Psychiatry’s serotonin-imbalance theory of depression, long discarded by researchers, was finally flushed down the toilet by psychiatry and the mainstream media in 2022. And psychiatrists’ primary treatments for depression—their so-called “antidepressants”—are now circling the drain. This leads to at least two questions: (1) What model of depression actually fits the facts? (2) What approach to depression makes sense?
Before getting to those questions, a summary of the discrediting of psychiatry’s chemical-neurobiological theories of depression and of its so-called “antidepressant” drugs.
Psychiatry’s Chemical-Neurobiological Theories of Depression
More than 25 years ago, researchers disproved the serotonin-imbalance theory of depression. In Blaming the Brain (1998), Elliot Valenstein, professor emeritus of psychology and neuroscience at the University of Michigan, detailed earlier research showing that it is just as likely for people with normal serotonin levels to feel depressed as it is for people with abnormal serotonin levels, and that it is just as likely for people with abnormally high serotonin levels to feel depressed as it is for people with abnormally low serotonin levels. Valenstein concluded, “Furthermore, there is no convincing evidence that depressed people have a serotonin or norepinephrine deficiency.”
While researchers had discarded the serotonin and other chemical imbalance theories by the 1990s, the first unequivocal declaration by establishment psychiatry of the invalidity of these imbalance theories was in the Psychiatric Times in 2011, when psychiatrist Ronald Pies stated: “In truth, the ‘chemical imbalance’ notion was always a kind of urban legend—never a theory seriously propounded by well-informed psychiatrists.”
Then in 2022, psychiatrist Joanna Moncrieff and her co-researchers published a review in Molecular Psychiatry of hundreds of different types of studies attempting to detect a relationship between depression and serotonin that concluded that there is no evidence of a link between low levels of serotonin and depression; this resulted in the mainstream media finally reporting on the jettisoning of the serotonin-imbalance theory of depression.
Less publicized in 2022 was another powerful discrediting of psychiatry’s neurobiological disease model. Published in Neuron, Raymond Dolan—one of the most influential neuroscientists in the world— and his co-authors, reflecting on the more than 16,000 neuroimaging studies published during the last 30 years, concluded, “Despite three decades of intense neuroimaging research, we still lack a neurobiological account for any psychiatric condition.”
Genes and depression? An investigation, published in 2021 in the Journal of Affective Disorders, of 5,872 cases and 43,862 controls that examined 22,028 genes, reported that the study “fails to identify genes influencing the probability of developing a mood disorder” and “no gene or gene set produced a statistically significant result.”
In summary, researchers have found no serotonin nor any other neurotransmitter association with depression, no neurobiological associations, and no genetic associations.
With the fall of the serotonin-imbalance theory, there was no scientific explanation for the mechanism of antidepressants. However, psychiatry assured the general public that antidepressants are still very effective medications, and The New York Times, trusting establishment psychiatry sources, published a 2022 article titled, “Antidepressants Don’t Work the Way Many People Think,” in which it reported that “nearly 70 percent of people had become symptom-free by the fourth antidepressant.” What is the scientific reality of antidepressant effectiveness?
Antidepressant Drugs
As is the case with any treatment for depression—including bloodletting—there will always be patients who offer positive testimonials. However, in science, such testimonials are called “anecdotal reports” and are not considered sufficient evidence for effectiveness. Scientific effectiveness is assessed by comparing a treatment to a placebo control and to the natural course without any treatment. Moreover, scientific effectiveness is gauged not simply by short-term drug-company studies but by long-term outcomes, and by evaluating whether benefits outweigh adverse effects.
In 2002, the Journal of the American Medical Association (JAMA) published a study comparing depression remission outcomes of a placebo to the herb St. John’s wort and to Zoloft. The placebo worked better than both St. John’s wort and Zoloft, as a positive “full response” occurred in 32% of the placebo-treated patients, 25% of the Zoloft-treated patients, and 24% of the St. John’s wort-treated patients.
Later in 2002, a leading researcher of the placebo effect, Irving Kirsch, examined 47 drug company studies on various antidepressants. These studies included published and unpublished trials, but all had been submitted to the Food and Drug Administration (FDA), so Kirsch used the Freedom of Information Act to gain access to all data. He reported that “all antidepressants, including the well-known SSRIs . . . had no clinically significant benefit over a placebo,” describing antidepressants as “clinically negligible” with respect to depression remission.
A 2022 large study, lead-authored by Marc Stone at the FDA’s Center for Drug Evaluation and Research, examined 232 drug-company trials on antidepressants submitted to the FDA between 1979 and 2016. Even in these drug-company studies, Stone and his co-researchers found that only “15% of participants have a substantial antidepressant effect beyond a placebo effect.”
Moreover, such drug-company antidepressant trials are dice-loaded in favor of the antidepressant (for example, using an inactive placebo rather than an active placebo which would more truly blind subjects); and drug studies submitted to the FDA are routinely short-term, usually around six to eight weeks.
In the long-term, outcomes are worse. In 2017, the journal Psychotherapy and Somatics published, “Poorer Long-Term Outcomes among Persons with Major Depressive Disorder Treated with Medication,” which found that controlling for depression severity, the outcomes of 3,294 subjects over a nine-year period showed that antidepressants may have had an immediate, short-term benefit for some people, but at the nine-year follow-up, antidepressant users had significantly more severe symptoms than those individuals not using antidepressants.
Another important question for scientists is: What is the natural course of depression without any medication? Published in 2006 was the National Institute of Mental Health (NIMH) study, “The Naturalistic Course of Major Depression in the Absence of Somatic Therapy,” which examined depressed patients who had recovered from an initial episode of depression, then relapsed but did not take any medication following their relapse. One year later, the recovery rate of these non-medicated depressed patients was 85%.
In evaluating any drug treatment, scientists also examine whether its benefits outweigh its adverse effects. In antidepressant studies, depression remission is routinely reported for 25% to 35% of the subjects. However, the journal Drug, Healthcare and Patient Safety, in a 2010 examination of several studies, reported that the percentage of sexual dysfunction for SSRI antidepressants runs from 25%–73%; and in one study of 344 patients who had a history of normal sexual function before SSRI treatments, there was an overall incidence of 58% sexual dysfunction. Furthermore, post-SSRI sexual dysfunction (PSSD), in which sexual dysfunction exists even after discontinuation of the SSRI, was first reported to regulators in 1991.
Psychiatry acknowledges that the majority of patients do not remit with a single antidepressant, but it has insisted that if patients are treated with enough different antidepressants, nearly 70% of them will achieve remission. They justify this with the 2006 reported results of the NIMH-funded “Sequenced Treatment Alternatives to Relieve Depression (STAR*D).
In the year-long STAR*D study of 4,041 patients, there were four stages. In each stage patients who did not remit with one antidepressant were prescribed a different one or augmented with another drug. STAR*D investigators claimed a 67% cumulative remission rate, however, from the very beginning this rate was published, it was challenged as being unjustified by the data.
The first challenge of STAR*D appeared as an editorial in the same 2006 issue of the American Journal of Psychiatry in which the STAR*D study had been reported. In this critique, psychiatrist J. Craig Nelson notes that 67 percent remission rate did not account for relapse, noting the following: “Among those achieving remission, relapse rates were 33.5% [in Step 1], 47.4% [in Step 2], 42.9% [in Step 3], and 50.0% [in Step 4] . . . . I found a cumulative sustained recovery rate of 43% after four treatments, using a method similar to the authors but taking relapse rates into account.”
Further analyses of STAR*D data revealed even worse news. Ed Pigott and his co-researchers published an analysis in 2010 that showed of the 4,041 patients who entered the study, only 108 remitted, stayed well, and remained in the study to its one-year end. Thus STAR*D could only document a get-well/stay-well rate at the end of a year of only 3%. This in contrast to the previously mentioned 2006 NIMH-funded study that documented a one-year remission rate of non-medicated depressed patients of 85%.
Despite all this, STAR*D’s “nearly 70% recovery” rate has not only been trusted and reported by the mainstream media but taught to psychiatry students, including in the 2018 textbook 50 Studies Every Psychiatrist Should Know.
Then in 2023, Ed Pigott and his co-researchers, utilizing the Restoring Invisible and Abandoned Trials initiative, conducted a reanalysis of STAR*D, which was published in BMJ. Pigott reported that among the 4,041 subjects, only 3,110 actually had met the depression criteria, and so 931 patients who should have been excluded from the calculation of a remission rate had not been excluded, which inflated the remission rate. STAR*D remission rate was also inflated through violating research protocol by switching the primary outcome measures, and by reversing the protocol on dropouts so that they were no longer viewed as treatment failures. And then results were further inflated by creating a “theoretical” remission rate based on the notion that if the drop-outs had stayed in the trial through all four stages of treatment, they would have remitted at the same rate as those who did stay in the trial to that end—this not justified by what is known from previous research about dropouts.
If STAR*D investigator’s original protocol been adhered to, Pigott concluded, “In contrast to the STAR*D-reported 67% cumulative remission rate after up to four antidepressant treatment trials, the rate was 35%.” Furthermore, that original protocol did not account for relapse.
Perhaps one day, a jury will decide whether the shenanigans of STAR*D investigators were merely “scientific misconduct” or rise to the level of “fraud.” However, even according to establishment psychiatry’s Psychiatric Times, standard drug treatment for depression may no longer be simply circling the drain but half-way down it. The cover of the December 2023 Psychiatric Times issue announced: “STAR*D Dethroned? Since 2006 It Stands Out As An Icon Guiding Treatment Decisions Of Major Depressive Disorders. But What If It’s Broken?” In this cover story, the editor-in-chief of the Psychiatric Times acknowledged that Pigott and his co-researchers reanalysis is “well-researched,” and he concluded: “For us in psychiatry, if the BMJ authors are correct, this is a huge setback, as all of the publications and policy decisions based on the STAR*D findings that became clinical dogma since 2006 will need to be reviewed, revisited, and possibly retracted.”
