Foreign Correspondents

The conventional wisdom is that antidepressant medications are effective and safe. However, the scientific literature shows that the conventional wisdom is flawed. While all prescription medications have side effects, antidepressant medications appear to do more harm than good as treatments for depression.

The Minnesota Starvation Experiment was conducted at the University of Minnesota during the Second World War. Prolonged semi-starvation produced significant increases in depression, hysteria and hypochondriasis, and most participants experienced periods of severe emotional distress and depression and grew increasingly irritable. It really should not be a surprise to this audience that the brain’s functioning is highly compromised when the body is being starved of food (and nutrients). What we wonder is whether eating a diet of primarily highly processed foods low in nutrients has similar effects.

So now we know Soderbergh’s movie Side Effects is not so Black/Noir after all – more Fifty Shades of Grey. Emily Hawkins (Rooney Mara) is put on Ablixa by her psychiatrist Jonathan Banks (Jude Law) and while on it kills her husband. She apparently murders him while sleep-walking triggered by Ablixa and sleep walking being a perfect defense against murder she is acquitted.

Evidence that antipsychotics cause brain shrinkage has been accumulating over the last few years, but the psychiatric research establishment is finding its own results difficult to swallow. A new paper by a group of American researchers once again tries to ‘blame the disease,’ a time-honoured tactic for diverting attention from the nasty and dangerous effects of some psychiatric treatments. People need to know about this research because it indicates that antipsychotics are not the innocuous substances that they have frequently been portrayed as. We still have no conclusive evidence that the disorders labeled as schizophrenia or psychosis are associated with any underlying abnormalities of the brain, but we do have strong evidence that the drugs we use to treat these conditions cause brain changes.

More than a year on from the release of DSM-5, a Medscape survey found that just under half of clinicians had switched to using the new manual. Most non-users cited practical reasons, typically explaining that the health care system where they work has not yet changed over to the DSM-5. Many, however, said that they had concerns about the reliability of the DSM, which at least partially accounted for their non-use. Throughout the controversies that surrounded the development and launch of the DSM-5 reliability has been a contested issue: the APA has insisted that the DSM-5 is very reliable, others have expressed doubts. Here I reconsider the issues: What is reliability? Does it matter? What did the DSM-5 field trials show?

Today is the fourth anniversary of the suicide of my only child. Supporting someone dealing with the grief of losing a child to suicide can be challenging. For all those who have been hurt by well-intentioned comments or interventions, I want to offer the following suggestions to friends, family and helping professionals.

‘I Don’t Believe in God, But I Believe in Lithium’ is the title of Jamie Lowe’s moving account of her manic depression in the New York Times. The piece reminds us how devastating and frightening this condition can be, so it is understandable that the author put her faith in the miracle cure psychiatrists have been recommending since the 1950s: lithium. The main problem is that there is no study in which people who have been started on lithium have been compared with people who haven’t.

Since the 1980s, a type of psychotherapy called Cognitive Behavioural Therapy (CBT) has become dominant. Like it or loathe it, CBT is now so ubiquitous it is often the only talking therapy available in both public and voluntary health settings. It is increasingly spoken about in the media and in living rooms across the country. Yet when we speak about CBT, what are we talking of? For CBT only exists - as we will see - as a political convenience.

Julia has received a lot of media attention in the last few days as a result of her blinded RCT published in a prominent journal, the British Journal of Psychiatry, showing that micronutrients were better than placebo at improving ADHD and mood symptoms in adults. But what interests us far more is the amount of public emails we get as a result of this work. And the theme running through almost every email is that the child/adult/husband/wife has tried all kinds of medications and the symptoms are still there and, often, getting worse. Could the micronutrients help?

Over the last twenty years there has emerged a body of work that questions the assumptions that lie beneath psychiatric knowledge and practice. This work, appearing as academic papers, magazine articles, books, and chapters in books, hasn’t been written by academics, sociologists or cultural theorists. It has emerged from the pens and practice of a group of British psychiatrists.

In 1972, prisoners at Holmesburg Prison in Philadelphia were paid $3 to have their eyes held open with clamps and hooks while Johnson & Johnson's baby shampoo was dropped into them. In 2011, mothers of newborns were arrested when their babies tested positive for exposure to cannabis, a false result caused by the use of Johnson & Johnson’s Head-to-Toe Foaming Baby Wash. Young men have undergone mastectomies to remove breasts grown as a result of Johnson & Johnson antipsychotics, which were used as a result of Johnson & Johnson's criminal promotion of its drugs for off-label purposes. And now, Johnson & Johnson has announced the removal of carcinogenic chemicals from their No More Tears baby shampoo.

In 2012, I found out that the ten biggest drug companies in the world commit repeated and serious crimes to such a degree that they fulfill the criteria for organised crime under US law. I also found out how huge the consequences of the crimes are. They involve colossal thefts of public monies and they contribute substantially to the fact that our drugs are the third leading cause of death after heart disease and cancer.

Forced treatment in psychiatry cannot be defended, neither on ethical, legal or scientific grounds. It has never been shown that forced treatment does more good than harm, and it is highly likely that the opposite is true. We need to abolish our laws about this, in accordance with the United Na­tions Convention on the Rights of Persons with Disabilities, which virtually all countries have ratified.

