Default Depression—How We Now Interpret Distress as Mental Illness

The Situational Approach provides an alternative to the poor outcomes seen with the medicalisation of distress.

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Regardless of the context and cause, distress is increasingly interpreted and diagnosed as a mental illness—commonly clinical depression and/or anxiety disorder. This process of medicalisation is now all too often a default response to distress and happens on a large scale. The biomedical approach to distress has spread beyond the health/mental health sector and has seeped into every sector of the community. This has been enabled by broad-scale organisational policy and practice relating to mental health, including workplace mental health (WMH), that perpetuates a medicalised approach. And this is complemented by well-funded public advertising and promotional campaigns—often with overt government support. This phenomenon itself is causing a great deal of suffering and is a major social and political concern.

Despite huge budgets for suicide prevention and mental health initiatives in Australia over the last several decades, there have been continuing increases in: the number of suicide deaths; the numbers of diagnoses of mental disorders; and the numbers of prescriptions for potentially harmful antidepressants and, increasingly, dangerous antipsychotics. Similar trends can be found in many western countries where similar political and business influences, including huge advertising and promotional budgets from pharmaceutical companies, are in place.

Pop art retro style. A female therapist leans over a male client reclining in a suit.

An ideology that has seeped into and influenced every sector of the community

This phenomenon—the increasing medicalisation of distress combined with the poor outcomes—is built on a bio-medical approach to distress and other common human behaviours and emotions and is now a pervasive ideology. As well as the pharmaceutical industry, the establishment and proliferation of the bio-medical approach to mental health difficulties has been heavily influenced by key organisations and high-profile individuals in the mental health sector. A process of enculturation and institutionalisation of the ‘illness’ paradigm around mental health and well-being has seeped into everyday life.

There are specific mechanisms that have enabled this broad-scale biomedical approach to mental health and well-being; these include deliberate messaging, strategic policy development, and the cultivating of allied political and business interests.

This increasingly entrenched pathway of identification, diagnosis and treatment of distress as a mental disorder is systemic with, historically, a major focus on depression. This approach dominates the policy and practice of the suicide prevention sector in Australia and other similar countries such as the US, Canada and the UK, and arguably contributes significantly to the challenges of effectively addressing the increasing numbers of suicide deaths. Despite the increasing budgets for suicide prevention and mental health, if assessed by one of the most meaningful measures—number of suicide deaths per year—the current approach to suicide prevention in Australia, and many other countries, is failing badly. Despite spending large amounts of government, corporate and philanthropic money, suicide deaths in Australia for the last two decades have risen from a little over 2000 deaths per annum mid-2000s to now consistently over 3000 deaths per annum.

Through the years roughly 2000 to 2015, the profile of suicide prevention and ‘mental health’, especially depression, grew considerably in Australia (as it did in other countries), and with this the domination of the mental health/suicide prevention sector by the biomedical approach. However, important research during this period offered an opportunity to directly challenge the way things were being done. Included in this was research both international and in Australia over the period that showed very clearly the importance of unemployment and financial difficulty as factors in suicide deaths and the limited value of putting too much focus on mental disorder; research discrediting psychological autopsies as a method for obtaining background information for suicide data and the unfounded notion of 90% of all suicides being mental disorders; and an editorial piece from a respected medical journal from the United States which directly challenged the methodology of much of suicide research.

The Situational Approach

Workplace mental health policies and practice have had a huge impact on industry and the workplace, including an enormous cost burden—both human and economic. In Australia, the economic cost has been particularly damaging to the life insurance industry who often pick up the cost of income protection for workers who have been diagnosed with a mental disorder.

During 2017–2018, I participated in a number of meetings and seminars with senior personnel from the life insurance industry who were concerned about the cost that the prevailing mental illness ideology was having on their industry. As a result of this, I initiated discussions that led to the development of a new conceptual framework for considering suicide prevention and mental health—the Situational Approach.  Initially, two papers were written, ‘A Situational Approach to Suicide Prevention’ and ‘A Situational Approach to Mental Health Literacy in Australia’.

In the former, we wrote:

Situational Suicide Prevention is an approach that acknowledges the predominant association of situational distress* rather than mental illness, with suicide (though in some cases the two are linked), and is principally informed by and responds to risk factors of a broad spectrum of difficult human experiences across the life span. This approach is also mindful of and wherever possible seeks to address: contextual, systemic, and socio-cultural risk and protective factors and determinants—the real world of individuals lived experience.

*Situational distress encompasses a significantly challenging or troubling mixed experience of mind, thoughts, emotions, bodily sensations, or behaviours, associated with an apparent decompensating event, such as bereavement, a change in health status, relationship breakdown, financial, or occupational difficulties. This distress may significantly overlap with many of the symptoms usually taken to suggest mental ‘illness’ or ‘disorder’ (such as those associated with depression and anxiety). Even when distress is sometimes inexplicable, there is no good reason to automatically assume illness or disorder.  

