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When a woman has a history of severe and relapsing mental illness, but is stable on her current treatment, and is planning a pregnancy or is postpartum, what is the best course of action for her and her baby?

People in roles of power in the mental health system often don’t realize how much complicity they have in actually creating the symptoms they claim are biologically-based in individuals with psychiatric labels.

I hadn’t seen this psychiatrist or any other now in several years. I chose to make this visit to the man who prescribed the drugs for my 6-year-long psychiatric drug withdrawal for several reasons. Upon reflection, I think the primary one was ritualistic. Something to mark the end of that phase of my life. A goodbye to psychiatry, concretized.

Note: This post originally appeared on August 18, 2014 on dxsummit.org. On August 5 and 6, 2014, a group of roughly twenty persons met in Washington, DC...

What do I tell my patients about diagnosis? I try to explain what a diagnosis is and is not. It is a label that reflects that the person has reported certain symptoms. It is a label for the symptoms not for the person.

Sandra Steingard’s recent post, “Is It All In Your Heads,” has occasioned a spirited discussion—on monism, dualism, and what may be going on when...

Two facts about Robert Califf are beyond question. He is an expert on clinical trials, who is already seen as a leading architect of the future of medical research. And as the New York Times put it, he has “deeper ties to the pharmaceutical industry than any FDA commissioner in recent memory”. A lot of senior figures in medicine support Califf in spite of his ties to Pharma. The guy is just so bright, and understands the nuts and bolts of drug research so well! Surely a person like this is more useful than some outsider who offers only a squeaky-clean resume, they argue.

Thanks to the work of Dr. Irving Kirsch, we now know that the majority of the effect of antidepressants is attributable to the "active placebo effect" or the belief that receiving a memified brain-chemical-corrector will actually help alleviate symptoms. As I discuss in this post, evaluation of published and unpublished data, in two metanalysis, demonstrated a non-clinically significant difference between placebo and antidepressants. A fascinating new study entitled The Role of Patient Expectancy in Placebo and Nocebo Effects in Antidepressant Trials further explores the power of belief in psychiatric treatment.

The label of schizophrenia has a chilling ring. It carries with it the suggestion of a wrecked and wretched life. It is also a diagnosis that is notoriously difficult to shed. For this reason, the diagnosis of schizophrenia should not be applied lightly and not without a thorough understanding of the patient’s family and wider circumstances.

Hope heals. Thousand of years of experience and, more recently, numerous hope studies, prove this to be true. Yet hope is still a 4-letter word in many mental health settings. How can we build a bridge to hope from hope-stealing physical and emotional pain, hopeless diagnoses and prognoses, and hope-numbing side effects?

It’s never too late to seek another explanation for the problems you’re facing, to change your mind and get your life back.

In a nutshell, I switched coasts and moved from Philadelphia to attend CIIS in San Francisco, because I couldn’t tell my story. In Philly I was known for my role as Storytelling Training Trainer, in which I facilitated a workshop to help people share their stories of mental health and substance abuse recovery. But I never felt I could tell my own real story, because the culture there wouldn’t allow it. The culture allowed me to be a person diagnosed with bipolar with psychotic episodes, who was living a meaningful life, but it did not allow me to be a person who is undergoing a very profound developmental process where my psyche was perceiving and processing my universe in ways that were shifting my paradigm of the potential of what reality can be, which for me, is a very spiritual process, and my true story.

You never know what you’re going to accomplish when you start something. Who could have predicted that Tom Insel and NIMH would throw the APA and the DSM under the bus? My guess is that two factors played a big part in NIMH’s decision. First, the unceasing barrage of criticism directed at the DSM – its lack of construct validity; its declining inter-rater reliability – had damaged its credibility beyond repair. On top of that, thirty years of DSM-based research had produced no biomarkers.

