A Letter to the American Psychiatrist Who Labeled Me

H. S.
53
4787

To the American psychiatrist who diagnosed me with Bipolar Disorder:

Doctor, you probably don’t remember me. But I remember you well. We met at the end of June 2014. I had already spent two days in the emergency room of your university hospital and another week at a regional hospital close to our college town. I was in the fourth year of the graduate program I’d come to the United States to pursue, and I had just experienced my first psychotic episode.  You see, I was terrified. Nothing like this had ever happened to me before. I did not have a history of mental illness, nor did anyone in my family. I did not do drugs, and I had never been intoxicated in my life. Nothing traumatic happened the day my psychosis began, and although it resolved as quickly as it came, it left me with a profound sense of trauma for years to come. But that is not what I want to talk to you about. I want to talk to you about our meeting and the disastrous effects it had on the next six years of my life.

Let me remind you of how it happened: I entered the conference room and sat at the table. You began to ask me a series of questions about my life. I answered all of them in a clear and calm voice as you took occasional notes. No one else was present. I told you about my life in the U.S., my friends, my Ph.D. program, my ex. By the end of this very tranquil conversation, you said something that I will never forget, and I quote your exact words: “If I saw you in a grocery store, I would not think you had anything.”

Two days after this conversation, you convened my mother and a number of your colleagues, and you gave me my official diagnosis: Bipolar 1 Disorder with Psychotic Features. You told me this was a serious mental illness and that I would need medication for life. But you also encouraged me by saying that I had a good prognosis and I would be fine if I took my medications regularly.

Well, let me tell you how it went. I took my medications religiously. Not only did I take them every single day, but I also took them at the same hour and minute of the day: 8 p.m. sharp. I attended therapy regularly. I did not smoke, drink, or do any drugs. But I was not fine at all.

Although I continued with my Ph.D. program, made significant progress on my dissertation, and successfully taught undergraduate students, I also had a psychotic episode every six months for the next four years, no matter how hard I tried, no matter how many different psychiatrists I saw, no matter which medications I switched to, no matter how high the dosage. Every time, I was admitted to the hospital, restrained, forcefully injected with psychiatric drugs, and released a few days later like nothing ever happened. Every time, on a higher dose of drugs than before.

Nothing I did could prevent these psychotic episodes, and I lived for years in constant fear of their return. Nothing helped until one day in 2017 when I was in an airport bookstore, waiting for a flight from my country back to the U.S. I was browsing in the psychology section and stumbled upon Robert Whitaker’s Anatomy of an Epidemic. Backed by research and a critical history of the pharmaceutical industry, the book demonstrated clearly that psychiatric conditions often resulted from prolonged drug treatment. Research on long-term outcomes for psychiatric patients showed fewer hospitalizations when people were not treated with antipsychotics continuously and for life than when they were— even if they initially had a poor prognosis. To reassure you, I did not discontinue my medications upon reading Anatomy of an Epidemic. But this was the first time that I felt some validation of all those unanswered, troubling questions in the back of my mind about my psychiatric diagnosis and medical treatment.

You see, I told you I did not have Bipolar Disorder on the day you diagnosed me. My mother, who regularly treats psychiatric patients, also told you as much, but you did not listen. The reason I knew this? I had never had sudden or abnormal mood changes in my life—not before, during, or after any of my psychotic episodes, and I’m now almost 40 years old. It is true that I was very happy in the days that preceded my psychosis. It was summer, I was on a break, and I finally had time to see my friends. I went to a party for an office mate who had just defended their dissertation. The next day, I met a friend for lunch at a local coffee shop. Earlier that morning, I met another friend for tea. None of them noticed anything strange or unusual in my behavior. They said I talked fast. I always do, so they did not think anything of it.

A few days before my hospitalization, I also found critical evidence that I needed to substantiate my dissertation thesis. Most who have worked for years on a research project will tell you how happy they have felt when—after painstaking work—they see everything coming together. So yeah, I was pretty happy in the days preceding my psychosis, but I was not manic. How do I know? I’ve read the criteria in the DSM-5 that could qualify one for a manic episode. Out of the seven listed symptoms, I had only one: racing thoughts.

They began suddenly on the day of my hospitalization. Their speed and content were terrifying. I felt my brain swell with each thought. I soon realized that I needed medical help and called my best friend in my home country. She immediately understood I was not well. Through a mutual U.S. connection, she called an ambulance to my apartment. The paramedics carried guns. I had never before seen armed medical professionals, but I figured arguing with armed men was not a good idea. I asked to go to the bathroom, took my wallet, locked my apartment, and off we went to the psychiatric emergency room. In the ambulance, one paramedic forcefully grabbed my arm (for bloodwork). I fought back because that’s what a normal person does when grabbed against their will and without warning by an unfamiliar man. For that one act of resistance, I was labeled a “danger to others” and—most illogically of all—“a danger to herself.”

But even at that point, the world was still full of possibilities. You see, no one thought that my striking a medical professional qualified me for a diagnosis of Bipolar Disorder and a lifelong cocktail of antipsychotic drugs and mood stabilizers. Once in the emergency room, I simply received the diagnosis of psychosis. These were doctors like you, trained in your country. They worked in your hospital. They observed me for two days. They did not think I had Bipolar Disorder. I had racing thoughts, I was visibly anxious, I could not articulate a coherent sentence, I was shaking (it was the middle of summer), I experienced a profound change in my sense of taste, and I was extremely disoriented. So yeah, I was definitely psychotic. Fun fact: I also had a visible under-eye infection that had begun several days before. My medical record does not mention this infection anywhere, although it was hard to ignore. You just had to look me in the eye.