A Model of Depression That Actually Fits the Facts
To repeat, no associations have been found between depression and serotonin (nor with any other neurotransmitter), nor with any neurobiological mechanism, nor with any gene or gene set. What then is associated with depression and suicidality? The answer is overwhelming life pains. Specifically:
Financial Poverty: Personal and Family Challenges to the Successful Transition from Welfare to Work (1996) reported that Americans on public assistance have at least three times higher rate of depression. A 2013 national survey, issued by the U.S. government’s Substance Abuse and Mental Health Services Administration (SAMHSA), reported that among American adults, serious suicidal thoughts occurred in 6.6% of those with family incomes below the Federal poverty level, which is more than double the 3.1% serious suicidal thoughts of those adults with annual family incomes at 200% or more of the Federal poverty level.
Unemployment: According to that SAMHSA report, these are the following percentages for adults having a major depression episode: 9.5% for the unemployed; 7.8% for part-time employed; and 5.3% for full-time employed. The unemployed were more than twice as likely as those who were full-time employed to have serious thoughts of suicide (7% for unemployed vs. 3% for the employed); and the unemployed were more than four times likely to attempt suicide (1.4% for the unemployed vs. 0.3% for the employed).
Involvement with the Criminal Justice System: SAMSHA also reported that the percentage of American adults with serious suicidal thoughts was 10.7% for those on parole or a supervised release from prison in the past 12 months, and 9.2% among those who were on probation.
Childhood Trauma: Adverse childhood experiences include physical and emotional abuse, physical and emotional neglect, and family trauma (such as a parent in prison, or witnessing a parent physically abused by the other parent). A 2004 study, “Adverse Childhood Experiences and the Risk of Depressive Disorders in Adulthood,” reported that exposure to such traumatic experiences is “associated with increased risk of depressive disorders up to decades after their occurrence”; and that childhood emotional abuse increased risk 2.7 fold for lifetime depressive disorders. In multiple studies linking childhood trauma to depression, The Truth About Depression (2003) reports that depression was from 1.6 to 12.2 times more common in individuals with a history of significant childhood trauma than in controls who did not report such trauma.
Miserable Significant Relationship: The Interactional Nature of Depression (1999) reports hundreds of studies documenting the interpersonal nature of depression. In one study of unhappily married women who were diagnosed with depression, 70% of them believed that their marital discord preceded their depression, and 60% believed that their unhappy marriage was the primary cause of their depression. In another study, the best single predictor of depression relapse was found to be the response to a single item: “How critical is your spouse of you?”
Lack of Social Support: Bowling Alone (2000) reports, “Low levels of social support directly predict depression, even controlling for other risk factors.” In 2004, the British Medical Journal reported that postpartum depression occurs in 10 to 20% of women in the United Kingdom and the United States but is considered rare in Fiji and some African populations with structured social supports after childbirth.
Critical Thinking: Ironically, while a denial of painful realities can cause problems, an awareness of painful realities can fuel depression and anxiety. Several classic studies indicate that depressed people actually deceive themselves less than nondepressed people. In 1980, the Journal of Abnormal Psychology reported that depressed subjects judge other people’s attitudes toward them more accurately than nondepressed subjects; as the nondepressed perceived themselves more positively than others saw them, whereas the depressed saw themselves as they were actually seen by others. In 1979, the Journal of Experimental Psychology reported that nondepressed subjects overestimated their contribution to winning a rigged game, while depressed subjects more accurately evaluated their lack of control when losing or winning.
The pain of shame and anxiety are routinely associated with depression, and painful losses—from the loss of a loved one and the loss of physical capacities, to existential losses of meaning and purpose—are routinely associated with depression.
Association and correlation don’t necessarily mean causality, as one can argue, for example, that it’s not clear whether unemployment results in depression, or depression results in unemployment; however, studies show nondepressed individuals become depressed after unemployment. Moreover, it is farfetched to argue that childhood depression causes adverse childhood experiences rather than such trauma fueling later depression; and as noted, in the study about unhappily married depressed women, the majority of these women believed that their unhappy marriage preceded their depression.
A variety of overwhelming pains are consistently associated with depression, and a more sensible model of depression would take this into account. One such model of depression is to view this phenomenon not as a disease, disorder, or pathology, but rather as a problematic “strategy” to reduce and shut down overwhelming pain.
Consider the “symptoms” of what is commonly called “depressive disorder.” These include the diminishment of energy, pleasure, interest, sexual desire, concentration, decisiveness, and appetite, accompanied by self-reproach, worthlessness, shame, and suicidal thoughts. The strategy of shutting down overwhelming pain is problematic because it is not selective for only pain but also shuts down our energy, pleasure, and cognitive functions. This shut down can result in complete immobilization or a fear of such immobilization, both of which are psychologically painful, and this can result in the pain of self-loathing and shame. In a vicious cycle, all of this results in more overwhelming pain, resulting in greater efforts to shut down pain.
Perhaps another model could fit the data better; however, unlike psychiatry’s chemical-neurobiological medical model, at least this model has some empirical evidence and rationality.
A More Sensible Approach
Overwhelming pains—including financial and legal pains, childhood trauma, relationship pain, and a variety of losses—are clearly associated with depression, and there is significant evidence that such overwhelming pain precedes depression, though in a vicious cycle, depression and immobilization can result in further overwhelming pain.
Some overwhelming pains are the result of societal policies, and thus political activism can be a solution. And while trauma and relationship pain can also be created, in part, by societal policies, talented therapists can help individuals heal from trauma, extricate from toxic relationships, and find community. Nowadays, however, depressed people are primarily treated with drugs.
Psychoactive Drugs: Psychoactive or psychotropic drugs are drugs that affect neurotransmitters. Such drugs include antidepressants and other prescription psychiatric drugs, as well as alcohol, cannabis, cocaine, and heroin, along with psychedelics such as LSD and psilocybin, and the dissociative anesthetic ketamine. Unlike medications such as antibiotics or insulin, psychoactive drugs don’t kill the source of infection or correct biochemical deficits. Instead, psychoactive drugs can, for some individuals, reduce, shut down, or dissociate them from overwhelming pains. However, each of these psychoactive drugs comes with a set of adverse effects as well as tolerance and withdrawal problems. While there are individuals who report that psychoactive drugs have helped them function, the question is how sustainable are these drugs? As noted, Psychotherapy and Somatics reported that among subjects equally depressed, at the nine-year follow-up, antidepressant users had significantly more severe symptoms than those individuals not using antidepressants; and as Robert Whitaker documented in Anatomy of an Epidemic (2010), while short-term use of psychoactive drugs may be beneficial for some individuals, long-term use often makes matters worse, not only for depression but for other crises.
Thus, it should be uncontroversial that depressed individuals deserve a truly informed choice and dialogue about the use of psychoactive drugs. It should also be uncontroversial that a sustainable approach to depression would include (1) changing societal policies to reduce avoidable overwhelming pains; and (2) dramatically changing the selection and training of mental health professionals so there would be more talented therapists.
Activism to Change Societal Policies: At the most obvious level, this would include:
(1) Eliminating, reducing or at least mitigating the effects of financial poverty. Some examples of social policy changes: significantly subsidizing housing costs; providing a guaranteed basic income; eliminating student-loan debt; and otherwise creating greater financial justice.
(2) Eliminating, reducing or at least mitigating the effects of unemployment. This would include increasing and extending unemployment benefits; and prohibiting CEOs of giant corporations from making 400 times more than the average worker while cutting jobs to raise stock prices.
(3) Preventing unnecessary involvement with the criminal justice system; for example, abolishing societal hypocrisy by decriminalizing all psychoactive drugs.
(4) Recognizing that alienating jobs that are vulnerable to layoffs are among the many reasons why so many people experience ever-increasing anxiety, powerlessness, resentment, and rage, which creates parents who in their interactions with their children have little frustration tolerance, making traumatic adverse childhood experiences more likely.
(5) Implementing policies at every level of society that build and maintain community.
Selecting and Training More Talented Therapists: Many depressed people today are immediately prescribed an antidepressant drug (more often from a primary care physician than a psychiatrist). Along with an antidepressant, or prior to taking one, some depressed people will try psychotherapy, but only with great luck will they find a talented therapist.
In The Great Psychotherapy Debate (2001), Bruce Wampold notes that while therapists tend to believe their therapy techniques—such as cognitive-behavioral therapy (CBT)—are significant, patients believe having someone who understands them and is interested in them is most important. Wampold documents research confirming that “belief in approach,” “relationship alliance,” and “therapist personal characteristics” are more important factors than any therapy techniques.
It has long been known that the variable of therapy technique has little effect on outcome. In 2008, the Journal of Consulting and Clinical Psychology (“Psychotherapy for Depression in Adults: A Meta-Analysis of Comparative Outcome Studies”) reported seven meta-analyses on 53 studies comparing psychotherapy techniques (CBT, psychodynamic, behavioral-activation, social skills training, problem-solving, interpersonal, and nondirective), and concluded: “This study suggests that there are no large differences in efficacy between the major psychotherapies for mild to moderate depression” (interpersonal therapy was slightly more effective, and CBT had a significantly higher dropout rate). In 2024, a Journal of Clinical Psychology study, “The Equivalence of Psychodynamic Therapy (PDT) and Cognitive Behavioral Therapy (CBT) for Depressive Disorders in Adults: A Meta-Analytic Review,” reported equivalent effectiveness of PDT and CBT.
Vital for helping depressed people are therapist “personal characteristics” that produce a collaborative “relationship alliance,” which facilitates healing and energizes and motivates patients to take constructive actions. Unfortunately, such personal characteristics are difficult to quantify, making standard empirical research difficult. However, as others have pointed out (probably misattributed to Albert Einstein), not everything that can be counted counts, and not everything that counts can be counted.
My experience is that talented therapists who facilitate healing are authentic and able to be fully present. They have a gentle presence, and they are superior listeners. They are not reactive to negativity; and the overwhelming pain of another does not make them anxious, so they are less likely to try to control “symptoms,” but instead focus on the whole person. Their lack of fear of emotional pain allows them to have a special kind of humor that is extraordinarily sensitive to pain, and adept at knowing how to lighten its burden. The personal characteristics of talented therapists create conditions for healing, which enable depressed people to experience being cared about; and this results in becoming more open to caring about others and becoming less self-absorbed—opening them up to the entirety of nature beyond themselves, which results in healing.
