Editor’s Note: Over the next several months, Mad in America is publishing a serialized version of Peter Gøtzsche’s book, Mental Health Survival Kit and Withdrawal from Psychiatric Drugs. In this blog, he introduces the book. Each Monday, a new section of the book is published, and all chapters are archived here.
I have written this book to help patients, and when I decided to write it, one of my tentative titles was “Listening to the voices of patients.” Most people I have talked to about mental health issues, be it my family, friends, colleagues, sports partners, filmmakers, gardeners, cleaners, waiters and hotel receptionists, have had bad experiences with psychiatry or know someone that has.
Coming from a background of being a specialist in internal medicine, which is entirely different, it slowly dawned on me how harmful psychiatry is. It takes years of close study to find out that psychiatry does vastly more harm than good,1 and my own research has contributed to revealing this.
My findings resonate closely with what the general public have concluded based on their own experiences. A survey of 2,031 Australians showed that people thought that depression pills (also called antidepressants), neuroleptics (also called antipsychotics), electroshock, and admission to a psychiatric ward were more often harmful than beneficial.2
The social psychiatrists who did the survey were dissatisfied with the answers and argued that people should be trained to arrive at the “right opinion.”
In early 1992, the Royal College of Psychiatrists, in association with the Royal College of General Practitioners, launched a five-year “Defeat Depression Campaign” in the UK.3 Its aim was to provide public education about depression and its treatment in order to encourage earlier treatment-seeking and reduce stigma. Campaign activities included newspaper and magazine articles, television and radio interviews, press conferences, production of leaflets, factsheets in ethnic minority languages, audio cassettes, a self-help video and two books.4
When 2,003 lay people were surveyed just before the launch of the campaign, 91% thought that people with depression should be offered counselling; only 16% thought they should be offered depression pills; only 46% said they were effective; and 78% regarded them as addictive.3
The psychiatrists’ view on these responses was that, “Doctors have an important role in educating the public about depression and the rationale for antidepressant treatment. In particular, patients should know that dependence is not a problem with antidepressants.”
When challenged about the fact that the colleges had accepted donations from all the major manufacturers of SSRI depression pills for the campaign, the president of the Royal College of Psychiatrists, Robert Kendall, acknowledged that, “One of their major motives was the hope that an increased recognition of depressive illnesses both by the general public and by general practitioners would result in increased sales for them.”5
He didn’t say what the companies’ other major motives were. I doubt there were any. Money is the only motive drug companies have.
The psychiatrists embarked on their re-education campaign. But people were not easily convinced that they were wrong. A 1998 paper reported that changes were of the order of only 5-10% and that depression pills were still being regarded as addictive and less effective than counselling.4 Interestingly, 81% of the lay people agreed that “Depression is a medical condition like other illnesses” and 43% ascribed depression to biological changes in the brain, but most people nonetheless also ascribed it to social causes like bereavement (83%), unemployment (83%), financial problems (82%), stress (83%), loneliness/ isolation (79%) and divorce/ end of relationship (83%).4 Something didn’t add up.
My interpretation is that despite claims for many years, long before 1992,1 that psychiatric disorders are caused by chemical imbalances in the brain, the public is not so willing to accept this falsehood.
In 2005, Danish psychiatrists reported what 493 patients had told them about their depression pill treatment.6 About half the patients agreed that the treatment could alter their personality and that they had less control over their thoughts and feelings. Four-fifths agreed that as long as they took the drugs, they didn’t really know if they were necessary, and 56% agreed to the statement that, “Your body can become addicted to antidepressants.”
The psychiatrists refused flatly to believe what the patients had told them, which they considered wrong, and called them ignorant. They also felt that the patients needed “psychoeducation.” The problem with this was that the relatives shared the patients’ opinion.
“Educating the public” and “psychoeducation” so that they can arrive at the “right opinion” is what we normally call brainwashing. Particularly when what the patients and the public reported are more than just opinions; they drew conclusions based on their own experience and that of others.
It is not only in research that psychiatrists dismiss what their patients tell them, they also do this in clinical practice. Often, they either don’t listen or don’t ask the appropriate questions about their patients’ experience and history and therefore don’t find out that the current symptoms are very likely caused by trauma or severe stress, and not by any “psychiatric disorder.”