But let’s assume, for argument’s sake, that my psychosis was due to a psychiatric condition, not a physical illness or infection. Does having a psychiatric condition make me bipolar?

You may wonder, “Does it matter? You clearly had something, and you clearly needed psychiatric care.” Every psychiatrist to whom I presented this question in the years to come said something along the lines of, “Oh, diagnoses are inaccurate. They are just there to provide guidance for clinical practice. All psychiatric conditions are treated with the same meds, so it really doesn’t matter.” But it does matter. It matters so much that the No. 1 reason for malpractice lawsuits in the U.S. is misdiagnosis, and this includes psychiatric misdiagnosis.

You know why my bipolar diagnosis matters? Well, simply because bipolar is a chronic condition that requires lifelong treatment with mood stabilizers and antipsychotics, or so you claim. A psychotic episode, on the other hand, is just that: an episode. It has a beginning and an end. It does not require lifelong treatment with psychoactive substances. In fact, the best psychiatric treatment for a first psychotic episode is the Open Dialogue model, developed in the 1980s in Finland. Of those who undergo this treatment, 85 percent of patients completely recover (not “remit,” recover), mostly with no meds at all, and certainly not with antipsychotics (they are typically given sleeping pills to regulate sleep). All scientific research I have read about brief psychosis states that patients regain normal functioning and can go back to their regular lives and live medication free.

But I was not fortunate enough to have my first psychotic episode in Finland. I had my first episode in the United States, the country with the worst possible outcomes for the treatment of psychosis, and the highest rates of chronicity and disability, according to the World Health Organization. My own bad outcome was not because I had no health insurance or received poor medical care. My insurance company paid for my hospitalization—at a cost of an astounding $11,500—and I was treated in one of the best hospitals in the world. Your hospital, doctor. Those drugs you convinced me to take for life—the mood stabilizers and antipsychotics you prescribed after talking with me for half an hour and determining that I had Bipolar Disorder—robbed me of my humanity. They made me a sad, anxious individual who could not experience any human emotions besides pain and anger. They messed up my thyroid and menstrual periods, made me gain a lot of weight, and affected my memory and ability to concentrate for years.

What did they not do? Prevent any of the psychotic episodes I had after the first one. Why? Because, evidence suggests and I believe, they caused those episodes. The higher the dosage I took, the worse I felt. And yet, for years, I was convinced I should take the prescribed medication and that the mental side effects I experienced were actually due to my ill brain, although I had never experienced any of them prior to being put on psychiatric drugs. You see, because you convinced me I would need medication for life and I in fact did have a psychotic episode every six months, I believed I must indeed have a severe and chronic mental illness. What else could I have?

The day I found Whitaker’s Anatomy of an Epidemic was the beginning of a profound change in the way I managed my psychiatric care. I began to look for research that could show long-term outcomes for patients with a history of psychotic episodes. I soon found the Myth of the Chemical Cure by British psychiatrist Joanna Moncrieff. I also found stories of lived experience by people who recovered from bipolar, psychosis, and schizophrenia, and I began to plan for reducing my medications. But not long after I started this journey, I became psychotic again. I did not do anything outrageous—just wandered around on campus (a public space) in the middle of the night— but that was enough for the police to arrest, handcuff, and throw me into your hospital’s psychiatric emergency room once again. No one, if you wonder, asked about my diagnosis. By then, I had a history of psychotic episodes and a diagnosis of Bipolar Disorder in my records. Everyone just assumed I was bipolar, and I received the usual cocktail of mood stabilizers and antipsychotics. Three weeks later, I was released. That was the last time I was hospitalized in your country.

Shortly after, I decided that I must leave academia and return home. I felt that unless I left, I would keep having a psychotic episode every six months. It did not matter how profoundly I wanted an academic career in the United States. I had to go. It was academia or my life, and I chose to live.

After I was released, I did not take antipsychotics, but I continued to take mood stabilizers, planning to come off slowly. I returned to my home country and moved in with my parents. I was so traumatized by my last hospitalization that I could not function. But I found an outpatient clinic that believed in a holistic approach to mental health. There, I did things such as receive acupuncture, play with puppies, play basketball, write creatively, make art, and participate in group and individual therapy sessions. It took half a year and one more psychotic episode (shortly after discontinuing the lithium you prescribed), but I was slowly feeling well enough to look for a job.

All this time, a psychiatrist from the holistic outpatient clinic had been monitoring me closely. I first met him at a weekly gathering at which he answered questions about medications, which I attended religiously. He answered every question I had, always with kindness and patience. Although I did not always agree with him, I respected his opinion. Then, by sheer luck, he was appointed to be my psychiatrist. I remember sitting with him and telling him my story. He listened patiently and then said there was something weird about my diagnosis. It did not fit. I remember him telling me, “I do not know what you have. Let’s call it ‘the H. Case.’” He monitored me during my last psychotic episode in my home country—now, more than two years ago. He also reviewed every medical record I had from my hospitalizations in the U.S., including everything you ever wrote about me—the true, the misunderstood, the outright false, and the absolutely ridiculous. He found no evidence for a bipolar diagnosis.