When I was in my training around many psychiatrists while interning in hospitals and other institutional settings, it was only those rare disgruntled resident psychiatrists whose company I enjoyed; and so I found myself rephrasing Charles Bukowski, saying, “I don’t hate psychiatrists, but I feel better when they are not around.” Helpful therapy with depressed people means dealing with painful aspects of their life—such as childhood trauma and toxic relationships—and obviously, it is not a great idea for a depressed person to be pained by the personal characteristics of a therapist while dealing with their own pain.
Talented therapists not only help facilitate healing but are also energizing and motivating, which is extremely important for depressed people. Seriously depressed people routinely lack the energy for constructive behaviors such as physical exercise. In 2000, Psychosomatic Medicine reported a study that compared outcomes for patients with depression in three treatment groups: (1) Zoloft, (2) Zoloft + exercise, and (3) exercise only. At the end of four months, there were no significant differences in the remission rates of these groups; however at 10 months, exercise only had the lowest relapse rates: depression symptoms returned for 38% of the Zoloft group and for 31% of the Zoloft + exercise group, but depression symptoms returned for only 8% of the exercise only group. While there is no better antidote to depression than physical exercise, depressed people routinely need to be energized and motivated to take constructive actions.
The personal characteristics of energizing therapists are, in many ways, the opposite of the traits routinely selected for in professional training programs. Virtually all medical schools and most graduate psychology programs select future professionals based primarily on their academic achievements, much of which requires a great deal of compliance. People with a talent for energizing and motivating are authentic, spontaneous, playful, risk taking, and find a way to have fun even with people who are seriously depressed.
The socialization process in training programs for virtually all psychiatrists and most psychologists routinely results in psychiatrists and psychologists who are so terrified of being judged by their superiors as “inappropriate” that they are afraid to be authentic, spontaneous, playful, and risk taking. So, even when a program applicant has not only sufficient grades and test scores to gain entrance into a professional program but also the personal characteristics to be a talented therapist, these programs routinely extinguish these talents, and so many gifted people quit when they recognize how hard they will have to fight to retain their authenticity and integrity.
Thus, there are only a handful of professionals I have met who have the talent to help depressed people. These talented therapists are usually anti-authoritarians who have fought off their professional socializations, and they often have had backgrounds outside of academia that have nurtured rather than squashed their talents. One such talented clinical psychologist—who has received high praise from my referrals—is an anti-authoritarian with a background as a personal trainer and in improv comedy who, in her graduate training, fought to maintain her authenticity and integrity.
Psychiatry’s depression outcomes are poor because its bio-chemical-electrical treatments are based on a depression model that science has flushed down the toilet. It should be obvious that new models of depression based on facts rather than fiction need to be created. With such models, hopefully, it will become obvious that when it comes to helping depressed people, societal policies and the talent level of therapists are damn important.
As usual, Bruce Levine is absolutely correct when it comes to his critique of debunked biologically oriented psychiatry, but I don’t accept his support for so-called talented therapists. For as I’ve repeatedly pointed out in my previous posts, without the bogus, wholly subjective categories of the DSM, which is the purported authoritative guide for the diagnosis and treatment of mental disorders, there cannot be any universally applicable, objective, and verifiable criteria for assessing the efficacy and superiority of one type of therapy over another. If mental illness and mental health are merely metaphors for states of mind and behaviors whose appropriateness is approved or condemned according to prevailing mores (which evolve in the course of time, as one can clearly see from the case of homosexuality and transgender identity), I see no valid reason to grant credence to would-be professionals who claim unique knowledge of and insight into the problems of their “patients.” See Jeffrey Masson’s deconstruction of the therapy cult in “Against Therapy: The Myth of Emotional Healing.”
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I can verify this. I stopped all mood stabilizers after futile 10 years, stopped all meds and finally took control of my emotions using meditation and relaxation. Did much better for next 20 years. Psychiatric drugs make things worse. Memory loss and lack of inhibition of emotions is a major issue other than serious side effects to kidney and liver and skin.
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While there’s no doubt there’s a correlation between life pains and depression for many people, this article fails to take into account that there may still be other causes of depression that are neurobiological. For example, MDD depression may look and respond much differently than bipolar depression.
What’s needed are better ways to distinguish the underlying cause of depression and treat that. Sometimes it may be therapy because of life circumstances, other times it may be certain kinds of medication.
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I suffered from depression and depressive episodes for my whole teenage and young adult life. So it was interesting to read this summary of the ideas that guided psychiatry at this time.
My luck was that after I first tried medication and then psychotherapy I understood from my experience that the first had no and the latter only minimal capacity to help me recover. So I had my eyes wide open to other things that could help, and so I bumped into one of Jon Kabat-Zinn’s mindfulness books and decided to try out yoga and meditation. After three years of an hour of yoga a day I didn’t experience severe episodes anymore but rather moderate ones and my quality of life had already increased tremendously.
Over the years I dicovered many more wellness and recovery tools but these two have always been my two main pillars. The way they work is like from two sides. They help you calm your stressed out mind and bring more peace and they bring you in contact with yourself again and that makes all the emotional stress and pain that you’ve learned to push down emerge again. And then by practicing you build the strength to just stay with it all and then sooner or later it dissolves. From this process comes the therapeutic effect of these “treatments”.
I think that the model that explains clinical depression as the result of (habitual) strategy to suppress painful feelings is spot on. I saw it first formulated in the article “A pain that is a solution to a deeper pain” by Robert Augustus Masters in Tami Simons beautifully edited article collection Darkness Before Dawn. Redefining the Journey Through Depression. It is a collection of essays by people from very different backgrounds who have a helper’s, healer’s job and have all experienced clinical depression themselves.
This book was very important for me to confirm my impression that I didn’t need to be healed by something or someone from the psy field but that I’d just as all the other authors in the book find my path out of this on my own.
What I missed in this article is a reference to the authors of the book The Mindful Way Through Depression Mark Williams, John Teasdale, Zindel Segal, and John Kabat Zinn. I think that they’re the only ones who have understood how exactly these unconscious habits of the mind and heart of pushing pain down, rumination, and the idea that depression could be solved by it are the fuel to the whole thing. And they give very good advice for practicing yoga and meditation when you have these habits and how to slowly unlearn them.
When you practice yoga and meditation with a good teacher they will naturally dissolve but with the help of the book you can see these behaviours and losen your grip with the advice of someone who has a really good understanding of them (what not every good meditation teacher has)
“Talented” psychotherapists may be an assistance in this but it can’t change that when these habit patterns are strong you will have to do many, many hours of a mind-body practice on your own and just seeing even an outstanding psychotherapist once a week will not be enough.
They are so rare though that I can’t recommend psychotherapy. The risks are too high, and as a matter of fact, a psychotherapist is absolutely not a necessity in this healing journey.
The only things required are patience, persistence, and trust in your intuition that actually there is and has never been anything wrong with you.
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I can’t recommend psychotherapy either. Against my better judgement I let myself buy into the garbage that “therapists” are a necessity which for me only served to reinforce the idiot notion that something was wrong with me for feeling overwhelmed, that I was “ill” for feeling upset by situations that would have upset anyone. And there was no worthwhile feedback, informationally or emotionally. So, is it any surprise I always left “sessions” feeling more confused, alone and emptier then when I arrived? NO. But that’s what happens in relationships where one person gets paid for keeping their true thoughts a secret and arbitrarily calling the shots about your life — aka “power imbalance” — a harmful dynamic that can (in its own strange and very sick way) make the so-called “psychotherapeutic relationship” as addicting as psychiatric drugs. Either way it’s hollow as hell which makes it no damn good.
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I find it refreshing the way you cut through psychiatric cant and obfuscation!
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Thank you! 🙂
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Critics, such as Dr. Levine, accuse psychiatrists of using drugs for Major Depression that increase serotonin without any evidence of actual deficits in serotonergic activity. However, what they ignore is the fact that the first two classes of antidepressants, MAOIs and tricyclics, were discovered completely by accident and without any suspicion of their potential effects on serotonin. When they were found to improve depression—which they did and do—research went into discerning their mechanisms of action. The most obvious and shared quality of those classes of antidepressants was to increase monoamines. With the discovery of fluoxetine and other SSRIs, it was quite reasonably concluded that the most likely mechanism of action was increases in serotonergic activity. WE have since learned that they were wrong. However, as Dr. Levine’s reference to Dr. Ronald Pies’ statements demonstrates, no knowledgeable psychiatrist has bought into the extraordinarily simplistic “not enough serotonin” theory of Major Depression for many, many years. Those early conclusions and theories were drawn without considering effects of antidepressants other than simply increasing serotonin, and without knowledge of the fact that there are many different subtypes of serotonin receptors that play different roles in Major Depression. Antidepressants, including SSRIs, have anti-inflammatory effects, activate the mTOR/Akt pathways, inhibit GSK3B, stimulate brain-derived neurotrophic factor, and have other such effects that may or may not be mediated by serotonin. Moreover, it is known that 5-HT1A receptor stimulation has an antidepressant effect as does inhibition of 5-HT2A receptors. There also appears to be differential effects of activation of 5-HT3, 5-HT7, and other subtypes of serotonin receptors.
I note that in 2007, the scientific publisher, Elsevier, published my book, Metabolic Syndrome and Psychiatric Illness. In that book I described how Major Depression is due in part to inflammation, immune system aberrations, cytokines from visceral fat, insulin resistance, mitochondrial dysfunction, hypercortisolemia, and many other factors that are at most tangential to abnormalities in serotonergic activity. I don’t know why people, especially knowledgeable ones such as Dr. Levine, keep harping on theories that psychiatrists have long ago abandoned as if psychiatrists were stupid, devious, and have ulterior motives. Antidepressant do help many people (acting only in part by affecting serotonergic activity), augmenting them with other medications greatly help many that don’t respond, and treatments keep improving. Major Depression is a bio-psycho-social phenomenon. In each individual, the contribution of each may differ. To suggest that Major Depression is due entirely to psychosocial factors is as absurd as insisting that it is entirely biological to be addressed only by medications.
