It seems more and more common for people who consider themselves mental health advocates to make some version of the argument that “mental illness is like physical illness” as they are trying to expand services, empathy and compassion. Have you heard this “depression is like diabetes” tactic? I have a hard time seeing how this is advocating for those in emotional and mental distress.
I’ll assume we’ve all heard the common argument about “language”—that is, depression and diabetes aren’t really like each other because we talk about them differently. You wouldn’t say “what do you have to be diabetic about?” but people do say “what do you have to be depressed about?” all the time. I’ll take it as a given that I don’t really need to expound on that.
I’m also going to assume that these advocates are not simply stating a “fact” that diabetes and depression can be comorbidities. Yes, physical disease can cause emotional distress; that’s not specific to diabetes or whatever we’re calling depression, and it’s saying about as much as saying that water is wet.
There are quite a few issues I have with the thought that “diabetes is like depression,” let alone the idea that this would be ostensibly used for advocating for people in emotional and mental distress. In the first place, it’s difficult to misdiagnose diabetes at this point. Doctors may argue over when someone has crossed the line from “prediabetic” to “diabetic,” but they don’t argue over the definition of diabetes.
If you have type 1 diabetes, it means your pancreas cannot make insulin, which is the hormone that helps escort sugar into your cells for energy. Without insulin, sugar stays in your bloodstream and causes all kinds of havoc. This is true for every person diagnosed with type 1 diabetes (provided it’s a straightforward case with no complications). If there are no other factors and all other things are equal, giving a type 2 diabetic insulin helps them control their diabetes. Type 2 diabetes is characterized by a lack of insulin.
If you are experiencing persistent sadness, loss of enjoyment of activities you once enjoyed, sleep disturbances, changes in eating patterns, withdrawal from social engagements and difficulty concentrating, you could be going through a divorce. You could be struggling to recover from an illness. Your partner of 40 years could have just died. You could be entering a time of existential questioning brought on by the insanity of the news, the callous lack of connection with fellow human beings that modern-day life demands of anyone who wants to “survive,” the repeated rejection by your own kind. And you could respond positively or negatively to psychiatric medications.
Doctors don’t need to try different kinds of insulin to treat type 1 diabetes. Psychiatrists have somehow legitimized their constant jiggering of psych med doses, combinations and brands as a normal part of treatment while still enjoying the “advocacy” that equates depression with diabetes. Depression is not characterized by a lack of antidepressants because there are so many people who do not feel better and many more still who feel even worse when taking antidepressants. So, in that way, depression is not like diabetes.
Maybe these advocates think that, by attempting to equate mental and physical illness, people in power will be more likely to fund the expansion of mental health services. After all, it would be totally barbaric to deny people access to medical care, right? Any rational person would surely agree that withholding insulin from a diabetic, either by price gouging or simply insufficient access, is cruel; thus, withholding “services” (medication, most likely, and therapy) from someone with a mental health issue is equally cruel.
But what if the “service” itself is cruel? What if the treatment is forced medication or involuntary commitment, exposure to stigmatizing judgment from “professionals” who have sterilized their view of humanity into “normal” and “abnormal” and see their role as “helper” to bring their patients back into within one standard deviation of whatever bell curve of normal they personally subscribe to?
People who equate mental illness with physical illness may also be assuming a certain level of care when it comes to the body that they think that of the mind should aspire to—but Western medicine is often as barbaric as psychiatry. Medicine for the body and medicine for the mind (as this culture practices them) are already similar—they compartmentalize, treat symptoms, don’t take the environment into account, in subtle ways blame the victim for their condition, rely on power and hierarchy, have as their end goal only the perpetuation of themselves (which makes remaining distressed or ill or damaged in some way by society’s definition inevitable, and alleviating suffering impossible).
It is true that the body and the mind cannot be separated. But saying diabetes is like depression is not the same as affirming the mind-body connection. Equating physical illness with “mental illness” says nothing about the mistaken notion that the body and the mind are separate. Instead, it’s an argument that the body and the mind are the same. They are not, and actually, saying that they are deepens stigma.
“Diabetes is like depression” is nothing other than an affirmation of the biomedical model dressed up to seem friendly, which makes it all the more insidious. The biomedical model is based on the assumptions of the Western model of medicine, which has very little idea what causes most of the physical suffering it encounters. This is largely, but not only, because it separates beings into “systems” or “organs” or “parts,” which disregards their most immediate environment (the whole body). Thus, a lot of times, when things go wrong, they are “spontaneous,” “random,” “without cause,” and therefore, without remedy.
When we apply that heuristic to mental and emotional distress, we get the idea of the “broken brain.” If your pancreas can stop producing insulin or maybe never did in the first place because beta cells are dead or malfunctioning, but we don’t know why, then saying “depression is like diabetes” could imply that we don’t know why the brain stops working (i.e., why chemical imbalances happen).