In the meantime, I have changed careers. I began to work in a new field I love. I moved to my own place. I attended career development workshops. I saw my friends. I found a wonderful therapist who shares my history of immigration and my cultural background and who helped me understand my psychosis beyond the medical model. And I continued to educate myself on psychiatry. I began a long process of medication reduction that lasted for about a year under the care of my trusted psychiatrist. The fewer meds I took, the better I felt. Finally, a few months ago, I discontinued my antipsychotic after discontinuing my mood stabilizer six months earlier. Within a month of becoming medication free, I regained my emotional richness, my innate sense of optimism, and my memory and concentration. My period became regular again, and my thyroid returned to normal functioning.

And then, I went to see my psychiatrist and asked him to review my bipolar diagnosis. We talked for two hours. He opened the DSM-5 and the ICD-10 and walked through every symptom listed in those books for Bipolar Disorder and psychosis. By the end of that session, my bipolar diagnosis had been officially revoked, establishing that there was never—and I quote—“clear evidence” to justify it. My past psychiatric experience now lives under the designation of “brief reactive psychosis”—a condition one can recover from without lifelong treatment with psychiatric drugs, as my experience and those of so many others abundantly prove.

I am sure you had the best intentions when we met. You were kind and patient. I think you understood my anger at your diagnosis and diagnostic methods. But you did not listen to me. My stubbornness, my chutzpah if you will, just confirmed for you that I had “problematic personality traits,” as you wrote in my medical record. You did not stop to think that perhaps I came from a culture that values intellectual debate and disagreement, contrary to yours that avoids conflict at all costs. You caused me profound harm that had far-reaching consequences upon my personal and professional life and the lives of everyone I love. As a physician, you swore to do no harm, and you broke your promise.

However, I did not write you this letter to talk about the past, but the present and the future. In the wake of the COVID-19 pandemic and its far-reaching economic, social, and mental consequences, many people will come to you in distress, seeking your help. Do not, I beg you, make the same mistake with them. Do not diagnose a person with severe mental illness within just half an hour of meeting them, especially if the person comes from a different culture, lives by different values, speaks a different language, and has a different emotional makeup than your own. What you can do to help those who come to you is to listen to them and their loved ones. And doubt. Not them; doubt your knowledge, your past clinical experience, your training, the medical model upon which it rests. Assume more frequently that you do not know than that you do. The truth about their condition, whatever it may be, will emerge with time.

And educate yourself. Read scientific research about long-term outcomes for patients undergoing different forms of treatment. Hear those with lived experience who have recovered; there are many more such people than you believe. And maybe, if you do all that, if you do it sincerely and willingly, you will be able to help so many people that are in profound need of care for mental distress in these challenging times.

Sincerely,

H.S.

***

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.

53 COMMENTS

  1. H.S.

    This was a well written and heartfelt account of recovery from serious abuse by psychiatry and their entire Medical Model.

    It is inspiring that you are now turning your escape from psychiatric abuse into activism to help save others.

    I have one question to ask about your journey. In the period of time just prior to your first experience of “psychosis,” (and other similar episodes) did you (while being very excited about your dissertation breakthrough) experience any periods of insomnia or reduced sleep cycle.

    I ask this question, because even the most resilient person could experience extreme psychological distress, and/or “psychosis” from even short periods of very little sleep. Some people are more sensitive than others when they have bouts of a short sleep cycle.

    H.S., I wish you the best in your journey and hope you write more for MIA.

    Richard

  2. “By the end of that session, my bipolar diagnosis had been officially revoked, establishing that there was never—and I quote—“clear evidence” to justify it. My past psychiatric experience now lives under the designation of “brief reactive psychosis”—a condition one can recover from without lifelong treatment with psychiatric drugs, as my experience and those of so many others abundantly prove.”

    Hi H. S.

    What do you mean by having a psychiatric diagnosis “officially revoked”?

    I ask because I have been subjected to a whole bunch of abuse as a result of having my medical records distributed without my consent, and as a means to deliberately ‘fuking destroy’ me. (So it’s not a ‘delusion’ I have, but I was actually threatened by the State [or more correctly a corrupt public officer] that they would do this to me for making a complaint about what I told them needed to be reported to authorities [Corruption and Crime Commission]. Easier to retrieve the evidence, threaten witnesses and dispose of the victim). These records would not have been a bother if they had no breached my trust and confidence by releasing them once I had been incapacitated by ‘spiking’ me into unconsciousness. Even then I do not believe the “extra ordinary circumstances’ clause standards of the Privacy Act was met.

    And I understand that your obviously not from the US, so systems can be very different if you live in a place that doesn’t have arbitrary detentions and the use of torture available to public officers, like we do in Australia.

    Imagine if your “brief reactive psychosis” could have been deliberately induced by ‘spiking’ you with benzos, and then pointing weapons at you to create an “acute stress reaction” and force you to talk to a Community Nurse asking questions for the police (while they stood and ‘assisted’).

    I guess the idea of a right to not self incriminate must be a bother to many public officers, so being able to have that ‘illness’ treated (sometimes with 90 plus rounds of ECT) must make their difficult task a little easier.

    https://www.youtube.com/watch?v=oZ9UQKBUrsg

    It can also provide a bit of practice in techniques not available when cage fighting when ensuring the bi polar gets the treatment they need. Ie kicking the back of the head with boots not allowed.