It was exciting going back to my old stamping ground. Years ago I’d worked in one of the local community mental health teams and had referred many women to the Drayton Park Crisis House. Walking up the steps of the house brought back memories of standing there with desperate and suicidal clients, some of whom had told me that they would rather die than go back into hospital. As you can imagine, to say I had been glad that there was an alternative would have been an understatement.

This has got to stop. Around the world a million people die from suicide each year and the response internationally is to pour more funding and channel more people into psychiatric services. Three large studies have now found that the more we spend on mental health services the higher our suicide rates. In addition, a recent study has completely discredited claims that 90% of those who die from suicide are mentally ill at the time of their death. We need to use this evidence to stop the expansion of psychiatry as a suicide prevention measure.

In a bold and unprecedented move for any professional body, the UK Division of Clinical Psychology, a sub-division of the British Psychological Society, issued a Position Statement today calling for the end of the unevidenced biomedical model implied by psychiatric diagnosis. In brief, the argument is that the so-called ‘functional’ diagnoses – schizophrenia, bipolar disorder, personality disorder, ADHD and so on - are not scientifically valid categories and are often damaging in practice.

As I see it this website is about filling the gaping hole in the official literature on mental health problems and their treatment. Since these problems were declared to be diseases, ‘just like any other’, academic papers present them as if they were simply technical glitches in the way the brain or mind works. They can be identified by ticking a few boxes, and easily treated by tweaking the corresponding defect with a drug or a few sessions of quick-fix therapy. What it is like to experience these problems and their treatments is nowhere to be found. Yet in post after post on this site among others, we hear about the harm produced by drugs that are prescribed for mental health problems.

At the Nordic Cochrane Centre, we have researched antidepressants for several years and I have long wondered why leading professors of psychiatry base their practice on a number of erroneous myths. These myths are harmful to patients. Many psychiatrists are well aware that the myths do not hold and have told me so, but they don’t dare deviate from the official positions because of career concerns. Being a specialist in internal medicince, I don’t risk ruining my career by incurring the professors’ wrath and I shall try here to come to the rescue of the many conscientious but oppressed psychiatrists and patients by listing the worst myths and explain why they are harmful.

‘Diagnosing’ someone with a devastating label such as ‘schizophrenia’ or ‘personality disorder’ is one of the most damaging things one human being can do to another. Re-defining someone’s reality for them is the most insidious and the most devastating form of power we can use. It may be done with the best of intentions, but it is wrong - scientifically, professionally, and ethically. The DSM debate presents us with a unique opportunity to put some of this right, by working with service users towards a more helpful understanding of how and why they come to experience extreme forms of emotional distress.

The 90s were labeled - rather optimistically - as the ‘decade of recovery.’ More recently, recovery has been placed slap bang central in mental health policy. Is supporting recovery pretty much good common sense? Or is the term being misused to pressure those suffering to behave in certain ways?

Sometimes regarded as “treatment,” psychiatric bullying and harassment can no longer be considered as such. During the past two decades, the often devastating effects of psychiatric bullying and harassment have evidenced themselves on the wellbeing of consumers, and the climate of mental health facilities.The advent of mandatory anti-bullying policies in schools and workplaces has shifted thinking towards an acceptance that bullying occurs, causes harm and should not be tolerated. Could the development of anti-psychiatric bullying policies in mental health institutions make psychiatric abuse visible and create a zero tolerance culture?

On 6 January 2014, I published the article “Psychiatry Gone Astray” in a major Danish newspaper (Politiken), which started an important debate about the use and abuse of psychiatric drugs. Numerous articles followed, some written by psychiatrists who agreed with my views. For more than a month, there wasn’t a single day without discussion of these issues on radio, TV or in newspapers, and there were also debates at departments of psychiatry. People in Norway and Sweden have thanked me for having started the discussion, saying that it’s impossible to have such public debates about psychiatry in their country, and I have received hundreds of emails from patients that have confirmed with their own stories that what I wrote in my article is true.

The Scottish Anthropologist Ioan Lewis, wrote the book Ecstatic Religion in 1971, in which he suggested a ‘shaman is not less than a psychiatrist, he is more.’   He claimed psychiatry was just one of the functions of the shaman, and he invited comparison between shamans and psychiatrists.  Some diagnostic criteria for schizophrenia appeared rather similar to the desired conditions of shamans in an altered state of consciousness.  Other terms used (and misused) for therapeutic practitioners included: native or traditional healer, medicine man, witch doctor, soul doctor, sorcerer, magician, spirit medium, exorcist, curer, diviner and diagnostician.

I have sometimes stopped en route to work, unsure how much longer I can continue. There is a sense of betrayal to my father and grandmother by working in a profession that failed them and is the only medical specialty to have its own survivor movement, not from the illnesses it hopes to treat, but from the ministrations of the profession itself.

Prescription drugs like antidepressants, antipsychotics and so-called ‘mood stabilisers’ are widely promoted as good for your health. But the history of prescription and recreational drug use is more intimately intertwined than most people recognise. Attempts to disentangle the two have created a false dichotomy – with prescription drugs, at least some of them, set up as the ‘angels’ that can do no wrong, and recreational drugs cast as the ‘demons’.