But that’s exactly why we should reject the biomedical model—precisely because it is asking us to accept a) that chemical imbalances cause “mental illness” in the first place and b) that we don’t know why the imbalances happen as if that’s an acceptable explanation for mental and emotional distress.
So, we should stop equating diabetes and depression exactly because it ratifies the biomedical model and is ultimately a defeatist approach to the kind of human suffering we’re calling “mental illness.” We do know what causes “mental illness”—environmental failure. That is, trauma, abuse, neglect and the like—exactly what the Power Threat Meaning framework points to.
But, in actuality, people don’t really think depression is like diabetes. If we really thought depression—or any “mental illness”—was just a physical disease, we wouldn’t, as a society, be deeply afraid of people who carried mental health diagnoses. We’re not afraid of people who have diabetes and it’s not because diabetes isn’t communicable.
We’re not afraid of people with diabetes because diabetes doesn’t inherently make people dangerous. The disease itself is quite dangerous for one’s vessels, heart, muscles and connective tissues. Diabetes can cause irreversible, amputation-worthy damage to extremities, persistent and worsening neuropathy and blindness. Diabetes used to be a death sentence.
In the case of type 2 diabetes, it’s a “lifestyle disease.” Surely, the mental health advocates who claim diabetes is like depression aren’t meaning to say that depression is a lifestyle disease. That would be doing exactly the same thing that they are advocating against: blaming the victim.
Depression is not like diabetes because, if it were, someone would call the cops every time someone’s blood sugar dropped or they didn’t take insulin. The medical system would involuntarily commit people who purposely refused to take “their” insulin and label that refusal as a “symptom” of their disease, thus denying them the right to truly free self-determination.
Doctors wouldn’t “recommend” certain courses of action—like cleaning up your diet, getting regular exercise and keeping stress levels low; they would command their diabetic patients to do whatever increases his bottom line (which definitely wouldn’t be anything free like exercise), call that the “most effective treatment” and construct more and more ways to ensure “compliance” such as digital insulin, which records the dose a patient takes, the time they take it and sends that information in real time to their doctor.
If depression were like diabetes, compelling treatment might actually help: I am not for overriding anyone’s free will, but if societal norms and fears endowed doctors with the ability to compel lifestyle changes in their patients with type 2 diabetes, we might be able to eradicate the condition completely. Doctors do have the ability to compel “treatment” in humans with mental health diagnoses, and I think it’s pretty clear that involuntary commitment makes things worse.
Even the voluntary “treatment” isn’t helping: as James Hill and Michael Ventura said in 1992, “we’ve had a hundred years of psychotherapy and the world’s getting worse.” But diabetics who “voluntarily” change their lifestyle don’t get worse because they start eating healthy, sleeping well and exercising (provided they don’t eat what they’re allergic to and their exercise regimen is appropriate for their level of health).
This is different if we’re talking about type 1 diabetes. If someone with undiagnosed type 1 diabetes eats a full meal, their body doesn’t process that food into the fuel it needs because they are lacking the key to unlock the cell that makes it able to take in that energy (that “key” is insulin). This might sound like a stereotype of depression—where all the necessary “good” inputs are present, but the person still feels depressed. But there are two main problems with this: first, there is a concrete, measurable reason that every person with undiagnosed and thus untreated type 2 diabetes still feels hungry after eating: a lack of insulin. This is always the reason and thus, always the solution.
No such thing could even come close to being said about depression. What is the “right” input for someone with depression? What physical or emotional substance has been identified to alleviate depression the majority of the time if not every time? One has not been identified (nor, just to be clear, has a combination of substances or actions or behaviors).
This is not at all to say that there are no causes of depression—those that want to push back on the question “what have you got to be depressed about?” are unknowingly making the valid point that there are always reasons for things. It just seems like there sometimes aren’t because the treatment system (psychiatry and increasingly psychology) refuses to look anywhere other than one particular mechanism in one particular person’s brain without regard to much else. If you hear that story enough times—that is, if you’re not allowed to look at your family of origin, your childhood, your diet, your country’s economic reality, the ways you experience oppression, what you’re exposed to energetically, socially, physically, chemically, etc., you would have a hard time identifying why you’re depressed, too.
Second, when you give a type 1 diabetic insulin, they are able to get the energy from their food into their cells, thus producing the felt sensation of fullness. There is an identifiable mechanism by which we know and see that insulin works. Yet, it is somehow acceptable in the realm of mental and emotional distress, some severe enough to kill people, for professionals to repeat in psychiatrist offices around the world, “We don’t exactly know what medication or combination of medications will help because each individual is different.” This is nothing more than an appropriation of bio-individuality.