    I’ll quote the Police Minister regarding this matter “There are some concerning aspects to this arrest” [the attempted suicide by traffic, and assault on the bottom of a police officers boot?] Which will no doubt be buried for years in the “Professional Standards” investigation, and will result in “are you still complaining about that?” and “insufficient evidence” because they refuse to take any proof of offences. That is if they’re lucky to not become the victim of an unintended negative outcome in the E.D. while police look the other way. Always a doctor prepared to assist the dying when you have Euthanasia laws.

    And who are these people who are releasing these videos without first speaking to police, and giving them the opportunity to ensure that the public are not made aware of mental health treatments? It makes it difficult for our politicians when they have to turn a blind eye while cover ups are done on their watch. Do your duty to your State people and stop videoing the police doing their jobs, it’ll make it much easier.

    And for a Nation that has less than 1/10th the population of the US, these types of videos sure do seem to be common. Lucky the remote indigenous communities haven’t gained access to the technologies yet, or there would be a whole lot more. They’re lucky to gain access to clean running water or electricity lol

    Good luck with your future.

    • Actually, what really makes me laugh is that these corrupt public officers were prepared to go to such lengths to not report to the watchdog (Corruption and Crime Commission). They were so afraid of them that they used police resources to retrieve documents before sending the fraudulent set to the Mental Health Law Centre, and then attempting to have me unintentionally negatively outcomed. Just so that they didn’t have to do their duty and report under mandatory reporting clause of the CCC Act. If you can tamper with the evidence and threaten any witness the Commission might speak to then you have carte blanche. So they obviously think the Commission is acting on public sector misconduct, and the use of known torture methods and kidnappings by police.

      And you know what? The Corruption and Crime Commission doesn’t give a damn lol. I provided them with the absolute proof and they refused to even speak to me (anyone care to see the letter of response while they thought the cover up had been effective? And the documents that police thought they had retrieved provided to the Commission? The crimes were obvious unless of course you accept the rewritten version of the Law allowing ‘spikings’ by public officers before interrogations by the Chief Psychiatrist), assuming that it had all been covered up by the corrupt public officers. They really should get together and let public officers know that the watchdog not only doesn’t have any teeth, but that it has been ‘spiked’ with benzos and is virtually unconscious when it comes to performing the duties it was tasked with.

      Really embarrassing when they found out about the events in the E.D. I assume. Happy with the cover up and unintentional negative outcome until they realised woops, he still has the proof. They really didn’t want to report these matters because …. well, snatching citizens out of their beds and taking them to ‘selection’ centers seems a bit National Socialist even for a Police State. Best we pass laws providing immunity from criminal prosecutions for politicians and make it a crime to draw the comparison to the Nasties. Because they have no intention of enforcing the legal protections afforded the public by the law. Police don’t even have a copy of the Criminal Code when it comes to crimes they don’t want to be crimes (intoxication by deception for example aka ‘spiking’). Which might explain the racial imbalance in the people who end up in prisons, the color of your skin being the determinate of whether police can find the copy of the Code. Black, there it is. White , nope someone must be using it to beat a black guy over the head and coerce a confession for the moment. When they speak about throwing the book at you here, they mean it literally lol

  3. Interesting. Perhaps since psychiatry within the grander field of MEDICINE (a much more solidly and verifiably ACCURATE Arena) is more or less a joke, your doctor and the majority of those like him can only prove themselves (especially TO themselves) with the Almighty Prescription and the big pharma money that entails.
    Makes sense in my humble opinion especially amongst, um, the Masculine. Which is what Modern Medicine has been founded by.
    Regardless, your case should be considered a social crime and a class action lawsuit is what will make that happen. And it’s going to!! ✌️

    • My comment was directed to the author of the article. The story described in the previous comments about the crimes and abuse (which I now just read and which was posted while my comment was being considered for posting) is atrocious and now I’m literally frightened as a psych survivor myself. Very difficult to completely understand the legal language especially but thank you (to the person who you wrote that lengthy comment) for the enlightenment!
      Didn’t mean to defend the system or offend in any way.
      I still believe the only real solution ever in any Conflict is peaceful exchange and proper negotiation, even if it takes the more spiritually gifted and peaceful types amongst us to voice themselves in that very real process ✌️

      Anita
      (This was written before I noticed any previous replies to my or his comments)

      • I tried to resolve my matters with the hospital concerned, in a peaceful manner.

        Procedural fairness, I approached the Community Nurse who arranged for police to snatch me from my bed after I had been ‘spiked’ with benzos and had a knife planted on me. I asked him about the lies he had written on his Form 1 statutory declaration, and he admitted they were lies, so what? (it is after all the equivalent of sworn court testimony, basically perjury) I tell him I am going to make a complaint about his conduct and he laughs, literally laughs in my face. (I guess he knows how it works with his colleagues who are quite prepared to commit further serious offences to enable him)

        So I move one step up the ladder. Now a ‘formal investigation’ is done, and what this actually consists of is finding out what the victim knows, and how to ‘fuking destroy’ them. In my case it meant removing the documents proving the crimes, and inserting others that created an appearance of me being a “patient” of this hospital for more than ten years. They call it “editing” I call it criminal fraud. Changing legal narrative in the chronology of documents is not “editing”.

        So I point out to the Operations Manager who did this that she has a duty to report the matters to the ‘watchdog’ authority, which of course she does not wish to do. A bit like asking a bank robber to attend a police station and tell them what they did, he could (a) do as you request, or (b) ensure that you don’t show anyone else that you have the proof he robbed the bank. She chose (b), and by maintaining the illusion that I was “mental patient” they really went to town on me.

