul killing nada.
    And other places? Canada, East Coast, Red State,Blue State, Oz. Nada.
    I exist in the whispers of perhaps better days. I cannot believe better will ever come.
    The twenty years of fairly stellar post grad SW is constantly erased by the female staff member who called me the bipolar bitch or the eyes of the nurse who licked me in seclusion.
    As. acimmitted pacifist I fight each day not to let Hate overwhelm me but if nothing my MH experience even with counselors who did no basically no harm and just shot the breeze with no treatment I have learned to hate all of them and especially myself for ALLIWING myself to be taken in.
    I trust no one because will you call the cops on me?
    Woody Guthrie – the BEOMEd psych residents who supposedly did a MH assessment and came from somewhere in the patriarchal Middle East had no idea of who he was. A Trump tenant and great American folksinger.
    Stupid stupid and more stupid.

    • The real question is why placebo so often equals or beats the drugs. I often wonder what would happen if active placebos were used to avoid accidental unblinding.

      Additionally, remember that most psych drug trials are 4-8 weeks at the longest. There are lots of drugs that can temporarily make you “feel better.” Alcohol is a great example. It’s a superb “antianxiety agent” and would certainly beat the pants off of placebo in a 6-week trial for anxiety. Unfortunately, the withdrawal effects have a tendency to counterbalance the benefits, don’t they? Especially after 10 years. Of course, the exact same thing can be said for Xanax, Valium, Klonapin and the other benzodiazepines. But somehow, these are considered “medications” rather than simply a way to distract oneself temporarily from the pain of living. What’s the difference? Someone’s making a lot more money off the benzos. That’s about it.