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Hello, and thank you Dr. Mendelson.
I knew something was amiss in this whole discussion in dismissing this class of drugs based on serotonin levels (alone).
As a layperson, I thoroughly appreciated your input about the other possible benefits to SSRIs for major depression. BUT-
My concern is for my 88 yr. old mother with moderate dementia (vascular), and her geriatric instantly has her on some type of anti-depressant / SSRI.
My concern is all these drugs are neuro-TOXIC, and that there better be a real sound reason / benefit, for these psychiatric or anti-psychotic drugs.
My mom is NOT clinically diagnosed as depressed. We lost our dad in 2020… but seriously my mother has been, and bounced back, as very upbeat, with belly-laughs.
But my sister who, who pushes pharmaceuticals being a Pharm-tech, claims our Mother is diagnosed {at this late age} as “Bi-Polar”. Please.
From your perspective:
Does dementia warrant these SSRI’s… based on what you mention of their anti-inflammatory, stimulating BDNF, inhibit GSK3B, etc. ?
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When you prescribe an “anti-depressant”, or any psychiatric drug, do you first go over the all the effects of the drug — what is printed along with the drug prescription at the pharmacy?
If not, aren’t you hiding important information, knowing the printout may never get read (and should be read in the doctor’s office during initial discussion)?
Do you remind each patient that drugs don’t have side effects, only effects? And that the real effects are not determined by the wishes of the prescriber or user?
If you don’t do these things, why would a thoughtful patient trust your assertion that “anti-depressants do help many people”?
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As a matter of fact, many psychiatrists and other participants in the fraudulent enterprise known as the mental health industry are devious and mercenary and do have ulterior motives.
If depression or any other emotional state that is arbitrarily labeled as pathological, sick, abnormal, dysfunctional, etc. in accordance with DSM criteria is conclusively proved, through careful testing and examination, to stem from genetic or other physical causes, such as dementia and other neurological conditions, some sort of medical intervention can be appropriate and legitimate. Without such a determination, however, it is absurd to speak of therapy of thought, emotion, and behavior in a literal sense. In the absence of universally recognized, verifiable criteria, the advisability and efficacy of any therapeutic modality are perforce arbitrary and subject to personal bias (as we can see, for example, in the case of the previously employed and now largely discredited “conversion therapy” for homosexuals and others regarded as perverted or sexually deviant). If the DSM is not a medically or scientifically valid document, what gives so-called mental health professionals the knowledge, skills, insight, and authority to pass judgment on the cognition and behavior of their clients?
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Is it really an unquestionable fact, as you claim, that “treatments keep improving?” Has the widely praised CBT, for example, superseded long-term intensive Freudian psychoanalysis, which used to be considered the gold standard of psychotherapy? What about Primal Therapy, which Arthur Janov, once touted as the SOLE effective cure for neurosis? But since the APA has formally dropped neurosis as a category of mental disorder, is Janov’s alleged cure for it just another psychiatric myth? Without clearly identifiable biomarkers, exactly what can be the legitimate basis for evaluating the efficacy of a treatment for any so-called mental disorder? If not the DSM, then what?
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The tone scale and the meter, sir.
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Thank you Dr. Mendelson – this reply has helped me more than you can imagine. Can’t wait to get a copy of your book now.
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The usual response from the psychiatric community when it is pointed that biomarkers do not exist is that people like Bruce Levine simply do not have all the facts. However, thanks to people like him the world is being woken up to the dishonesty and falsehoods of psychiatry.
On a side note, the book “Metabolic Syndrome and Psychiatric Illness” could more aptly have been titled “Metabolic Syndrome and Psychiatric Drugs”.
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Typical the way most psychiatrists still manage to spit out medical jargon whenever they’re put on the spot. The problem is these days fewer and fewer people are falling for their crap — despite being subjected to the ridiculous number of ads for pharmaceutical garbage now polluting mass media.
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Dr. Mendelson, thank you for your reply. In response, I note that the research is exceptionally clear that antidepressants of all types are largely ineffective. As you know, the clinical trials literature shows whatever advantage they have over placebo is very small and clinically insignificant. The small difference that exists may be due to the breaking of the blind and other unscientific aspects of clinical trial design that stack the deck in favour of the drug. Following the logic of the randomised placebo-controlled trial, the mechanism of action of antidepressants is at least 80% placebo effect. You wrote, “Antidepressant do help many people.” Sure. They also fail to help many people and harm many other people. In the short-term, antidepressants are largely ineffective, their long-term outcomes are lousy, and your claim that ” treatments keep improving” is based on wishful thinking as opposed to scientific reality.
The data are the data, however inconvenient that may be to their proponents.
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Scott, dancing the biopsychosocial swing doesn’t change the fact that most “major depression” is the result of suppressed grief and anxiety that psychiatric drugs only numb and psychotherapy can actually augment.
Please tell me how that’s a good thing.
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Though I can appreciate the more nuanced clinical explanation Dr. Mendelson provided surrounding the various subtypes of serotonin, etc., I find his characterization that Dr. Levine suggest or even remotely intimates that “Major Depression is due entirely to psychosocial factors”, to be both false and disingenuous. More, nowhere in Bruce’s article does the word “Major” appear, much less used to describe or distinguish depression.
Dr. Mendelson seems to (implicitly) suggest that just because our neuro-biology is far more complex than our longstanding cultural narratives have informed us (having been handed down by psychiatry to begin with), that this somehow either excuses or negates decades of multiple levels of institutional chicanery and abject failure surrounding professional mental health care. Now that people from all walks of life are becoming ‘increasingly’ educated about the cognitive, emotional, and neurological impacts resulting from “psycho-social” trauma-especially when beginning in childhood, and are at a time when multiple psychiatric paradigms are crumbling, psychiatry seems ill-poised and ill-suited to meet the moment.
I think most honest, informed, and critically thinking people can agree that anyone who suggests that mental health issues are automatically or only caused by environmental factors (developmental, structural, relational, event precipitated, etc.), is not someone to be taken seriously. But the existence of such people, however, is negligible to utterly irrelevant. But let’s be real here; for decades psychiatry has systematically displaced, ignored, foreclosed, protected, and defended environmental roles in mental health by way of designating one “disorder’ or another (with far too much unprincipled drugging in tow) to legions of vulnerable individuals (this pernicious dynamic was prominent throughout much of my childhood, and cannot be overstated for its life impacts). James Davies and many others have written extensively on this dynamic surrounding psychiatry’s politicizing mental health to protect the social (capitalist) status quo. So, then, it appears that neither the bio nor the social of mental health telos is going anywhere for some time to come. My hope is that this (growing) dialectical tension-sans politics-will sooner than latter lead to the integral complexity “and honorable practice” their respective “truths” deserve.
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I read comment after comment in the Mad in America columns that spend all their time criticizing psychiatrists. Your comment made a lot of sense and explained so many aspects of treatment and thought. I do so wish the many people who believe half the crap put out by MIA would actually pay attention to what you are trying to communicate. (BTW I am not in the medical field myself). Thank you for your attempt to educate so many people
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What you call the “crap” put out by MIA is the real-life accounts by people who have been harmed physically and/or emotionally by degrading, brain-disabling treatments that have no justification other than ever-changing hypotheses. These accounts are far more convincing to me than the spurious arguments of mental health “professionals,” the majority of whom base their diagnoses on the scientifically invalid DSM categories of mythical disorders arbitrarily created (and occasionally dropped, depending on current social and cultural trends) by panels of self-styled experts.
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Scott, just because so-called “antidepressants” affect people’s biological makeup (serotonin levels, blah, blah, blah,) doesn’t mean that someone has an illness or “disorder”. All it means is that they’ve swallowed a powerful emotional anesthetic. And I wouldn’t be surprised if many of the same biomechanisms you mention occur whenever someone inhales laughing gas or any other potent anesthetic. Furthermore, minute biological variations (inflammation, immune system aberrations, cytokines from visceral fat, etc.,) happen in people all the time for any number of reasons that are impossible to isolate so declaring that such variations are due to so-called “Major Depression” (something that has no biologically definitive cause) is grasping at straws.
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…but it is beautiful example of confirmation bias.
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CLARIFICATION: Just because so-called “antidepressants” affect people’s bio-chemical makeup (serotonin levels, blah, blah, blah) doesn’t mean someone has an illness or a “disorder”. All it means is that they’ve swallowed a a powerful emotional anesthetic (aka sedative).
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Bruce, this article has made it possible for me to pull together a lot of fragments into a cohesive whole. Thank you for writing it. BTW, I’m a patient and a former peer counselor, not a professional. I need your help with something.
I also happen to be a Republican. I thoroughly agree with the prevailing popular wisdom that a wholistic approach is far superior to drugs and shock treatments when you’re trying to help somebody. But here’s my beef:
The components of a wholistic approach happen to run parallel to the agenda of the traditional liberal dogma, particularly when advocates profess socialism.
What gives?
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Mr. Kumin, I feel compelled to reply. Bringing politics into this remarkable and informative article and the equally impressive, professional replies is simply out of order. I have many arguments that I could bring to the table, but I won’t; it doesn’t belong. This topic is bigger than you and I. This topic needs to rise above politics. We need to put aside any references of socialism, liberalism, and conservatism. Don’t spoil a good thing, sir. I need this conversation, our nation needs this conversation. Politics may define some, but *when* it divides us, we will never achieve happiness.
* this reply is respectfully submitted.
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I can see your point, Mary.
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Thank you
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Excellent and I agree with your description of good psychotherapists and that they are hard to find. I am a psychotherapist in a large practice in a major metropolitan area and struggle to find other clinicians to refer people to because so many lack the personality and skills. They believe in the “medical model” and drug pushing as well, so I dread what they might tell someone I send over. The profession has a long way to go, but maybe some will read this article…
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I always grateful when I hear a professional psychotherapist effectively give obverse voice to my experiences with psychotherapist (30 years ago when I didn’t know any better, or could, as a result, sufficiently advocate for or protect myself). Hearing such sentiments never ceases to be a most unexpected gift…Thank you for your post Harper West.