While acknowledging the fundamental importance of the social determinants of health/mental health, the Situational Approach also acknowledges the need to consider the level of the individual: that there are times when an individual’s personal characteristics have a significant role to play in their well-being and in the case of the onset, management and resolution of psychological distress.

The current approach to suicide prevention and supporting people in distress in Australia is a system of failure: the current approach is dominated by influential organisations and self-anointed ‘mental health experts’ who work aggressively to perpetuate an unhelpful over-medicalised approach to distress. They enact business strategies designed to maintain or further extend their already well-entrenched place—not just within the suicide prevention/mental health sector but throughout every sector of the community through workplace and organisational mental health policies and practices and training programs that serve to perpetuate their business and cultural dominance.

The Situational Approach papers resonated with a number of insurance industry personnel and academics, and I was encouraged to investigate this topic further. Using the Situational Approach as the guiding conceptual framework, my findings from this work, along with other considerations about our approach to mental health and suicide prevention, have now been incorporated into a book, Default DepressionHow We Now Interpret Human Distress as Mental Illness.

Despite some recent literature pointing to the need to consider social determinants in suicide prevention, for the most part suicide prevention has been dominated by the biomedical approach prevalent in the mental health sector—and with a focus on depression. There has been a disregard of key causal correlates of suicide such as: unemployment, other than in tokenistic acknowledgement; the importance of gender in considering suicide deaths and non-fatal self-harm incidents; and data collection that highlights mental disorders and minimises or disregards altogether social factors such as homelessness or inadequate housing, financial difficulties, legal difficulties and unemployment or precarious employment.

The current approach has been demonstrably ineffective; and patterns of suicide are similar for a number of different countries around the world as many of the same political and economic dynamics apply. Much of the marketing of antidepressants, for example, is done as a global marketing strategy.

The World Health Organisation (WHO) has had a key role to play in the increased focus on both suicide prevention and workplace mental health over the last several decades. WHO has openly encouraged countries to place suicide prevention high on their agenda, and the national governments of the US, Canada and the UK have accordingly published strong policies promoting suicide prevention.

Closely related to this in terms of impact on communities, WHO has also taken a strong leadership role in the rise in profile of workplace mental health. However, despite their intention of helping to meet the support needs of workers in distress, WHO has been heavily influential in spreading some of the limitations of the current approach, including perpetuating the ambiguity and confusion around key terms and concepts in the workplace mental health literature.

The spread of the medicalisation of distress

The medicalisation of distress has spread though the culture and bureaucracies of the mental health sector, organisational policy and practice in business and community sectors and general medical practice. These sectors are integrally involved in the mental health domain and mutually contribute to maintaining the mental illness ideology.

The role of the mental health sector

The core notion of the biomedical model imposed upon human difficulties and distress is that there is a biological basis to distress that can be diagnosed and treated—often with potentially harmful pharmaceuticals such as antidepressants. A focus on depression in Australia corresponded with similar campaigns in the US and the UK in the 1980s and 1990s. These international campaigns helped lead to the development of the National Depression Awareness Campaign, launched in 1994 by the Mental Health Foundation of Australia. This campaign was designed to educate the public that depression is ‘serious, common and treatable [my emphasis]’, and significantly influenced the initiation and development of Beyond Blue, still a leading player in the sector.

The medicalised approached was given a huge boost with the equating of distress as an illness prominent in mental health literature, accompanied by the encouragement to identify, diagnose and treat the ‘illness’ according to clinical guidelines such as the DSM and the ICD medical textbooks.

Organisational policy and practice and mental health

The policies and practices of the biomedical approach to mental illness are not confined to the health and human services sectors. They now pervade our day-to-day lives. Governments at all levels sanction and promote the current approach through policy and substantial funding allocation and energetically partner with businesses and employers to make mental health a priority for organisations in all sectors.

This unfortunate default response to distress now happens across the breadth of our community—all business and industry sectors, schools and higher education, the welfare and not-for-profits, entertainment and sport. Authorities such as human resources personnel and school counsellors intervene and recommend or direct people, including school-age children, to visit a doctor (GP) to determine or confirm a mental disorder. Following diagnosis, these ‘patients’ are now generally treated with antidepressants—and all of this is now happening on a very large scale.

The institutionalisation of this default response to distress in the workplace has had an enormous impact on workplace health and safety. For example, ‘mental disorders’ has surpassed musculoskeletal problems as the leading cause of long-term work incapacity in Australia for workers compensation claims—similar trends can be found on the international stage. As a consequence of this, there are escalating numbers of diagnoses for workplace mental disorders to the extent that mental health is now the main activity of general practice in Australia.