Each individual certainly is different, but if the psychiatrist truly meant that when they say it, they would take into account each of their client’s physical, social and economic environment and realities when attempting to offer solutions, chemical or otherwise. On the whole, they don’t.
Perhaps the only way that depression is like diabetes is that neither depression nor type 2 diabetes has to be chronic, but that the respective mainstream treatment systems still mostly believe they are chronic. Professionals are still trained to help people “manage” depression and type 2 diabetes rather than reverse or eradicate it. The only difference is that the popularity of consigning a human being to chronic-condition status is waning much faster in the medical field (at least in relation to diabetes) than it is in psychiatry.
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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“Depression” is a feeling, not a disease. It has been noted how shrinks will take someone who is “depressed” (extremely sad, hopeless, etc.) then say “this is a disease called depression.” The same with “anxiety” and other human reactions to a toxic culture. It’s a lie, and it’s criminal.
Consider the following statements:
“Mental illness” is a semantically absurd concept which falsely conflates the abstraction known as “mind” with the physical brain to mislead people into believing they have literal diseases.
Psychiatry is a tool of social control which enforces conformity to the values of the prevailing social order.
Anything you disagree with?
Considering the brilliance of your writing some of us are wondering if you have reached the point of “officially” declaring yourself anti-psychiatry, period. Are you? And is there a way for AP people to contact you directly? (Let me know if you need a conduit for such communication.)
Good seeing you at MIA again.
I have been pretty depressed lately. Not getting much done.
My depression is a symptom of pernicious anemia. A physical (real) illness. Anemia can be treated with iron supplements and infusions. By a real doctor.
Hello oldhead! There’s nothing in either of those two statements I disagree with, no.
And yes, I’d be interested in hearing more about what a conduit for communication would entail so I know what I might be getting into. I’m thinking about the best way for you and I to communicate; email me through here? http://meganwildhood.com/contact-me/
Cool. Things are slow as we all hide from the virus but I’ll be in touch.
Thank you OH, you said,
“Depression” is a feeling, not a disease. It has been noted how shrinks will take someone who is “depressed” (extremely sad, hopeless, etc.) then say “this is a disease called depression.” The same with “anxiety” and other human reactions to a toxic culture. It’s a lie, and it’s criminal.”
I thought “Mental Illness” was a figure of speech, until I noticed medical staff with very serious and dedicated expressions on their faces promoting it as true. God help us!
Stand by for some very serious-looking animal control workers arriving with nets to contain the next incidence of it “raining cats and dogs.”
Sorry to keep repeating this but I think it’s a perfect analogy.
I’m not all that expert on “Depression” but “Anxiety” is a good one for me. Anxiety is also I believe quite close to depression.
Anxiety is not an illness. Anxiety responds to straight forward psychological approaches that can be accessed organically (i.e. without professional contact). And what works for Normal Anxiety also works for Extreme Anxiety.
“Depression is the same as Diabetes” is in my opinion just “Silly Talk”.
I prefer to think of depression as a syndrome- a collection of symptoms and signs, that, in this case, can have multiple causes. The reason psychiatric treatments for depressed moods are frequently so futile and useless is because psychiatrists are chained to the idea that depression is some kind of unitary entity that responds to a single (chemotherapeutic) treatment.
DIABETES? Pure desperation on the part of those who have no validation for what they are treating!
It has just added to all the confusion.
Love this article Megan. It offers a new spin on “What if we treated ‘mental illnesses’ like physical illnesses?” Ignoring that “mental illnesses” are supposed to be brain diseases (physical) and rendering the analogy nonsensical. But the doctors who claim to fix these alleged brain diseases act like no others.
My own pet peeve is how our culture practices “sadness shaming.” Like there’s something disgraceful about not grinning like the Cheshire Cat 24/7. It really irritates me.
My peeve is not that people find their own sadness/depression intolerable (understandable) but those around them do. No matter how much cause you have to feel gloomy friends and neighbors nag you to hurry up and see a doctor to take some medicine cause unhappiness is a disease.
If you express reluctance or argue your sorrow/grief is reasonable since you lost your job, your kid disowned you, your spouse left or beats you, you have cancer, your dog died, your house burnt down it’s always…”Oh no. You must have depression.” Then, if you still decline they get mad at you. Accuse you of being too proud to get “help.”
Like being sad is a crime. Ironically once you say you’re getting “helped” you can quit smiling altogether and act gloomy all the time and quit bathing or going out. But say you’re taking your “meds” and everyone applauds. Never mind it isn’t working or maybe you feel like Riley in Inside Out once she lost Joy and Sadness.
Reverse pill shaming. You must take drugs–even if they make you feel 10 x worse–as penance for the sin of unhappiness.
I wonder if having to pose as Happy Stepford Robots is behind the loneliness epidemic. Phoniness can be VERY alienating.
What I love is when you have some major trauma you want to talk about, and the person you tell acts like just hearing about it is an even bigger trauma than living it. What is that about?
