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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”.

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.

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.

Since I left the psychiatric prescribing trenches and came south for the winter, I’ve been staying in a beach town within driving distance of a technology metropolis. I take breaks from my writing and walk to the beach. There, I meet and talk with the winners of the American dream. They are intelligent, highly educated and financially successful. They take their beach vacations here.

I remember the first time I read the Bill of Rights. I was a child suffering with extreme states and didn’t have any idea what I was experiencing. I believed and I was told that I was different. At the same time, I watched my mother get fired from a job she worked so hard for and went to school for, because of a diagnosis. I then watched all her rights stripped away in psychiatric hospitals. Through it all I felt hope because of those rights contained in the Constitution.

I am returning to the subject of psychological formulation after rather a lengthy gap, during which controversy about the forthcoming 5^th edition of DSM has continued to grow – sign the petition ‘Stop the Insanity’ at  www.dsm5response.com if you share others’ concerns about the creeping medicalisation of everyday life and the risks that it poses.

It’s taken me a while to write part 2 of this series, and honestly I’ve been torn between several compelling topics. But, here I land. Just a brief re-cap before I get rolling: The foundation of this ‘False Arguments’ series is that sometimes I, you, we... all get drawn into arguments and belief systems that are based on a particular starting point that is assumed to be, or acted upon, as if they are valid.

It’s been the kind of contemplative, hibernating winter that’s left us ready for an action-packed spring. Jacks and I spent two months living in a little house in the woods finishing our first solo books and revising the classic Icarus text Navigating the Space Between Brilliance and Madness...

The United Nations Human Rights Committee has asked the U.S. government to clarify how the possibilities for nonconsensual medication in psychiatric institutions comply with their obligations under Article 7 of the International Covenant on Civil and Political Rights - i.e. the obligation to ensure that no one is subjected to torture and ill-treatment. This is the fruit of successful advocacy by Maxima Kalitventsev and myself; we went to Geneva last month to meet with members of the Human Rights Committee and urge them to ask questions related to forced psychiatry and psychiatric profiling as violations of our human rights.

A few months ago I had the great honor of speaking with Kofi Annan, former secretary general of the United Nations, after a talk he had given locally here in Washington, DC. We spoke about eCPR and there was a moment that I will remember for the rest of my life. He looked deep into my eyes and said, “We are in the same line of work. We are peacemakers.” It was a profound statement that inspired me to think more about eCPR as a tool of peacemaking.

Journalist/humorist Jon Ronson’s TED talk “Strange Answers To The Psychopath Test” addresses the DSM, diseasing normality, faking mental illness, and the psychopathy of former CEO “Chainsaw” Al Dunlap. The Huffington Post, for their TED Weekends section, asked me for a reaction to Ronson’s talk—but then refused to print my blog because, a Huffington Post staffer emailed me, “the TED Weekends team said that the wording of the post was too strong.” Below is the original post.