Please note that when I generalise, it does of course not apply to everyone. Some psychiatrists are excellent, but they are in a small minority. It is no wonder that the UK pre-campaign survey found that “the word psychiatrist carried connotations of stigma and even fear.”3 This is understandable, given that psychiatric drugs kill hundreds of thousands of people every year and cripple millions, physically and mentally.1
The term “psychiatric survivor” says it all in just two words. In no other medical specialty do the patients call themselves survivors in the sense that they survived despite being exposed to that specialty. They fought their way out of a system that is rarely helpful, and which many survivors have described as psychiatric imprisonment, or a facility where there is a door in, but not a door out.
In other medical specialties, the patients are grateful that they survived because of the treatments their doctors applied to them. We have never heard of a cardiology survivor or an infectious disease survivor. If you have survived a heart attack, you are not tempted to do the opposite of what your doctor recommends. In psychiatry, you might die if you do what your doctor tells you to do.
Many psychiatric survivors have described how psychiatry, with its excessive use of harmful and ineffective drugs, had stolen 10 or 15 years of their life before they one day decided to take the responsibility for their life back from their psychiatrists and discovered that life is much better without drugs. They often say that what woke them up was that they read some of the books about psychiatry by psychiatrists David Healy, Peter Breggin, or Joanna Moncrieff, science journalist Robert Whitaker, or me.
There are thousands of personal stories by psychiatric survivors on the Internet, e.g. on SurvivingAntidepressants.org. In many of them, people explain how they withdrew from psychiatric drugs, one by one, often against their doctor’s advice and often with great difficulty, because the drugs had made them dependent and because the psychiatric profession had failed totally in providing proper guidance about how to do it. The psychiatrists have not only been uninterested in tackling this immense problem but have actively denied its existence, as you have just seen and will see much more about in this book.
Mental health issues prevent you from living a full life and they go on in your mind. All patients should be offered psychotherapy, which is also what 75% of them want.7 However, this is not what they get, which shows once again that the psychiatric profession doesn’t listen to its patients. A large US survey of people with depression showed that 87% received depression pills, 23% psychotherapy, 14% anxiolytics, 7% neuroleptics and 5% “mood stabilizers” (a euphemism that the psychiatrists never defined, but they usually mean antiepileptic drugs and lithium, whose main effect is to sedate people).8
Most people have issues with their mental health now and then, just as they have issues with their physical health. There is nothing abnormal about that.
Throughout this book, I shall give advice based on the scientific evidence that I have good reasons to believe will lead to better outcomes than if my advice is ignored. But please note that whatever you do and whatever the outcome, you cannot hold me responsible. The information I provide is not a replacement for consultations with healthcare professionals but might empower you to engage in meaningful and informed discussions or to decide to handle the issues yourself.
I shall start with a little advice and will give the background for it in the rest of the book:
- WARNING! Psychiatric drugs are addictive. Never stop them abruptly because withdrawal reactions may consist of severe emotional and physical symptoms that can be dangerous and lead to suicide, violence and homicide.1
- If you have a mental health issue, don’t see a psychiatrist. It is too dangerous and might turn out to be the biggest error you made in your entire life.9
- Don’t believe what you are told about psychiatric disorders or psychiatric drugs. It is very likely to be wrong.1
- Believe in yourself. You are likely right, and your doctor is wrong. Don’t ignore your hunches or feelings. You can easily be led astray if you don’t trust yourself.10
- Never let others have responsibility for your life. Stay in control and ask questions.
- Your spouse or parent might be your best friend or your worst enemy. They might believe what doctors tell them and might even see it to their advantage to keep you drugged.
Many of the stories I have received from patients have a common theme. The patients had no idea how dangerous it is to become a psychiatric patient and trusted their doctors, willingly following their advice, until they found out years later that their lives had been ruined.
What is particularly diabolic is that the psychological and physical deterioration often occurs gradually, and therefore passes unnoticed—like becoming nearsighted, which you don’t discover until one day a friend wonders why you cannot read a road sign close to you. The patients may even be grateful for the drugs they received, although it may be obvious to others that they have been harmed.
Gradual and unnoticed deterioration is not the only problem. A brain under chemical influence may not be able to assess itself. When the brain is numbed by psychoactive substances, the patients may be unaware that they can no longer think clearly or evaluate themselves. This lack of insight into feelings, thoughts and behaviours is called medication spellbinding.11,12 Medication spellbinding is usually ignored, both by patients and their doctors, which is surprising because we all know that people who have drunk too much cannot judge their ability to drive.
Here is a patient story that illustrates many of the common issues.
A patient’s psychiatric “career”
In November 2019, I received an outstanding account from Stine Toft, a Danish patient I met when I lectured for “Better Psychiatry,” an organisation of relatives to psychiatric patients.13
Stine was seriously harmed by psychiatric drugs; her life became endangered; and she suffered an excruciating withdrawal phase because she did not receive the necessary guidance. But she is doing well today, aged 44.
