Welcome to Planet Psychiatry

Robert Yoho
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Editor’s Note: This piece is an edited excerpt from the author’s 2020 book, Butchered by Healthcare.

Most physicians view psychiatrists as somewhat feral animals. We suspect—with some justification—that many of their ideas are hot air. Unlike any other specialty, psychiatrists take care of people with normal labs and radiologic tests. They keep only patients with purely subjective problems. Psychiatrists pass patients with “organic” issues such as thyroid disease to others. These are the ones with identifiable physical signs, symptoms, and tests. Likewise, psychiatrists base treatment outcomes solely on their theories and observing patient behavior rather than on measurable, objective results.

No other specialty has a sizable group of protesters who oppose their legitimacy. These include not only Scientologists, but psychologists, scientists, journalists, and a few renegade psychiatrists. These “psychiatry deniers” believe that most psychiatric drugs used today are harmful, ineffective, and vastly overprescribed. They question the specialty’s power to lock people up and force them to take damaging medications based only on their opinions.

Most of the public, however, sees psychiatry as valid, sensible, and scientifically based. Patients expect health insurance to pay for it.

Mainstream psychiatrists believe the four primary drug categories they use—the stimulants, the SSRIs (Selective Serotonin Re-uptake Inhibitors), the benzodiazepines, and the antipsychotics—are effective, beneficial, and cause little harm. Citing their close-range experience treating mental illness, they claim that these diseases are under-treated and that even patients with mild symptoms should take medications. Their studies and standards support this. But these are so structurally compromised and biased with industry money that they are useless.

These “psychoactive” medications influence sleep, wakefulness, mood, behavior, and so forth. Unlike most drugs, they enter the brain by crossing the blood–brain barrier, which is a natural microscopic defense against toxins. Drugs that behave like this can alter or damage the entire central nervous system. Although these medications are commonly used and casually prescribed, taking them is a trap because addiction is common and frequently irreversible.

As you read the following, contemplate:

  1. Mental health is America’s most expensive medical sector, estimated to be $213 billion in 2018 (cardiology and cardiac surgery combined might be in second place, at $143 billion).
  2. A 2016 Scientific American source said one in six US citizens takes psychiatric medication. The Wall Street Journal said this is one in five, and the US Centers for Disease Control and Prevention (CDC) claims that one in four of us have a mental illness.
  3. Thirteen percent of all US citizens age 12 and over received an antidepressant in 2017.
  4. In the US, 9.4 percent of our children get diagnosed with hyperactivity (CDC, 2019) and about half get medication (The New York Times, 2013).
  5. Antipsychotics are considerably overused for nursing home residents. The vast majority of patients with dementia get them, mainly for the convenience of the caregivers and in order to cheaply decrease staffing levels.
“PSYCHIATRY IS IN DEEP CRISIS”

Psychiatry is the drug industry’s paradise, as definitions of psychiatric disorders are vague and easy to manipulate. Leading psychiatrists are…  at high risk of corruption and, indeed, psychiatrists collect more money from drug makers than doctors in any other specialty. Those who take the most money tend to prescribe antipsychotics to children most often. Psychiatrists are also “educated” with industry’s hospitality more often than any other specialty. This has dire consequences for the patients.

Peter Gøtzsche, Deadly Medicines and Organized Crime (2013)

How modern psychiatry developed: A few decades ago, psychiatrists were losing their status. Then, the fabrication of new diagnoses along with the invention of medications to treat them saved them economically. First the antidepressants, and then the newer antipsychotics came to the rescue. This moved the specialty into the medical mainstream because the psychiatrists were the only ones who purportedly understood it all.

The novel diagnoses—some say concoctions—were enshrined in the psychiatric manual, the Diagnostic and Statistical Manual of Mental Disorders (DSM). Pharmaceutical companies played a huge role in its creation.

The American Psychiatric Association (APA) started aggressive disease-mongering of the new ailments. They hired ad agencies to produce “public service” drug advertising. The corporations marketed the new supposed cures alongside.

By 2008, 28% of the APA’s income came from drug companies. According to influence theory, this made the APA virtually a subsidiary of the companies. Senator Chuck Grassley (R, Iowa) publicized the story in a congressional investigation.

Ben Furman, MD, a psychiatrist in Finland, explained how it happened in a 2018 blog:

The psychoanalytic belief system was thrown out and replaced with the DSM and the biomedical doctrine: everyone should have a diagnosis, and everyone should have medication. The psychiatrists now treated all the conditions that had been treated with therapy with medication. This became the treatment of choice for almost all mental health conditions regardless of whether the patient was an adult, teenager or child. A patient without medication became a rarity. The data system of mental health services required clinicians to diagnose anyone who sought help.

The psychiatrists and corporations ignored studies showing damage from long-term drug use. They left disparaging critics out of the debate and out of the textbooks.

Finally, long after the science matured, a few of the doctors are telling the truth. In 2012, an editorial in the British Journal of Psychiatry said the psychiatric medication revolution was at an end. Others now echo this sentiment.

The DSM is a kind of chaotic bible used to promote mental diseases. With its code numbers used for insurance, some call it the billing bible. Created primarily by psychiatrists on industry payroll, it mutates and metastasizes every few years through a vote of the APA members. In 2017, after many editions, it was 947 pages long.

Insiders have decried its intellectual disarray for decades. It has become the perverse standard in the service of drug marketing. The following are a few inside opinions about it:

There was very little systematic research, and much of the research that existed was really a hodgepodge—scattered, inconsistent, and ambiguous. I think the majority of us recognized that the amount of good, solid science upon which we were making our decisions was pretty modest.