And pretty well everyone I know except immediate family now recommend professional “help” for even the slightest problem now. I don’t know how anyone is expected to have friendships or an intimate relationship anymore, when any time there’s a problem the person needs to be farmed out to a professional. A lot of therapists I met seemed to enjoy creating interpersonal dramas between people…and then there are psychiatrists who can do far worse!
Reverse pill shaming is a thing.
Popular with psychiatrists.
Excellent piece, thank you so much for writing it. I constantly tire of hearing this comparison too and have pointed out to people before that likening “depression” to diabetes especially when the latter can cause blindness and loss of limbs via amputation is not a valid comparison. I’m glad to hear someone else say it too!
Also regarding this statement:
“It seems more and more common for people who consider themselves mental health advocates to make some version of the argument that “mental illness is like physical illness” as they are trying to expand services, empathy and compassion.”
I’d be so thrilled if people just entirely stopped advocating for more mainstream “mental health” treatment since that means more drugs and ECT. Whether people realize this or not, usually mainstream advocacy is basically begging for more of a torture regime. It only really makes sense to do advocacy around more drugs if you live somewhere where you are being denied access to drugs you need to taper safely, or to prevent a withdrawal.
Also it’s a bit..bizarre to think that asking for more paid “help” is advocating for “more empathy”. Can a person really buy empathy? (“Excuse me, I haven’t much time..can you tell me in what aisle you keep the empathy?” ) It reminds me of that old Simpson’s episode where they have Millhouse’s dad trying to draw dignity….
Lastly it seems to me that people should really rethink most “we need more mainstream mental health treatment” advocacy because many of them are just acting like unpaid spokespeople for pharma.
Not that I think anyone should be doing their work for money either, but, well, what’s with volunteering to do free work for a trillion dollar industry?
Great article Meagan.
There is also “treatment resistant depression”, which is either decided
by shrink or client, or both. But that realization usually comes after many, many years of chemicals.
I doubt anyone receives one stamp only, such as “depression”. We need fancy descriptors that take away from it’s simplicity. We have to try and make it sound like something that only a shrink would know about in all his “medical” approaches. Make it sound more possible, plausible, sort of like poetry. Say enough silly words and once we cannot make common sense of it, it must be true, and in the case of psychiatry, it must be scientific.
So we say things like “secondary to”, and “co-morbid”, and use other labels and words like “clusters” and “axis” and “polar”.
It is poetry of the worst kind, poetry combined with chemicals and that is all there is to it.
It is how their poetry results in labeling human beings as “defective”. If they were not doing this, how does it stand to reason that the labels work against you, in worse manners than any murder sentence can.
And this area also, is where psychiatry has to outright lie.
It is also where the ‘public’ turns the other way.
“well gee, you must be bad if they did this to you”. “you must have deserved it”.
And they are so blind, thinking it will never happen to them, nor their offspring. And IF it does, they might still think that it is “others” that deserved the package, not themselves.
And let us NOT pretend, nor excuse people of being misled, of politicians, doctors, lawyers or psychiatry itself being misled.
They made a biz model out of cult and I have never met anyone who is under cult spells that “admits” to how bad it really is. People HATE to address power, especially if they are involved in keeping it alive.
Nope, they have no answers, so they just keep letting them do the garbage misuse of tax dollars.
The thing about tax dollars, it gets taken from your cheque and you don’t question the almighty.
How are humans being looked after and respected with your tax bucks? Look around. Keep pumping money into cages and chemicals and see where it gets you.
Mankind has not changed much, that self delusion, or outright lies to uphold their lies.
Like any empire, psychiatry will fall. People are forever moving away from oppression. It is the nature of us.
I was afraid I would go insane and kill innocent people if I did not do exactly as I was told. They were wrong.
Despite my physical pain my soul is free at last! 🙂
Ooops sorry Meagan,
I forgot to say thankyou for the excellent blog.
Removed for moderation.
Is being born with only one leg or any an illness?
Will it cause the person a strange gait? Something observable?
Should we then say that “he walks different or strange”, or should we say he IS strange.
What if noises cause me to run for the hills and neurology can’t find anything about my ears?
Is it then “psychological”? In the absence of a finding in scant neurology?
What if neurology found the problem but has no fix?
If the person needs to hole up or run for the hills, that is their coping, their medicine.
Coping cannot be labeled as an illness. Neither can sensitive hearing anymore than a missing leg is an illness.
Psychological musings, psychiatric musings written up as a DSM, are nothing more than saying “we don’t know”, so we made up these names and “illness”.
People that buy the nonsense are in a fog, yet that is NOT considered an illness.
I’m a licensed clinical mental health social worker. I was also diagnosed with manic-depression as an adolescent and now re-diagnosed with bipolar II disorder. I’m co-morbid with anxiety, ADHD, and c-PTSD.