Stine gave birth to her second daughter in 2002 after a hard time with “all kinds of trials and hormone treatments.” In the aftermath, she wasn’t well. She was afraid of losing her daughter and of not being able to protect her well enough. Her doctor diagnosed her with depression, and she was told it was perfectly normal and that she should just take Effexor (venlafaxine, a depression pill) so that her brain would work again—possibly for the rest of her life, but at least for five years.
Her life changed markedly. She put on 50 kg (110 lbs.) and had several weird episodes that she didn’t understand. Once she wanted to dig a sandbox for her children, but she ended up putting an entire trampoline 70 cm into the ground by removing seven cubic metres of soil with a shovel. She also knocked down a wall in the kitchen without warning and without being a craftsman in any way because she felt the family needed a smart conversation kitchen.
Stine saw a psychiatrist again, and 15 minutes later the case was clear—she had become bipolar. She was sent for psychoeducation and was told that her condition would definitely last for the rest of her life. She was trained in how to notice even the little things that confirmed that she was ill, and special care was taken to ensure that she took her medicines.
“They managed to put a massive fear in me,” Stine wrote, and she clearly identified herself with a sick person who had to tackle life in a certain way in order to survive.
Time passed and she ended up leaving her husband of 15 years. In 2013, she met her current husband, and he asked quite quickly “what the sickness was all about,” because he couldn’t see it. After a year and a half, she surrendered and agreed to make a small trial with a small withdrawal of the medication.
He was happy for that, because he had seen several times how disastrous the withdrawal was when she forgot to take the medication. She once ruined a trip to a summer amusement park because she had forgotten to bring the medicines with her. As the day went on, she got worse and worse with headaches and vomiting; she was confused and just wanted to lie down and sleep until she got the drugs again.
Her medication list included Effexor, later switched to Cymbalta (duloxetine), lamotrigine and Lyrica (pregabalin), two antiepileptics, and Seroquel (quetiapine, a neuroleptic). In addition, she was given medication for the adverse effects caused by the drugs and for her metabolic problem.
This is a dangerous cocktail. Depression pills double the risk of suicide, not only in children but also in adults,1,14-18 antiepileptics also double the risk of suicide,19 and both depression pills and antiepileptics can make people manic,18,19 which happened to her and resulted in an erroneous diagnosis of having become bipolar.
The withdrawal process took two and a half years, with her husband helping the best he could to make the process as gentle as possible. They did not understand it at the time, but discovered along the way, what the receptor saturation curve means—namely that you need to reduce the dose by less and less the further you come down.
Extremely few doctors are aware of this,20 and most official recommendations are outright dangerous (e.g. they may say that you should reduce the dose by 50% every two weeks when you taper depression pills.21 Thus, already after two reductions, you are down to only 25% of the starting dose, which is far too quickly for most patients).
Stine’s life became endangered. She was scared to death that it would end badly and was often thinking about giving up. She introduced several pauses in the process. Thoughts of suicide were extremely pressing during the times when she tapered, because it was absolutely horrible.
Inexplicably, Stine had accepted that she obviously hated life and wanted to put an end to it. She is otherwise an energetic person who loves life and had never had suicidal thoughts until she started taking drugs, nor after stopping them. But the withdrawal process was completely “crazy,” and she often considered whether taking her own life would be more humane.
During withdrawal, she had some “wildly weird experiences.” On the good end, she took it upon herself several times just to listen to nature and the birds. It was a powerful experience, because she could not remember when she had last experienced this in the years she was “doped.”
A little sadder were the other symptoms that came during withdrawal. The abstinence symptoms included dives that could easily be interpreted as depression, and during withdrawal of Lyrica, she was anxious and felt life was unbearable. One morning in the bath she began to cry, because just feeling the water on her body was something she had not noted for many years.
At this point in time, she became aware of two of my books about psychiatry1,22 and realised that everything she had experienced was well known and perfectly normal. It was really shocking to her to read about how it is normal practice to be exposed to the hell she had been through, but also liberating to discover that it is normal; that she probably wasn’t sick; and that there was nothing wrong with her.
By the end of the withdrawal, she had a strange experience where, for about half a year, she was almost crooked in her body. She constantly had a feeling of tipping to the left and had a hard time walking straight. During several periods, other muscle groups failed. When she once played a game where a stick is thrown after wooden blocks, her hand didn’t release the stick.
