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.

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.

‘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.

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.

I want to follow up my first post by outlining the principles of possible alternatives to psychiatric diagnosis – that is, alternatives in addition to the most obvious one, which is simply to stop diagnosing people.

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’.

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.

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.

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.

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?

This is the final of four installments about the bizarre, ongoing conduct of psychiatrists at Upton House, an Eastern Health psychiatric facility in Melbourne, and the collusion with their conduct by all relevant agencies. This last installment will document the failure, so far, of the State and Federal Governments to intervene in even this most extreme and blatant example of abuse of power by psychiatry. If I, as a Professor of Clinical Psychology with 40 years clinical and research experience in this field, can be so easily dismissed/ignored by the relevant systems in Victoria, what chance do the average users of mental health services and their families have of being heard in this State?

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.

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.

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.

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.

Just this week, a report written by a task force advising on new dietary guidelines commissioned by the US departments of Health and Human Service and Agriculture recognized the importance of nutrition in mental health outcomes for the first time. Is the public ready to accept the importance of nutrition for mental health?

We are profoundly social beings living not as isolated individuals but as integral members of interdependent social systems—our nuclear family system, and the broader social systems of extended family, peers, our community and the broader society. Therefore, psychosis and other forms of human distress often deemed “mental illness” are best seen not so much as something intrinsically “wrong” or “diseased” within the particular individual who is most exhibiting that distress, but rather as systemic problems that are merely being channeled through this individual.

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.

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.

One thing that amazes us is that even though information linking nutrition to physical health is quite advanced, and generally very prominent in the media as well as in public awareness, people seem to be surprised when told that nutrients are essential for brain function. It may be silly to remind everyone of this, but we need to begin with this simple fact: the brain is part of the body. But to add some heft to this point, let us also recall that the brain is the organ of the body with the greatest metabolic demands (the heart is second).

Over the last decade, people have commonly made statements to me of the ilk — “What bugs me about antipsychiatry people is they only care about tearing down; there is no commitment to actually helping people” — Which suggests that there is a serious dearth of awareness about antipsychiatry.

I know that this might sound odd coming from a critical psychiatrist, but I believe that psychiatry has a future. Furthermore, I maintain that a good deal of psychiatry as practised now is helpful and that many psychiatrists manage to play a positive and therapeutic role in the lives of their patients. However, I also believe that we are at our most helpful when we depart from the current biomedical ideology that has come to dominate in our profession. As a first step, we need to get beyond the reductionism that currently guides most psychiatric research and education.