Blogs

In the wake of the new study by Dutch researcher Lex Wunderink, it is time for psychiatry to do the right thing and acknowledge that, if it wants to do best by its patients, it must change its protocols for using antipsychotics. The current standard of care, which—in practice—involves continual use of antipsychotics for all patients diagnosed with a psychotic disorder, clearly reduces the opportunity for long-term functional recovery.

On the 6th of June 2013, ITV's This Morning hosted the News Review. One story was about the actor Stephen Fry and his recent publicity on how he has battled with his ‘bipolar’ condition and suicide attempts. While we don’t have any issue with this and the important message Mr Fry was trying to put across, we do have grave concerns over the comments made by the two guest speakers, and with what was imparted to This Morning’s vast susceptible viewing audience.

If we believe that emotional problems are primarily disorders of the brain, then perhaps taking a “fill-in-the-blank” medical history is sufficient. However, if we believe that emotional crises and dis-ease are problems that exist between people, in our sticky or not-so-sticky web of relationships, then whether families, survivors and those in crisis can heal together is a much more relevant, if still complicated, question. Perhaps the most honest answer to this question is: “It depends..."

Robert Whitaker spoke to a full house at the NAMI Conference in San Antonio last month. For many his message was a hard one to hear. I was among them; a parent, whose son, Max, sat beside me. He’s been on and off antipsychotics for more than ten years to treat the psychosis that comes with his bipolar episodes. Whitaker was telling us that might have been a mistake.

If I'd known then what I think I know now about our overuse of psychiatric medications (and all the words we were using to dehumanize people and their experiences), what would I have done differently? Was my occasional reference to recovery hollow? Once I get beyond my increasing regrets and start trying to imagine steps I could have taken, here's what I would do.

For a time this community intimidated me. I was in somewhat unfamiliar territory. Reading your impassioned cries for understanding and accurate analysis of ideas I'd never really thought about has been moving and enlightening for me. Some of you have been through things I'd rather not imagine. Your stories fiercely bring to mind the fates of some of my closest friends; they remind me of challenges faced and horrors narrowly avoided in my own efforts to "pass," even as I worried I was completely mad. Today I will tell you five things I have learned, and how I would like us to be doing things differently.

Fireworks and heated debate were expected by many when Robert Whitaker recently addressed a group at the National Alliance on Mental Illness (NAMI) annual convention in San Antonio, Texas. So why was Whitaker invited to the national NAMI convention and how did it turn out?

Just as the American Psychiatric Association's (APA) long-delayed DSM5 was about to launch, the director of NIMH, Dr Thomas Insel, provoked a flurry of acrimony when he mentioned in his blog that his organisation intended to move away from the ideas behind DSM: “Patients with mental disorders deserve better... NIMH will be re-orienting its research away from DSM categories... we will be supporting research projects that look across current categories – or sub-divide current categories – to begin to develop a better system”. It now seems Insel's comments had more to do with NIMH funding needs than points of principle.

I got a call from a colleague – someone with whom I’ve worked fairly closely over these past six years. The problem was the typical reaction one can expect when you bring together people in clinical and a variety of other roles who have been indoctrinated to think that medication is the way, and you offer clear and direct challenges to their belief system. Many people (most, even) responded well to the workshop. Some did not.

In this blog, I discuss three RCTs that support Martin Harrow's findings in his naturalistic study that long term use of neuroleptics is associated with worse functional outcomes.

If your government espouses freedom for all but abuses citizens of its own as well other countries, its pronouncements are pure propaganda. This article seeks to help readers make the connection between the public and secret behaviors of the U.S. government as it continues to oppress those individuals within its reach that occupy a politically marginalized status; including, of course, persons who are survivors and/or users of psychiatric services.

Users & Survivors in Academia (USA) is a support, advocacy, and resource-sharing group for graduate students (both master’s and doctoral) with psychiatric disabilities or current/past experience in the behavioral health system. USA started primarily for us to reach our peers across the country and engage in mutual support and advocacy around issues we face in higher education settings. Over the past year, USA has grown to 30 members in states across the country, and has quickly evolved into a forum to organize individual and systems advocacy, and support one another in self-advocacy in our own academic institutions.

When we look closely at the current mainstream diagnostic and support system for so-called mental disorders today, the utter absurdity of it quickly becomes apparent. We have a system composed of literally hundreds of discrete “mental disorders” (those listed in the DSM), all of which are believed to be the direct result of soon to be discovered brain diseases, in spite of the fact no reliable biomarkers have yet been found for any of them after a century of intense searching, a fact acknowledged just last month by the current designer-in-chief of this system himself.