        9 years later I still haven’t seen my family because of the threats and intimidation by police and the hospital.

        “I’m literally frightened as a psych survivor myself.”

        I’m sorry if I have contributed to that feeling Anita. I have pondered my truth for some time now and am of the opinion that this truth exposes a ‘con’ that is being used against many people by those we should be able to trust. I think the only way to protect oneself from confidence tricksters is to understand how they operate. If I were to tell you about a phone scam operating would you be afraid to answer your phone? I hope not, but I do hope you would gain enough information to protect yourself when you realised it was all a means to trick you and steal from you. I had my right to liberty and my right to bodily integrity stolen by a fraud and a slanderer. I hope that this is not done to anyone else by this person. Though I note that the people who authorise the prescribing of drugs (AHPRA) don’t care that this Nurse with no prescribing rights is arranging the concealment of ‘spikings’ with date rape drugs. And this is the regulatory body who would know he has no right to be prescribing ‘spikings’. Is it any wonder the system is in a mess with such ‘thorough investigations’ being done by their Board?

        These organised criminals within the system need to be dealt with for people to be able to trust. And they are being provided with protection from other criminals who are prepared to go to some extreme lengths to ensure any misconduct is concealed and the victims destroyed. The claim seems to be it is “not in the public interest”, and yet they informed us when someone was putting needles into strawberries in the supermarkets. terrible crimes to put items in peoples food without their knowledge. So why is it not in the public interest to know mental health services are authorising the ‘spiking’ of citizens with date rape drugs to make planting items for police to obtain referrals when arbitrary detentions are not available? To force them to ‘confess’ when a person may chose t exercise their right to silence?

        Not in the public interest? I get it that it is ugly what can be concealed as medicine by changing the legal status of citizen to ‘mental patient’. In my instance that simple change post hoc denies me the right to make a complaint about being tortured and kidnapped. And of course this then exposes the fact of why others are traumatised by their ‘interventions’, due to the exploitation of the “inherent in or incidental to lawful sanction” loophole of the Convention. We simply can’t have the public recognising the link as to what these ‘treatments’ are if you do not have lawful sanction (aka drop em with benzos and plant a knife on them for police to get a referral). It’s all lawful if you can have police hand the “patient” over to you, you can then begin the ‘treatments’. I lived in a delusional place where I thought the Chief Psychiatrist stopped these sorts of things happening, but he doesn’t even recognise the protections afforded the public in the Mental Health Act, so how could he possibly protect the community? They need absolutely no reasonable grounds to snatch you from your home, only a ‘suspicion’ he writes in his letter of response to the Mental Health Law Centre. Suss laws, that result in incarceration and forced drugging for o other reason than a Community Nurse wants it done to someone he doesn’t even know, and lied to police about being a “patient”.

        I’d really like to be made aware of who can ‘spike’ me and with what drugs. Especially given that the results of the ‘spiking’ can be used as proof that I am in need of forced drugging and incarceration. And the fact of the matter is that the Minister considers complaining about such matters an illness that you should be treated for. I see a problem when matters of law become illnesses to be treated, he sees an illness to be treated when public servants have no respect for the law.

        I hope you see my point. Many more will be harmed if these people are not exposed. And believe me with the powers they have, it is highly unlikely that anyone who they decide to ‘fuking destroy’ would escape unharmed. They poke the snake and then use it’s response as justification for their vile conduct, and turn witnesses away with claims that what they are doing is ‘medicine’.

  4. Thank you H.S.

    Your post was deeply moving and brilliantly written.

    Wouldn’t it be an improvement if ‘first episode psychosis’ was managed by physicians trained to use this as an opportunity to EXCLUDE ‘psychosis” and, via meticulous differential diagnosis, to prevent the mis-labelling for life, which may follow adverse psychotropic drug reactions?

    • I think it could be an improvement, but the physicians would also need to be trained better in these situations as well. In my case, I worked with my physician for two years trying to figure out why I was more lethargic. This was back in 1996. I wasn’t depressed but I was sleeping a bit more and didn’t have my usual energy level. We tested my thyroid and stuff like that.

      We discussed if I could be dealing with a “mental illness” and bipolar came up. When I laid out my personal history and relationships, she said, “I don’t think you have an illness. You are under a lot of stress.” The part she didn’t say was “And you could be heading towards a stress breakdown.”

      The following summer, I did seek counseling, which alleviating some grief issues, but didn’t address any of my codependent behavior in some significantly dysfunctional systems. Through work, I did take stress management classes, changed jobs to a different division (which was going from the frying pan into the fire).

      In my opinion, part of the problem is that the professionals too often don’t really know what they are dealing with. The behavior of someone going through a “manic” period or “psychosis” or whatever you want to call it is disturbing and even frightening to the provider. As a result, the natural reaction is to try to shove, manipulate and coerce the person back into the role they were in — the same role that led them to the “manic” or “psychotic” state. And that reaction is actually exceptionally traumatizing to an already traumatized person. In my case, that made absolutely no sense.

      Ultimately, no diagnosis should be made without some kind of evaluation and understanding or what is going on in the person’s life, specifically stress, including past trauma and tragedy, including the dynamics that a person is in with regard to family, friends, work and society, financial means, cultural beliefs, and also things like the role of religion, philosophy, education, and worldview beliefs.