Workplace mental health training

The medicalisation of distress is promoted strongly through training, including workplace training, to ‘identify’ a stressed person, and presume them to be depressed (implying a clinically diagnosable depression). Whether or not the distressed person has a history of mental disorder, and whether or not the stress is the result of difficulties completely outside the individual’s own making is largely irrelevant to this process. The training organisations that deliver workplace mental health training align themselves with, and implicitly endorse, the leadership of the current approach.

Beyond Blue was a key pioneer of workplace mental health training in Australia and has been highly influential in the development of workplace mental health activity. In their 2004 Depression in the Workplace Program document, Beyond Blue describes aspects of its workplace training and, in a glaring example of pathologisation, equates depression with ‘illness’:

Training enables participants to more clearly understand depression and conceptualise it as an illness, differentiating depression from normal sadness or ‘stress’.

The role of general medical practice

GPs are at the pointy end of much of this unhelpful and often unnecessary medicalisation process. For many decades, GPs have played a key role in the challenges of dealing with work-related accidents and injury by providing diagnosis, advising and facilitating the treatments required for return to work for workplace issues.

GPs are therefore under enormous community, political and business pressure to provide some form of mental health treatment to already large—and still increasing—numbers of attending patients with ‘mental health’ issues. We now have a cultural expectation that GPs, as a part of their day-to-day practice, will routinely diagnose patients in distress for clinical depression and offer treatment that regularly includes prescribing antidepressant drugs. This culture is so pervasive and firmly established that many distressed patients presenting to GPs now actually expect this outcome, regardless of the factors involved in their distress. Bureaucracies across industries and other sectors, including education, require a formal diagnosis of mental disorder to provide follow-up support—and there is now a broad expectation that the GP will rubberstamp this process.

Media and the mental health narrative

Media covering mental health has a strong preference for high-profile leaders of the mental health/suicide prevention sector. These same figures also influence government and corporate policy, so that media coverage and policy development are heavily influenced by people who endorse the current approach while contrary expert opinions are generally disregarded.

Language

While we need change across a number of important aspects of our current approach to mental health and suicide prevention, if we are wanting change, our use of appropriate language is one key area that we can begin to change immediately.

The use of appropriate language is vitally important in understanding people’s distress and providing appropriate support for them. The terminology we use is fundamental to our understanding of the issues we face. The United Nations recognises the inherent ambiguity in terminology in mental health and has commented on this:

Terminology in the sphere of mental health is a contested terrain. There is a need to accept different terms according to how people define their own experiences of mental health. “Mental health” itself can signal a biomedical tradition for explaining and understanding lived experiences, psychic or emotional distress, trauma, voice hearing or disability. The Special Rapporteur acknowledges this contested area and the importance of the health sector and the medical model when used appropriately. He challenges stakeholders to reflect on how biomedical dominance has led to overmedicalization in the health sector, particularly in mental health.

Developing a more effective approach to issues of mental health and suicide will depend upon the introduction of appropriate language and terminology and avoiding pathologising language. Our understanding of key terms and definitions needs to be clear and consistent if our prevention efforts are to be effective. In Default Depression, I present a set of terms and definitions consistent with the best available current thinking and data; in some cases, these are new terms, while in other cases they are commonly used terms with important clarifications added.

There has been a good deal of interest shown from key organisations in the mental health/suicide prevention sector in the themes of Default Depression and the language alternatives I propose, and there are several initiatives currently being developed using some of the content of the book at the core of new training modules for the suicide prevention/mental health sector. Hopefully we can soon provide a follow-up account of these initiatives so they can be used as models for others to build upon, both in Australia and around the world.

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

24 COMMENTS

  1. Erm: are we not noticing what a crude and obvious observation this is, and how you affirm the concepts of mental health and illness as if these problems are an illness of a conceptual abstraction called ‘the mind’, which is our consciousness and its content which it accumulates through its confrontations within and conditioning by the social reality it exists with. The mind as you are understanding it is entirely made up of and contains the memories and reactions to and concepts from the social environment, so mental illness implies a sickness of social intelligence and society more broadly, because you don’t understand that human consciousness is actually one – it’s one total process encompassing the whole of humanity, and it has conflicts within itself on various levels, so what you call psychological disease implies social disease, or diseased social processes (ones that undermine structures of health and harmony and the wholeness of life) just as social, political and economic failures and pathologies imply, obviously, failures of and dysfunctions within the socially conditioned human conscious, and in America it as sick as it has ever been in the Western democratic world, a fact which is absolutely beyond any dispute if you look at it. You would have to be insane to deny it, or completely unaware of anything outside of US boarders.

