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Hey Doc; I was wondering if before you see me the next time and tell my parents that I still need to be medicated for ADHD, you might consider a few things about me that you might not know. You see as a kid who can barely pick out an outfit that matches, make my bed, or wake up not hoping it's Saturday, I kind of have an active imagination. Like nearly all of my friends, I hate taking baths and I like to daydream. And when I daydream, I seem to not pay attention to what others are talking about. I kind of get lost in my own little world where rainbows do lead to pots of gold, leprechauns are real, life often feels like my favorite video game, and fart jokes never get old.

I’ve had some criticism of the recent Doctor Munchausen posts. They’re not fair on doctors. Many people have told me of lives saved by good doctors. It’s not fair to tar these good doctors with the brush of a few Dr Munchausens here and there. So there’s bad doctoring and good doctoring and great doctoring. What would great doctoring mean?

We want to start an international initiative to promote the writing of recovery stories in every country, with the ultimate goal of sharing at an international level the most compelling ones from each country. Our proposal is born from an awareness that recovery stories are necessary today in order to give back to mental sufferance its meaning and transparency, to fight the biographical opacity of biological theories (the broken brain) and to guarantee decisional power to those who are offered (or imposed) mono-dimensional or dehumanizing treatments.

As a prescription drug and addiction expert for The O’Reilly Factor, Fox National News and many other news outlets, I am often called when a celebrity death occurs. While the loss of a talented actor or musician is tragic, I know from personal experience that the magnitude of devastation from legal drugs is happening to millions of innocent people – through psychoactive medications.

What I find most compelling about the message of RECORD is its reclamation of pain, for the album makes clear that Dylan's is not the story of a journey to happiness and bliss and total peace of mind, but rather, one back to the truth of what it means to be human— pain, anguish, and all. It is an embracing of suffering, not a leaving behind of it, and this, too, has been my journey. This, I believe, is what psychiatric liberation is all about.

Shamans are the magician spirit healers in tribal, non-technological societies around the world. Anthropologists use the word “shamanism,” from the Tungus people of Siberia, to mean the commonalities between different traditions. Shamans find their calling through a life-threatening initiatory illness or crisis, go into visioning and trance to connect to other realities, shapeshift out of their regular identity to identify with animals, spirits, and even illnesses, and return to the ordinary world to share skills of healing and creativity. Living at the edge of society and defying conventional norms, conduct, and even gender, shamans are respected as a powerful community link to the divine.

From time to time, I find myself feeling the urge to articulate my views and delineate them from people with whom I may be identified. Rightly or wrongly, I feel that way with this website. Although the goal is to have wide ranging goals there is nevertheless a distinct perspective represented here. I feel the urge to articulate where I part ways with some of the views expressed here. I do this in the spirit of discourse. I am not certain I am correct. I may someday change my mind. I am just expressing my perspective.

In his Alternatives Conference 2012 Address, Will Hall called attention to the ongoing phenomena of “medicalizing poverty and calling it mental illness.” Mental health systems and practitioners often tend to perceive and identify the myriad ways that impoverished people cope and adapt to adverse environments (such as food and housing insecurity) as pathological indicators of mental illness. A poor child who does not pay attention to the day’s lessons at school may be diagnosed with ADHD, yet focuses intense attention on how he will return home safely, take care of his siblings and get a meal. A young woman may be labeled as Oppositional/Defiant who bravely copes with an erratic mother and her abusive boyfriend. Behaviors that can make sense in one context (home, neighborhood), are flagged as dysfunctional and impaired in another (school & work).

When constructing the ADHD diagnosis, progenitors essentially say, "Let's study a group of people who do particular hyperactive, impulsive, and distracted behaviors that are associated with chronic and pervasive problems in school, social life, and work. If the person is an adult, the problems must be present in childhood and show consistency throughout development. We will call this group "ADHD" and study correlated biological characteristics and other associated difficulties. We will continue to tweak the criteria so that the diagnostic net falls on the people with the correlated dysfunctions and patterns of biology that we find in our research.

In the world of emergency medicine time is a critical resource. But Ryan McGarry, ER physician and stage IV lymphoma survivor, understands at the bone that idle minutes mean something very different to a patient. He recalls “waiting on news if the therapy is working . . . is there more disease that we didn’t know about, is it getting bigger . . . the clock was torture, watching that dial go around is torture.” McGarry horridly remembers what it’s like to wait on a simple, overdue dose of anti-nausea medication. He reflects, “You’re clearly at an advantage as a physician or provider at any level if you’ve been a patient. It’s just an unbeatable perspective.”

When I as a European follow American politics I can’t help being amazed by the  - I believe a polite expression would be – colorful personalities in the Tea Party and how they manage to continue to be a powerful part of American politics despite making claims that as I see them reported are easily debunked. American politics does not affect me directly but when I compare psychiatry as a part of the medical science to the Tea Party there are some striking similarities.

How do we distinguish between ordinary feeling down, on the one hand, and depression-the-illness on the other. Psychiatry's answer is that depression-the-illness causes " . . . clinically significant distress or impairment in social, occupational, or other important areas of functioning." This phrase occurs as a criterion feature in almost all psychiatric "diagnoses," and is embodied in the DSM definition of a mental disorder, but is unsatisfactory from a number of aspects. Firstly, the term "clinically" has no meaning, other than a thinly-veiled attempt to lend a medical flavor to the phrase. Secondly, the term "significant" is not defined, and inevitably rests on the subjective opinion of a psychiatrist, who, in many cases, has a vested interesting in "finding" a "diagnosis."