      I wouldn’t care if that assessment were done by a physician or a mental services provider, but in my opinion, no diagnosis of “illness” should ever be made without full consideration of those other contributing factors.

      • I agree wholeheartedly – the tendency of the “professional” is often to force the person to be “reasonable,” and to re-a. ssume the roles they are rebelling against. Which is actually the very WORST thing you can do! A “mental health” crisis generally means that whatever role a person HAS been playing is not working. Maybe they need to reconsider how they’re living their life! Forcing them back into their old roles would drive them into apathy.

        Having a crisis is not an illness! And the solution is not to. force someone back to “normal,” whatever that is.

  5. My comment would probably be against the tide. But your letter puzzles me.

    1. Psychiatric drugs, antipsychotics, and mood stabilizers do not cause psychotic episodes. They might kind of do rarely when you try to get off them. But when you are on them they just don’t cause psychotic episodes.

    2. You had repeated psychotic episodes while being on drugs which is a strong indicator that you don’t have a “brief psychotic episode”. What you do have is a chronic disease.

    3. You changed statistically proven treatment for “playing with puppies” and “acupuncture”. You refused treatment from the best hospital, and choose instead some questionable form of help. There are no evidence that acupuncture is curing mental illness en masse.

    Psychiatric drugs are not candies. Yes. We are in need of better drugs. Yes. Apart from drugs, the psychiatric treatment of people is downright unacceptable. Yes.

    But you really do have a disease. Just from what you’re saying. There is something really wrong with you. And what you need – is drugs. Better drugs. Newer drugs. A minimal dose of drugs. Drugs that won’t interact with your thyroid. Maybe only mood stabilizer (e.g. not lithium, Depakote), maybe no antipsychotic or some kind of better antipsychotic. But you do need real serious medical help.

    So you won’t be psychotic again. Nor depressed. Maybe only hypomanic for example.

    You’re a smart person. You have worked in the academy. You don’t have anosognosia or whatever. Just don’t ruin your life. Try to find a better doctor or a better drug combination.

    You are sick. Don’t be.

  6. When someone is in a state of overload, it would be ideal to make them feel safe. I am glad you finally wrote to your “doctor of the mind”. The one that knows what you had. He was misinformed, but he carved a niche and follows it. It is his niche. His income. His reality…… even though his reality is very connected to painting a story of other’s realities. The reality he paints on you affects only you and your family, friends.. not him in any way. It affects your whole life, whereas your overload needed rest.
    He offered no rest, no hiatus. He offered disconnect.

    Your letter is important to the general public, so thank you for writing. Hopefully one shrink reads it and defies protocol, defies the “DSM”. It is the most difficult thing to become a dissident shrink or patient.

  7. Sponging off the Welfare State

    Since the Psychiatric system has little success anyway, I believe the genuine “Experts” are the people that reject the Psychiatric system.

    I was diagnosed as a relapsing “Schizophrenic” in Western Ireland, until I made Recovery 30 plus years ago as a result of stopping Psychiatric treatment.

    At this time 30 plus years ago: My Psychiatrist (a University Researcher) was on the examining board of the Royal College of Psychiatrists; and the Professor of Pharmacology (at the local University), was President of the British Association of Psychopharmacologists.

    Psychiatry today is still useless

  8. As I read H.S.’s letter, I felt as though she must surely have had knowledge of many details of my own distressing encounter with the American psychiatric system. So much of the abuse she suffered is strikingly similar to what happened to me. I have learned over the years, however, that there are many many – too many- who have been in similar circumstances.

    At age 48, I was a single mother of four children, a former (operating room) R.N., and a new graduate of Harvard Law School, still contesting (Pro se) the sequelae of my recent divorce and custody battle. I had no money and no assets because I was married at a time when it was customary that almost all financial assets and instruments were kept in the husband’s name. Consequently, I did not have money to hire an attorney, and the Court denied my motion for attorney’s fees pending the outcome of the case. I struggled to put food on the table and pay my half of the mortgage to keep a roof over our heads since the child support I had been awarded was woefully insufficient and was predicated on only two of the children. The two oldest who were 18 and 19 years old and living at home were not factored in by the judge. I had been a stay-at-home mom since the birth of the children and had not worked outside my home in several years. In fact, my medical license had lapsed. I, therefore, decided to go back to school to start a less physically demanding career and was able to obtain several scholarships and grants to attend college and law school full time.

    My former spouse was agitating all this time to have the house sold which meant I had to spend an inordinate amount of time researching and preparing my defense as well as caring for the children while doing my own school work. I was not yet a law graduate. I should state at this juncture that I am also an alcoholic who had long-term sobriety.

    My former spouse and his attornies finally prevailed and the Court ordered that the children’s and my home was to be sold. It was, and we were literally out on the street. I was even living in my car briefly. There is much more to this tale, but the foregoing is sufficient to show the high level of stress and anxiety under which I was living just prior to my emotional breakdown.

    I was feeling overwhelmed, fearful, anxious, and like I had nowhere to turn. I could not think what to do or how to plan and had no family or friends who I felt I could turn to. This is when I made my greatest mistake. I went to the emergency room of a Boston hospital and told them I was in complete despair. I had also picked up alcohol again the previous week after 15 years of sobriety, and my second son had been rendered a quadriplegic the prior month as the result of an auto accident (fortunately, what is referred to as a “super quad”). He was out of the house also with the rest of us.