    So the key point is that even in allowing yourself to talk of mental and psychological issues in abstraction from the social millue and vice versa is to fragment and destroy a total grasp of the whole problem, because society IS our thought and feeling materializing itself through our action, and our thought and action is conditioned by these materializations in society so they are part of one total problem, and to see this is to see the fallacy of any approach in intellectual affairs which divides the two, hence this insight condemns the whole idea of mental health treatment which is meaningless when they are patching up the dysfunctions in a pathologically insane society. Understanding and caring about each other is the only truly human solution to what we call mental health but if we don’t see how the pathology of individualism and selfishness has destroyed any possibility of achieving this on the broad social level, you live in cloud cookoo land and have no grounds to talk about mental health or illness if you are so deluded about reality. Your own mental health depends on the strength and independence of your consciousness FROM society, which myself and some of the other commentors here can thank their ‘mental health problems’ from helping them to do, or else from the strength and health of your personal relationships, because in those relationships alone is a society you can trust. Alas, healthy personal relationships are actually very rare, and social normality is no measure of a healthy personal relationship. Really, I think we are all on our own at the moment, but understanding is growing and uniting some people on some levels, which is something.

    This may not be convenient to appreciate because it requires a radical intensification of your penetration and grasp of the problem, which is allot of hard work, but anything else is absurdity in face of the reality just outlined. I think you are directing your intelligence to the wrong target entirely, and if you’re honest with yourself you are not wholly clear who this target is, and you haven’t assessed the likely efficacy of targeting thus. Truth is for everyone, not some target, and it is that alone that will transform and radicalize, but you haven’t uncovered the whole rotten structure of this problem, and until you do nothing you say about it has any enduring value besides marking your progress towards the goal of understanding the problem, the goal you are unlikely to reach unless you see how extensive and complex it is, and then you might make the effort, but don’t shirk it. It’s actually your life and our people that are on the line, not just psychiatric patients and the tainted interests of ‘mental health professionals’ (sic). You need to be understanding the whole social and psychological structure of the problems of which psychiatry is embedded, which is at the same time an understanding of the fundamental problems of Western social consciousness which is evidently in crisis everywhere. Please, don’t abandon the interest in the critique of psychiatry, because it is the perfect field to illuminate the whole human problem: just see that the problem is much vaster and there is no solution outside of understanding this vaster problems, and the way in which society expresses our dysfunctional social consciousness and also conditions our action in it’s image, which is why everything is going wrong. You need to go MUCH further. don’t delay. You don’t know how much further you need to go, and it is much further, and ultimately, way beyond.

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  2. The simple one word answer to all of our problems was captured in a word whose meaning has now been completely destroyed, and that word was meditation. Now spiritual people think they need to try and meditate, and then find it too boring and instead indulge in books written by spiritual quacks as a way of sating their interest in the ‘beyond’, but the beyond we need to understand right now is our own lives and the reality of the world, which is beyond all our opinions, conclusions and theories the latter which are not the culmination of understanding but a proxy for the fact that understanding, which means clear perception and understanding of the actual, has not yet been reached, and meditation is this direct, clear and unremitting perception of what actually is.

    Reading religious books of any kind is contemporary or historical research into religious intellectual history. It has absolutely nothing to do with anything that is real in what you call religion or spirituality. Much of the literature is mere entertainment, but it is all damaging because it prejudices the brain, and the serious researchers into the field of spirituality and religion, although often more sincere and passionate about the truth, are doing very little besides sharpening their linguistic and thought tools but these latter are absolutely useless unless they are used to convey real spiritual insight, the kind of insight that is made impossible when you search for reality in books rather then into an ever deepening perception, penetration and understanding of what is, which is one thing we call variously consciousness, life, reality, world, what is etc. It is all a happening within awareness, and watching that total happening only takes place when your brain understands the imperative necessity in doing so, and to have total meditation there cannot be any effort to meditate because this brings in he illusion of the meditator, hence duality.

    Meditation happens only when the meditator, is not, obviously, because only then is there total awareness of what is, and if the thought comes in as ‘meditator’ you will see how false and unreal the meditator is. It’s a product of your social conditioning, this meditator, that destroys and prevents meditation, and no conceptual armory will help you fight your way out of that problem. Perception and understanding alone is what is required and is what the Buddha and Jiddu Krishnamurti emphasised, who were surely two of the most sane human beings that ever walked the Earth (besides me. Joke!), So don’t confuse what reading books on anything, least of all meditation, as anything useful to meditation or to what people call ‘spiritual growth’ which if it isn’t a growth of understanding is some kind of delusion. Reading or listening to talks on meditation just blights your perception with conditioned prejudices and makes the clear perception of what is all the harder. It may seem like I’m prejudicing perception but if you notice, everything I say is destructive, and destruction is the much sought after fruit of mediation. It destroys the false, which is this very conditioning that blights perception, but still it is not a fact if you can’t see and understand it for yourself.