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There is so much talk here about supposedly talented therapists. Please explain to me, a layman, the precise, verifiable criteria by which you can distinguish such talented therapists from the ones who are hopelessly incompetent or simply mediocre albeit well-meaning. Furthermore, I would really like to know what type of therapies you consider effective and scientifically respectable, in contrast to those which are useless if not downright harmful. Who should have the ultimate authority to make such determinations–the APA guild, the pharmaceutical industry, the NIH? And on what body of knowledge should that authority be based? If not the DSM, then what? The hypotheses of Freud, Jung, Skinner, Janov, Beck, or Ron Hubbard?
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I have been trained by Hubbard (through his writings and lectures and working on staff).
The “patient” has a strong voice in the quality of his therapy. We don’t actually call them “patients” but that is the closest non-technical word. He is also tested visually and on a meter, and those results noted. The testing must be done by a trained individual. In our system, all therapy (“spiritual counseling”) is also monitored by a trained third party called the Case Supervisor. This person looks for technical errors based on session notes and patient indicators. The Case Supervisor may correct the therapist if errors are found. This system stays in place for the entire career of the therapist, unless the therapist gets trained to be a Case Supervisor and moves over to that role.
We have something called a Tone Scale which is used as a major indicator of whether or not the patient is getting better. One must be trained to use it, though it is rather intuitive. I wish it were more broadly known. One of the problems with the field of mental health is that different “schools” each have their own theory and terminology.
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Since you speak approvingly of Ron Hubbard, I assume that you subscribe to the tenets of Scientology. You’re entitled to believe whatever you want, but I see no compelling reason why I should accept your notion of “mental health” (a term that I regard as a metaphor) rather than the hypotheses put forward by Freud, Jung, Reich, Janov, Beck, Ellis, Adler, Horney, or the many other founders of competing brands of psychotherapy.
I further assume that scientologists reject the DSM psychiatric bible in favor of Hubbard’s own fanciful teachings, with which, I frankly admit, I am completely unfamiliar. Can you therefore explain to me and the other MIA readers, as simply and concisely as possible, exactly how the “Tone Scale” and “meter” you refer to gauge someone’s mental and emotional state? And what kind of training is needed to master this technique? Who certifies the would-be therapist’s skills and knowledge?
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I you are unfamiliar with Hubbard’s teachings, how do you know they are fanciful? In my experience, they get results.
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Bruce writes most beautifully, but he writes as though he believes that “depression” is a thing.
I believe he knows better.
I believe we all do
I believe we know that “depression ” does not cause feelings of hopelessness: It IS feelings of hopelessness.
Who has not experienced such feelings?
Who can say when, if ever, any such feelings, of any duration, can ever become “pathological?”
But as soon as one believes that such feelings result from some supposed “depressive disorder” or “prolonged grief disorder[!],” one may cease searching for the true, real, actual cause/s of any such feelings, moods or attitudes, and succumb to all the harms which may flow from prescribed neurotoxins, such as SNRI’s etc., and/or from self-prescribed general anesthetics, such as booze, nicotine, opioids, overwork etc.
The “sins” of “sloth” and of “despair” may have morphed into the “depressive disorders,” but Carl Jung knew better; Joanna Moncrieff knows better; Bruce Levine knows better; and we all know better.
Thank you, Bruce and Joanna, and Carl Jung and MIA and whoever reminded and reminds us that we are every single one of us “The light of the World,” and that our task, as that Light is simply to make the unconscious conscious.
Comfort and joy, and love and light and laughter!
Tom.
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ATTENTION ALL PSYCHIATRIC SURVIVORS: HEAR YE, HEAR YE!
THE TURNING POINT…
(Our Time Has Come)
By
Phil Kumin (2024)
I’m always trying to figure out where things stand as far as the achievement of the Epiphany we’re all looking for is concerned. I’m never able to do this by any other means other than to assemble the fragments I’m aware of about what’s going on. Then, I look to see if they point to a specific conclusion. My biggest recent disappointment has been over the absence of a class action lawsuit against Big Pharma and the APA, stemming from the advent of Robert Whitaker and his revelations.
I’ve had the good sense to accept that it may be premature for a lawsuit such as this. Perhaps if lawyers were to now rush in excitedly to the courtroom these efforts would fail, since there’s a lot more which has to be discovered regarding dimensionality. But there really is a thought I find encouraging anyway. There isn’t going to BE any solution to today’s homelessness problem, at least not the way everything falls into place right now. This fact is simply one of the matters the news media is too crooked to reveal. New York’s Mayor Adams can blather on all he wants about how he intends to give homeless people the, “opportunity,” to get well and get in off the streets using, “benign,” coercion. He will briefly hospitalize them against their will. But what’s he going to do with them after that? Does New York State have the permanent inpatient capacity to end deinstitutionalization and keep people locked up for the remainder of their lives again? I always thought the impetus behind deinstitutionalization in the first place was that the government DOESN’T have that kind of money anymore? So, Mayor Adams has no choice but to discharge homeless people from their hospitalizations and allow them to go back out on the streets which they will do.
What is it going to take to spring the lid on the scandal perpetrated by the drug companies, the media, and Hollywood which homeless people are evening the score with? Wouldn’t allowing them to do this be preferable to today’s endless and futile chaos?
One other thing: I know it’s tempting to lump all the powers-that-be together in a huge cauldron of culpability for this mess. But someone even as influential as Thomas Insel, recent retired head of the National Institute of Mental Health, has professed a perplexing dearth of understanding regarding what it is the mental health system still isn’t doing right. I see no reason not to take him at his word on this. I think the fact that even influentials have been bamboozled by everything is not a sign of complicity on their part. I think this is a measure of the success the drug companies have had in covering their tracks.
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The evidence base for Talking Therapy is also poor quality and most of it is based on DSM constructs with all the issues outlined here – with the same wide range of biases, self report, mixed measures, inability to measure something tangible, high attrition, data manipulation and fraud, etc, replication crisis remains unresolved and the same incentives ensuring garbage in garbage out is common place. Meanwhile this neoliberal gang bang crushes ever more of us but the message remains the same, it is YOU not the culture that is disordered and in need of ‘treatment’
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I think the main problem with “talk therapy” is that it’s really more about the therapist than the client. After all it’s designed BY therapists FOR therapists in order to protect themselves from liability while skillfully manipulating clients into trusting therapists more than themselves.
No therapist or psychiatrist ever asked me what I wanted. All I ever heard was what THEY wanted, which I finally figured out meant only one thing: WHAT I WANTED DIDN’T MATTER.
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As an independent peer support worker in community, the modality from which I work brings change to depression. We work on trauma, critical thinking, meaning, belonging and I use psychosynthesis tools also from my previous counselling training. People I support have come back from very hopeless places to independence and life and I do wish that peer support was mentioned more in articles like this.
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Bravo.
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Holy cow. It takes stamina to read and absorb all this — while not abdicating critical thinking — but well worth it. May your wisdom find a huge audience.
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Terrific article!! Thanks so much for sharing.
Murray Kirkwood
Clinical Psychologist
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A truly wonderful dissection and damnation of the psychiatric profession that has for so long told the lie that anti-depressants in particular, are a one size-fits-all solution for depression.
And a damnation too, of the pharmaceutical industry that has been, and continues to be, out of control.
I wept a number of times reading this enlightening article, because so many of his well-made points resonated with me on a very deep level.
I hope you get as much from this wonderful article as I did.
Thank You sincerely Bruce
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Thank you Bruce! Overly biomedical understandings also contribute significantly to oppression and stigmatization, which worsens outcomes. Pill-pushers try to say “destigmatize mental health!” without acknowledging that it’s their ideology which contributes.
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Existential angst, manifesting as any unique mixture of what Brendan Carlin used to call, “them auld bachelor afflictions, self-pity and loneliness, a.k.a. ‘d’anxiety an’ depression,” are a human being’s natural and rational response to the apparent ultimate meaninglessness of an apparently one AND ONLY human lifetime, doomed to end, like any relationship (unless you both expire simultaneously, I suppose, with a rebel yell), in heartbreak.
There is and can be no getting away from that, from human suffering………until we learn our own unique escape, to acceptance, to the peace that brings, to the meaning and so much more that it finally reveals, and to the joy which knowing oneself and others to be immortal brings.
I believe that this is what Jung was pointing towards when he reported that:
have treated many hundreds of patients. Among those in the second half of life – that is to say, over 35 – there has not been one whose problem in the last resort was not that of finding a religious outlook on life.”
“Enlightenment is the end of suffering,” – Buddha, reportedly.
“If you had not suffered as you have, there would be no depth to you as a human being, no humility, no compassion. You would not be reading this now. Suffering cracks open the shell of ego, and then comes a point when it has served its purpose. Suffering is necessary until you realize it is unnecessary.”
– Eckhart Tolle, “Stillness Speaks.”
“Deny thyself!” Presumably, Jesus meant your false, ego, suffering self if he said this
“God” rest ye merry, all!
Tom.
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Great article. I really enjoyed it and will share. Community and a common sense approach to human wellness is always key. Of course we must recognize that it is hard for many to abandon what they have believed to be true for many years. I worked as a pharmaceutical sales rep for a few years in my youth. Like my colleagues, when I started out l wanted to be part of an industry that was helping people. That’s how it was presented to us university science graduates. It didn’t take long for me to realize that our company like all the others was only interested in making profits. Our role was to convince people that they were sick and needed our products from doctor prescriptions. Financial incentives were offered for anyone (sales reps or doctors) who sold the most. I say this with absolute certainty…for the most part, not even paracetamol should be trusted. Medication should be administered only after rigorous assessment and diagnosis. Treatment should be short and direct. Anything else is a scam. The medical community, food manufacturing and pharmaceutical industries, news and entertainment media, regulatory bodies and institutions of higher learning have all been infected and spoiled with this “for profit” strategy. Unnecessary prescriptions, surgeries, treatments and interventions are forced on people. To be healthy we must, as humans, disconnect from these structures and return to a simpler way of life where we take care of ourselves by taking care of each other. Peace and love to all.