This past June, Illinois became the 3^rd state to allow psychologists to prescribe medications commonly used for psychiatric issues, after New Mexico and Louisiana have enacted similar laws.  When it comes to gambles for our profession, and frankly for the general public, it doesn’t really get much bigger than this. The following list provides a brief overview of some of the most serious issues that face this discussion, both for psychologists and the general public.

I grew up in an environment that taught me my worth as a person was directly tied to my grades, my athletic performance, my list of extra-curricular activities, and my SAT scores. That if I wasn’t the best, I was the worst. That if I wasn’t perfect, I was a failure. At thirteen and in all my psychiatrized years to follow, I never had the chance to step back and process what this all meant, and whether these were values I wanted to hold onto, and I continued through high school and on to Harvard in this existential limbo, simply because I saw no other way.

I had a soul-redemptive heart-to-heart reunion with a woman I had known from a distance but whom now (after our hours long coeur-a-coeur/heart-to-heart) I consider a close friend. I shared with her some very exciting and some challenging circumstances I have been experiencing of late. After I shared and shed a few tears she told me a story from her life that also poses, like my story, an invitation for profound change in our lives.

It seems almost every week now that we hear of a mass murder/shooting in the media. By now the pattern is too familiar to be as frightening as it once was. The response has also become reflexive: Guns should be made less available, especially to people with mental illnesses, and potentially dangerous people should be treated for their mental illnesses − involuntarily if necessary − so they can live safely in our community. Yet, nothing much changes, outraging the next set of victim’s families and communities.

It is hard to believe that a year has gone past since I posted Playing the Odds: Antidepressant Withdrawal and the Problem of Informed Consent. The feedback I received underscored the more controversial aspects of SSRI toxicity.  Common themes concerned the abrupt onset of new symptoms 3 to 12 months after stopping the drug, reinstatement of the drug failing to help withdrawal related symptoms, the possibility that withdrawal-related symptoms can persist indefinitely and concerns about using benzodiazepines to help with tardive akathisia.

On July 17, I wrote a post on the use of neuroleptic drugs as chemical restraints in nursing homes.  The article generated some comments, one of which touched on some very fundamental issues which, in my view, warrant further discussion. The comment read as follows: "All drugs can be dangerous toxic chemicals when not used appropriately. While many valid points are made in this article, it’s very one-sided and could be considered biased in that it’s written by a psychologist. I’ve seen many patients and families benefit from their use."

Before Michael Pollan gained well-deserved respect and influence authoring five bestselling books about food, he got my attention in the late 1990s writing about American illegal-legal psychotropic drug hypocrisy. Then he stopped writing about it. If he had continued his assault on American drug hypocrisy, he likely would have been attacked by many psychiatric drug users, mistaking his confronting this hypocrisy as challenging their decision to choose psychiatric drugs.

The kinds of experiences we call psychotic are often incredibly scary: people feel they are being persecuted by strange forces, or that their brains have been invaded by demons or riddled with implants from the CIA . . . the list of possible fears is endless, and often horrifying. While standard mental health approaches counter many of these fears, they often create new fears of a different variety.   Wouldn’t it be helpful if professionals were trained in an approach that could help people shift away from both dangerous psychotic ways of thinking and also away from the sometimes equally terrifying explanations which emphasize pathology?

Even as we have access to more and more information linking that which gets labeled mental illness to trauma — treatment that exacerbates the trauma response continues to gain legal traction all over the country. This, of course, leads to the epidemic of harm and iatrogenic illness we’re watching happen. (See: Anatomy of an Epidemic.)

It is rare to get involved in a dialogue over psychiatry without sooner or later someone defending the use of such “treatments” as ECT “as long as they are consented to,” with the term “informed consent” periodically employed. Herein lies the context for this piece. The issue that I want to probe, to be clear, is not whether force should be used—for of course it shouldn’t—but the thorny issue of consent itself—what exactly constitutes consent and what other issues besides consent are critical to factor in when considering what it is and is not legitimate for a “medical” professional to offer.

Many people who have never been severely depressed might ask, “Why would anybody want to kill themselves?” After all, taking one’s life goes directly against the survival instinct that nature has programmed us with. For example, if you were walking across the street and saw a car coming towards you − your first instinct would be to jump out of its path. Yet, when the brain becomes overwhelmed with chronic, intense pain that seems to have no end, then suicide becomes not only a rational choice, but a compelling option. After all, if you are faced with the prospect of being in eternal hell, then taking your own life seems like an act of self-love, not an act of self-detruction.

When I became a case manager at a community mental health agency in Cincinnati, Ohio, I had a bachelor’s degree in journalism, 11 months of experience working in the advertising world, and 10 months of serving with AmeriCorps under my belt. I was not the most qualified person for the position, but I was hungry for experience in the mental health field, and I was determined to be good at the job. My supervisor said he hired me because he knew I had the interpersonal skills to do the work, and that he could teach me the rest. Two of the main axioms I learned as a case manager were that mental illnesses are due to chemical imbalances, and psychotropic medications are the solution. As a result, I spent an abundance of energy negotiating with my clients to take their meds or try new ones that the pharma reps encouraged us to promote.

There's an interesting article in the July-August 2014 issue of the AARP Bulletin.  It's called Drug Abuse: Antipsychotics in Nursing Homes, and was written by Jan Goodwin.  AARP is the American Association of Retired Persons.   Jan Goodwin is an investigative journalist whose career, according to Wikipedia, ". . . has been committed to focusing attention on social justice and human rights…" The article is essentially a condemnation of the widespread and long-standing practice of using neuroleptic drugs to suppress "difficult" behavior in nursing home residents.