    So, are you one of those that read and study religious texts? I used to be read stuff like that years ago, very naively, and in my case I feel it was ignorance and the fear brought about by this ignorance that I needed to learn from others who knew more then me. My hunch is that people generally are just too afraid to let go of the accumulated works of others because we have so little confidence in our capacity to see and understand things directly for ourself, but clearly this is further proof of the need to do so urgently. Obviously enlightenment, as they call it, is nothing to do with book learning because Jiddu Krishnamurti never passed an exam and never studied a single religious book but is widely recognized as one of the greatest ‘teachers’ of all time, and the most eminent Buddhists really could not find any fundamental disagreement with his teaching and that of the Buddha. And they would have both told you to put your books away and learn how to see and understand things for yourself obviously, which is what they taught. And this is needed not for religious reasons per se but because the truth and clarity is demanded by our present state of affairs.

    Yet it is only the spiritual people who talk or are interested in meditation, because they want to get somewhere, but clear perception of what is right now is not getting anywhere that is not right here and now, and obviously no book can have anything to do with being aware. So how has it come to pass that all those interested in the fields of religion and spirituality these days do nothing but burry their heads in books, or carry on with repetitive religious rituals, or travel to the holy sites of India or wherever, do absolutely everything besides what the Buddha and Krishnamurti said? You tell me. You will not degenerate in any way if you are still concerned above anything else with the truth, you’ll just shift from seeking it in books to true meditation, which happens naturally when the brain has learned the fundamental necessity to be aware of what is all of the time, rather then indulging in it’s own security seeking operations. This isn’t theory or opinion or idea, OK? It’s YOUR reality too so you can look at what I say and find the answers. At the end of the day I think it is fear that explains the attachment to the books and traditions but surely there is more to fear in this attachment then there is in saving and redirecting that energy into a penetrating observation and understanding of your own life. Probably also it’s because you imagine meditation is a passive, boring thing, which it becomes when you try and practice it but that’s not the real thing. Meditation is an intense thing and it demands intensity, energy, and that energy in part could come from you giving up the books and deciding to learn about reality directly through an intensity to discover everything that takes place in the consciousness, which is a journey much more demanding of brain power then reading all these boring books, and much more engaging for the brain. I’m too lit by the whole thing of meditation and need a drink or crazy and explosive and destructive activity of some kind in order to calm down. It’s an exciting thing at times like these to be in meditation, but would be too much for many because you see an absolutely immeasurable crisis all around you with no hope for the vast majority of people alive today. An if that cannot wake you up to reality from books then I don’t know what will. You are the reality. It ain’t in any book.

    Sorry I know I’m an ‘insufferable bore’ as the old people of Britain used to say but I wanted to say this because it is the way of true understanding and the only thing that gave even Wesern philosophy it’s sparkle. Because the true Western philosophers were true enquirers into life, which is also consciousness, and they couldn’t have read it in books because they were the ones to write the books. As soon as a continental Western philosophical tradition emerged the sprawling mediocraty of secondary criticism and commentary invaded the philosophical endeavour like a disease and came to replace the philosophy with itself, and killed the true life-impulse within Western philosophy pretty much by the second world war. Perhaps when Adorno said “art is impossible after Auschwitz” he could also have been talking of philosophy, which would figure, because he was really one of the last great philosophers and he destroyed philosophy with his philosophy of negative dialectics. Anyways….

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  3. “Watch your language” isn’t merely an admonition for using profanity.

    About being unemployed or underemployed driving distress, obviously so–worthless to the world.

    I recently had a psychiatry group reach out after reading one of my published blogs, dangling the possibility of paid work. Not having two nickels to rub together, I was really hopeful. I sent them several essays. When they finally responded, their “offer” was for me to write about how their patient-centric approach to suicide is 76% effective—essentially a promotional piece. It was like decoding an ad just to realize it said, “Drink more Ovaltine.”

    Unemployment isn’t just about money in this monetary world. It’s about dignity, purpose, and feeling like you matter. When you’re already struggling, being led on like this—having your skills and contributions acknowledged but not valued—just adds another straw to the camel’s back. Is it any wonder that unemployment fuels distress and suicidal ideation?

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  4. That was an intro to Brighton from a boring source but this is Brighton from a less boring source, and it’s a famous Brighton artist whose music video is set in Brighton and I can assure you all the people in the video are actually typical Brightoners. The one drinking a cup of tea on the steps who gets slapped around the head has a prototypical Brighton response to violence, and I should know because I’ve had more clouts then hot dinners, which is to look around looking obviously stoned and then fall back into their previous meditative slumber and within an instant forget the thing even happened. Most of the time I break bones these days I can’t remember what happened and that is the truth I’m afraid. I broke bones on three or four ocassions this year and only twice I remember what happened – one of the times was from the police and I didn’t commit any crime besides speaking truthfully my mind… https://www.youtube.com/watch?v=FVbupT0o0gQ . I know this isn’t stricktly relevant but I am an insane person and this is Mad in America, and we created America by accident so it’s we who are responsible for the whole of America and the madness in America and therefore MIA. You can tell Robert Whittaker he owes his career to the British state – I’m sure he’ll feel very humbled at the thought.