Christopher Lane in Shyness: How Normal Behavior Became a Sickness (2007),
quoting one of the DSM’s contributors

I pictured all these normal-enough people being captured in DSM-5’s excessively wide diagnostic net, and I worried that many would be exposed to unnecessary medicine with possibly dangerous side effects. The drug companies would be licking their chops figuring out how best to exploit the inviting new targets for their well-practiced disease mongering. I was keenly alive to the risks because of painful firsthand experience—despite our efforts to tame excessive diagnostic exuberance, DSM-IV had since been misused to blow up the diagnostic bubble.       

Allen Frances, lead psychiatrist, DSM IV, author, Saving Normal (2013)

The National Institute of Mental Health (NIMH) in 2013 finally tossed the DSM—psychiatry’s diagnostic system—into the wastebasket.

Bruce E. Levine, psychologist and journalist

Of the 170 contributors to the most recent edition of the …  DSM…  ninety-five had financial ties to drug companies, including all of the contributors to the sections on mood disorders and schizophrenia…  Not only did the DSM become the bible of psychiatry, but like the real Bible, it depended a lot on something akin to revelation. There are no citations of scientific studies to support its decisions. That is an astonishing omission.  

Marcia Angell (2011), former editor-in-chief of NEJM

The DSM’s diagnostic categories lack validity, and the NIMH will be re-orienting its research away from DSM categories.

Former NIMH Director Thomas Insel

To understand the DSM-5 better, scan the following excerpt:

Criteria for Oppositional Defiant Disorder: A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months as evidenced by at least four symptoms from any of the following categories, and exhibited during interaction with at least one individual who is not a sibling. Angry/Irritable Mood: 1. Often loses temper. 2. Is often touchy or easily annoyed. 3. Is often angry and resentful. Argumentative/Defiant Behavior: 4. Often argues with authority figures or, for children and adolescents, with adults. 5. Often actively defies or refuses to comply with requests from authority figures or with rules. 6. Often deliberately annoys others. 7. Often blames others for his or her mistakes or misbehavior.

Parents of boys need no other commentary unless they support using medications with pernicious side effects to suppress normal, but somewhat irritating behavior.

The DSM has worldwide influence. It is the ultimate resource for courts, doctors, prisons, hospitals, and insurance companies. These diagnoses lock people into legal and therapeutic boxes, but they are of dubious benefit since the drugs work poorly and promote chronicity. Since withdrawal from these medicines is severe and mimics the conditions treated, long-term use becomes almost inevitable.

The corporations blatantly falsify research to get psychiatric drugs approved. Studies that show drugs do not work get concealed. Positive reviews get published multiple times, and the journals mostly only print the data that show the drugs work. These last two tricks are such standard practice that the drugmakers have internal nicknames for them: “salami-slicing” and “cherry-picking,” respectively.

Another often-used fraud is to compare massive doses of an old drug such as Thorazine with standard doses of a new medication. This makes the side effects of the new one look modest.

In proper drug studies, patients who take a placebo are compared with those consuming the genuine thing. However, in some psychiatric research, the people chosen to receive the sugar pill recently discontinued an older antipsychotic such as Thorazine. They are having withdrawal effects such as severe restlessness (akathisia) and anxiety. Placebo patients should not have any reactions. When such a trial is over, the lie is told that the treatment group using the drug had fewer ill effects—fewer side effects—than the sugar-pill group, which is absurd.

Psychiatric drugs are disasters. For example, Hengartner and his colleagues did a 30-year prospective study of 591 depressed Swiss adults at the University of Zurich. They found that no use of SSRIs (Prozac-class medications) had better patient outcomes than some use, which in turn had better results than long-term use. After nine years, they reported that the SSRIs cause more depression rather than less.

The benzodiazepines (Valium-class drugs) relieve anxiety for a few weeks. But after about a month, they stop working. After this, patients require higher dosages to produce the same effects. Later, if the drugs are discontinued, months of agonizing dread, sleeplessness, and crippling nervousness commonly occur.

The original studies of Xanax for anxiety were for 14 weeks; after four weeks, it was working; after eight weeks, it was not; and at the end of the study, as the experimenters withdrew the drug from the patients, they got much worse.

The psychiatrists and the drugmaker ignored the longer-term results and claimed there was a net benefit based on the first four weeks. (See Robert Whitaker’s explanation of the study on YouTube.) The FDA approved the drug, and it became not only the most commonly prescribed benzodiazepine but the most frequently prescribed psychiatric medication. But Xanax is addictive, and most physicians are well aware of it by now.

Other benzodiazepines are also hard to stop. Klonopin (clonazepam) is a chemically similar drug. One patient I worked with had used this 17-hour benzodiazepine to sleep every night for a decade. He decided to stop it. I wrote a compounding pharmacy prescription for smaller and smaller doses, so he tapered it over three months. He suffered with anxiety and sleeplessness the whole time, but felt better at the end. He said his energy and creativity both improved.

Another example: bipolar patients’ outcomes are profoundly worse in today’s medication era than they were before. Prior to the drugs, the disease often went away on its own. But now, we treat children who have psychological ups and downs with a stimulant or antidepressant before their first severe mania develops. The ones treated with antidepressants have four times increased chances of becoming “rapid cyclers,” which means they have frequent recurrences.

Robert Whitaker, a distinguished journalist, summarized the horrific medication problems in Anatomy of an Epidemic (2010):

Given what the scientific literature revealed about the long-term outcomes of medicated schizophrenia, anxiety, and depression, it stood to reason that the drug cocktails used to treat bipolar illness were unlikely to produce good long-term results. The increased chronicity, the functional decline, the cognitive impairment, and the physical illness—these are usual in people treated with a cocktail that often includes an antidepressant, an antipsychotic, a mood stabilizer, a benzodiazepine, and perhaps a stimulant, too. This was a medical train wreck…

Whitaker learned that most patients in emerging countries could not afford psychiatric drugs. Doctors there may even leave psychotic people unmedicated. The result is much less chronicity and some spontaneous cures. Almost half of the people with schizophrenia recover if they never get antipsychotics, but in the US, with treatment, this happens rarely or possibly never. History is also encouraging: before the drugs were developed, some studies showed the same thing. But since Americans now medicate practically everyone, comparison with placebo has become impossible.

