Are Psychiatrists More Mad Than Their Patients?

This question is not a joke. It has come up repeatedly when I discuss how absurdly harmful mainstream psychiatry is with like-minded colleagues, e.g. critical psychiatrists or psychologists.

Madness is characterised by delusions. An Oxford dictionary defined delusion as an idiosyncratic belief or impression maintained despite being contradicted by reality or rational argument.

According to the WHO’s International Classification of Diseases, a delusion is a belief that is demonstrably untrue, is firmly held with conviction, and is not susceptible to modification by experience or evidence that contradicts it. Similarly, in the DSM-5, delusions are fixed beliefs that are not amenable to change in light of conflicting evidence.¹

One type of delusion is grandiosity, which is a sense of superiority, uniqueness, or invulnerability that is unrealistic and not based on personal capability. Many psychiatrists behave in a grandiose way, believing in their infallibility and omnipotence and that they have a special insight no one else has. If you are a patient and disagree, you are called ignorant or in need of psychoeducation, even when your relatives share your views.² Or you are told you have a lack of insight into your disease, which is a symptom of your mental illness, a catch-22 situation from which there is no escape.

Joseph Biederman was an example of grandiosity. During his testimony in a court case in 2009, when an attorney asked him about his rank at Harvard Medical School, Biederman replied: “Full professor.” “What’s above that?” the attorney asked. “God,” he replied.³

Psychiatrists regard religion as a special case.¹ A religious delusion may concern a special relationship with God or gods or involve claims such as being Jesus but “these kinds of delusions are notoriously difficult to distinguish from nonpathological religious beliefs.” Indeed. It would be more logically consistent to say that a belief in one or more gods is a delusion.

Faith plays a big role in psychiatry. It is a great trust or confidence in something for which there is no proof, or an unshakeable belief in something even if there is proof against it. A large survey of 2,031 people from 1995 illustrates this.^4,5 People thought that antidepressants, antipsychotics, electroshock and admission to a psychiatric ward are more often harmful than beneficial. This view concurs with the best evidence we have,^3,6-12 but the social psychiatrists who had done the survey were dissatisfied with the answers and argued that people should be trained to arrive at the “right opinion.”

In what way exactly? How do you train people to go directly against the science? Usually, we call this indoctrination.

As psychiatrists’ beliefs in what they are doing are in contrast with the science, this makes psychiatry a pseudoscience, a kind of religion. If you want more evidence that most psychiatric leaders are delusional, just read their guidelines and textbooks, which I have done.

My Critical Psychiatry Textbook is freely available.⁹ I read the five most used textbooks in Denmark and uncovered a litany of misleading and erroneous statements about the causes of mental health disorders, if they are genetic, if they can be detected in a brain scan, if they are caused by a chemical imbalance, if psychiatric diagnoses are reliable, and what the benefits and harms are of psychiatric drugs and electroshocks. Much of what is claimed amounts to scientific dishonesty. I also describe fraud and serious manipulations with the data in often cited research. I conclude that biological psychiatry has not led to anything of use, and that psychiatry as a medical specialty does more harm than good.

It is noteworthy that the psychiatrists’ predominant idiosyncratic beliefs are not shared by people considered sane—the general public. And the great majority of psychiatric patients do not have delusions whereas most psychiatrists have. I therefore believe I have proven that psychiatrists are more mad than their patients.

Forced treatment is a particularly dark chapter in psychiatry. I have argued why I consider forced treatment a crime against humanity.^11,12 The psychiatrists believe they do it for the patients’ own good, but the patients see it very differently,^13,14 and the evidence shows it does far more harm than good, mainly because it virtually always involves treatment with antipsychotics.^8,9,11-14 In 2019, a Norwegian study found that 52 of 100 consecutively admitted patients to a psychiatric hospital would have wanted a drug-free alternative if it had existed.¹⁵ Why can’t people get that then?

A delusion can by persecutory, where people believe they are at risk of being harmed because of the malevolent intentions of others.¹ Leading psychiatrists commonly suffer from this type of delusion. They may call people who criticise psychiatry conspiracy theorists or “anti-psychiatry,” like people who deny or oppose Christ are called “anti-Christ.” This curious phenomenon does not exist in any other medical specialty. If you criticise the overuse of statins, you are not called “anti-cardiology” or a conspiracy theorist.

