Editor’s Note: Over the past several months, Mad in America has published a serialized version of Peter Gøtzsche’s book, Mental Health Survival Kit and Withdrawal from Psychiatric Drugs. In this final piece, he summarizes a few stories of psychiatry’s failures from both patients and young psychiatrists, and he provides concluding remarks about psychiatry. All chapters are archived here.
Here are some stories young psychiatrists and patients have sent to me.
An 18-year-old student was still grieving after his father hanged himself five years earlier. After he was put on sertraline, he tried to hang himself and was admitted to a psychiatric hospital. The admitting psychiatrist increased the dose of sertraline. When a young psychiatrist noted that depression pills increase the risk of suicide, the consultant replied that they were aware of this but had to treat depression, and if the young man committed suicide without being on a depression pill, they would be questioned why he was not treated.
A middle-aged man with pneumonia symptoms and a low mood was put on penicillin, sertraline, and a sedative by his family physician. When the patient started sweating profusely and developed psychosis with mania, he was admitted to a psychiatric hospital with a fever. The admitting consultant opined he had polymorphic schizophrenia, stopped sertraline, and started olanzapine and another sedative. When discharged, the diagnosis was dissociative trance disorder.
When a young psychiatrist asked if the psychosis could have been caused by sertraline, he was told: “I’ve never seen anybody with antidepressant-induced psychosis.” This lack of logic kills patients. If people who come home from Africa with a fever are not examined for malaria because the admitting physician has never seen anyone with malaria, some will die.
I was in that situation as a young man after an expedition in Kenya.25 Although I was very ill, with typical malaria symptoms, two attending doctors who visited me in my apartment on different days didn’t find it necessary to examine my blood for malaria. I lived alone and was lucky that I survived without getting the treatment I needed.
Hundreds of people have sent me the most extraordinary stories from their life. Some have thanked me for saving their life or their spouse’s, son’s, or daughter’s life, e.g.: “It was your book (Deadly psychiatry and organized denial) that gave us the courage to withdraw our son from antipsychotics, four years ago, less than five months after he started.” I later met with this father who is now very active in the withdrawal community in Israel.
Another patient who thanked me for having saved her life wrote that if she had not read my books and learned that there is something called withdrawal, she would have thought she had become insane. After ten years on duloxetine, she went through a three-year withdrawal that was very difficult.
A patient wrote: “I have used depression pills for five years because of social anxiety. They made my life a mess. Things are now way worse at every level of my life. The pills have changed my personality into being angry and disrespectful. I am more “brave,” but it is not me. I would never have started on them if I had known what would happen; I have also lost many friends. Thank you for your book; I am very happy that someone says how things are. The world is so insane. I have lost my trust in psychiatry, drug companies and doctors. I just wanted you to know that people are becoming more aware of this madness. In our SSRI withdrawing group, the number of members increases all the time.”
A family doctor used depression pills as a diagnostic test: If they worked, you had depression, and if not, you did not have depression. Another family doctor responded to a question about how to stop a depression pill: “You can just stop!”
A patient was told by her psychiatrist that depression pills were like putting a plaster cast on a broken leg. She tried to withdraw twice in vain and was told she had a chemical imbalance and needed the drug for the rest of her life, and her psychiatrist even increased the dose. A substitute for her family doctor saved her. He said that the pills were devilry and made her sick, and he helped her withdraw. She now wants to help others because she works as a job consultant with unemployed people, many of whom get hooked on the pills because of stress and anxiety.
A father was denied custody of his children because he refused to take psychiatric drugs. Numerous other people have written to me about how badly they were treated by psychiatry, sometimes with derogatory comments in the patient’s file about their personality, when they tried to avoid having their children treated with neuroleptics.
One patient wrote to me that a test showed she had an IQ of 70 while she was doped.
Another wrote that her psychiatrist had told her she had an incurable genetic disease and needed neuroleptics for the rest of her life. When she had withdrawn the drugs, her psychiatrist told her she would have a new psychotic episode again. When she had complained that she could no longer concentrate, slept a lot, and believed the drugs affected her memory so it was hard to study, the reply was the problem wasn’t the drugs but that she lost neurons due to psychosis and that her brain wasn’t the same anymore. So, she needed to take antipsychotics indefinitely to protect her brain from losing more neurons; otherwise she would become demented.
When the patient said she did not want to take the drugs for the rest of her life, the psychiatrist replied that she would then not see her anymore because she only worked with patients who wanted to be treated.
She wrote: “Ziprasidone withdrawal was hell. I was vomiting and couldn’t sleep for several nights until my body adjusted. I told my father I had stopped, and he wanted to force me to go back on medication and threatened to send me to a mental hospital if I didn’t follow the doctor’s instructions. He asked me: Do you want to be tied up in a madhouse? So, I lied to him saying that I went back on the medications. Anyway, I am fine now, the people I live with agree and support my decision and the new therapist accepts it too. Thanks for reading a bit of my story.”