In the US, mental illness, disability, and drug prescribing rose in tandem. Our psychiatric disability percentages have grown over tenfold during the modern medication era. Whittaker built a cautiously stated and well-referenced case that the medications were the cause. He also reported studies showing that within a few years, antipsychotics caused brain shrinkage in both monkeys and humans.

Psychiatrists have pressures to pass out medications. I interviewed one who said, “We cannot support our families unless we see a patient every ten minutes and give them the latest drug. Most of us know these are unproven, ineffective, and sometimes harmful, but people will not pay us just to talk with them anymore.”

David Healy further describes this circus in Pharmageddon (2012). The industry’s interest in funding psychiatry picked up when Prozac became available in 1987. As these SSRIs and other inventions became lucrative, corporations spared no expense for psychiatrists. They cater food, pay for meetings, arrange free hotel rooms, and sometimes provide first-class plane tickets for them. Lectures, trinkets, social events, limousine service, and massive exhibit halls are all available courtesy of the drugmakers.

These companies give some working psychiatrists $300,000-$400,000 per year. This creates the desired effect; for example, one group from the American College of Neuropsychopharmacology published a claim (2004) that SSRIs did not cause youth suicides. They were discredited after the discovery that nine of the ten doctors on the panel had a financial relationship with the industry.

The psychiatrists have credible excuses. The phenomena they treat are chronic and poorly understood. No labs, physical testing, or examination findings help make the diagnosis. Studying treatment is difficult because every detail is subjective. I felt sorry for them until I read about their misbehavior.

Since nothing seems to help, in their frustration, they have historically tried about anything. Ice-water baths. Electrical brain shocks—electroconvulsive therapy (ECT). Overdosing with insulin to crash the blood sugar. Even a destructive brain surgery called lobotomy, for which the inventor received the 1949 Nobel prize in medicine. These were all discredited. ECT, for example, is no longer believed to be effective and at least a third of treated patients suffer substantial memory loss. Worse, the fatality rate is 1/1000.

Psychiatrists customarily use medication combinations. They prescribe Topamax and Lamictal, which are unpleasant anti-seizure medications, to treat various symptoms and side effects. Depression, drug abuse, anxiety, and bipolar disease are all treated off-label using these. Military psychiatrists are fond of giving these seizure treatment drugs to combat troops. They often throw antipsychotics into these “drug cocktails.” The side effects of all these medications include fever, hair loss, nausea, mood changes, dizziness, diarrhea, double vision, loss of appetite, and suicide.

Brexanolone is a steroid hormone approved in 2019 for postpartum depression. It requires sixty (60) hours of medically supervised intravenous injection costing $34,000.

Progesterone, a female hormone that rises during pregnancy and goes nearly to zero postpartum, can ease these symptoms. The 100 mg dose is a patent drug, but compounding pharmacies can inexpensively provide the larger doses required for this condition. There is little interest in this because there is no huge price tag.

Hallucinogens such as ketamine or LSD are recurrent fashions in psychiatry. Recent trials are underway to treat depression, anxiety, and post-traumatic stress disorder using small doses of these, and there is a lot of enthusiasm in some circles. LSD has been considered disreputable and classified Schedule I since the war on drugs in the 1970s, even though it has no fatal dose and its toxicities are modest compared with many prescriptions. Although these therapeutic uses may have merit, I fear they are further abuses, even though there is no patented way to profit from these older drugs—yet.

The mental health industry’s ambition—now mostly realized—is to be the universal solution for every problem, and to use the drugs for nearly anyone. The National Institute of Mental Health says one in five US citizens “live with a mental illness.” Wikipedia (2020) noted that: “Worldwide, more than one in three people in most countries report sufficient criteria for at least one [psychiatric disorder] at some point in their life. In the United States, 46% qualify for a mental illness at some point.”

They were citing (respectively) the Bulletin of the World Health Organization and a 2005 paper by Ronald Kessler in Archives of General Psychiatry. He is the most widely cited psychiatric researcher in the world. He said in his paper: “Interventions aimed at prevention or early treatment need to focus on youth.”

Industry financing pushes this narrative. The money passes back and forth, and it is hard to tell what is industry propaganda and what comes from legitimate psychiatric sources—if there is such a thing. For example, MentalHealthfirstaid.org says: “In the United States, almost half of adults (46.4 percent) will experience a mental illness during their lifetime. Half of all mental disorders begin by age 14 and three-quarters by age 24.”

They emphasize that besides 50% of adults, children, who are traditionally off-limits, should be drug candidates as well. The following chapters explain how 17% of the entire US populace came to be using psychiatric drugs.

SSRI PSEUDOSCIENCE

The Selective Serotonin Re-uptake Inhibitor (SSRI) name was pseudoscience dreamed up in the marketing department of SmithKline Beecham.  The “chemical imbalance in the brain” idea was the brainstorm of a sales copywriter. Knowledge of serotonin and other neurotransmitters was even more sketchy when Prozac was invented than it is now. Today, this seductive but mythical gibberish embarrasses researchers.

The marketers said depression was like diabetes, and SSRIs were an “insulin” for brain disease. However, no clear relationship of depression to serotonin or other neurotransmitters was ever established, and the drugs all work about the same, with a similar lack of benefit. Jill Moncrieff in The Bitterest Pills (2013) confirmed this:

No chemical imbalance or other biological process that might explain drug action in a disease-centered way has been substantiated for any psychiatric disorder … Most authorities now admit that there is no evidence that depression is associated with abnormalities of serotonin or noradrenaline, as used to be believed (Dubovsky et al., 2001). There is also little empirical support for the dopamine hypothesis of schizophrenia.