I use the diabetes analogy and will continue to do so.
Mental illness is a physical illness. The brain is tangible. It’s a muscle and an organ; and one of its myriad of functions is to produce emotions. The brain transmits chemicals (dopamine, serotonin, etc.) which influence moods and emotions. And like diabetes, the brain is treated with medications.
It’s true identifying the appropriate psychotropic and dosage is trial and error; however, this challenge does not negate the fact that when a chemical treatment is discovered, it is extremely effective. I’m one of the fortunate ones, my drug cocktail reduces my mood lability and eliminates my suicidal impulses.
Evidence-based research finds both mood and metabolic disorders, in addition to chemical treatment, are successfully managed by cognitive behavioral change, nutrition, and PHYSICAL exercise.
My bipolar depression produces acute physical pain: tense muscles, constricted breathing, headaches, fatigue. I have phantom physical feelings of coming out of my skin. Washing is painful. Climbing stairs is a physical impossibility. I lose the desire to eat which enflames my IBS.
On the other hand, diabetes can induce moods: depression, hopelessness, and anxiety.
I appreciate how the diabetes/depression comparison is infuriating to you. But I chose to continue to make the correlation because it’s supported by evidence based practice.
I hear that you’ve had a good personal experience. It concerns me that you seem not to want to hear that not everyone experiences things the same way you do. You write a number of philosophical assumptions regarding the brain, but provide no scientific proof that the brain is the cause of “mental disorders.” If you read the article, you’ll see that the primary difference is that we KNOW that insulin is the singular causal factor in high blood sugar – it can be measured, blood sugar can be measured, and adding insulin or coming up with a way to increase insulin reduces or eliminates the problem in almost 100% of the cases. Add insulin, reduce blood sugar – it is that simple.
With psychiatric “diagnoses,” there is no known missing substance that needs to be replaced. There is no substance that can reliably replace the mystery “missing substance” and create beneficial results 90% of the time, or even 50% of the time. Compared to placebo, Kirsch’s work showed that ADs are barely better than taking a sugar pill. Compare that to the almost universal success of insulin in reducing blood sugar. Heck, we don’t even know if there IS any chemical causing ANY of these conditions, let alone are we able to MEASURE those chemicals.
SO the analogy fails completely. There is no SCIENCE saying that “depression is caused by low serotonin,” and lots of evidence saying that it is not. Doctors are GUESSING as to what drugs may or may not be perceived to “help” by reducing the experience of depressed emotions. The analogy with drinking a controlled amount of Jim Beam whiskey daily is a much more accurate one. People DO feel better when they drink alcohol, but there is no “condition” being addressed by the alcohol – it has a general numbing and elating effect on everyone. All psych drugs work similarly – they create effects that some find agreeable, and some don’t. The “diagnosis” itself is made by listening to a list of feelings and behaviors, not by measuring something concrete like blood sugar levels.
So in essence, the “insulin for diabetes” analogy is a complete deception. Vague philosophical assertions about the nature of the brain (unproven, except that the brain is of course nervous tissue 100%, not a muscle) do not count as hard science. If there is nothing to measure and no reliable approach to improving such a measurement, we’re talking about something VERY different than diabetes.
Your clients are relying on you for honest information. I don’t believe it is ethical to provide them with unscientific ideas based on your personal belief system. I believe you are responsible for telling them the facts, including the fact that we don’t know WHAT causes “mental illnesses,” or indeed whether they are “illnesses” at all.
Sorry you’re still “drinking the Kool-Aid” (another analogy).
I use the diabetes analogy and will continue to do so. Mental illness is a physical illness.
So which is it? It can’t be both
The brain is tangible. It’s a muscle and an organ; and one of its myriad of functions is to produce emotions. The brain transmits chemicals (dopamine, serotonin, etc.) which influence moods and emotions. And like diabetes, the brain is treated with medications.
All true. But the mind is NOT tangible, nor treatable with “medications” (also known as neurotoxins).
And therein lies the essential deception of psychiatry.
one of its myriad of functions is to produce emotions
Almost missed this. The brain does not “produce emotions”; it simply serves as the central switchboard for channeling electrical/psychic activity in the physical body.
“I hear that you’ve had a good personal experience.” Although he/she was defamed/ “diagnosed with manic-depression as an adolescent and now re-diagnosed with bipolar II disorder. I’m co-morbid with anxiety, ADHD, and c-PTSD.”
“My bipolar depression produces acute physical pain: tense muscles, constricted breathing, headaches, fatigue. I have phantom physical feelings of coming out of my skin. Washing is painful. Climbing stairs is a physical impossibility. I lose the desire to eat which enflames my IBS.”
Doesn’t really sound like a good personal experience, though. Sounds more like the common adverse symptoms and effects of the “bipolar” drugs.