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Love this comment.
Mindlessly labeling people in psychological distress and reflexively prescribing pharmaceutical garbage isn’t medicine in any sense of the word, but it is evidence of a sick business model.
IMHO people don’t need “talented therapists” any more than they need psychoactive drugs. At least not for long. But they do need kindly people with a talent for listening. And talent can’t be taught, no matter how extensive the “training”, and I think any therapist that’s good is good in spite of their “training”.
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Thankyou so much Bruce – this is such a logical, comprehensive summary on depression. It is one I will definitely refer people to time and time again. It is especially useful because it has combined the reasons why drugs do not help with the potential causes of depression and what those with lived experience find helpful about talking therapies.
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Excelente articulo . Desafortunadamente esta información pocos profesionales la conocen y muchos otros se resisten a creerla .De hecho, yo la he hecho publica en mis redes sociales como profesional en psicología y he recibido múltiples ataques de profesionales y personas del común que la consideran irresponsable .
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Another essential “Levinian” primer for navigating todays professional mental health services.
But let me add one additional point with regard to Bruce’s “A Model of Depression That Actually Fits the Facts” section, however otherwise obvious: each of these contributors to depression are most likely accompanied by one “or more” categories, and are so over extended periods of time-of which can have a cumulative negative impact upon ones emotional health and overall quality of relationships. This is important, I believe, because if these “facts” aren’t adequately and “critically” addressed in mental health settings for their respective roles (plural) in ones “depression”. symptom abatement therapies alone are pretty much a recipe for unnecessary MH issues down the road.
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Though this sort of thinking is a step forward, this article is imbued with overly ideological terminologies.
I can assure you that there are people who are “depressed” who are NOT poor, unemployed, in bad with the cops, worried by their job or obviously lonely.
There has always been the realization among people that various social factors can suppress the human spirit. But people’s responses to these factors are not uniform across the board. Some people have had a very hard life yet ended up “successful” by all the usual metrics.
My major objection to this whole field, including those in it who hope to “reform” it, is that it has simply ignored a body of work that was started in 1950 and that contributes significantly to the understanding of the human condition and human psychology. This body of work was ignored, it seems, totally out of the hubris (arrogance) of the people involved in Psychology, and not really for any other good reason based on science or workability.
Though pieces of this new approach exist in much older teachings, and thus can be rediscovered by “decolonizing” the subject, that alone will be insufficient to produce real change in outcomes.
Because this new material has now been available for around 70 years and is not difficult to find or read about, I have concluded that most people participating in the current field they laughingly call “mental health” have no real conviction to help anyone, and are most concerned with drawing a paycheck. Though this is in many ways a crass and cynical attitude towards this “profession,” every day they continue to pussyfoot around the real issues that are central to the human experience, I only become more convinced that these people have no interest in mental health, and likely are deficient in it themselves.
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This would not be the first time you have complained about “ideology” within articles and/or comments, which is ironic given that it seems pretty clear that your own thoughts on any given topic on MIA are chiefly driven by ideology.
And while you try to portray your statements as being supportive of the mentally ill, reading between the lines it seems you do not have a lot of empathy for anyone who continues to suffer because they do not subscribe to your “ideology”.
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Most psychiatrists are not good doctors and they’re even worse at actually listening to people. Why would they? They have the credentials power and income to say and do as they please. The people who come to them for do called treatment? Not so much.
I’ve found the talking professionals dangerous and mendacious. What they lack in income and power compared to the psychiatrists they make up for with fraud lies and destructive practices.
While I appreciate honesty about the available data on so called treatments and outcomes, I can’t help but find myself turning to Szasz yet again…
Psychology and psychiatry at best deal with problems in living. More often they destroy lives as a form of social control masquerading as “help.”
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There can be no “cure” (talking, pharmaceutical, electrical, or other) for mythical psychiatric illnesses that are nothing but metaphors for socially proscribed states of mind or patterns of behavior. As we can see readily from the now discarded disorder of drapetomania.
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There would be no demand for mental health services if those “illnesses” were entirely mythical. Something real IS going on.
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Yes, something real is indeed going on:
Bullying, racial hatred, injustice, sexual abuse and other violence, economic exploitation, unemployment or stultifying work environments, and many many other frequent horrors, all of which engender understandable, appropriate depression, anxiety, anomie, alienation, and other types of emotional distress in their victims (not “patients” supposedly afflicted with defective genes, a chemical imbalance, faulty brain circuits, or whatever other abnormality the mental health racket successively concocts to fill its coffers and arrogate to itself unwarranted prestige and authority. The demand for these “services” is largely fueled by deceptive promotion of neurotoxins by pharmaceutical companies and their enablers in powerful institutions–the media, academia, and so-called regulatory agencies.
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You can believe this if you want.
But what you are describing is what I know as “suppression.”
If people were completely mentally healthy, suppression would have no mental or emotional effect on them.
The fact that people suffer so much from this-life suppressors is only an indication that something deeper is going on.
You can’t live a happy life if you spend most of it trying to avoid “triggers.” True mentally healthy people do not respond poorly to most triggering events. That’s why a few people survive “bad childhoods” to become successful adults.
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I have been dealing
with depression and childhood trauma. Hood, trauma. I have used magic mushrooms and MDMA AND it cured me. We need to look at plant medicines. Even the history of LSD during the 50s and realized that we’re totally ignoring these powerful healing medicines. Some of which completely cure trauma like MDMA.
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Sometimes it seems as though lots of people have the unfortunate habit of wanting to make things more complicated than they need to be.
Take “depression” for example: lots of people disagree on what it is or what causes it when the answer is obvious: PAINFUL EXPERIENCES HURT — especially if caused by people we look to for our physical, emotional or financial survival. And “depression” isn’t a “thing”; it’s a miserable collection of feelings that affects one’s outlook and ability to experience enough emotional equilibrium or to function adequately enough to meet the demands of everyday living. And what relieves it is no mystery either: being around accepting people who know how to listen.
But this doesn’t automatically mean “see a therapist”, most of whom imo are insecure overachievers whose training drains them of their humanity which is hardly a sane model or approach to anything.
Feeling safe in one’s own company is often more than enough.
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…and how did I learn to feel safe in my own company? That got started after reading a book review about an Iraq war veteran’s fruitless effort to find relief in the mental health system from his so-called PTSD. His thoughts about what psychiatry and psychotherapy have to offer mirrored mine which prompted me to take seriously my own extreme dissatisfaction with it all, too. And get this: it wasn’t until after countless hours of randomly surfing the internet to finally stumble across some random article stating that psychiatric drugs don’t “treat” anything, that these only mask feelings!
From then on, the algorithms did the rest as more and more information started popping up with people like Laura Delano and Daniel Mackler whose vivid stories of disillusionment gave me the courage to take seriously my own deep dissatisfaction and long-held suspicions regarding psychiatry and its multitude of professional sycophants.
And since then, not a day goes by that I don’t thank my lucky stars for finding the information I needed to learn to develop enough self-confidence to have to finally have faith in myself which for Christ’s sake was the only thing I truly needed all along.
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Yes! They prey upon people who lack self confidence. I mean…us in particular..,
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Both fields are emotional exploitaion at its worst.
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Needing emotional support shouldn’t mean “run to your nearest MD or therapist” as this often leaves people trapped on a medicalized merry-go-round that never stops.
Our cultural mindset needs to change.
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I have MDD and was diagnosed as Bi-Polar. On Lithium I was great…..until the Lithium destroyed my gut! I’ve tried so many drugs that do nothing but make me sicker. Now I fight it myself. But I must say I’ve found the right therapist. He has all the good qualities you describe. I’m not “cured” and I know I never will be, but I’m not dead, either. Thanks to multiple childhood traumas I have fought depression for 70+ years. I have no one to talk to and no one to listen to me except my therapist. I look forward to my appointments even though I don’t always improve. I thank God for leading me to Jason
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I have several comments regarding this essay.
Moncrieff’s et al.’s 2023 umbrella review (1) simply rediscovered what had already been known, the cause of depression is not explained by a simple chemical imbalance. As Dr. Levine nicely stated:
“While researchers had discarded the serotonin and other chemical imbalance theories by the 1990s, the first unequivocal declaration by establishment psychiatry of the invalidity of these imbalance theories was in the Psychiatric Times (2) in 2011, when psychiatrist Ronald Pies stated: “In truth, the ‘chemical imbalance’ notion was always a kind of urban legend—never a theory seriously propounded by well-informed psychiatrists.” The most impressive result of Moncrieff et al. (1) was their well-orchestrated media campaign that was magnified by Mad in America and X (formerly known as Twitter) which was used to further magnify their claims that psychoactive medications are ineffective and should be avoided.
Although Moncreiff et al.’s article (1) (which was published online ahead of print in July 2022) received a huge amount of attention, other psychiatrists quickly detailed flaws in their article. In June 2023, Jauhar et al. (3) published a manuscript in Nature titled “A leaky umbrella has little value: evidence clearly indicates the serotonin system is implicated in depression”, noting that “We present reasons for why this conclusion is overstated, including methodological weaknesses in the review process, selective reporting of data, over-simplification, and errors in the interpretation of neuropsychopharmacological findings.” For other perspectives regarding the paper by Moncrieff et al., the following are suggested: a) An ‘urban legend’ remains an ‘urban legend’ (4) and The serotonin fixation: much ado about nothing new (5).