After withdrawal, things started to get better and she wanted to work again, even though she had been out of the job market for many years and was on disability pension. She planned to take a business driver’s license and drive a taxi, but “Oh no, oh no! There was a big no from the police.” They sent a letter stating that her driver’s license was time-limited and that she would need to provide documentation every two years that she wasn’t sick.
“The fact that they chose to throw an extra diagnosis after someone who is on depression pills is pretty terrible,” she wrote. “Today, I must renew my driver’s license every two years for that reason. But you wouldn’t imagine how hard it was to avoid that they took it away completely. When I contacted psychiatry because of my contact with the police, they first refused to see me—because I was well. So, I couldn’t get their help to prove I wasn’t sick and thus fit to drive. After intense pressure from me, my own doctor finally persuaded them to take me in for a talk and make a statement, which dryly noted that my ‘illness’ wasn’t active. I could have strangled them, because that means I’m still sick and, in the eyes of the police, one that needs to be monitored in future.”
Stine completely disagrees with the bipolar diagnosis. She never had manic episodes before starting on the medication, and never had them after she quit. But the diagnosis is glued to her for the rest of her life, although it is well known that depression pills can trigger mania and thus cause the psychiatrists to make a wrong diagnosis, confusing the drug harm with a new illness.
It is medical malpractice to make a new diagnosis, as if there is something wrong with the patient, when the condition could be a harm caused by the medication. Psychiatrists do this all the time.
Stine gave up the idea of becoming a taxi driver. She became a coach and went on studying to become a psychotherapist. She works with many different people and helps patients taper off their depression pills, with great success. They are reclaiming life and seeing it move forward. She knows it is important to support them when they withdraw so that they will not face the same troubles as she did. There are many thoughts and fears, and many people have difficulty defining themselves if they are no longer sick. The combination of tapering and therapy seems to have an extremely beneficial effect.
It is difficult to convince people that stopping their drugs is a good idea. Many passionately believe in them, because they have been told they are sick, and there is often great pressure from their relatives. Stine experienced herself what it means to stand alone with the withdrawal. Today, she no longer sees her family. They maintained the claim that she was ill and just needed to take her medication.
This mistaken view is nourished by the fact that three-quarters of websites even today still falsely claim that people fall ill with depression because of a chemical imbalance in their brain (see below).23 If you believe in this bogus, you also believe that you cannot do without the medicine.
A few years ago, Stine bought the domain name medicin-fri.dk (medicine-free.dk) because she wants to provide information about taking drugs and their harms, in cooperation with others, as well as provide help and support for withdrawal.
Too few people know about the problems or have ever heard of them. Stine wants to change that and wants to make sure that she does not give incorrect advice and information. She therefore wrote to me and asked if I knew others who would like to join an organised network about these issues.
In addition to her daily work with clients, Stine lectures, but finds it difficult to “be allowed” to get the message out. She has lectured for Psychiatry in the Capital Region about being bipolar, which was easy, as everyone wants to see a sick person and hear her story. But a success story that calls the system into question is not interesting.
Stine is passionate about changing things and has, for example, established several self-help groups; lectured for the Depression Association; volunteered in the Red Cross; started groups for lonely people; and mentored young people.
She suggested to Better Psychiatry in her hometown that they invite me to lecture. They didn’t know who I was, and the chairwoman introduced the meeting by saying that if more money was allotted to psychiatry it would probably be okay. I started my lecture by saying I wasn’t sure this was a good idea. If more money came in, even more diagnoses would be made, even more drugs would be used, and even more people would end up on disability pension because they cannot function when they are drugged.24
Stine wants to lecture on the theme, “Surviving psychiatry.” She finds it overwhelming to live a life that, after so many years on medication, she thought was completely out of reach. Although her past life was “foolishly handled by various psychiatrists and other well-meaning doctors,” she doesn’t want to mess it up by asking for access to her files. She would rather look ahead and inform others via websites and lectures about how harmful it is to blindly become medicated—often for no reason at all.
Stine is convinced that virtually none of her strange experiences during the 14 years she was drugged would have happened if she had not been given medication. Her memory suffered a severe blow, but it is improving.
She cannot understand why her doctors didn’t stop the drugging. Nothing could justify her massive drugging, and even when she gained weight from 70 to 120 kg, the doctors didn’t respond, besides giving her medication to increase the metabolism, which was “completely nuts … extremely disabling in every conceivable way and in itself almost something they could give a depression diagnosis for, because it was a sad thing to expose your body to.”
Stine considers the system to be hopeless. The colossal overuse of psychoactive drugs produces chronic patients, often based on temporary problems,24 as I shall explain in the following.
To read the footnotes for this chapter and others, click here.
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.