Foreign Correspondents

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.

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.

There was a heart-breaking and disturbing story in yesterday’s Guardian newspaper entitled, My Daughter, the Schizophrenic’, which featured edited extracts from a book written by the father of a child called Jani. He describes how Jani is admitted into a psychiatric hospital when she is 5, diagnosed with schizophrenia when she is 6 and by the time she is 7, she has been put on a potent cocktail of psychotropic medications.

What do you do when the media reports stories of children who have killed themselves on SSRIs? Position the stories of these children, not the drugs they were taking, as a suicide risk. Warn that more children will die if mouthy parents are allowed to speak and upstart journalists are allowed to report. And then position psychiatrists as the only people who can talk about suicide without producing an epidemic of self inflicted deaths.

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’.

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.

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.

Academia has long been the official search engine for knowledge. Here supposedly are the ivory towers where seekers after truth, men and women intellectuals, teach new generations and carry out learned research, to add to the sum of human wisdom. It also has a longstanding history of questionable relationships; from those with the arms trade, to continuing over-reliance on big pharma psychiatric research funding.

‘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.

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?

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.

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.

Stephen Fry’s exploration of manic depression (in the current BBC series on mental health, ‘In the Mind‘) has drawn both praise (because of his attempts to destigmatize mental illness) and criticism (because he appears to have a very narrow biomedical understanding of mental illness).  I have sent an open letter to the actor which challenges some of his assumptions about mental illness, and offers a very different understanding to that promoted in his recent television programme.

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.

Based on any data from any country it is clear that we have a problem. Mental illness is on the rise. Researchers in the emerging field of nutritional psychiatry have documented the benefits of micronutrients to treat mental illness, showing that micronutrients help treat depression, stress, anxiety and autism and ADHD. Not a single study shows that the Western diet is good for our mental health. Many questions remain to be answered, but we can make some recommendations.

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.

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.

This is a very important, well-written book which should become essential reading for anyone involved in the healing arts, since suffering is - or should be - at the heart of our endeavors. Suffering tells us what’s really important to us, and our approach to it tells us what we’re really made of.

Subscribers to Mad in America might be interested in a Keynote Lecture given by Professor Nikolas Rose in Nottingham on May 15th 2013. In this lecture Professor Rose very thoughtfully challenges a number of the assumptions which underpin conventional and contemporary psychiatric practice. He asks five hard questions:

• Is there (really) an epidemic of mental illness?
• Does the path to understanding mental disorder lie through the brain?
• What is the role of diagnosis and of diagnostic manuals?
• Should we seek early identification of those at risk of future mental pathology?
• What is the place of patients, users, survivors, & consumers of mental health systems?

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.

There are very few things considered more taboo in the world of mental health than the suggestion that problematic family dynamics can lead to a child developing a psychotic disorder. And yet, when we look honestly at the history and research of psychosis and the broader concept of “mental illness,” it becomes apparent that there are few subjects in the mental health field that are more important. I’d like to invite you, then, to join me on a journey into this taboo territory, dividing our trip into three legs. In the first leg (Part One), we’ll go back in time to explore how such a crucial topic has become so vilified, and then embark upon a flight for an aerial view of some of the most essential findings of the last 60 plus years of research that look at the links between problematic family dynamics and psychosis.

Over the years of my explorations into psychosis and human evolution a very interesting irony became increasingly apparent. It is well-known that people who fall into those deeply transformative and chaotic states typically referred to as “psychosis” often feel, at different points throughout their journeys, that they have received a special calling to save the world, or at least the human race. Indeed, this experience played a particularly prominent role in my own extreme states, as well as within those of at least two of my own family members. From a pathological perspective, this is often referred to as a kind of “delusion of grandeur,” though in my own research and writing, I have come to feel that the term “heroic (or messianic) striving” is generally more accurate and helpful.

A report on antidepressant consumption released on 18 February 2014 by the OECD shows huge increases in prescribing of the drugs across most countries. According to the report a key factor driving this increase is the expansion of the off label use of the drugs for a vastly increased number of indications. While this may not seem like news, I think it warrants some analysis because I think what we are seeing is something more complex than simple market expansion.

I thought I would make a small contribution to the discussion about how coverage of the recent airline tragedy focuses so much on the supposed ‘mental illness’ of the pilot and not so much on the possible role of antidepressants. Of course we will never know the answer to these questions but it is important, I think, to combat the simplistic nonsense wheeled out after most such tragedies, the nonsense that says the person had an illness that made them do awful things. So, just to confirm what many recipients of antidepressants, clinicians and researchers have been saying for a long time, here are some findings from our recent New Zealand survey of over 1,800 people taking anti-depressants, which we think is the largest survey to date.

In Part One of this article series, we reviewed the contemporary research into the links between psychosis, problematic family dynamics, and other forms of childhood trauma. After reviewing this research, we find that a very interesting and important question emerges: What do all of these have in common? In other words, is there some common denominator that all of these types of trauma and patterns of problematic family dynamics share, a single underlying factor that makes someone particularly vulnerable to experiencing a psychotic crisis? Indeed, I believe that there is.