    For the next 8 years, I was caught in the system, in and out of mental hospitals and mental health facilities and put on one psyche. medication after another. It was determined that I had a “brain disease.” I love that obfuscation! First diagnosed as severely depressed (who wouldn’t be in my situation?) and then when it became apparent that I was fairly bright, adaptable, and didn’t fit with the usual cohort of patients seen at the hospital (the “frequent flyers”) my diagnosis had to be changed so the medical professionals wouldn’t look foolish. So I became Bipolar (in their subjective opinion). Still, that diagnosis didn’t really fit because I did not exhibit the swings of highs and lows and the degree of dysfunction that would neatly fit the DSM criteria. Fortunately, the committees that come up with new diagnoses had just recently formulated a new one: Bipolar II. So, happy day, the doctors could all slap each other on the back and congratulate themselves that they had solved the dilemma of me and which box they could put me in.

    The only remaining problem was that none of the medications they convinced me I must take seemed to have any effect. So I was put on one after another. I even developed Stephens-Johnson Syndrome and spent a week in a medical unit. I did not respond to any of these medications, and did not even have the common placebo response and just felt less and less like a real living human being. I spent most of my day sitting in a chair at home dozing on and off all day where I was now living with my sister. I was pretty much just a zombie with no quality of life whatsoever and had put on close to 40 pounds. This went on for 7 years, years when I should have been working, engaging with my family, engaged with life, and contributing my talents instead of simply surviving biologically. I think one of the greatest things I lost during this time was that I couldn’t read, an activity that had been pivotal to me prior to my psychiatric abuse, that and my sense of curiosity and wonder.

    Eventually, my eldest son was able to get through to me and convinced me that the medications I was taking were the problem and were kidnapping me from me. I told my doctors that I wanted to come off my medications. They, of course, gave me all the reasons that I could not possibly do that. I told them that if they wouldn’t supervise my withdrawal, that I would titrate down each medication separately myself. I had some medical knowledge and told my family members what I was proposing. I asked them to be alert along with me to observe anything untoward.

    It has been almost 20 years since I discontinued all psyche. medications and despite the dire warnings of doom from the various psychiatrists, I have had no further mental health problems. I have experienced the usual ups and downs of being human, but the joys have vastly outnumbered the sadness. I am incredibly angry at the abuse I endured and at the hubris of the so-called healers. I am also livid at the pharmacology industry which has an outsized roll in the abuse and the destruction of peoples’ lives for the sake of profits. Of course, when those such as I write screeds such as this or try to talk to others about the malpractice of the psychiatric profession, we are mostly dismissed. After all, we are not doctors, and we have the scarlet letter of mental illness forever inscribed on our foreheads. Even now, I watch with great sadness and concern as friends and family members are prescribed poisons to treat what are mostly social and emotional problems. Usually, it is not the patient who is sick, but society.

    • I have a very similar story in almost every way but my ex got custody and I’ve only been ‘med’ free for (almost) 7. Still dealing with the aftermath in all ways.

      The kids have written me off as ‘crazy’.

      and the wheels go round and round

    • Wow farmor,

      “Of course, when those such as I write screeds such as this or try to talk to others about the malpractice of the psychiatric profession, we are mostly dismissed.”

      As a lawyer farmor does it make sense to you when I say that by changing the burden of proof in our law from “an authorized mental health practitioner who suspects on reasonable grounds that a person needs to made an involuntary patient (with criteria set out in s.26 Criteria of the Mental Health Act) to “the authorised mental health practitioner need only ‘suspect’ on grounds he believes to be reasonable that a person requires an examination by a psychiatrist” that our Chief Psychiatrist is misrepresenting the law and allowing arbitrary detentions?

      To me the first can be tested in a court of law using logic and reasoning (objective standards set out in Criteria), the second is whatever the AMHP wants the grounds to be (subjective), and there is a difference between a belief that the person should be locked in a cage (1st) as opposed to a nice little chat with a psychiatrist (2nd).

      My questioning of this rewriting of the burden of proof places on an AMHP and the fact that I was ‘spiked’ with benzos before being subjected to 7 hours interrogation is I am told not a question of law, but a question of my sanity.

      I have asked where I make a complaint regarding the use of a known method of torture by public officers only to be “dismissed”. A right to remain silent with police can mean that you are handed over to mental health services for them to put the police questions to you in front of police, and where your refusal means you can be subjected to 90 plus rounds of ECT and forced drugging causing akathisia without consent. I would imagine that usually has the ‘suspect’ ready to confess to anything they wish.

      Combine this with “proceeds of crime” legislation where the coffers of the State can be filled once the ‘suspect’ confesses and is it any wonder the government is trying to pass laws to stop people making comparisons to the National Socialists in Germany?

      So as a lawyer can you see why I might be trying to have the Chief Psychiatrist recognise the protection of a burden of proof? Particularly when he is the preson charged with the “protection of consumers, carers and the community”, and provides “expert legal advice to the Minister”? And yet he doesn’t know what a burden of proof is, and is allowing citizens to be snatched out of their beds by police, and subjected to interrogation whilst intoxicated by deception (I have the documented proof that police failed to retrieve) because someone wants it done?

      Might I add that we do have a section of the Criminal Code which makes it a crime to “Procure the Apprehension or Detention of a Person not suffering from a Mental Illness” (defined in the MHA).

      I get the feeling that our elected representatives and the authorities charged with protecting our human rights are PRETENDING to be asleep at the wheel, while the laws are simply ignored.