Another patient wrote: “The psychoanalyst said I had to trust the doctor and the doctor said I had to be on medicines for the rest of my life, but I discontinued all medicines for about 8 weeks and I couldn’t feel better. I am no longer a zombie, I am back to listening to music, laughing, singing in the shower, feeling life and having sexual pleasure. I am back to being myself. I told the doctor that medicines were giving me anorgasmia and she asked with these words: ‘Which do you prefer, not having orgasms or going mad?’
“That was when I realised something was wrong, as I do not wish to live chemically castrated as if I am going through a lifetime with a lobotomy.” This patient had been sexually abused as a child.
A patient wrote that he took fluoxetine for ten years, which changed his personality, and he lost almost all his friends. He went through a horrible withdrawal without help where he couldn’t even get out of bed. His doctor told him that psychiatric drugs were vital for him, like insulin for a patient with diabetes, and he started on a drug again, but tolerated it badly. Then, his psychiatrist said that his side effects were likely caused by his depression, and he wanted him to try another drug. This patient had attended one of my lectures in Stockholm and therefore knew I had a list of people who could help him withdraw, which is why he wrote to me.
Here is my last patient story, told by himself and his mother, which summarises tragically what is wrong with psychiatry.
David Stofkooper, a young Dutchman, ended his life in January 2020, only 23 years old. He had a flourishing social life, was a lively, very intelligent student, with a lot of friends, enjoyed socialising and loved listening to music. Since he was 17, he could ruminate a lot, with repetitive thoughts; not constantly, and he still had a fun life. But he made a fatal mistake. He consulted a psychiatrist and was put on sertraline in October 2017. Within two weeks, he became suicidal. The psychiatrist increased the dose, and it got worse. He became zombified, with no libido and no emotions; his whole personality had disappeared.
His mother called his psychiatrist and said this definitely didn’t work, but she was fobbed off, being told she couldn’t call due to her son’s privacy. Her intervention was badly needed, however, as David didn’t notice what was going on anymore; he had lost himself totally. He told his psychiatrist that he was very suicidal, but the psychiatrist said he needed to wait longer, so he believed in that.
After five months, he got a new psychiatrist who told him to quit sertraline since it obviously didn’t work, cold turkey, in just two weeks. At first, he got a one-day long mania and called his mother, telling her he hadn’t felt so awesome before. After that, he got into horrible withdrawal where he couldn’t sleep.
This went on for months and didn’t get better, and the emptiness took over more and more. In the first few months of withdrawal, he told his psychiatrist how he felt, but she didn’t believe him. She told him it was not due to the drug, as it was out of his system. She said it was probably his obsessive, compulsive disorder that created all the problems.
David wrote in a suicide note that, “You present them with a problem that is created by the treatment you got from them, and as a reaction, get blamed yourself.”
His life had stopped. He couldn’t get pleasure out of anything. Even easy entertainment like gaming, something he had always enjoyed, gave him nothing. Everything was grey. Although he didn’t feel anything from meeting girls anymore, his zero libido and erection problems weren’t even the worst part: “The total erasing of any pleasure in life, as if I have been stripped of all my dopamine, is life debilitating.”
He realised he was doomed to be in this state forever and saw no other option than suicide. He was very rational about this decision. It was a kind of self-euthanasia, which his parents, both doctors, understood.
The blunting of his emotions was fatal. He didn’t feel emotionally connected to people, wasn’t able to feel joy in anything, not even music. His whole personality had been wiped out, and he felt he was already dead and not human anymore, an empty shell. The last year of his life he often said that he desperately wanted to live, but not as a kind of lobotomized zombie. David had never had any sleeping problems before he took sertraline, but the drug caused severe insomnia, which lasted till the day he killed himself.
David wanted his story to be told, as a warning to others. Both he and his mother had read my book,38 but unfortunately, nothing could be done. If he had read it before he was put on sertraline, he might have refused to take the drug that killed him.
I have heard similar suicide stories, also from Denmark, where not only the sex life continued being destroyed, but where the patients also experienced severe anhedonia, flatness of emotions, memory problems, and cognitive dysfunction, which some of them described as a chemical lobotomy. Patients who have come off neuroleptics have also sometimes complained of persistent sexual dysfunction, which might be related to the fact that they were unable to have any sex life while they were on the drugs, or that they were on depression pills simultaneously. There is still a lot we don’t know about persistent harms after withdrawal.
If people who are not psychiatrists—for example, doctors who don’t use psychiatric drugs, nurses, pharmacists, psychologists, social workers, and people with no formal education but who care about other people—took over the whole psychiatric enterprise tomorrow, it would mean tremendous progress.