But that just comes from one who was misdiagnosed as “bipolar,” and healed by getting off those neurotoxins. And one who wasn’t brainwashed into believing in the DSM billing code “bible.”
My best wishes to you, amkrueger, and I hope you choose to pursue a healing and truth seeking journey instead.
I suffer many of the above. IBS, chronic pain, artaxia, weird burning sensations on occasion. All of these came 20 years after my diagnosis of bipolar 2 after a bad reaction to Anafranil which the psychiatrist blamed on my unmasked illness.
Antidepressants are proven to mess up your digestion and heart rhythm. And significant nerve damage is normal. None of these were a problem before-though I did feel depressed and anxious. Those are easier to control now.
There is no such thing as a weird burning sensation. If I put a flame to your hand, there is no mistaking it.
A burning sensation without a flame to my hand. It’s “weird” because there is no visible cause. Like neuropathy.
Psychotropics can do “wondrous” things …
Well, Rachel, the doctor didn’t want to tell you he fumbled your treatment from the getgo, which is why you’re still symptomatic. That would be hard on his professional self impression, as well as his pool of patients- he wouldn’t want evidence of his blunders to come out in the waiting room.
“It’s true identifying the appropriate psychotropic and dosage is trial and error; however, this challenge does not negate the fact that when a chemical treatment is discovered, it is extremely effective.”
Let’s take a popular antipsychotic like olanzapine as an example. It seems to work on over 20 chemical neurotransmitters at differing affinities. If the main therapeutic action is supposed to be dopamine d2 blockade, why would you want, for example, histamine h1 and serotonin 5ht2a saturation at sub-therapeutic doses? What do you do, if over time, the brain compensated for the d2 blockade? Up the dosage? What effect would that have on the other chemical neurotransmitters? What long term effects do saturating certain chemical neurotransmitters have? Can the brain recover from that, if, for some other more pressing health reason, you are advised to stop the drug?
If a chemical treatment is discovered, it’s per definition effective (at least for the target symptom). It’s very unlikely to cure anything, however. And the statement doesn’t say anything about existing psychotropic medication.
Evidence-based research finds both mood and metabolic disorders, in addition to chemical treatment, are successfully managed by cognitive behavioral change, nutrition, and PHYSICAL exercise.
Could you provide some studies which support this? Apply it to obesity. Can you show that changing your behavior, nutrition and physical exercise are not (as) effective without some form of chemical treatment? With chemicals, I mean psychotropics, which is what your comment seems to be about.
Excellent article; there are many things wrong with this analogy.
P.S. I think you meant “reifies” rather than “ratifies”? just fyi
If people compare depression with diabetes, then misdiagnosis is not uncommon.
yep, it kinda sucks to be in a profession where one has to keep changing language to try
to keep one step ahead.
What specialty takes away my rights as a person?
Having done nothing wrong?
The legal abusers of society.
“We do know what causes “mental illness”—environmental failure. That is, trauma, abuse, neglect and the like—exactly what the Power Threat Meaning framework points to.”
What is “environmental failure”, the financially entrenched systemic fraud that affectively twisted “mental/emotional” symptoms of trauma (aka STRESS) and abuse into causal agents of “mental health problems?”
”if you’re not allowed to look at your family of origin, your childhood, your diet, your country’s economic reality, the ways you experience oppression, what you’re exposed to energetically, socially, physically, chemically, etc., you would have a hard time identifying why you’re depressed, too.”
What imaginary forces are stopping anyone from personally looking at and addressing the above?
The fear-based disease mongering “MH” system is simply opposed to people taking personal growth journeys without them controlling how they choose to do so.
Imagine lying on your couch for a year of your life, tinkering about with your own formulation and eventually stumbling upon your “best guess” of why you feel like you do, only to then…what… start “treating” those feelings?
Or is the process of formulation, itself the “treatment?”
“Surely, the mental health advocates who claim diabetes is like depression aren’t meaning to say that depression is a lifestyle disease. That would be doing exactly the same thing that they are advocating against: blaming the victim.”
Depression is in fact well documented to be caused by poor lifestyle choices.
Stating that fact is not victim blaming, it’s called re-educating people who have been effectively brain washed by the very business entities that developed brain washing propaganda and consistently use it to widen the net of customers they ensnare.
“But diabetics who “voluntarily” change their lifestyle don’t get worse because they start eating healthy, sleeping well and exercising (provided they don’t eat what they’re allergic to and their exercise regimen is appropriate for their level of health).”
Diabetics who voluntarily exercise, change their diet, in fact get better when they do these things and so do “mental health patients”.
The following can be found at Mercola. com
How exercise treats depression
• Research suggests exercise is a powerful tool for the prevention and management of depression, in part by normalizing insulin resistance
Is Exercise the Best Drug for Depression?