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    • I don’t disagree with you, but I’m glad MIA is here to give a voice to those whose voices are often dismissed. MIA arose in response to a misguided psychiatric industry, which itself arose in support of a dysfunctional way of life. So, MIA’s existence could be viewed as a reaction to a mad status quo. I’m grateful for and supportive of this response. It was bound to happen.

      While I agree with MIA’s anti-pharmaceutical stance and the rejection of the current biomedical view of “mental illness” held by the psychiatric professions, I still get the sense that the drug war is being fought here.

      I don’t think drugs are the ultimate answer—living right is (something our governing systems effectively prohibit). What some call substance use disorder, however, I don’t believe is a disorder. It’s a result, a reaction, a response.

      Until better societal circumstances arise, I see nothing wrong with a natural reaction to finding comfort and satisfaction in nature’s medicine cabinet. ACE research suggests that this is a natural response in those with significant ACE scores. Those seeking remedy from nature shouldn’t be punished for it. Some of us with significant ACE scores don’t need scientific studies explicating precisely how marijuana reacts with the brain to produce relief and comfort to know—first hand—that it does just that. For some perhaps more than others (perhaps due to differing brain structures and functionalities we don’t understand). At the same time, I don’t see anything wrong with people dabbling in nature’s medicine cabinet for recreational purposes, either. Many of nature’s creatures like to get high. Is nature wrong for not conforming to human ideas of how nature should be?

      I believe there are good reasons for this reaction, and it’s not something to be pathologized or criminalized by those who don’t understand it. That it’s a problem due to our way of life isn’t the fault of those seeking relief and comfort in life. Pathologizing and criminalizing marijuana use, for example, is essentially ignorantly and self-righteously condemning nature. Passing judgment without knowing seems like evidence of a taste for judging what is not understood. I wish people would stop doing that. To me, marijuana is as much a gift from nature to those who benefit from it as is saw palmetto.

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      • The problem is that all the concerns of psychiatry and critical psychiatry objectively pale into insignificance when you see the problem of the destruction of social intelligenc, clarity, sanity, and health, and I want to really show you the best kind of evidence you can have for this – direct observation of teenagers discussing issues of life in the late 1950s. See there clarity, rationality, their apparent wholesomeness and sanity compared even to adults of today. There are scores of these videos and i think it provides excellent historical research on the health of Western social consiousness for YOU MUST SEE THIS – you can’t read about this in books. you have to observe, see, understand, so here is four teenagers discussing the problems of truth, religion and life. This is absolutely wonderful to watch. These kids have such more rational and clear minds and seem so much more intelligent which in a sense they are because they see much more clearly and are more rational, but in one respect our brains have infinitely more to contend with now, so potentially can be more intelligent in this society, but it seems this isn’t happening anymore as most of our brains have been utterly destroyed by this onslaught of meaninglessness and unreality that you call ‘reality’. Does your thought know what it is? Does your thought really know what a feeling or emotion or love or hate is? Does awareness know what it is? Does sensation know what it is? Everything you think you know is socially conditioned ideas (words) about something real which is beyond words, so nothing in what we think or know is the real at all. So where is your actual concrete grasp of reality? You think the world’s outside you but no consciousness can ever go outside of itself, and everyone is consciousness, so what is this ‘outside world’ outside of? Consciousness? No consciousness has ever been outside of consciousness, and even the science of quantum physics refutes that there is any divisibility between what we call consciousness and materiality. Matter is a socially conditioned concept for something within consciousness called ‘sensation’ which through a short period (perhaps 40,000 years) of human linguistic and conceptual development became this idea of a world ‘out there’, but for most of that 40,000 years everything was alive, and that is true, because conscious life is the only one real. There are not two things called consciousness and life, and to think there is is a brain disease. Anway I strayed very far off the point. If I saw adults using their intelligence and reason in such a clear way today and also having so much more intrinsic health and clarity then us adults of today then I think the prospects of humanity would be looking much more bright. The conversation starts off on quite a superficial discussion of religion and then launches into a consideration of the problems of truth and social conditioning by religion. I think the reason they seem so intelligent and clear compared to us is that the sprawling disease of technological and corporate civilization had not yet invaded all our lives and skulls and infested our hearts and minds with it’s bullshit and captured and instrumentalized all of our lives and the brains and educations and lives of our children has destroyed our brains, health and clarity and made us all frightened and confused, aimless human beings. These kids were very much different. See how sick we have become….

        https://www.youtube.com/watch?v=B0K12jOumYA

        It is not difficult to find many more of these discussions by such exchange kids and you can begin to measure what has happened to all of us, and if you examine their concerns and their discussions you get actually insight into the historical development of many of our current problems and socio-cultural dynamics of the modern world. Unprejudiced listening to them is the best possible education for the brain if you ask me. The brain knows what it’s doing with what it clearly perceives and it blows my mind – I learn so much from these.

