Blogs

When people call someone in their family “mentally ill,” what does it mean? The term mental illness has gotten out of control vague. There is no way to prove someone does or doesn't have a mental illness in the way it is referred to, so why don't we hear people say, “There's someone in my family who's extremely challenging for me (and others perhaps)”? Why don't we hear descriptions of the behavior, how people feel in response to it, and what concerns it brings up in an honest way where the speaker owns their own experience?

Anyone who has used benzodiazepines and sleeping pills knows how difficult it is to get off them (worse than heroin!) and how much time it takes to recover. Although there is a lot more helpful information on the web these days, a lot of it is based on anecdotal accounts, personal stories and theories rather than “real” evidence.

Hey I did an interview this morning on WNYC about my new book, Maps to the Other Side, and told the thousands of listeners to check out the Mad in America website if they want strong and articulate views on what's happening in the world of mental health. I have this exciting feeling that the Icarus Project underground culture is breaking up out of the pavement and crossing paths with the mainstream. Check out the interview here and tell me what you think!

Is it really best to force someone into the hospital when they are suicidal? Do suicidal feelings plus "risk factors" really mean professionals can predict whether someone might try to kill themselves? And are suicidal feelings the symptom of a treatable illness that should include medication prescription?

At the 50th American Psychosomatic Society meeting in New York, Michael Shepherd was speaking. His topic - The Placebo. When the lecture finished, Lou Lasagna said "this paper is now open for questions." Nothing happened. Nobody said anything at all. Lasagna couldn't refrain from commenting: "There are 3 possible explanations. First, you were all asleep and therefore you heard nothing. Secondly, it was so bad that since this speaker has come 3,000 miles you didn't want to embarrass him. Third, it is genuinely so original and new that you don't quite know what to make of it. I'll leave you to decide which it was". What had Shepherd said?

David Romprey walked up to me one day when I was in the middle of planning the next new 16-bed facility in a community setting for people who were in our state hospitals in Oregon. Progress was in the making. He asked why I called these places 16-“bed” facilities. Answering matter-of-factly what seemed obvious, I replied that these residences, nicely furnished in pleasant neighborhoods, had 16 beds. Looking me straight in the eye, as he always did, David asked me, “Do you think we’re lying around prostrate all the time?”

For the last month or so, Mad in America has been hard at work building a directory of “mental health” providers across North America (and eventually, we hope, the world) who will work with people wanting to come off psychotropic drugs.  I’ve been honored to have been tasked with the responsibility of building this directory, and I have to say, it’s been inspiring to talk to people all over the country who do this work, and who “get it”.

Carina Håkansson, co-founder of the Family Care Foundation in Sweden, discusses her work with family care homes, psychotherapy and family therapy absent from psychiatric diagnoses and manuals.

The National Council on Disability is holding an in-person public comment session on April 23 regarding its engagement with the Convention on the Rights of Persons with Disabilities. I have submitted the following comments on behalf of the Center for the Human Rights of Users and Survivors of Psychiatry (CHRUSP).

Human knowledge of the relationship between nutrition and mental function probably goes back many thousands of years, but it has been documented for ‘only’ about 2700 years. Our ancestors knew that nutrition was a big part of the mental health picture. The pharmaceutical era eclipsed the rich historical knowledge that our ancestors had about the importance of food for maintaining good mental health.

In previous posts in this series, I noted that the standard treatment of conditions labeled as schizophrenia (and related disorders) is to start neuroleptics early and to continue them indefinitely. This is based on the belief that untreated psychosis is bad for the brain and that relapse is much higher when the drugs are stopped than when they are continued. The rationale for this approach, and my discussion of the limitations of these assertions, were the topics of previous blogs in this series. In this final post I want to discuss how realistic this paradigm of care is.

Earth Day 2013 is a good time to reflect on how problems in our mental health system reflect deep flaws in “normal” conceptions of what it means to be a human being. These flawed conceptions then contribute in a critical way to the climate crisis that threatens us all.

In July 2006, I wrote about Electroconvulsive Therapy and stated, “If I had the opportunity to have another series of treatments I would do...