Despite this consensus, nearly everyone still believes the metaphor and parrots the message. The idea is 1) your brain is damaged, 2) the drugs fix something, and 3) you need to take medications indefinitely.

SSRIs cause substantial harm. A 2017 literature review of randomized controlled trials in Frontiers in Psychiatry said these drugs are ineffective and damaging. It linked them to osteoporosis and movement disorders, including akathisia and tardive dyskinesia. They may double the risks of miscarriage and congenital disabilities. But physicians use them off label for pregnant women and during breastfeeding. Expectant mothers get severe withdrawal symptoms just like anyone else.

Sexual side effects occur in a range from 2% to 59% in various trials. In some studies, they never asked the patients about the issue. When used for premature ejaculation, about a third of men permanently improved, sometimes after just a few pills or even a single dose. This suggests significant long-terms effects that are adverse for most people. Many patients report having long-lasting problems with having orgasms after taking and then stopping these drugs.

In the first nine years of Prozac’s use, between 1988 and 1996, there were 39,000 FDA complaints, a record for any drug. This included reports of suicide, psychosis, abnormal thinking, and sexual dysfunction. Many patients taking the medication have sexual difficulties, are “emotionally numb,” and have “reduced positive feelings.” In October 2004, the FDA introduced a written warning about suicide in children and adolescents treated with SSRIs. The agency extended this in 2006 to include young adults up to age 25.

Antidepressants are touted as preventing depression for people having medical problems. Prophylaxis is a market for nearly anyone.

Industry hid SSRI-related suicides and violence. The manufacturers have always claimed suicide was because of the underlying depression and not the drugs. They altogether avoided addressing violence, and the psychiatrists parroted this.

SSRIs may help for severe depression, but only for a brief time. If your depression puts you in bed full time for months and you can barely resist killing yourself, you may want to risk the drugs. If you do, you must accept the risk that the medications themselves will enable you to get up and commit suicide or harm others. For moderate depression, the drugs work poorly or not at all. For mild depression, which is their current primary use, these medications are ineffective.

Casual prescription of SSRIs is unconscionable. Allowing the pharmaceutical publicity machine to promote them for brief adjustment disorders, mild sleep problems, and even grief reactions is a travesty. I wish I could say that awareness of this situation has percolated through the psychiatrists and primary care physicians. Unfortunately, industry propaganda has overwhelmed all the other narratives. In some years, SSRIs have been the most prescribed drugs, even ahead of blood pressure medications. Between 1996 and 2005, US antidepressant usage rose from 5.8 percent to 10 percent of the population, and by 2017, it was 12.7 percent.

CONCLUSION: LIVING ON PLANET PSYCH

Working psychiatrists address formidable problems, and we must respect their experience treating severely impaired patients. There is a definite place for their drugs, but they should only be prescribed to a fraction of those who take them now.

For more healthy individuals—who are victims of the universal overprescribing—the drugs cause much more harm than good. People seem to forget that life is full of challenges. Long-term use of a pill will not fix these. Even if they were side-effect free, which they are not, these drugs just put issues off.

The atypical antipsychotics, SSRI antidepressants, and stimulants have infested healthcare through a process of industry promotion, physician payoffs, and diagnosis-creep. The antipsychotics are likely the most damaging drugs ever widely used.

With the leadership of industry and their cosseted, lapdog doctors, psychiatric medications are prescribed indiscriminately to nearly anyone entering a physician’s office with a psychological complaint. The short-term benefits of controlling crazy, violent, and antisocial behavior has been indecently extended to decades of expensive, damaging drugging for one in six US adults. Worst of all, we push the medications into the mouths of many of our treasured children under two.

 

Note: The full version of this piece, with references, can be read in the author’s 2020 book, Butchered by Healthcare.

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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.

54 COMMENTS

  1. “There is a definite place for their drugs, but they should only be prescribed to a fraction of those who take them now”.

    I highly disagree.

    I always wonder how a reasoning human being can settle for such a disappointing, crude, and harmful mean (drugs).

    Drugs are ugly distorters of the delicate brain with horrendous side effects.

    Maybe, in some situation, such a blunt ‘tool’, is the only way to stall a disaster. But it must be EXTREMELY ponctual and limited (if ever used), with the shameful awareness of the grotesque inadequacy and dangerousness of the product.
    But it is too crude to be registered on the official arsenal.

    I find it deeply sad and inhumane that there are people that can’t seem to be able to envision things without those fucking drugs (aka damageing brain distorters).
    Why is it ok to treat other humans like guinea pigs? Why is it ok not to do everything to avoid such a grotesque situation?

    Why is it that so many critics can’t seem to get pass this nonsensical wall? It is a honest question that deeply baffles and saddens me.

    • I agree with you there Exit.

      There may be a place for some psychiatric drugs as short term emergency measures but it’s a kind of percussive maintenance for the psyche. Whack ’em hard with chemicals, electroshock, alcohol, a near death experience, whatever. If you’re in a bad enough place then maybe that will put you somewhere not quite so bad. But if they’re going to be a standard part of the emergency arsenal they first need to be evaluated as such against potentially less harmful alternatives.

    • where I live the homeless mentally ill are on street corners. Talking with themselves. untreated. using street drugs. suffering mightily
      If a medication can stop the tormenting voices>>>
      If a medication can calm a mania>>>

      since we can’t seem to stop people from abusing children and causing complex PTSD with hallucinations and frequent suicide attempts, even though what we have is imperfect, it’s better than doing nothing.

      • Do you realize that the bulk of those “homeless mentally ill” who are talking with themselves are either taking “psych drugs” or have taken them without any real success? Do you know that some people have reported BECOMING psychotic after taking psychiatric drugs when they had none before? Have you noticed that the number of such people has dramatically INCREASED in the years since psychiatric drugs became the “treatment of choice” for such people? If these drugs are so great, why are there more and more “mentally ill” people living on the streets?