      Similarly not a soul can tell me who I make complaint to regarding acts of torture by public officers, other than to refer you back to the people doing their torturing for unintentional negative outcomes (also known as ‘refouling’). As Jim Gottstien (quoting someone else I think) said that ‘rights without remedy are no rights at all’. I have been tortured, kidnapped and when I complained about these matters to the relevant authorities who had a lawful duty to report the matters to our corruption watchdog, I was told I would be ‘fuking destroyed’ and fraudulent documents sent to my legal representatives at the Mental Health Law Centre.

      Care to examine the letter of complaint and the response by our Chief Psychiatrist where he authorises arbitrary detentions? And Australia is complaining about it being possible in China? Drugged without my knowledge, snatched from my bed by police because of items planted on me (which coincidentally they didn’t even find on my person) and locked in a cage where I could have been injected with a ‘chemical restraint’ leaving me dribbling on the floor of a cell for months on end with no access to a lawyer, family or my own G.P. and they are pointing the finger at others? Even if it were April Fools Day I still wouldn’t consider it funny.

      • Just a point of interest, I have just been speaking with a doctor at one of our hospitals about the Forms used for patients. Always good to know what the State will and will not cover up for you as a public servant. So he is now aware that he can make anyone he likes into his “patient” with a pen, and police can then be used to have them delivered to him for ‘treatments’ they may or may not want.

        Consider my situation where I was made into a “patient” by the Community Nurse before he even left the hospital. He has completed forms titled “Outpatient Case Notes” which is an official document. Surely a Community Nurse would know who is and is not a “patient” at his hospital? And I, as was shown on one of the documents concealed from my lawyers was NOT a “patient” before he left to meet up with police and ‘verbal’ me up.

        Of course they had received a call saying “Hi he won’t talk to a psychologist so I’ve ‘spiked’ him with benzos and when you tell me that police are prepared to jump him in bed, i’ll plant a knife and some cannabis on him. So I was going to become a “patient” but as yet I wasn’t actually a “patient”, police not able to force drug and incarcerate me for not speaking to a psychologist, but …. with a little bit of fraud.

        So this Community Nurse just fabricates a reality and then uses police as his own personal kidnapping service by pretending that a citizen is actually his “patient” before he does the ‘assessment’ that police are about to request from him as a result of the knife and the cannabis. And should they refuse to talk? We have ‘treatments’ for that.

        And not a soul prepared to speak up about it. That’s REAL power when the whole community is so afraid of you that you can literally kidnap and torture citizens in front of their loved ones and threaten them to remain silent about it. I guess the concern being that your name is next on the “Outpatient Case Notes” and the 90 plus ECTs, and akathisia from chemical cocktails your about to receive will not be stopped because the hospital will (a) not provide the documents to your lawyers for 3 months and, (b) when they do, they will be “edited” to create a false legal narrative which gives the appearance that you have been a “patient” of the hospital for ten or more years.

        And that was the least of my concerns when one takes into account the unintended negative outcomes occurring in the Emergency Dept as a result of complaining about public sector misconduct. Something police tell me “it might be best they don’t know about”. What?

        Care to see the documents?

    • farmor — thanks for sharing your story. This is an excellent basis for an article for Mad in America. You should consider expanding it and submitting it. This growing chorus of how the current system and model don’t serve people and the public must continue to grow.

  9. Thank you H. S. for writing and sharing. “You are not alone” sounds like a cliché, nevertheless that’s what I feel when I read about your experiences. I was a PhD candidate who had moved back to my homecountry Finland after many years abroad and a painful breakup from a long term relationship. I was very busy that autumn, and, like you I experienced something of a breaktrough in my research. Then I collapsed, had a psychosis and was hospitalized for about 1,5 months, forced to take anti-psychotic medicine, interrogated with the whole arsenal of questionnaires on disorders (all!) they had at the department. What I told myself about what had happened was not enough. Even in my “unusual state” I understood that it had something to do with very big changes and confusion resulting from this, a crisis. Instead my identity was re-defined and my voice taken from me. It is very ironic, in a setting where it is stated that “patient centered care” is offered. It was patient centered only insofar you were willing to play “the patient”. I only found out about Open Dialogue when I started to read and research after getting out of the hospital. I can assure you that mainstream psychiatry with its theories on chemical imbalances in the brain is alive and well in Finland! Question this as a patient, and you are considered paranoid and laughed at. My way of coping after this traumatic hospitalization has been dependent on finding sites like “Mad in America”, and reading about experiences such as yours. Thank you!

  10. unfortunately hs no you are incorrect an episode of psychosis will frequently lead to the inevitable label of schizophrenia .. It is rare it will be categorised as a single stand alone abberant episode then the drugs will damage your brain and that is the end if that sad but true

  11. I think that someone wrote that she was diagnosed as a “relapsing schizophrenic” in Ireland and then she stopped psychiatry and is now well . How tragically ironic, that the best way to return to health and wellness is to completely divorce oneself from the psychiatric industry. I don’t want to throw rain on anyone’s parade, but, even, more tragically may very well be how “modern medicine” seems to now be following a similar path as psychiatry and related disciplines. And, dare, I say, in my experience, the “Medical M.D.s” seem to close ranks with the “Psychiatric M.D.s”. All were denying everything and anything about my condition or conditions. So, I trust no one with an “M.D.” by their name. Anyone with an “M.D.” by their name would have to earn my fragile trust. Thank you.

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