Tension mounts across the ideological divide as D-Day (DSM-5 Day) approaches. The APA has powerful allies on its side. President Obama has just launched Decade of the Brain 2 with the announcement two weeks ago that heralds the arrival of BRAIN ( Brain Research through Advances in Innovative Neurotechnologies). If that’s not enough, those who believe that science will ultimately explain madness can always rely on the media to fawn at their feet.

Some psychiatric drugs are extraordinarily effective, for instance benzodiazepines for catatonia or SSRIs for premature ejaculation. These treatments are so effective that controlled trials are an irrelevance. Every trial conducted would show a positive result. The point here is not that it is impossible for a treatment to achieve effectiveness but rather that controlled trials have little useful to contribute to the issue of effectiveness. Randomized placebo controlled trials have not shown any drug within the mental health domain is effective. If a treatment were effective virtually every RCT undertaken would show a positive result.

It is not often that you will find an issue on which the editors of The Lancet and Guinea Pig Zero agree, but the need to investigate the University of Minnesota is one of them. At this point, it still not clear who will prevail: those who want to honor the Department of Psychiatry, or those who want to have it investigated.

Many of the posts on MadInAmerica are devoted to looking at solutions that are more promising than medications. The two of us are so pleased to be able to fill in one of the very large gaps in the topics covered thus far: the role of nutrition in mental health.

For the past 20 years, there has been a prevailing concern in psychiatry that psychosis is bad for the brain. When I read Anatomy of an Epidemic, this was one of my most pressing concerns; if I suggested to my patients that they pursue other treatments before starting drug treatment, was I helping or harming them?

In January 2012, Mad In America went live with a handful of bloggers and the mission to become a central community in the effort to rethink and transform the paradigm of psychiatric care.

I want to offer some thoughts and figures about where we've been in the past year and what we are growing into.

Then I want to ask you for money.

What goes wrong for the 10-15% of women who feel like hiding under the covers instead of gazing blissfully into their newborns peaceful face? Is it expectations unmet? Is it hormones? Is it the brain? Having spent several years treating these women, I believe that what we are calling postpartum depression and anxiety is in fact postpartum immune dysfunction, and its attendant inflammation.

For those of you who haven't read it, I published a blog post called, 'Too Much Pies,' on Mad in America on Wednesday, April 10th.  The post included an invitation to psychiatrist Ronald Pies (who caught the interest of many when he wrote a letter to the New York Times about psychiatric diagnosis) to a real dialogue, not limited by number of words, frequency of reply or professional licensure. I copied the letter directly to Mr. Pies, not knowing if he would reply.  On Thursday, April 11th I received a direct reply that Mr. Pies has authorized me to repost here.  I am also including my response to him.

On March 18th, Ronald Pies, a psychiatrist based in Lexington, Massachusetts, wrote a letter to the New York Times. He argued in favor of the usefulness and harmlessness (when well used) of psychiatric diagnosis and wondered as to the misgivings so many seem to have. The Times invited its readership to participate in a dialogue by submitting responses to Pies’s piece. Laura Delano, Paula Caplan and I were among the relative few who managed to get our voices heard. Pies had the last word, though: He gave just two short sentences to my dispatchment, and summarily disregarded so many years of pain and loss and abuse of power.

In 1956, Lou Lasagna was on his way to being the most famous doctor in the United States; an advocate for controlled clinical trials of both the safety and effectiveness of medication, as well as for a revision to the Hippocratic Oath to include a holistic and compassionate approach to medicine. Then, caught in the nexus of reason, regulation, and the pharmaceutical machine, his star fell.

Those of us, the survivors, who speak from experience, with nothing to gain from sharing our stories and in fact a hell of a lot to lose, risk having them revised or repudiated at every turn by the very people who, and paradigm which, sickened us. I’m simply trying to tell my story as I lived it, because I know exactly what I went through and why, and I don’t think anyone else should have to suffer this way if they need not do so.

I hope this will be of help to people who hear voices and their friends and supporters. I also hope it will be helpful to the voices which are parts of many people's lives. Many voices I have come across and the people that hear them are convinced that their voices are spiritual in nature. I take an agnostic position on this, and therefore endeavour to respect different spiritual understandings. My intention is not to explain all voices psychologically but to help people make peace with their voices so they can get on with their lives.