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      • I agree, Dan, “MIA’s existence could be viewed as a reaction to a mad status quo.” I have a 2005 painting of the American flag painted upside down and backwards, so sadly it’s not a new societal problem. Although, sadly, an older, male, psychologist told me his goal was to “maintain the status quo,” and he also tried to steal more than everything from me, with the most appalling thievery contract you’ve ever read, just a few years ago.

        But I agree with most of the rest of what you say, too. I found marijuana, or its relatives, to be quite effective in helping a manic loved one, get the much needed sleep he needed.

        Personally, I think it would likely be a better first line of treatment for manic and psychotic people, than the antipsychotics, which are already medically known to create psychosis, both when on them, via anticholinergic toxidrome, and when taken off them, via a drug withdrawal induced super sensitivity manic psychosis.

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  5. PS, the picture i paint may look catastrophic, but it’s actually catastrophic because we don’t look. If I saw a family being marched unwittingly towards Auschwitz I would tell them personally. However, this is contentious because out of the two people I have asked – would you tell that family on their way to Auschwitz? Neither could answer the question. To me that is concerning.

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  6. There is actually here a profound public discussion of the whole social and environmental crisis as a crisis of consciousness with Jiddu Krishnamurti that shows a level of insight of all involved that is utterly lost today and non-existent seemingly in American culture. Subtitles would be required to hear all the contributions as some aren’t close to microphones and some may have less familiar accents…

    https://youtu.be/7oE7JJOse-s?si=d5jibimTGYIptNBN

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  7. An odd thing about suicide: after a loved one is gone, somebody will cry, “I would have done ANYTHING!” Yet all the while the person was alive, given the chance, they didn’t—at least not enough “anything” to be useful to the person who checked out. If they had been willing to do “anything” while their loved one was alive, their loved one might be alive.

    “Anything” might have entailed abandoning the status quo by which the person was so hurt and mistreated that life was no longer worth living (as opposed to embodying that status quo and effectively siding with the oppressors). It might have meant giving the person shelter from the storm instead of being another clap of thunder.

    “Anything” might have entailed understanding how things happen in order, even if the order of events so distressing their loved one to suicide weren’t clear to anyone other than the distressed person (which might have been part of the problem). It might have meant active listening and empathizing, as opposed to listening for signs of mental illness and considering how best to respond to that illness.

    “Anything” might have entailed treating the person like a human being instead of like collateral damage resulting from a loveless, dysfunctional way of life.

    “Anything” might have entailed showing the person some good love instead of tough love or love that ends in distant best wishes, thoughts, prayers, or apologies. Or pleas to get professional “help.”

    The best help would have arrived in the form of good love from those in the person’s orbit. But the best they might have mustered was a reserved, theory-laden, superficial love while awaiting the person to be “healed” by modern psych professionals.

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  8. Terrific article, thank you.

    Anthony gives me the impression that he does believe that there is such a thing as “clinical depression.”

    I wonder if I am alone in this, and if I am mistaken.

    I may be alone in struggle to see what all this has to do with Mick Crocodile Dundee or Paul Hogan, but I feel sure it will soon come to me, as the missing link is always humor, and as Cheerfulness always keeps breaking through.

    I had left Ireland in hopes that Australia’s blue skies and wide open spaces would dispel blues, but found that, as my colleague Jim back in Donegal told me 30+ years later, “I could have told you you’d be there as soon as yourself.”

    I applied for a job in the Blue Mountains, funnily enough, and my prospective employer, and about as decent a man as ever anyone could hope to meet, one John I. drove me out to see a horse and to have a chat.

    John as a doppel ganger for John Alderton of “MN y Wife Nextdoor” fame, but who, funnily enough, had also played James Herriot in the movie “It Shouldn’t Happen to a Vet.”

    Funnily enough, that first horsey client we saw together was a very dour individual, possibly very worried about his valuable horse, of course, but also suffering from that which not one of us humans seems so far to have learned to enjoy – “clinical anxiety-depression.”

    As we drove away again, John genially remarked, as Aussies do,

    “Well, HE didn’t seem to have a big sense of humour, did he?”

    I had never heard such an observation before, and that remark etched itself on my psyche.

    “Clinical,” of course, literally, at least in the original Greek, means bedside, and we may all agree that “Consciousness is that annoying time between naps” when, having left our beds, we do tend to lose our sense of humor, even if we had a big one to begin with.”

    Wishing you mirth,

    Tom.

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  9. Focusing solely on suicide prevention and the language surrounding the pursuit of an elusive “mental health” allows institutions and those in positions of privilege to avoid addressing the urgent need to rectify significant social inequalities. This narrow approach also strips individuals of their autonomy, denying them the fundamental right to make choices about their own lives, including when and how to die.