No hope for psychiatry
There is no hope for psychiatry, which has degenerated so much, for so long, and is so harmful that it must be stopped. It is much better for us not to have psychiatry at all than to have the one we have, or anything remotely similar.
We need to act collectively. This is our only chance. If one worker strikes because of inhumane working conditions, the boss doesn’t care but just fires the worker. If everybody walks out, all of sudden he has to negotiate.
Everybody needs to “walk out” of psychiatry. This is why I have written this book. Human beings can accept almost anything, if they get used to it, no matter how horrible, unfair and unethical it is, and few will protest against a sick system because it could be uncomfortable or even dangerous for them. This is why we have had slavery as an officially accepted norm for thousands of years. This is also how the Nazis came to power in Germany and kept it; people were too afraid to protest, as the Nazis murdered their enemies early on. Only two months after president Paul von Hindenburg made Adolf Hitler chancellor of Germany, on 30 January 1933, Hitler opened the first concentration camp in Dachau, outside München.
Can you name any influential politician, psychiatrist, psychologist, or patient advocate who has run a great personal risk by criticising psychiatry? Perhaps you can name one or two. I can mention quite a few but that’s because I am part of the resistance movement, like my grandfather was during the Nazi occupation of Denmark.25 My grandfather survived despite being taken by the Gestapo and sentenced to a concentration camp. He saved many Jews; I want to save as many psychiatric patients as I can.
History means a lot to me. If the psychiatrists had not forgotten their history, then perhaps we would have had a better psychiatry today, but they repeat the same mistakes they have repeated for over 150 years. When Margrethe Nielsen drew me into psychiatric research in 2007, it was with this proposal:
“Is history repeating itself?” She compared benzodiazepines with SSRIs and showed that indeed it does (see Chapter 4). I have the following suggestions:
- Disband psychiatry as a medical specialty. In an evidence-based healthcare system, we should not use interventions that do more harm than good, but that’s just what psychiatry does. In the transition period, let psychologists who are against using psychiatric drugs be heads of psychiatric departments and give them the ultimate responsibility for the patients.
- Psychiatrists should be re-educated so that they can function as psychologists. Those who are not willing to do this should find themselves another job or retire early.
- The focus should be on getting patients off psychiatric drugs, as they are harmful in the long run, and as the vast majority of patients are on long-term therapy. Courses on drug withdrawal should be mandatory for everyone working with mental health patients, and all patients must be told why they would likely get a better life without drugs.
- Establish a 24-hour national helpline and associated website to provide advice and support for those adversely affected by prescribed drug dependency and withdrawal.
- Provide tapering strips and other aids to help patients withdraw from their drugs at no cost for the patients.
- Apologize. It means a lot for victims of abuse to get an apology. Governments must require of psychiatric associations that they apologize unconditionally to the general public about the immense harm they have inflicted on mental health patients by lying systematically to them, e.g. about the chemical imbalance and by telling them that psychiatric drugs can protect against suicide or brain damage. If organisations are unwilling to do this, governments must do it for them and dissolve the organisations because they are harmful to society.
- Stop using words such as psychiatry, psychiatrist, psychiatric disorder, psychiatric treatments, and psychiatric drugs, as they are stigmatising and as patients and the general public associate them with bad outcomes.40,43 Change the narrative and use terms such as mental health instead.
- Leave mental health issues to psychologists and other caring professions, as what the patients need more than anything else is psychotherapy, empathy, caring, and other psychosocial interventions.
- Discard psychiatric diagnosis systems like DSM-5 and ICD-11 entirely and focus on the patients’ most important issues. Psychiatric diagnoses are so unspecific and unscientific that virtually the whole population could get at least one, and they don’t fit with the issues patients have, but often lead to additional diagnoses and more harm for psychiatric “career” patients.
- Make forced treatment unlawful. All treatment of mental health issues must be voluntary. Forced treatment does vastly more harm than good,38,44,45 and is discriminatory.
- Make psychiatric drugs available only for use under strictly controlled circumstances:
a) while patients are tapering off them; or
b) in rare cases where it is impossible to taper off them because they have caused permanent brain damage, e.g. tardive dyskinesia; or
c) available for alcoholic delirium and used as sedatives for operations and other invasive procedures, e.g. colonoscopy, which can be extremely painful.
- Make it unlawful to use drugs that are registered for non-psychiatric uses, e.g. antiepileptics, for mental health issues, as this is harmful.
- No one working with mental health patients should be allowed to have financial conflicts of interest with any manufacturer of psychoactive drugs or other treatments, e.g. equipment for electroshock.
- All rules about the need for a psychiatric diagnosis in order to get social benefits, or economic support to schools, must be removed, as they create an incentive for gluing psychiatric diagnoses to people instead of helping them, which would involve other interventions than drugs.15
Everyone: Do what you can to change psychiatry’s misleading narrative. Speak about depression pills, major tranquillizers, speed on prescription, etc.
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.