Any time you create a word that only has meaning in a very specific context and then you start quite literally referring to people as if they were that word, you create more barriers to them moving beyond that context and on with their own life. Sure, it might feel good for a while. It might feel like you finally ‘belong’ somewhere. But what does that mean for your future?

It’s hard not to be enraged when your life is in shambles, you want nothing more than to get it back (and it’s happening barely, slowly, if at all), and you feel betrayed by the very people who you thought, at least at one point, meant to help you.

I am constantly around people who build their lives around negative beliefs. More specifically, I am around people that build their lives around being “broken” because of something they identify as being a “brain disease.” It breaks my heart to hear the way people view themselves.

We work with one-size-fits-all interventions and reduce patients to their indication, or diagnosis. We tell ourselves that the algorithm works when it is “evidence-based”. What does this mean when we see that the house of cards has been glued into its position?

There is a class of “naturalistic” research that can only be conducted if the researcher happens to be in the “right” place at the “right” time. Julia Rucklidge was running clinical trials using micronutrients to treat Attention-Deficit/Hyperactivity Disorder (ADHD) in adults when major earthquakes hit New Zealand. She and her research team contacted all current and past participants to establish whether they were taking micronutrients and for how long, and then they assessed how anxious, depressed and stressed people were one and two weeks post-quake. The results were revealing.

We find ourselves in very interesting times with regard to our understanding of mental health. We find ever more heated, passionate and polarized discussions taking place with regard to the so-called mental disorders — how or even whether to try to classify them, which factors are generally helpful in recovery vs. which factors are generally harmful, what does “mental disorder” or “mental illness” even mean, and what does “recovery” even mean. Given the way my own mind works, I find it helpful, when such conundrums appear, to try to take the issues all the way down to the most fundamental assumptions and experiences that give rise to them, and then try to reconstruct an understanding that is more conducive to meeting our needs. This discussion, then, is an attempt to do just that.

Research by Andreasen et al. published in American Journal of Psychiatry in June of 2013 reported that the dosage of antipsychotic medication correlated with the reduction in the cortex volume; higher dosage was associated with greater reduction. In that same article, the authors suggested that, since they found brain shrinkage correlated with duration of relapse, curtailing or preventing the relapse would probably decrease damage. Their suggested mechanism for shortening the relapse process was to prescribe more drugs. Before advising fellow physicians to increase the dosage of antipsychotic drugs to prevent brain volume reduction, it is important to show the following: first, demonstrate that symptoms, in fact, reflect the occurrence of a damaging process; second, demonstrate that any treatment intervention actually targets the damaging process itself and not just the downstream symptoms of this process.

The use of seclusion and restraint in mental health care in Ohio is legitimately subject to the assessment, criticisms and recommendations of the United Nations Special Rapporteur of the Human Rights Council on torture and other cruel, inhuman or degrading treatment or punishment.

Today I read Psychiatric News, the newspaper of the American Psychiatric Association, and I was drawn to an article about the new APA President, Jeffrey Lieberman, because the front page teaser announced that "he is 'mad as hell'".

It's been fourteen and a half years since the moment that first set me on my path to becoming an activist - a moment that overwhelmed me, cowed me even, but did not, in the end, destroy me. It was the day I was physically broken because I had tried to assert what I felt was an absolute right to some meaningful hearing on my detention. It was the day I learned about torture.

To respond to controversy and resistance developing in response to the recommendation of Special Rapporteur on Torture Juan E. Méndez for an absolute ban on nonconsensual psychiatric interventions, I suggested to use June 26, the International Day in Solidarity with Victims of Torture, to raise awareness and support for the recommendations. What started out way more ambitious became a relatively informal call put out over email lists, Facebook and with the help of the Mad In America website, to MIA bloggers.

My journey into the dark night of the soul was launched by an adverse reaction to the drug Effexor. Taking this medication triggered a maddening condition called Akathisia--a syndrome characterized by inner restlessness and agitation. My body was possessed by a chaotic, demonic force which led to my shaking, twitching and pacing back and forth across the room. The force of my symptoms was so great that I considered the possibility that I might be possessed by some malevolent demon. What made the situation even worse was that my experience was discounted by the psychiatric community.