    We must recognise that suicide is a personal right, not an “illness” that must be eradicated at any cost. Suicidal thoughts and attempts do not merit unsolicited interventions, incarceration, mistreatment, or unnecessary drugging. This perspective emphasizes the urgent need to reevaluate how financial resources are currently misallocated to ineffective suicide prevention efforts and research.

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  10. I agree, very much. Apart from refraining from incarceration and forced drugging, I think euthanasia also needs to be available. If life is unbearable suffering with no relief, it’s a human right to decide to end it. It is then a completely rational and reasonable choice – though I don’t think anyone else but the person themselves can truly evaluate that.

    A lot of people don’t have effective and not-inhumanely-painful ways to self-euthanize.

    The current approach does largely nothing for the reasons the person wants to end it, but it simply seeks to strip the person of their freedom and capability to do it. The suffering itself only increases.

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  11. If Australia and all the Austrailans weren’t there, we’d have had to invent them.

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

    She gave us Paul on her east coast and Heath on her west.

    https://www.youtube.com/watch?v=Jrt2xoy5UHo

    In very different ways, both actors may forever remind me that Humor can and will save us, that Cheerfulness KEEPS breaking through, and that we can all learn to encourage Her to.

    When the Blues hit, we can chant any three magic words we choose, be they

    “Come, Holy Spirit!

    or Sherwin Nuland’s

    “Ah, F**K it!”

    or any others: W can learn that attitude is not quite everything, and that we are not our attitudes, but that we may well be that which can adjust them: We may essentially BE Humor; our soul may be our sense of humor, and “God,” if “God” is us all and more, may be “a comedian playing to an audience too afraid to laugh.”

    Niels Bohr, who said that he went into the Upanishads

    (“As the web issues out of the spider
    And is withdrawn, as plants sprout from the earth,
    As hair grows from the body, even so,
    The sages say, this universe springs from
    The deathless Self, the source of life.”)

    to ask questions, also pointed out that

    “Some subjects are so serious that one can only joke about them.”

    https://en.wikiquote.org/wiki/Niels_Bohr

    Such a misfit have I been since moving from ruralest Ireland to metropolitan Southern California when just about the same age as Mick Crocodile Dundee (the first) was, that I have shared many of his “Ah, GOTTT it!” moments – eventually.

    WE all have a knife that IS a knife, that can cut through ancient layers of enculturation and indoctrination and finally see our own hegemonies for what they are.

    Many young people may have killed themselves in rural Ireland because they saw themselves as hopeless sinners.

    Many young Californians may have killed themselves because they saw themselves as hopeless victims of “anxiety/depression.”

    Rather than deciding that “L’enfer, c’est les autres:” Hell is other people, it may be a sign of progress if teeangers say they suffer from “social anxiety,” at least insofar as they recognize that the problem is their own attitude.

    The next obvious step may then be to figure out if there are better ways of curing “social anxiety” than by intoxicating it with booze or other drugs, prescribed or otherwise.

    I believe that everyone who is not yet a Zen mistress/master suffers from anxiety-depression (worry-hopelessness) and that, by all appearances, all the Zen mistresses/masters have done so, too.

    https://www.youtube.com/watch?v=6w_RNrrfh0g

    By all accounts (even if not so much the Gnostic ones), Jesus had lots and lots AND lots of bad days or bad moments, at least, and don’t they say that Buddha died of food poisoning?

    The wonderful work on pain and suffering by people like Howard Schubiner have shown that it is not so much as question of ?mind over matter,” at all – as of our Attitude Adjuster over our minds.

    Once we agree that “Clinical Depression” does not cause human hopelessness, but IS human hopelessness, then, I believe, coercive psychiatry is no more.

    Thank you, Anthony, from the bottom of my heart, for your groundbreaking work in Oz and all over this planet.

    May you achieve as much towards our global enlightenment as Paul Hogan continues to do, bringing light into the darkest corners, and ensuring that Cheerfulness (OwzitgoinMiteawrite?) keeps breaking through.

    Wishing you mirth,

    Tom.

    “The human condition: lost in thought.” – Eckhart Tolle, in “Stillness Speaks.”

    “I know exactly where I am: I was lost HERE before.” I believe we all were – together.

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  12. So important to recognize that one tool in all this was removal of situation-related dx from the DSM. My first psychiatric referral was for what was then called “reactive depression” (in the doctor’s words: “Anyone who’d been through what you’ve been through would be depressed.”) It took a number of years to find a med that helped, but it was prescribed for “as needed” use. Once depressions became “lifetime” conditions based on “biology”, I was put on a daily long-term meds routine that created symptoms leading to 4 new dx and the next 16-17 meds. Sometimes sad—even desperately, suicidally sad—is truly just the appropriate response to disastrous circumstances.

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