A popular saying is that madness is doing the same thing again and again expecting a different result. Psychiatrists are not the only doctors who do this but they are by far the “best” in this futile discipline.

When a drug doesn’t seem to work, psychiatrists increase the dose, change to another drug from the same class, add another drug from the same class, or add a drug from another class. The science tells us that these manoeuvres do not benefit the patients.^8,9,16-18

Increasing the dose or the number of drugs increases the occurrence of serious harms, including irreversible brain damage, suicides and other deaths,^8,9,19-21 but psychiatrists often lie to their patients telling them that their disease might harm their brains, or they might die, if they don’t take their drugs.^8,9,11 This is perverse.

The madness is increasing

Unfortunately, the madness is getting worse. In office-based psychiatry in the USA, visits with three or more drugs doubled, from 17% to 33%, in just nine years, and prescriptions for two or more drugs from the same class also increased.²² In Australia, the use of psychiatric drugs and polypharmacy for children and adolescents were twice as high in 2021 as in 2013,²³ and the use of neuroleptics increased by 45% in just six years.²⁴ In the UK, psychosis pill prescriptions increased by 5% per year on average and depression pills by 10%, from 1998 to 2010.²⁵ In Denmark, the sales of SSRIs increased from a low level in 1992 almost linearly by a factor of 18, closely related to the number of products on the market that increased by a factor of 16 (r = 0.97, almost perfect correlation).²⁶

These data suggest that drug usage is determined by marketing and the widespread corruption of leading psychiatrists.^8,27

Another indicator that the madness is increasing is that the mortality for patients with schizophrenia has increased markedly; the median standardised mortality ratio for the 1970s, 1980s and 1990s were 1.84, 2.98 and 3.20, respectively.²⁸

Two Danish textbooks mention that several psychosis pills may be needed simultaneously, and one notes it can be appropriate to increase the dosage above the approved interval.

In 2006, a report from the Danish Board of Health showed that half of the patients were in treatment with more than one psychosis pill simultaneously,²⁹ although both national and international guidelines recommend against it.

In 2014, the Danish Ministry of Health issued a licence to kill. It allowed psychiatrists to use extraordinarily large doses of psychosis drugs for forced treatment, especially when patients have been in prolonged treatment and where smaller doses have been tried without success.³⁰

This is as mad as it gets. These drugs are highly deadly, e.g. kill 2 of 100 demented people in just 10 weeks,³¹ and the risk of death is of course dose related.^32-36 The psychiatrists say that the patient is “treatment resistant,” which is an insulting term as it suggests that the patient is at fault and not the drug. They don’t realise that they should not increase the dose or add another drug but taper off the first drug slowly, which will have the best outcome.

I have witnessed the madness directly. I was once invited to follow the chief psychiatrist during one day at a closed ward at my hospital, Rigshospitalet. One of the patients appeared totally normal and reasonable to me, but the psychiatrist considered him delusional. As I couldn’t see why, he explained that the patient was delusional because he had been on the internet and had found out that psychosis pills are dangerous! I was so stunned that I didn’t comment.

On another occasion, I phoned Psychiatric Centre Amager, which has a particularly bad reputation because the psychiatrists have killed several of their patients with psychosis pills.³⁷ A patient in great distress had contacted me, but I couldn’t get a psychiatrist on the phone, even though I explained I was a colleague, and it was within normal working hours. When I insisted, I was transferred to a head nurse. She told me not to get involved because the patient was delusional. When I asked in what way, she said he had found out that psychosis pills are dangerous! I asked if she knew who I was. Oh yes, she did, but that didn’t stop her from exposing psychiatry’s insanity.