Research has shown again and again that patients who follow aerobic-exercise regimens see improvement in their depression — improvements comparable to that of those treated with medication. Exercise not only relieves depressive symptoms but also appears to prevent them from recurring.
Study: 12 Percent of Depression Could Be Prevented With 1 Hour of Exercise a Week
• In an 11-year study, people who engaged in regular leisure-time exercise for one hour a week were less likely to become depressed
• Those who didn’t exercise were 44 percent more likely to become depressed compared to those who did so for at least one to two hours a week
• Twelve percent of depression cases could be prevented by exercising at least one hour a week
“if psychiatrist truly meant that when they say it, they would take into account each of their client’s physical, social and economic environment and realities when attempting to offer solutions, chemical or otherwise. On the whole, they don’t.”
Psychology calls out psychiatry’s Medicalization of symptoms as if they are “mental diseases” while it vigorously Mentalizes symptoms as if they cause “mental health problems.”
By design, both sides of the “MH” coin either completely ignore the human body, except when they conveniently use it to their advantage by claiming physical diseases cause psychological distress when in fact over 100 medical diseases come part and parcel with normal sequalae consistently misdiagnosed as “mental illness/problems”. Even when and after the underlying medical condition was properly treated and completely resolved as a result of proper medical treatment, people are left to suffer the fall out of having been associated with “MH” and are permanently tarred and feathered as a “mental patient.”
The pseudo-p’s are the one’s who severed the human body into two separate and distinct “parts” and falsely declared that there are two separate kinds of “health”,
one for the body
and a separate health housed in the hypothetic construct they invented called the “mind”.
The entire Sick Care system embraced the fraud because they all financially benefit from cross treatment/ referrals, etc.
Medical Mimics and Psychiatric Pretenders are symptoms “mentalized” and misdiagnosed as “mental Illness/mental health problems.”
For but one of countless examples:
A very large number of medical conditions can cause psychosis
Misdiagnosis remains medical malpractice and insurance fraud.
“Misdiagnosis remains medical malpractice and insurance fraud.”
There is not “diagnosis” that fits some, but a “misdiagnosis” for others.
In psychiatry, all “diagnosis” is a “misdiagnosis”, and in regular medicine, a diagnosis is only a partial diagnosis, the rest is “opinion”.
I am a recovering alcoholic with double depression and psychotic features. I use analogies when talking with other people who have similar issues. An example would be likening alcoholism to an allergy -a common comparison in alcoholism recovery circles. It is not exact – alcoholism is NOT an allergy – but it is a useful way of thinking about alcoholism. Depression is NOT like diabetes in many/most ways, but the comparison might be helpful if the depressed person is struggling to accept the need for medication. (In my own case, medication is appropriate and I benefit from it – not unlike how a diabetic would benefit from insulin. It was difficult for me to accept this in the past – I rebelled against medical treatment and suffered the consequences.)
I think comparisons to physical diseases can be useful when it is clear that an imperfect illustration is being used. I use them in conversations, where there is opportunity for clarification, and I am willing to drop an analogy if it seems unhelpful.
I especially try to treat other people who have depression, alcoholism, or other mental conditions with the same courtesy and compassion that I would want – and which I mostly received earlier in my journey. We know ourselves and each other better than people who don’t share our experiences, but who have PhD’s. We can help each other to survive and thrive. If an analogy to diabetes or allergy will help a friend to understand or frame what they’re experiencing, I’ll use it.
Another recovering alcoholic recently shared with me that she was having problems with her recovery because her method of recovery placed a lot of emphasis on her “powerlessness”. This was triggering some problems related to the lack of power and agency which she had experienced as a child. We spent a couple hours talking in my backyard, burning stuff in the fireplace, unpacking the concept of powerlessness and how it related to alcoholism versus childhood abuse and/or being a woman in a man’s world.
I believe this kind of dialogue is what is most beneficial for people who have mental health issues, substance abuse disorders, and general life problems. Being able to hash things out with a knowledgeable friend has always had the best results for me. It was a knowledgeable friend who said “You need medication” – he was right.
I do want to distinguish somewhat between you as a layperson saying this vs. a medical professional saying this. You are not purporting to be representing the latest scientific knowledge in the field, so it’s more understandable and less damaging to use analogies to explain things. That being said, I still consider it a damaging framing of the reality of “mental illness.” What you said at the end is much more relevant to understanding most people’s situations – that we have trauma, neglect, and other harm from how we grew up, whether from parents, siblings, school, church, or other institutions. Finding someone to talk to who really understands these experiences is what I’ve found helps people the most. Most folks don’t “need medication,” they need UNDERSTANDING. This is not to say that some people (like you) don’t find these drugs USEFUL. It is to say that the idea that you are “treating a brain malfunction” is simply wrong, both scientifically and sociologically. It is not a “disease” or “disorder” to feel bad, act in antisocial ways, or think unusual thoughts. Some disease states DO cause emotional distress, weird thoughts, or antisocial behavior, but those disease states have specific causes and usually specific remedies. To say that someone “has clinical depression” is totally subjective, and it is highly misleading to create an analogy with diabetes, as diabetes is objectively measurable and has a specific treatment that is effective almost 100% of the time. This is simply not true of “antidepressants” or any of these psychiatric drugs. They are very simply efforts to make someone feel better or act better temporarily. There is nothing observably wrong with the person, and there is nothing specifically being “fixed.”