        Were you aware that studies show that long-term use of antipsychotic drugs DECREASES chances of recovery? Were you aware that providing shelter for homeless people, with no other intervention, IMPROVES their “mental health” symptoms? Did you know that people are more likely to attempt suicide AFTER they leave the hospital than before?

      • even though what we have is imperfect, it’s better than doing nothing.

        It might make us feel better than doing nothing (and perhaps improve the look of street corners) but whether it helps the people who are suffering is another question.

        “It’s better than doing nothing” has been used to justify all sorts of abuses, up to and including wars.

        • Yes, sure, killing people 25 years earlier after having nullified their life and destroyed their prefrontal cortex is better than nothing.

          People seem to be biased towards any kind of intervention when facing sth problematic.
          But an intervention is not good on the basis of being an intervention. It may very well compound the situation (a lot).

          As Phil Hickey so aptly framed in one of his collectors sentence:
          “you can’t help people by damageing their brain”.

        • That’s what people in the “reform movement” always say when they are objectively and repeatedly banging their heads against the wall. My response lately is if something (even something self-defeating) is always better than nothing, why not do jumping jacks, it’s good exercise and less painful, and frustrating.

          • In 2001 I attended a conference at which a couple of research psychiatrists presented one of the early studies showing that antidepressants caused suicidality in children.

            During the meal break that followed I spoke to several psychiatrists about it and eavesdropped on others. Though only a couple were at all skeptical of the study all the ones I heard insisted they would continue to prescribe to children as before, justifying it with the belief that though there were risks they believed themselves capable of judging whether a patient was at risk of suicidality despite the evidence they’d just heard that most prescribers were not. I guess it was the same sort of thing that makes around 90% of car drivers believe they’re better than average drivers.

            One shrink I knew well from other conferences and who I respected for his intelligence and modesty told me he too would continue to prescribe as usual, despite not believing himself able to reliably judge whether the patient would become suicidal on the pills. His reason?

            “These kids and their families are desperate for help. We can’t just stand by and do nothing.”

            So doing something that makes the situation worse is better than doing nothing when your mystique as a ‘healer’ is at stake.

      • Funnily enough, I am one of those people who “talks to nothing in the air, engages in arguments, and shouts”. I’m not doing that because I’m hallucinating. I do that because, in my mind, I’m arguing with my horrendously abusive father, and whatever I’m thinking, I verbalise it out, as if the guy is right in front of me. It makes me look odd and crazy to people, but they don’t and can’t understand what’s going on inside me. I was never like that. I’ve become that way. And psychiatry didn’t make it any better. By labeling ME, they simply gave the man even more tools to gaslight and harass me, and call me mad.

        I’m blessed to have a home. Without that, I’d be a homeless “mentally ill” person as well.

        • I would like to see pharmaceutical drugs eventually removed from the exclusive control of people with medical degrees. More and more information is available to the public. By keeping drugs in their control, they are forcing people to pay a terrible price. They are forcing derogatory psychiatric labels on people, so insurance will cover them; they are forcing repeated visits to people with degrees in psychiatry who have become a danger to people’s lives and dignity. Whether you want to take them, or leave them, you cannot do it without psychiatry. In both cases, they screw you. Yes, I know of the potential dangers of this. But there are dangers of NOT having this advantage as well. Some solution has to be reached. Not the way it is now.

          It reminds me of the movie Dallas Buyers Club, where Ron Woodroof (who had HIV) had to smuggle in pharma-grade drugs to treat himself (and others), because the medical system and the US FDA kept drugs under their control, and made his life, and the lives of other people with HIV miserable.

          We have also seen what “healthcare” becomes for people psychiatrically labelled. Even by ordinary non-psychiatric medical professionals. They cannot be trusted anymore.

          Unfortunately stating any of the stuff we do on this website makes MDs feel victimised themselves, forced to be on the defensive. I remember one doctor getting irritated with us and labeling us as “personality disordered individuals railing against abusive doctors”. Some of them seem unable to stop psychiatrically labeling individuals.

          Personally, I wish I owned my own hospital/clinic with all the equipment I need for most medical problems and it is only our own people, who have some degree of functionality left and can do the necessary work for people like us, who worked in the place.

          • “I remember one doctor getting irritated with us and labeling us as “personality disordered individuals railing against abusive doctors”. Some of them seem unable to stop psychiatrically labeling individuals.”

            That is rather funny and surprised name calling individuals got past the moderator but I’m glad it did 🙂 It is helpful.

      • Drugs don’t stop child abuse.
        I used to teach Sunday school and was asked to stop because women found out about my “diagnosis.” So hurtful and unjust.
        Maybe people should be judged on the content of their character–what they actually DO–instead of what some quack in a lab coat says after talking to them and looking at files for 10 minutes.

  2. “Working psychiatrists address formidable problems, and we must respect their experience treating severely impaired patients. There is a definite place for their drugs, but they should only be prescribed to a fraction of those who take them now.

    For more healthy individuals—who are victims of the universal overprescribing—the drugs cause much more harm than good.”

    How on Earth does the good doctor propose that we distinguish the severely impaired patients from the less so, especially as severe impairment can be induced by the drugs already given to those with less impairment? Additionally, even among severely impaired populations – a group I might at times include myself in – how are we to say which of us needs psychiatric drugs and should be seen by the psychiatrists he spent the rest of his article/book excoriating, and which need a whole lot more traditional medical care to figure out what is wrong.

    Is someone that is suicidal because of severe chronic pain in need of traditional psychiatric care? Or perhaps should we keep looking for what is underlying the pain? What about someone coping with undisclosed domestic abuse? Or someone struggling with chronically dysfunctional family members? What about the person who is deeply traumatized and holding on to reality by a thread but otherwise generally harmless and well-meaning?

