Blogs

When the idea that selective serotonin re-uptake inhibitors (SSRIs) might make people feel suicidal first started to be discussed, I admit I was sceptical. It didn’t seem to me the drugs had much effect at all, and I couldn’t understand how a chemical substance could produce a specific thought. Because these effects did not show up in randomised controlled trials, they were dismissed and few efforts were made to study them properly. Then some large meta-analyses started to find an association between the use of modern antidepressants and suicidal thoughts and actions, especially in children.

Many posts on this website have cited studies linking stressful life events as a causal factor in the emergence of psychosis. What science requires is a mechanism connecting psychological stressors with functional changes that drive behavior. Recent studies connect psychosis with inflammation in the brain. Thus, the studies provide a mechanism for how trauma can increase the emergence of psychosis

The Future of Mental Health interview series continues with interviews this past week with James Maddux (on positive clinical psychology), Lucy Johnstone (on critical psychiatry and psychological formulation), Michael Cornwall (on being present to “madness”), Monica Cassani (on beyond meds: everything matters), Tim Carey (on parenting skills and family mental health) and Sharna Olfman (on the science and pseudoscience of children’s mental health. Here some highlights...

Every day we read, on the one hand, another compelling headline touting "news" of a “scientific breakthrough” that claims to have discovered the “cause” of “mental illness,” while another headline tells of researchers uncovering egregious falsification in the clinical trials of the pharmaceutical industry. The list goes on and on. Though many people report that they find medications helpful when they are in an extreme state (mostly to help them sleep ), given that there is as yet no scientific evidence confirming a specific disease/illness process underlying "mental illness,” and evidence that most if not all of the perceived effect is comparable to placebo, the fact remains that any positive effect of these meds are based on theory, while their harms are well-established.

Too many people have come to view themselves as defective and powerless to change their life situations, when this may not be the case. Conversely, individual treatment with drugs or psychotherapy may cause individuals to reframe their problems in terms of neurochemistry or thinking styles – internalizing a belief that they are the problem, when their problems exist in a wider sociopolitical milieu.

Mad In America bloggers, and everyone who is interested, you are cordially invited to participate in a Campaign to Support the CRPD Absolute Prohibition of Commitment and Forced Treatment. The requested action is to write a blog post or contribute artwork, relevant to the purpose of the campaign, i.e. discussing and supporting the absolute prohibition that is promulgated under the Convention on the Rights of Persons with Disabilities (CRPD).  Posts should be ready for March 29, 2016, the opening day of the 15th session of the Committee on the Rights of Persons with Disabilities.

What does screening mean, in the ever more prevalent field of Psychiatry? Psychiatric screening is not a biological metric that can be assumed to predict the future in a linear manner. It’s a series of subjective questions. It is, in short, a survey.

Rethinking Psychiatry is an independent, grassroots group in Portland, Oregon that advocates for a paradigm shift in mental health care. On January 20, we hosted a film and discussion by activist and artist Barbara Ford. The subject was “Despair and Resilience: How to Face this Mess We’re in Without Giving Up.” Ford also showed film called Joanna Macy and the Great Turning, featuring philosopher, writer, and activist Joanna Macy.

If antidepressants are effective, and people with depression are more likely to be prescribed them, then you would expect the consequences of depression to start to lessen. One of those consequences, according to government statistics, is being out of work. But what we see is quite the opposite: Increasing use of antidepressants correlates with increased numbers of people with depression who are out of work and claiming benefits, and increasingly on a long-term basis. And this is at a time when disability due to other medical conditions has fallen.

Four weeks ago, after I wrote a blog about a study that concluded there was no good evidence that antipsychotics improved long-term outcomes for people diagnosed with schizophrenia, I was cc’d on an email that had been sent to a number of “thought leaders” about what I had written. At least as I read the email, it put me into the usual pigeonhole for critics of psychiatric drugs: I apparently was globally “against” medications, and I had displayed a type of simplistic “categorical” thinking. All of this led to my having an email exchange with Allen Frances, and his laying out, in his opinion, the considerable "collateral damage" my writings had done.

A simple, one-time visit to an unfamiliar counselor resulted in my diagnosis of ADHD. That same visit started my avalanche of drug abuse. I was 19 years old when I was falsely diagnosed with ADHD, and it forever changed my life.

In his NY Times article “A Drug to Cure Fear,” Richard Friedman noted: “It has been an article of faith in neuroscience and psychiatry that, once formed, emotional memories are permanent.” This has not been a principle of these disciplines, including clinical psychology, for many years. Consolidation-reconsolidation-extinction models have been around for some time now, applied in particular to persons suffering from traumatic memories; e.g., Holocaust survivors, war and genocide survivors, etc.