In 2023, the whole Board of the Norwegian Psychiatric Association felt so threatened by colleagues who wanted a radically different psychiatry that they published an opinion piece to defend the status quo in a newspaper.³⁸ I explained what the worst falsehoods were:³⁹

Claim: The drugs do not change the personality. Fact: This is the reason for using them and many patients experience this, e.g. 43% in one survey.²

Claim: The drugs do not have greater side effects than other drugs. Fact: They are the third leading cause of death, after heart disease and cancer.⁴⁰

Claim: “Conspiracy theories abound that the pharmaceutical industry only wants to profit on making people as dependent as possible.” Fact: It is not a conspiracy theory that the drug industry doesn’t care about withdrawal effects from psychiatric drugs but only about its profits and that the business model of Big Pharma is organised crime.⁴¹

Claim: “Drug treated patients return to work more quickly, and disability can be prevented.” Fact: The more drugs that are used, the more patients come on disability pension.³

Claim: “The prognosis and risk of relapse are improved significantly when patients take antipsychotics.” Fact: All trials that provide the basis for this misconception are deeply flawed. They have introduced withdrawal symptoms in the discontinuation group, which psychiatrists have falsely interpreted as relapse.^8,11

Claim: “Patients with ADHD often have reduced quality of life, more frequent depression and more drug problems and criminal behaviour if they are not treated.” Fact: In the long run, the opposite is true.¹¹

Claim: “Drug treatment makes patients more accessible to psychotherapy.” Fact: Psychotherapy is superior to drug therapy, particularly in the long run where it has an enduring effect, in contrast to drugs.^11,42

Claim: “There is no biological basis for saying that commonly used psychiatric drugs such as antidepressants, mood stabilizers and antipsychotics cause dependence.” Fact: The drugs up- or downregulate neurotransmitters in the brain, which is why abrupt withdrawal can cause terrible and dangerous withdrawal symptoms.^43,44

Claim: “So far, most studies indicate that drug treatment is absolutely necessary to achieve recovery and increase quality of life and prevent relapse for most patients with severe psychiatric disorders.” Fact: These statements are also blatantly false. The drugs decrease quality of life and do not prevent relapse.^9,11,45

Conclusions

The misconceptions among psychiatric leaders are so much at variance with the scientific evidence, and with what the patients and their relatives and others experience, that it seems justified to say that they suffer from a serious, collective delusion.

So, here is a thought experiment. Using the psychiatrists’ own diagnostic systems and practice, it can be argued that psychiatric leaders such as the Norwegian psychiatric leaders should be forcefully treated with psychosis pills. If they tasted their own medicines, which some doctors have done to see what it was like,⁴⁶ few of them would sustain their delusions about how good they are, which would benefit mankind.

The doctors experienced a marked slowing of thinking and movement, profound inner restlessness, a paralysis of volition and a lack of physical and psychic energy, being unable to read or work.⁴⁶ Psychiatrist David Healy found the same in 20 staff from his hospital who received droperidol.⁴⁷ Everyone felt anxious, restless, disengaged and demotivated to do anything; a psychologist volunteer found it too complicated just to obtain a sandwich from a sandwich machine. Some felt irritable and belligerent and many were unable to recognise the altered mental state they were in and to judge their own behaviour.

As a specialty, psychiatry is more mad than its patients. To keep the patients on pills they don’t like, three quarters of popular websites attributed depression to a “chemical imbalance” or claimed they could fix an imbalance.⁴⁸ This is like threatening with the Loch Ness Monster. Such an imbalance being the cause of depression (or any other psychiatric disorder) does not exist.⁴⁹

Psychiatry should be demolished and built up from the ground, focusing on psychosocial interventions, as recently recommend ed by the United Nations and the WHO.⁵⁰ And all treatment needs to be voluntary.^11,12

References

1 Collin S, Rowse G, Martinez AP, et al. Delusions and the dilemmas of life: A systematic review and metaanalyses of the global literature on the prevalence of delusional themes in clinical groups. Clin Psychol Rev 2023;104:102303.

2 Kessing L, Hansen HV, Demyttenaere K, et al. Depressive and bipolar disorders: patients’ attitudes and beliefs towards depression and antidepressants. Psychological Medicine 2005;35:1205-13.

3 Whitaker R. Anatomy of an epidemic. New York: Broadway Paperbacks; 2015.

4 Jorm AF, Korten AE, Jacomb PA, et al. ”Mental health literacy”: a survey of the public’s ability to recognise mental disorders and their beliefs about the effectiveness of treatment. Med J Aus 1997;166:182-6.