I think you’d be far better off telling people that “I’ve taken these pills and they have helped me feel better. That apparently doesn’t happen for everyone. Nobody really knows if there is something biologically wrong with you, but I can tell you that I understand your plight and am very happy to listen. I find that listening and caring for each other is the best ‘medicine.'”
FWIW psychiatry puts a great deal of emphasis on how powerless you are.
Being told I had an incurable brain disease that would surely drive me mad without unquestioning obedience made me feel helpless and hopeless. Truly horrific.
The exact opposite of 12 Steps in many ways.
“….We spent a couple hours talking in my backyard, burning stuff in the fireplace, unpacking the concept of powerlessness and how it related to alcoholism versus childhood abuse and/or being a woman in a man’s world.
I believe this kind of dialogue is what is most beneficial for people who have mental health issues, substance abuse disorders, and general life problems. Being able to hash things out with a knowledgeable friend has always had the best results for me”
Luther, I’m not sure if you are defending psychiatry and it’s practices or yourself.
You don’t have to justify your way of life to me, but I won’t be listening to someone defending psychiatry with all it’s offensive lies, it’s insults to intelligence, and dehumanizing labels and authority.
No you do not need a PHD, a PHD does NOT make you an expert over someone’s experiences.
The chemicals simply disrupt whatever is your normal and it can go badly. It is absolutely not like diabetes because insulin treats a disorder. It is not a chemical that randomly disrupts an experience.
The analogy is silly and is supposed to make it sound medical.
There is nothing “medical” about random chemicals designed to scramble the brain, in HOPES of something happening.
That is not knowledge.
And I’m not sure what “double depression” is. Is there triple and quadruple depression? What about the other 500 labels?
People are very damaged and defamed by labels.
And you say that “talking”, “dialogue” is most helpful to people with “mental health issues”.
Now I believe that honest dialogue is helpful to everyone “honest”.
Real life can be overwhelming and if someone wants to see that as a “mental illness” so be it.
Nothing I say will make a difference, but I sure as hell hope that you don’t tell people that their kids might “need” chemicals for their brains.
Your friend had no right to diagnose you btw. But neither does a PHD on the human mind. One cannot diagnose something that is theory, where it merely remains a belief, and is taught as a religion and theory taught as fact.
“Double depression” refers to chronic depression and reoccurring major depression.
I wasn’t defending anything. I have no interest in justifying anything.
My friend had every right to diagnose me – I gave him that right when I asked for his opinion. And I had every right to ignore his opinion. I chose to take his advice because I knew him well enough to trust him. He had had experiences similar to mine and he told me what had been beneficial to him.
I had no idea that my belief that people benefit from sharing their problems with friends who have had similar problems, openly discussing and analyzing the various methods of treatment available – including the possibility of medication – would generate such negative responses. I thought I was advocating for basic friendship and cooperation, information sharing and empathy.
I believe that I misjudged the premise of this site. I thought it was a place for neurodivergent people to vent their spleen at anyone who appeared to hold another opinion.
I will unsubscribe.
“It was a knowledgeable friend who said “You need medication” – he was right.”
Did he give any indication as to which medication, at what dosage? And, for how long?
I’m pretty sure my serotonin is too low. That’s what SSRI drugs actually do. The “high” is temporary and your body quits producing enough thanks to disrupting the way your body recycles it.
I’m going to go on tryptophan. And exercise.
I used to believe it. I do think it’s a phrase that implies antidepressants to a depressed person are like insulin to someone with type 1 diabetes. I think the phrase is used by mental health advocates to promote the idea that mental health is just as important as physical health, and there’s no shame in medicating it, but it’s meaningless when it’s not based on facts. I only stopped believing it when I found out that:
1. There are people who take antidepressants but are still depressed, looking for the “right combination” for years and still not finding it despite being on up to 4 drugs at a time.
2. Going (slowly) off antidepressants will not make the person immediately depressed.
3. Depression often resolves when the biggest problem in the person’s life is taken away. If it was like diabetes, this wouldn’t happen.
4. Effectiveness of antidepressants in general is way overhyped.
5. It leads to a feeling of lower self-efficacy, more pessimism and doesn’t even reduce stigma. Who needs that?