    We need to decide what the end goal of “treatment” is. Is it good coping skills? A productive job? Happiness? Some semblance of physical health? Not bothering others? I’m not at all sure there is any consensus about this even among psychiatrists, much less medicine as a whole. It seems like people are generally allowed to be as miserable as they want just as long as they have financial support and aren’t creating a public nuisance or otherwise disclosing their “depression” to others.

    We will also have to contend with the “mental health awareness” propaganda that Gen Z has been taught in public schools. If we want to move toward more empathic and compassionate responses to distress, we have to stop teaching kids that the answer to feeling bad when bad things are constantly happening is to simply develop better coping skills. Coping is a community affair. If you want psychiatry to stop medicating normal life experiences, a community must exist in which genuine support can be obtained and in which struggle is allowed, without pathologizing normal responses as madness or mental illness or some other moniker to denote othering.

    • “If your depression puts you in bed full time for months and you can barely resist killing yourself, you may want to risk the drugs. If you do, you must accept the risk that the medications themselves will enable you to get up and commit suicide or harm others.”

      I think the author assumes that a patient will hear about this risk from their physician. Several times recently, I have had emergency and urgent care physicians administer or prescribe drugs with zero informed consent. It has been up to me to ask the doctors involved in my care why I was being given those drugs and what side effects they might cause. In one case, I was only informed the drug was likely to induce severe nausea and vomiting after I asked about side effects and I had to request a prophylactic antinausea drug. For the drugs I was prescribed, I never took two of them, which I believe were prescribed inappropriately. I was never given any counseling on them by the pharmacist even though the paperwork I received with them suggested I had. In fact, the tech had to get the pharmacist to come to the computer and sign off that I had been counseled but I wasn’t. So we’re talking four medications prescribed or administered in which none of two doctors or the pharmacist gave me any informed consent except in one case in which I initiated the discussion.

      This is the norm in my long experience with the medical system. So how is a patient given an antidepressant for moderate depression supposed to know it may make him or her suicidal or violent? This is a complete farce in an era where a significant number of Americans are drugged and “mental health awareness” is ubiquitous.

      • I also want to note the subtle but damaging implication in the statement, “…you must accept the risk that the medications themselves will enable you to get up and commit suicide or harm others.” The word “enable” is the problematic term. It makes it sound as if the depressed person is lying in bed, thinking about suicide or murder, but only doesn’t kill people because s/he lacks the energy to do so. It buys into the mythological trope that the “antidepressants” are not themselves creating suicidal or homicidal impulses, but that depressed people are ticking time bombs just waiting for the burst of energy enabling them to act on their dastardly deeds.

        SSRI antidepressants, at the least, have been tested on non-suicidal people and a small but significant number of those become suicidal. THey were not “lacking energy,” they BECAME suicidal after taking the drugs. Similarly, these drugs were initially banned in Germany due to an increase in aggressive behavior in those taking the drugs. This information has been known for decades. Pretending that the “activation” of the SSRIs “enables” suicidal or homicidal people to act out their impulses is a false narrative created to absolve the SSRIs and their prescribers from responsibility for their known adverse effects.

        • It makes it sound as if the depressed person is lying in bed, thinking about suicide or murder, but only doesn’t kill people because s/he lacks the energy to do so.

          Not necessarily. One way that SSRI’s lead to bizarre mass violence is by enabling someone’s “deep dark fantasies,” normally confined to the “id” or whatever, to be manifested in waking reality. Several experts on MIA confirmed this when I asked, but I can’t remember whom.

          • It is true, the SSRIs most definitely can take away someone’s inhibitions, such that something which seemed horrible (I can’t kill myself, how would my mother feel?) can now seem acceptable, (“Ah, she’ll be fine, not my problem anyway…”) I had a friend once who called it “Zolofting” – where she simply didn’t care about what anyone or society thought about anything. This might seem like a relief to someone who was always worrying, but if someone was always repressing a desire to go on a shooting spree for fear of the consequences, it might not be such a great idea…

            Still, there are plenty of reports of people who had no suicidal and/or homicidal impulses beforehand contemplating these actions after being “medicated” with SSRIs. And in any case, removal of inhibitions is NOT the same as “providing the energy” to do something. It is an alteration of one’s moral compass, a muting or deletion of the sense of right and wrong. And it is pretty damned dangerous! Though I’m sure you’d agree with me on that last point.

          • It’s beyond “loosening inhibitions” and reaches into the “unconscious”dream level of experience, involving primal urges and archetypes, not conscious-but-repressed fantasies, it’s not that linear — at least not until the drug bridges that level of consciousness with waking reality, and the person attempts to reconcile the two levels of experience, with distorted and deadly consequences.

            Of course I can’t “know” this, but I can surmise.

          • You are probably right. I know of a few cases personally where the person had zero history of suicidal or homicidal impulses before the drugs. But I know from both research and direct personal conversations that the suppression of inhibitions is one of the cardinal effects of cranking up serotonin artificially. It is too consistent a report to be chance, according to my “inner p-value test!”

          • The mass shooter in the theater a few years ago now — the one with the orange hair — seemed totally unaware of his actions later, however they had been carefully premeditated on some level. Like his imagination was married to his practical competence in manifesting his grotesque scenario.

          • A Scientific Reality:-
            “…The researchers explain that “relapse” of psychotic experiences after discontinuing antipsychotics, especially very soon after stopping the drug, is likely due to withdrawal effects. ..”

            https://www.madinamerica.com/2020/09/slow-taper-best-antipsychotic-discontinuation/

            BBC Provides Example:-
            “…He cites as an example the random murder of 67-year-old Bjorg Marie Skeisvoll Hereid in a graveyard in 2019 by a psychotic man with an axe. The murder shook the quiet town of Haugesund in the south-west of Norway and made national headlines…”

            I Say:-
            People need to be adequately warned about the Real Dangers of Stopping Neuroleptics Abrubtly, a line or two in the Patient Information Leaflet (as with Suicidal Reaction to SSRIs) – Would Not IMO, be Enough.