I’ve been teaching a course on substance abuse for about 30 years now. In this course, I cover a new drug class each week and always review the history of the drug. All of the drugs of abuse, cocaine, alcohol, marijuana, opiates are not new on the human scene. They date back to the Sumerians and the Greeks. The question for me is what accounts for epidemics? I have come to believe that epidemics are supplier driven rather than a function of consumer demand. For the current opiate epidemic, the suppliers were the pharmaceutical houses.

German psychiatrist Stefan Leucht and colleagues have produced another really important paper. The results indicate that the small differences usually found between antidepressants and placebo are far below the sort of differences that would be clinically detectable or meaningful. Leucht et al. have conducted the first thorough, systematic attempt to provide some empirical evidence about what constitutes a clinically meaningful difference in scores on depression rating scales, although the study did not set out to explore antidepressant effects.

Mad in America readers will not be astonished by the news that Big PhRMA showers physicians with “free” trinkets and samples and lunches and dinners and junkets and dollars. Such tactics are common throughout the world of commerce, where they are described by terms ranging from “promotion” to “commercial bribery.” But do bribe-like actions ensnare physicians?

In the mainstream, psychological difficulties are seen as “symptoms” of an “illness” or “mental disorder” and based on this the focus is put on suppressing them, either by using drugs, or shock, or by psychological interventions that also aim to “eliminate the problem.” Unfortunately, this mainstream approach often works poorly, and too often its main effect is to aggravate the problem, or to cause “collateral damage” as critically important parts of the person are suppressed along with the supposed “symptoms.” But if we want to replace the mainstream approach, we need a coherent alternative view.

Several months ago, two professors at the University of Pennsylvania were accused of ghostwriting. The university has now announced the results of their investigation, which is partially based on work by the great moral philosopher, George Constanza...

On January 6th, 2014, a teenager with a diagnosis of schizophrenia died in North Carolina. He was shot and killed by the police that his parents called for help after he wanted to fight his mother. It is said that he was "having an episode."

I believe the question of whether to medicate or not cannot be kept separate from the question of whether or not to consider individuals...

We need all of our voices to come together to challenge that sort of power in order to have any sort of hope at all. To the best of my knowledge, the majority of people who hang around these ‘Mad in America’ parts are particularly interested in prioritizing, promoting, and creating access to (true) alternatives, including those built upon peer-to-peer supports. But, whenever one of us falls, it becomes that much easier to knock the next one down. We need more examples to point to, not less; more places to reference and say, “If they can do it, why can’t we?”; more places to call upon and say, “If you don’t believe us, how about them… or them… or them?”

This is a memorial to my friend Ken Braiterman who was a long time member of the mental health civil rights movement. He was a best friend/ally/coworker/enemy of David Hilton, who lost his life to mental health civil rights battles. Ken wrote a great series of posts about David's struggle with advocacy.

Just a few days ago, the Bazelon Center for Mental Health Law, perhaps the foremost legal advocacy organization for persons with disabilities in the country, issued its “vision of community integration” for the disabled, listing the “key principles” that should be utilized to achieve that aim.

Ever since critics began asking questions about the death of Dan Markinson in a clinical trial at the University of Minnesota, the General Counsel for the university, Mark Rotenberg, has responded with a uniform message: the case has already been investigated many times, and no wrongdoing has ever been found. That's how Rotenberg responded to my article about the case in Mother Jones, and that's how he responded last week to the news that the Board of Social Work had issued a “corrective action” to the study coordinator for the clinical trial in which Markingson died.

The core of Acceptance and Commitment Therapy, or ACT, is the idea of simply accepting, rather than trying to get rid of, disturbing or unwanted inner experiences like anxiety or voices, and then refocusing on a commitment to take action toward personally chosen values regardless of whether that seems to make the unwanted experiences increase or decrease. This idea is consistent with the emphasis in the recovery movement of finding a way to live a valued life despite any ongoing problems, but ACT has value because of the unique and effective strategies it offers to help people make this shift.