5 Raven M. Depression and antidepressants in Australia and beyond: a critical public health analysis (PhD thesis). University of Wollongong, Australia; 2012.

6 Read J, Bentall R. The effectiveness of electroconvulsive therapy: a literature review. Epidemiol Psichiatr Soc 2010 Oct-Dec;19:333-47.

7 Whitaker R. Mad in America: bad science, bad medicine, and the enduring mistreatment of the mentally ill. Cambridge: Perseus Books Group; 2002.

8 Gøtzsche PC. Deadly psychiatry and organised denial. Copenhagen: People’s Press; 2015.

9 Gøtzsche PC. Critical psychiatry textbook. Copenhagen: Institute for Scientific Freedom; 2022 (freely available).

10 Read J. Major adverse cardiac events and mortality associated with electroconvulsive therapy: correcting and updating a 2019 meta-analysis. Ethical Human Psychology and Psychiatry 2024 Sept: DOI: 10.1891/EHPP-2024-0003.

11 Gøtzsche PC. Is psychiatry a crime against humanity? Copenhagen: Institute for Scientific Freedom; 2024 (freely available).

12 Gøtzsche PC. Forced treatment in psychiatry is a crime against humanity. J Acad Publ Health 2025;Jan 30.

13 Gøtzsche PC, Sørensen A. Systematic violations of patients’ rights and safety: Forced medication of a cohort of 30 patients. Ind J Med Ethics 2020;Oct-Dec;5(4) NS:312-8.

14 Tasch G, Gøtzsche PC. Systematic violations of patients’ rights and safety: forced medication of a cohort of 30 patients in Alaska. Psychosis 2023;15:145-54.

15 Heskestad S, Kalhovde AM, Jakobsen ES. Medikamentfri psykiatrisk behandling – hva mener pasientene? Tidsskr Nor Legeforen 2019;Oct 2. doi: 10.4045/tidsskr.18.0912.

16 Santaguida P, MacQueen G, Keshavarz H, et al. Treatment for depression after unsatisfactory response to SSRIs. Comparative effectiveness review No. 62. (Prepared by McMaster University Evidence-based Practice Center under Contract No. HHSA 290 2007 10060 I.) AHRQ Publication No.12-EHC050-EF. Rockville, MD: Agency for Healthcare Research and Quality; 2012:April.

17 Rink L, Braun C, Bschor T, et al. Dose increase versus unchanged continuation of antidepressants after initial antidepressant treatment failure in patients with major depressive disorder: a systematic review and meta-analysis of randomized, double-blind trials. J Clin Psychiatry 2018;79;17r11693.

18 Samara MT, Klupp E, Helfer B, et al. Increasing antipsychotic dose for non response in schizophrenia. Cochrane Database Syst Rev 2018;5:CD011883.

19 Miller M, Swanson SA, Azrael D, et al. Antidepressant dose, age, and the risk of deliberate self-harm. JAMA Intern Med 2014;174:899-909.

20 Ho BC, Andreasen NC, Ziebell S, et al. Long-term antipsychotic treatment and brain volumes: a longitudinal study of first-episode schizophrenia. Arch Gen Psychiatry 2011;68:128-37.

21 Zipursky RB, Reilly TJ, Murray RM. The myth of schizophrenia as a progressive brain disease. Schizophr Bull 2013;39:1363-72.

22 Mojtabai R, Olfson M. National trends in psychotropic medication polypharmacy in office-based psychiatry. Arch Gen Psychiatry 2010;67:26-36.

23 Wood SJ, Ilomäki J, Gould J, et al. Dispensing of psychotropic medications to Australian children and adolescents before and during the COVID-19 pandemic, 2013-2021: a retrospective cohort study. Med J Aust 2023;219:18-25.

24 Klau J, Gonzalez-Chica D, Raven M, et al. Antipsychotic prescribing patterns in children and adolescents attending Australian general practice in 2011 and 2017. JCPP Adv 2023;4:e12208.

25 Ilyas S, Moncrieff J. Trends in prescriptions and costs of drugs for mental disorders in England, 1998-2010. Br J Psychiatry 2012;200:393-8.