          • Of course, there is no actual way to objectively determine who “has bipolar illness,” so this provides a handy excuse to let the drug off the hook and blame the patient. I think it’s fair to say that suicidal and/or violent behavior can be caused by exposure to SSRI drugs, regardless of “diagnosis.” It may be that people with a “bipolar” diagnosis are more likely on the average to react in this way, though I have seen no scientific study ever done to prove this (and it would be difficult to prove anyway, as again “bipolar” is such a vague and subjective “diagnosis” as to defy any clear definition of who “has” or “does not have” such an ostensible “condition.”)

            I am not in the least inclined to let doctors and drug manufacturers off the hook by blaming their victims as being “bipolar.” If they don’t know their craft well enough to judge who will and won’t become suicidal taking SSRIs, then they ought to admit that up front and warn everybody of this possible danger, rather than trying to hide it for decades and then complaining when the FDA forced them to put it on the label, claiming that “lives will be lost” if we tell people the truth. Well, guess what, making people suicidal and/or homicidal loses lives, too!

            The hiding and denial of the adverse effects of SSRIs is one of the many heinous acts that prove psychiatry to be essentially a corrupt industry that is more interested in covering up their failure than in learning how to do their jobs better.

          • Robben, Are you aware that SSRIs can cause the “symptoms” classified by the DSM as Bi-polar Disorder or Manic Depression? Are you aware that SSRIs can contribute to suicidal or homicidal ideation, etc. even violence while the person is taking them or in the intense withdrawal stage from the SSRI? One more point, if they were really were a drug or drugs that could take people off the street from the suffering of homelessness, that would be so nice, rather like Huxley’s “Brave New World”. I think, we as human being, can think of much more creative ways to get people off the street so they retain their dignity, freedom, and free will. It just takes work on our part. Giving someone a drug for anything is the easy way out. Thank you.

          • “Bipolar illness” in my own personal experience looks an awful lot like a relapsing/remitting inflammatory disorder. When I’m too physically ill to do much more than go from the bed to the couch, am I “depressed” or physically ill? When my body is cooperating and I’m trying to get as much as I can done to make up for the length of time I was ill, am I “manic” or catching up? I have a relapsing/remitting illness that incapacitates me at times. I am extremely high functioning when my body and mind cooperate. Calling that “bipolar” and further disabling me with psych (and other) drugs seems like an unnecessary cruelty. My suicide attempts have only been while I was taking drugs that lowered my inhibitions against such. All of this seems pretty straight-forward to me.

  3. “SSRIs may help for severe depression, but only for a brief time. If your depression puts you in bed full time for months and you can barely resist killing yourself, you may want to risk the drugs. If you do, you must accept the risk that the medications themselves will enable you to get up and commit suicide or harm others. For moderate depression, the drugs work poorly or not at all. For mild depression, which is their current primary use, these medications are ineffective.”

    FALSE.
    They do not “help” ANYTHING.
    The effect is like hitting the person with a hammer. Same outcome.

    Question is. Why is the person in bed? “depression”. What is it? And if you don’t know what it is, how could you possibly ever develop a drug for it?
    Someone is having a response. To what?

    • You ask too many questions!

      Don’t quote me, but my guess is most people who stay in bed either have someone around to plead with them “to get out of bed,” or eventually abandon this on their own. Otherwise the most lethal effect of “depression” would be self-starvation.

    • Depression as I see it, might be a condition of incapacity almost to the extent of paralysis. I’ve read that this can happen to a person and (if they experience it without medication)
      they usually never experience it again.

      I have taken tricyclic antidepressants on doctors recommendation, and these drugs had no MH effect on me whatsoever. Going on them, Being on them and Coming off them made no MH difference whatsoever to me.

      But, I wasn’t depressed at the time, though I did experience periods of sadness or melancholy. I think the AntiDepressants were probably prescribed to me, to cover my Akathisia induced Suicidal Hospitalisations!

  4. And thanks for the article Robert.

    “The mental health industry’s ambition—now mostly realized—is to be the universal solution for every problem, and to use the drugs for nearly anyone. The National Institute of Mental Health says one in five US citizens “live with a mental illness.”

    You said you used to feel sorry for them.
    Who do you think advertises about mental health, and who “diagnoses” the confusion of people” This is not big pharma, it rests on psychiatry alone. They can’t even blame the consumers anymore, because psychiatry single handedly decided that the dastard issues of life are an illness.
    Do they ever strongly discourage even the most distraught people from their “service”? Who holds the pen to prescribe harmful chemicals? Who writes awful things about people in charts? Who writes on charts that people lack insight or “appear” this way or that way?
    Psychiatry attacks VICIOUSLY and in most hateful pathological ways and our governments sit on their fat asses and do absolutely nothing.
    These shrinks are really what it means to be messed up. To go on damaging people because you have some stupid identity and image to fulfill, for all the people in your life, from the lineage of bossy women and men most of these shrinks come from, a lineage of privilege where dark secrets are not to be shared and where weakness or neediness is frowned upon. A lineage where mom and gramma thought it was great to repeat “my son, the doctor”. Because they were shallow enough to think it was such a thing. And by the time junior catches on, he does everything in his power to deny the reality. A shrink would know first hand what “insight” means.
    These people cannot actually understand humanity. They are certainly not doctors, but it’s the only dam job they can do. No one else would put up with them.

    It’s difficult to even have a drink with one. I’ve tried. It’s the most painful experience when their brains are busy hiding from themselves.