Dr. Levine goes on to summarize articles that appear to support the ineffectiveness of antidepressants or to attribute positive results to the placebo effect. However, a problem arises. The STAR*D article by Rush et al. (6) reported success rates of up to 67%. This report contradicts the narrative that antidepressants are ineffective. Thus, ever since its publication in 2006, proponents of critical psychiatry have mounted an impressive ongoing campaign attempting to bring the results of this study into question. The latest attempt (7) was that of H.E. Pigott et al. who claimed that reanalysis of STAR*D data yields a 37% success rate rather than the 67% reported by Rush et al. (6). In response, Rush et al. in 2023 in a letter to the editor (8) titled The STAR*D Data Remain Strong: Reply to Pigott et al. noted that “It appears that the authors created rules to define post hoc which subjects to include, which eliminated many subjects who experienced large improvements during one or another of the study’s levels. By doing so, the sample is biased to underestimate the actual remission rates”. Interestingly, in their rebuttal Rush et al. (8) noted that “the senior author of the Pigott et al. (7) paper, Dr. Jay Amsterdam, co-authored a paper (9) reporting the results of a study in which he played a key role and that utilized a sequential pharmacotherapy protocol informed by the STAR*D results. They found a 60% cumulative remission rate across 12 months with antidepressant treatment alone, a result that is much closer to the 67% remission rate of the original Rush et al. STAR*D report than the Pigott et al. (7) rate of 35%.” This rebuttal by Rush et al. (2023) was not addressed in Dr. Levine’s commentary.
Dr. Levine also commented on the placebo effect. It is absolutely true that the placebo effect is real and is a stubborn confounder in any study of the statistical effectiveness of antidepressants. As a case in point Dr. Levine referred to a Journal of the American Medical Association (JAMA) article (10) studying the efficacy of Zoloft (Zoloft is the brand name for Sertraline) versus St. John’s Wort (Hypericum perforatum) and a placebo in which the placebo was reported to be better than the other two treatments. Interestingly Dr. Levine elected not to include in his commentary the further finding by these authors (10) that “Sertraline was better than placebo on the CGI improvement scale (P =.02), which was a secondary measure in this study”. Also not included by Dr. Levine are others investigations that show different results. For example, Linde, Berner and Kriston (11) report that “The available evidence suggests that the hypericum extracts tested in the included trials a) are superior to placebo in patients with major depression; b) are similarly effective as standard antidepressants; c) and have fewer side effects than standard antidepressants. The association of country of origin and precision with effects sizes complicates the interpretation.” If nothing else, these investigations demonstrate the difficulty in conducting and interpreting statistics associated with studies comparing the efficacy of antidepressants.
Dr. Levine also states that “As is the case with any treatment for depression—including bloodletting—there will always be patients who offer positive testimonials. However, in science, such testimonials are called “anecdotal reports” and are not considered sufficient evidence for effectiveness.” It should be noted that many commenters in Mad in America and proponents of critical psychiatry are quick to provide and/or accept, at face value, anecdotal reports (“lived experiences”) concerning patients who have had negative experiences with antidepressants or other psychoactive medications. In my view comments by patients with “lived experiences”, positive or negative, should be taken at face value. Continuing with Zoloft as a case in point, consider that for this medication 57% of patients responding (N=584) who provided a rating on the Drugs.com (12) platform, reported a positive experience (remission of symptoms) with this medication while 22% reported a negative experience. Although these comments are anecdotal, I would have a hard time dismissing out of hand any of the comments (positive or negative) provided.
Depression is a difficult illness to treat, likely because there are several biochemical and social causes for it. I believe that Dr. Levine is absolutely correct that many things (including financial poverty, unemployment, involvement with the criminal justice system, childhood trauma, miserable significant relationships, lack of social support and critical thinking) have a negative impact on depression. I would also add that political division, international and religious conflicts and the financial costs they incur also contribute to depression. However, unless there is a dramatic change in international policies worldwide, national politics and spending priorities, these issues will not be resolved any time soon. I would also add that people who experience depression, whatever the cause (biochemical or social), should be well informed regarding available treatments (both pharmacological and nonpharmacological) and their side effects. And well-informed patients should be free to choose which treatments they wish to pursue.
1) Moncrieff, J., Cooper, R. E., Stockmann, T., Amendola, S., Hengartner, M. P., & Horowitz, M. A. (2023). The serotonin theory of depression: a systematic umbrella review of the evidence. Molecular psychiatry, 28(8), 3243-3256. https://www.nature.com/articles/s41380-022-01661-0
2) Pies, P. (2011) Psychiatry’s New Brain-Mind and the Legend of the “Chemical Imbalance” Psychiatry July 11, 2011Times. https://www.psychiatrictimes.com/view/psychiatrys-new-brain-mind-and-legend-chemical-imbalance
3) Jauhar, S., Arnone, D., Baldwin, D. S., Bloomfield, M., Browning, M., Cleare, A. J., … & Cowen, P. J. (2023). A leaky umbrella has little value: evidence clearly indicates the serotonin system is implicated in depression. Molecular Psychiatry, 1-4.
https://www.nature.com/articles/s41380-023-02095-y
4) Dawson, G., & Pies, R. W. (2022). An ‘urban legend’ remains an ‘urban legend’. SSM-Mental Health, 2, 100133. https://www.researchgate.net/publication/361537710_An_%27urban_legend%27_remains_an_%27urban_legend%27.
5) Pies, R. W., & Dawson, G. (2022). The serotonin fixation: much ado about nothing new. Psychiatric Times, 3. https://www.psychiatrictimes.com/view/the-serotonin-fixation-much-ado-about-nothing-new
6) Rush AJ, Trivedi MH, Wisniewski SR, et al.: Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry 2006; 163:1905–1917. https://ajp.psychiatryonline.org/doi/full/10.1176/ajp.2006.163.11.1905
7) Pigott, H. E., Kim, T., Xu, C., Kirsch, I., & Amsterdam, J. (2023). What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapies in real-world depressed patients? A reanalysis of the STAR* D study’s patient-level data with fidelity to the original research protocol. BMJ open, 13(7), e063095. https://bmjopen.bmj.com/content/13/7/e063095.abstract
8) Rush, A. J., Trivedi, M., Fava, M., Thase, M., & Wisniewski, S. (2023). The STAR* D Data Remain Strong: Reply to Pigott et al. American Journal of Psychiatry, 180(12), 919-920. https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.20230869
9) Hollon, S. D., DeRubeis, R. J., Fawcett, J., Amsterdam, J. D., Shelton, R. C., Zajecka, J., … & Gallop, R. (2014). Effect of cognitive therapy with antidepressant medications vs antidepressants alone on the rate of recovery in major depressive disorder: a randomized clinical trial. JAMA psychiatry, 71(10), 1157-1164. https://jamanetwork.com/journals/jamapsychiatry/article-abstract/1897300
10) Hypericum Depression Trial Study Group, & Hypericum Depression Trial Study Group. (2002). Effect of Hypericum perforatum (St John’s wort) in major depressive disorder: a randomized controlled trial. Jama, 287(14), 1807-1814. https://pubmed.ncbi.nlm.nih.gov/11939866/
11) Linde, K., Berner, M. M., & Kriston, L. (2008). St John’s wort for major depression. Cochrane database of Systematic reviews. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7032678/
12) https://www.drugs.com/comments/sertraline/zoloft-for-depression.html (accessed 2-28-2024)
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In response to your comment that “depression is a difficult illness to treat, likely because there are several biochemical and social causes for it.”
In the absence of conclusively proven genetic abnormalities, brain pathology, or another physical cause, depression cannot properly be regarded as a medical illness in the literal sense of the word. I notice that you have qualified your assertion with the word “likely,” but until you can adduce credible sources (not Big Pharma marketing material) for this supposed biochemical causation, this claim is nothing but speculation. Unfortunately, such groundless hypotheses taken at face value can have very harmful life-changing physical and emotional consequences for those subjected to the “treatments” based upon them–as one can readily see from the numerous true-life accounts by contributors to this website.
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Joel
Thank you for your comments. Being so far near the bottom, I was wondering if anyone would read my comments. I have to disagree with you that one must know the biochemical causation in order for it to be “regarded as a medical illness in the literal sense of the word.” There are many medical illnesses for which the biochemical causation is unknown. Examples include Alzheimer’s disease, Parkinson’s disease, Fibromyalgia, and Idiopathic pulmonary fibrosis. Actually, the list of such illnesses is quite long.
Part of the problem with the study of depression is that depression might be a disease in and of itself or it might be a symptom of an underlying illness. Pellagra is a good example in which depression is one of several symptoms of an underlying illness. As you may know, Pellagra is a vitamin deficiency disease caused by a deficiency of niacin (Vitamin B3). In addition to depression, symptoms include inflamed dark and crusty skin, bleeding, diarrhea, dementia, and sores in the mouth. In 1926, Dr. Joseph Goldberger was the first to determine that Pellagra was due to a dietary deficiency. It wasn’t until about 1939 that Drs. Conrad Elvehjem, Tom Spies, Marion Blankenhorn and Clark Cooper demonstrated that niacin deficiency was the cause of Pellagra. Fortunately, if treated early enough, all symptoms (including depression) of Pellagra are resolved by addition of niacin to the diet. I would note that clearly Pellagra was recognized as a medical illness long before its biochemical causation was elucidated.
It would be a wonderful thing if the precise biochemical mechanism(s) of depression were known. Then scientists would have better direction to develop medications that target the precise biochemical problem(s). When treating medical illnesses for which the biochemical mechanisms are unknown, physicians are left with using medications (or other non-pharmaceutical approaches) that provide symptom relief, but not a cure. This is a reasonable approach. Consider that aspirin was used for pain relief for about 70 years before the mechanism by which it functions as a pain reliever was discovered.
I do not dismiss the true-life accounts of contributors to this website who have had negative experiences, nor do I dismiss the true-life accounts of people who have had positive, sometimes lifesaving, experiences with antidepressants and other psychoactive medications.
All the best,
JB
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John, thank you for your thoughtful and measured reply. Thomas Szasz addressed this particular issue long ago. If a state of mind or pattern of behavior classified hypothetically as a psychiatric disorder is eventually found to stem from a verifiable physical cause (genetic, hormonal, neurological, etc.), said disorder will then become the remit of a medical professional specializing in treating that specific condition. However, depression is such a vague catch-all term that it cannot be fit neatly into the category of a single discrete “illness.” Yes, conceivably it could turn out to be the result of some underlying pathology, but it may also be an understandable, totally appropriate reaction to distressing circumstances (as in the case of a non-binary teenager who is humiliated or assaulted by his/her/their peers, or the victim of sexual abuse, or someone traumatized by the horrors of war). To characterize those suffering from verbal or physical violence as “sick,” “dysfunctional,” or “disturbed” is a gross misappropriation of medical terminology.