In recent months, two teams of researchers in the UK and the US published complementary findings about the epigenetic origins of schizophrenia that have scientific communities who indulge in ‘genetic conspiracy theories’ abuzz. While these results are intriguing, and no doubt involve pathbreaking research methodologies, this line of thought represents a decontextualized understanding both of the symptoms that are typically associated with schizophrenia, and their causes.

Human beings can be helped in all sorts of ways: with better schools, cleaner water, less tyranny, more peace, and fairer institutions. Movements of the last hundred years have given names to these different aspirations for betterment: the women’s movement, the civil rights movement, the gay rights movement, clean air and clean water initiatives, and so on. Now another sort of “helping” is desperately needed.

I can’t even begin to count the number of times I’ve heard “Research has found that about 90% of individuals who die by suicide experience mental illness.” Here’s what I believe it means in far too many instances: It’s an 'out.' It’s an easy answer that absolves us all of blame. If someone has a ‘sickness in the brain,’ then it doesn’t have to be our fault or even necessarily our concern.

The Grand Jury indictment on January 21st of a Georgia policeman for the felony murder of Anthony Hill brought national attention to the intersection of Black Pride and Mad Pride. Hill, who was black and a veteran, was murdered in March 2015 while in an extreme state or “mental health crisis.” He was naked and clearly unarmed when shot by a white policeman. The indictment brings attention to the failure of mental health care system in America.

Health systems are extremely hierarchical and, rather than empathy, the dominant approach to people's difficulties is based on top-down management practices which assume experts know what is best for people. I am hopeful that we can help people within the mental health system and other parts of society to strengthen their empathic ways of relating. However, I've noticed how easy it is for me to get self-righteous about mental health workers who are more 'medical' or 'expert-lead' in their approach. I realise that if I really want to help change things for the better I, too, will need to understand people who seem to be my opponents.

Families are often very important for people encountering severe mental and emotional difficulties. But how can family members really know what is helpful, and what is likely to make things worse for the person having problems? Similarly, for those who want to help families, how can they know what will really be helpful for those families, and what will make things worse?

A "diagnosis of schizophrenia" is based on two or more of five criteria. Each of these behaviors (or lack of behaviors) can be passed on from generation to generation through normal social learning, without any assumption of a genetically-mediated pathology. Genes transmit biological structure. Structure has an impact on behavior, obviously, but there are always multiple intervening factors.

“The substantial hereditary component in schizophrenia,” a pair of researchers wrote in 1993, “is surely one of the two or three best-established facts in psychiatry.” But is it really? For mainstream psychiatry and psychiatric genetics, schizophrenia is “a severe mental disorder with a lifetime risk of about 1%, characterized by hallucinations, delusions and cognitive deficits, with heritability estimated at up to 80%,” or a “highly heritable neuropsychiatric disorder of complex genetic etiology.” Many commentators have challenged these claims, and some have challenged the concept of schizophrenia itself.

Our priorities for studying and improving "mental health" are way out of whack. They have been for a long time. For the past 30 years, the National Institute for Mental Health has been spending most of its gigantic budget ($1.3 billion in 2015) on studying the brain and looking for the genes that cause "mental illness." That's been a tremendous waste of money, time and effort.

On January 7, 2016 my newly 13-year-old son (he helped me fashion the title for this blog!) brought home two permission slips from the middle school where he is currently (hopefully) making his way through the 7th grade. One of the slips was for a class trip to the Bronx Zoo. Okay, fine. However, the other asked me to give my okay for him to participate in a “Signs of Suicide” (SOS) curriculum and the perhaps-too-honestly-named ‘Brief Screening for Adolescent Depression’ (BSAD) that accompanies it. (Does no one else see the perverse humor in a depression screener that seems to actually be encouraging those screened to “be sad”?)

This week we launched PeerRespite.net, a website dedicated to information and resources regarding peer respites in the U.S. As part of the initiative, recruitment is open for the 2015 Peer Respites Essential Features Survey.

Let us put the final nail in the coffin of the neurotransmitter myth of big Pharma and the APA. The idea that psychiatric issues come from some quantitative soup of neurotransmitters in the synapses of the brain is completely wrong. Yes there are neurotransmitters in the brain. However, serotonin does not create symptoms.

Mental health policy does not sound exciting. It is - you’ll just have to take my word for it-, but even if you don’t, you might agree with me that it’s crucial. Mental health policy shapes mental health legislation, and mental health legislation shapes issues such as consent, access, equal opportunities and de-institutionalisation, to name but a few. Influencing policy is key to reframing the debate around mental health, and changing the reality on the ground for people with lived experience. With this in mind, here is an introduction to Mental Health Europe’s work on the revisions to ICD 10, and a call to action, for you to get directly involved in this international debate.