    What I am having a very difficult time with is that none of you writers are getting together and approaching governments and the who.
    En masse. No because you guys figure that you have nothing else, no alternatives.
    Education is NOT enough.
    Here we are in our cosy homes while millions of kids are swallowing drugs and psychiatry keeps getting excused.
    I think if we all really cared, we could do MUCH more than write books and articles.

  5. One of the problems is that non-psychiatric physicians arent willing to criticize psychiatrists–their colleagues—or report psychiatric harm and abuse (including the tremendous number of iatrogenic illnesses and adverse drug reactions that present in life-threatening situations at ER’s) until they are safely retired. Remember the man labeled with bi-polar who was kicked out of the ER who crawled out of the ER in excruciating pain? It made CNN. The public has no idea how common it is for ER docs to treat psychiatrized patients with scorn when they present with iatrogenic illnesses. The difficult ‘mental patients’ in the ER always get kicked out without full work-ups or outsourced to the jails or psych wards where the trigger happy shrinks and psychiatric nurse practitioners are waiting with needles–only too happy to inflict chemical lobotomies on the unfortunate victims. These ‘frequent flyers’ get blamed for non treatment compliance or lack of insight when they desperately take steps to eliminate their drug-induced akasthisia through non-adherence to harmful psychiatric drug cocktails. In the absence of zero safe alternatives such as peer respites, psychiatric drug withdrawal clinics, med free wards, etc. and with the collusion of ER physicians who should know better, these psychiatric victims get pushed under the bus time and time again.

  6. there is no patented way to profit from these older drugs—yet.

    Sure there is. J&J showed the way with esketamine.

    All you have to do is isomerise the off-patent molecule into something new that shares many properties with the original. Then you patent it and you can charge many times the street price of the original version.

    Of course by isomerising you’re potentially adding new, unknown properties that can cause adverse events and side-effects never seen in the original, so all of the safety knowledge about the old drug accumulated over decades goes out the window. But hey, you’ll be raking in the $$$!

    We’ve already seen something like that with synthetic cannabinoids. The regulators outlaw one molecule so the syndicates tweak it into something else with worse side-effects to evade the regs. I’m sure drug companies will be quick to learn from the other criminals.

  7. This is their story; “Despite the consensus, nearly everyone still believes the metaphor and parrots the message. The idea is 1) Your Brain is Damaged, 2) The Drugs Fix Something, and 3) You Need to Take Medications Indefinitely.” (“Indefinitely” is underlined.) This is what is really happening; 1) We made it up that your brain is damaged, 2) This is to justify prescribing these drugs, and 3) Now, Your Brain is Really and Truly Damaged INDEFINITELY. But, “Planet Psychiatry” will always deny their culpability in this. Thank you.

  8. I do understand many of the justifiably frustrated commenters’ comments, as one who was also “butchered” by incompetent “healthcare” workers. But I also appreciated the amazing amount of truth spoken in this blog post, Robert.

    I may have to pick up your book, and thank you very much, for trying to wake society up to the fraud, and truly horrifying, systemic, crimes of psychiatry. But you should get Joanna Moncrieff’s name correct, and hopefully, I spelled it correctly.

    • I see nothing inflammatory.
      We have put up and continue to put up with “inflammatory” rhetoric, propaganda advertising and much damage against innocent victims, including millions of kids.

      It is inflammatory for psych to advertise about their mental health ideals, plus their poisons. They inflame the public to make them believe that the distress they might see or feel is an illness and that there are drugs for it.

      These articles above are part of “the voices”. It is not inflammatory to call BS on psychiatry.

      I think we all get it. Maintain nice dialogue that asks for change for the next forever. It will never end, other voices need to enter.
      What is psychiatry doing? Oh yes we are all aware of how a few professionals get together and talk about how awful it is and how they wish it was different. They even talk about “overmedicating”. To talk about it makes them feel as if they are DOING something false with good intention.
      And they say things like “well what will we do about all these suffering people”. But they have NEVER gone en masse to the governments themselves and said “we need to drop this damage and we need your help”

      They could literally change it overnight if they had any interest. They are all waiting to be forced. A bit like forced treatment.

  9. “So doing something that makes the situation worse is better than doing nothing when your mystique as a ‘healer’ is at stake.”

    They know that they have nothing close to being helpful. But their own egos are more important than the lives of completely innocent and vulnerable people.

    They could never allow this grotesque secret out.

  10. “As in, “If you rail against abusive doctors, you must have a ‘personality disorder?’” And if the doctors are abusive, is there something wrong with railing against them?”

    And if they are abusive (and of course calling people disordered is abuse, if calling them that has repercussions for them) it seems to me there is something “wrong” with the “doctors”.

    And of course it’s the insult that they grab for. It’s what happens after they go to school for 8 years and start to become angry at having been lied to and the clients they lied to.

    But yeah, it’s kind of like “gee, I’d like to give this up, but can I practice as I was”

  11. “And he didn’t write that on MIA, he went back to his blog and wrote about it there.”

    Yes registered, I’m familiar. We say all kinds of things when frustrated, even reverting back to ammunition we kept since childhood. most of psych is built on not knowing and frustration. And it gets them really pissed off when pointed out to them. “boy I will show you”.

  12. Had to recover from 24 years in the system by hiding in my parents’ back room for a year to withdraw. A remote, rural area.
    Every afternoon I lowered my aching, trembling body into bed so I would have the strength to eat dinner. Drug withdrawals. My parents had no idea why I was so horribly ill on a physical level.
    I also had to cope with painful thoughts. I can never have a family now. I’m forced to live on less than $10,000 a year. In chronic pain thanks to long term drug damage.
    All so some controlling bureaucrat can present himself as a “real doctor” and earn $300,000 a year instead of a piddling $100,000. Sigh.
    I have forgiven the individuals responsible. But what they did was wrong.

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