As for the comparative benefits and harms of antidepressants and other psychoactive medications (whose proven neurotoxicity has been revealed by a number of eminent contributors to this website, including Robert Whitaker, Peter Breggin, Joanna Moncrieff, and Phil Hickey, among others), I think the evidence is clear by now that for the great majority of patents to whom potent drugs are administered over the long term for treatment of the hundreds of hypothetical disorders listed in the DSM, the deleterious effects on their brains and other organs outweigh whatever short-term benefits that chemical lobotomies may bring. Far more lives have been irreparably harmed than saved by the mental health industry. If you don’t believe me, I refer you to the valuable, well documented studies that Dr. Peter Gotzsche has contributed to MIA in regard to this subject.
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Joel
It appears that you are opposed to characterizing depression as an illness or disease. Fair enough. Can we agree that people having this problem can be described as follows (taken from (www.mayoclinic.org))?
“Although depression may occur only once during your life, people typically have multiple episodes. During these episodes, symptoms occur most of the day, nearly every day and may include:
• Feelings of sadness, tearfulness, emptiness or hopelessness
• Angry outbursts, irritability or frustration, even over small matters
• Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
• Sleep disturbances, including insomnia or sleeping too much
• Tiredness and lack of energy, so even small tasks take extra effort
• Reduced appetite and weight loss or increased cravings for food and weight gain
• Anxiety, agitation or restlessness
• Slowed thinking, speaking or body movements
• Feelings of worthlessness or guilt, fixating on past failures or self-blame
• Trouble thinking, concentrating, making decisions and remembering things
• Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
• Unexplained physical problems, such as back pain or headaches
For many people with depression, symptoms usually are severe enough to cause noticeable problems in day-to-day activities, such as work, school, social activities or relationships with others. Some people may feel generally miserable or unhappy without really knowing why.”
Instead of depression, would it be acceptable to use the terms “emotionally very troubled” or “unacceptably low mood”?
Regarding the individuals you mentioned, I believe they are all proponents of critical psychiatry and have unwavering views concerning the use of psychoactive drugs and I am skeptical of much that they write. As a case in point, please refer to my initial comments concerning the chemical imbalance theory and the fact that Moncrieff et al. (https://www.nature.com/articles/s41380-022-01661-0) simply discovered what had already been known, depression is not caused by a simple imbalance of serotonin.
My skepticism is further fueled by Dr. Levine’s article. In his discussion claiming placebo was more effective than Zoloft, Dr. Levine elected not to include other information and references that showed just the opposite, one result appearing in the same paper he mentioned. Similarly, Dr. Levine was quick to accept the arguments of H. E. Pigott (https://bmjopen.bmj.com/content/13/7/e063095.abstract) without mentioning the rebuttal published by Rush et al. (https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.20230869). You made the statement that “Far more lives have been irreparably harmed than saved by the mental health industry.” This argument would be strengthened by a reference or two for this that appears in a peer-reviewed mainstream medical journal by an author who is not a proponent of critical psychiatry or antipsychiatry.
All the best
JB
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John B, I would call chronic depression a “chronic grief neurosis” or in deeper cases a “chronic apathy neurosis.” But these labels are secondary to the task of getting to know the patient and discovering what is really going on with them.
If their problem is not chronic, the cause of it could be very temporary, and rest and a healthy diet would be the wisest intervention. But then, what do I know? I’m not a psychologist.
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I remember listening to one of Ralph Nader’s podcasts on which he cited a study by the Harvard School of Medicine. According to this study, approx. 100,000 patients a year (if memory serves) die from iatrogenic illness, not to mention the countless others who are severely harmed or traumatized in some way. Of these unfortunate victims of medical incompetence, how many were subjected to chemical lobotomies or electroshock therapy? Does the number of those people harmed by psychiatric treatments far exceed the number of those who claim to have been helped? If that indeed is the case, I cannot but agree with Dr. Peter Gotzsche’s conclusion: the worst thing a person in emotional distress can do is to consult a psychiatrist, whose first impulse will be to assign him/her a DSM label and prescribe a potent drug or neurotoxic cocktail promoted by a pharmaceutical company (often on the basis of manipulated or incomplete research findings).
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If depression is not acceptable and “emotionally very troubled” or “unacceptably low mood” are not acceptable, What would be acceptable to describe this phenomenon?
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There was a time in history where people would say loudly and with religious conviction, “The bible says so!”. These days the opposite is happening: “The science says so!”.
What’s the problem with both? Potential censure for those who think independently, the kind of thinking that unfortunately is frowned upon in places entrenched in philosophical and scientific bureaucracy. And nowhere is this kind bureaucracy more prevalent than in places of “higher learning”. But the harsh reality is that subjects as scientifically porous as psychiatry and theoretically porous as “psychology” and are entrenched in dogma which only require an inordinate amount of parroting ability on the part of their students.
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CLARIFICATION: The harsh reality is that fields as scientifically porous as psychiatry and as theoretically porous as psychology are entrenched in DOGMA — a kind that requires an inordinate amount GULLIBILITY in its students.
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…. that (not surprisingly) prepares all but the most ethical of students to spend the majority of their work lives happily chanting whatever dogma rules the day, aka “pissing into the wind”.
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In other words, critical thinking (and that magical something called “empathy”) in the psy disciplines more often than not are nowhere to be found and are usually quickly shut down if they dare make an appearance at all.
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Agree with 99% of this.
I entered counselling after 21 years as an entrepreneur.
What I learned was that the DSM is a sales catalogue!
That many therapists are themselves neurotic and inexperienced in life, lacking wisdom.
Now I work to treat the iatrogenic victims of gender-ideology that has wrecked the vulnerable in Gen Z and the males who cannot relate to the feminised ‘therapeutic’ culture.
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Wow, “sales catalog” describes the DSM perfectly! And for what it’s worth, as a woman I can’t relate to ‘feminised therapeutic culture’ either.
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To John Bumpus:
Thank you again for your reply to my comments. I read through the Mayo Clinic’s list of so-called symptoms of depression, and it hasn’t changed my basic view: psychiatry is based on the fallacious, harmful premise, embodied in the quite subjectively chosen criteria set forth in the DSM, that certain patterns of thought, emotion, and behavior can be grouped into discrete categories of illness, disorder, dysfunction, etc. The fundamental flaw of this notion is that such criteria evolve in keeping with prevailing social and cultural trends (to cite just one glaring example–the declassification of homosexuality in 1973, and transgenderism in 2010, as mental disorders). Was psychiatry’s shift in attitude due to findings obtained through extensive, worldwide, replicatable research? What magical transformation occurred overnight in the supposedly abnormal brains of LBGT individuals to restore their mental health?
Nor will I agree with your characterization of depressed people as being “emotionally very troubled” or having an “unacceptably low mood.” Such terms are entirelyu subjective and situational. As I have said in previous comments, so-called negative emotions such as fear, anxiety, grief, and feelings of hopelessness can be quite understandable, sensible and appropriate in certain circumstances, and I regard it as the height of arrogance for a therapist to diagnose them as a form of pathology requiring external intervention (by means of neurotoxins, ECT, or whatever other modality may be his or her stock in trade).
Lastly, you raised the issue of peer-reviewed journals. Suffice it to say that Robert Whitaker, Jeffrey Masson, Bruce Levine, Peter Gotzsche, Jeffrey Schaller, and other courageous critics have pointed out the incestuous relationship between the pharmaceutical industry and the authors featured in such journals as well as the “experts” on the panels responsible for compiling the DSM, so I would hardly expect the official organs of the psychiatric guild to honestly acknowledge the physical and emotional harm it has caused its many victims over many decades. Such an admission would fatally undermine its already shaky prestige and authority–not to mention its lucrative, drug-fueld profits.
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A More Sensible Approach
Psychoactive Drugs
Be honest? Seems fair. A simple change in a culture which at present is operating on lies and fraud, to one where truth is expected. Oh wait, i’m becoming delusional again. Vulpes pilum mutat non mores.
This is serious Mum
https://www.youtube.com/watch?v=1-mLIdLZZeI
Activism to Change Societal Policies
I read something earlier which went like;
‘Only when the last tree is cut down, the last fish caught and the water totally poisoned, will the white man realise that he can’t eat his money.’
Why bother with activism? If covid has taught us anything, it is that the powers that be will go to ANY length to ensure their ‘societal policies’ are implemented, by force if necessary. One positive from that was that I got to watch as the whole community was subjected to what most ‘mental patients’ live with each and every day (restrictions to liberties, forced or ‘coerced’ injections).
I bet they were sweating when they were discussing how far they could go with their human rights abuses though. People seem to accept a lot when the target has been slandered with the label of mental patient (which is what a lot of people who refused the ‘vaccines’ were accused of being. Conspiracy nut jobs etc)
Well, this is how far they will go to get someone the ‘help’ they need……
https://www.youtube.com/watch?v=oZ9UQKBUrsg
Luckily the Police have not been co opted by ‘mental health services’ in the same manner they were in National Socialist Germany. The Fuhrerprinzip rather than the rule of law Australians value so much….. well, obviously not these particular police, and not a lot of those who work in mental health who know what is good for you. And it was referred to “Ethical Standards” (if only they knew what that little euphemism means lol)
Selecting and Training More Talented Therapists
Why on earth would anyone who was talented want to become a therapist? It’s like the problem we have here in Australia. Our education system (or to be precise, the students. We don’t actually have an ‘education system’ it’s more an ‘indoctrination system’ but putting that aside) provides billions to the Govt in fees (HECS), and with that money they subsidize the Oil Companies (ie they pay no tax).
We have a lack of talented people because no one wants to go to University and end up with a debt which will take them many years to pay off. Instead they go and work on the mines and make big bucks. This means we don’t train any local people (because we don’t have any teachers) and have to import all of our ‘skilled workers’.
Why not make education free and tax the Oil and Mining Companies? Awww I forgot (Just noticed ma sign ….Jeff Foxworthy style) our Politicians are being paid to ensure the outcomes are favoring the Companies we aren’t allowed to know they have shares in? Which seems to feed back into point 2.
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