26 Nielsen M, Gøtzsche P. An analysis of psychotropic drug sales. Increasing sales of selective serotonin reuptake inhibitors are closely related to number of products. Int J Risk Saf Med 2011;23:125-32.

27 Whitaker R, Gøtzsche PC. The pervasive financial and scientific corruption of psychiatric drug trials. Copenhagen: Institute for Scientific Freedom 2022; March 23.

28 Saha S, Chant D, McGrath J. A systematic review of mortality in schizophrenia: is the differential mortality gap worsening over time? Arch Gen Psychiatry 2007;64:1123-31.

29 Forbruget af antipsykotika blandt 18-64 årige patienter, med skizofreni, mani eller bipolar affektiv sindslidelse. København: Sundhedsstyrelsen; 2006.

30 Notat om dosering af lægemidler i psykiatrien. Ministeriet for Sundhed og Forebyggelse 2014;Oct 30.

31 FDA package insert for Risperdal.

32 Joukamaa M, Heliövaara M, Knekt P. Schizophrenia, neuroleptic medication and mortality. Br J Psychiatry 2006;188:122-7.

33 Tenback D, Pijl B, Smeets H. All-cause mortality and medication risk factors in schizophrenia. J Clin Psychopharmacol 2012;32:31-5.

33 Waddington JL, Youssef HA, Kinsella A. Mortality in schizophrenia. Antipsychotic polypharmacy and absence of adjunctive anticholinergics over the course of a 10-year prospective study. Br J Psychiatry 1998;173:325-9.

35 Ray WA, Meredith S, Thapa PB, et al. Antipsychotics and the risk of sudden cardiac death. Arch Gen Psychiatry 2001;58:1161-7.

36 Ray WA, Chung CP, Murray KT, et al. Atypical antipsychotic drugs and the risk of sudden cardiac death. N Engl J Med 2009;360:225-35.

37 Christensen DC. Dear Luise: a story of power and powerlessness in Denmark’s psychiatric care system. Portland: Jorvik Press; 2012.

38 Lien L, Reitan SK, Halvorsen NJN, et al. ”Pilleskam” i psykiatrien er et alvorlig samfunnsproblem. Aftenposten 2023;Aug 10.

39 Gøtzsche PC. The media’s false narrative about depression pills, suicides, and saving lives. Mad in America 2023;Aug 23.

40 Gøtzsche PC. Prescription drugs are the leading cause of death. And psychiatric drugs are the third leading cause of death. Mad in America 2024;April 16.

41 Gøtzsche PC. Deadly medicines and organised crime: How big pharma has corrupted health care. London: Radcliffe Publishing; 2013.

42 Gøtzsche PC. Psychotherapy has an enduring effect on depression—in contrast to depression pills. Mad in America 2021; Nov 23.

43 Davies J, Read J. A systematic review into the incidence, severity and duration of antidepressant withdrawal effects: Are guidelines evidence-based? Addict Behav 2019;97:111-21.

44 Moncrieff J, Read J, Horowitz MA. The nature and impact of antidepressant withdrawal symptoms and proposal of the Discriminatory Antidepressant Withdrawal Symptoms Scale (DAWSS). J Affect Disord Rep 2024;16:100765.

45 Paludan-Müller AS, Sharma T, Rasmussen K, et al. Extensive selective reporting of quality of life in clinical study reports and publications of placebo-controlled trials of antidepressants. Int J Risk Saf Med 2021;32:87-99.

46 Belmaker RH, Wald D. Haloperidol in normals. Br J Psychiatry 1977;131:222-3.

47 Moncrieff J. The bitterest pills. Basingstoke: Palgrave Macmillan; 2013.

48 Demasi M, Gøtzsche PC. Presentation of benefits and harms of antidepressants on websites: cross sectional study. Int J Risk Saf Med 2020;31:53-65.

49 Moncrieff J, Cooper RE, Stockmann T, et al. The serotonin theory of depression: a systematic umbrella review of the evidence. Mol Psychiatry 2023;28:3243-56.

50 Shifting the balance towards social interventions: a call for an overhaul of the mental health system. Beyond Pills All-Party Parliamentary Group 2024;May.