Foreign Correspondents

I’ve had some criticism of the recent Doctor Munchausen posts. They’re not fair on doctors. Many people have told me of lives saved by good doctors. It’s not fair to tar these good doctors with the brush of a few Dr Munchausens here and there. So there’s bad doctoring and good doctoring and great doctoring. What would great doctoring mean?

So here we go again; another meeting with another young person who describes how he is in an acute crisis - you may call it - and is diagnosed and prescribed neuroleptics. He is told by the doctor that he suffers from a life-long illness and he will from now on be dependent on his “medication.” As long as people are met this way I see no alternative than showing that there are alternatives. If that means being "antipsychiatry," then I am more than happy to define myself and our work in that way.

"I want to change the way we think about mental health care so that any child, whether they have a mental illness or simply need support through a difficult time, can get the right help at the right time." This was said by Care Minister Norman Lamb and quoted by the BBC on March 17th 2015. Mr. Lamb is known to have a son who has suffered mental health difficulties and it may well have come from the heart as much as it did from the election fever which is beginning to infect British politicians. However it says something worth picking up upon. I want to change the way we think about mental health care… and … simply need support through a difficult time. These are important shifts of language, and doubly important when they come from a government health minister.

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.

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.

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.

If the blimp that is psychiatric treatment were a passenger aircraft, the authorities would have grounded it many years ago, but still it continues to inflict harm on countless thousands of people. I read Joanna Moncrieff's latest book with a growing sense of anger and shame. The roots of drug treatment in psychiatry are thoroughly rotten. They sustain the decaying trunk of psychiatric theory and practice through misrepresentations and untruths; it is snake oil peddled by quackery.

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.

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.

In our last blog, we focused on the fact that nutrient supplementation has not only been accepted in the realm of physical health in the past, but it has actually been endorsed by reputable sources such as the Journal of the American Medical Association editors who published the Fairfield and Fletcher articles 11 years ago recommending that all adults take a multivitamin to reduce their risk of cardiovascular disease, cancer, and osteoporosis (note that this is completely inconsistent with very recent studies reported in the Annals of Internal Medicine --- but that’s just the way science works, using different nutrients and different methodologies, coming up with discrepant findings, until facts finally emerge).

We have come to believe that technology can eradicate all human suffering and provide unblemished and everlasting happiness. We have paid for this irrational expectation with our autonomy, our dignity and our ability to endure.

This thought-provoking reflective checklist strategy is designed to challenge the increasing 'quick fix' mentality of many doctors who decide to move immediately from a possible diagnosis to medication. With school-aged children we need to promote their Safeguarding, and a Pause-Reflect-Review process that will, hopefully, reduce unnecessary prescribing.

I just attended my first American Psychiatric Association (APA) meeting even though it has been going for 168 years. I was invited to join a symposium on vitamin-mineral combinations as primary treatment of psychiatric symptoms. There was one talk I decided to attend, not because I was particularly interested in the topic, but because it would give me an opportunity to ask Jeffrey Lieberman a question.

In August 2010, my friend and fellow ‘suicide mum’ Deb Williams and I established CASPER – Community Action on Suicide Prevention Education & Research. CASPER’s goals are to provide peer support to families bereaved by suicide, to educate politicians and opinion leaders on suicide and its prevention and to support families and communities to reclaim suicide prevention from medical professionals and governments.

The serotonin reuptake inhibiting (SSRI) group of drugs came on stream in the late 1980s, nearly two decades after first being mooted. The delay centred on finding an indication. They did not have hoped-for lucrative antihypertensive or antiobesity profiles. Even though a 1960s idea that serotonin concentrations might be lowered in depression had been rejected, drug companies marketed SSRIs for depression even though they were weaker than older tricyclic antidepressants. They sold the idea that depression was the deeper illness behind the superficial manifestations of anxiety. The approach was an astonishing success, central to which was the notion that SSRIs restored serotonin levels to normal, a notion that later transmuted into the idea that they remedied a chemical imbalance.

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.

In the light of the much trumpeted claims that recent research has identified genes for schizophrenia, it is important to review the track record of this type of endeavor. Despite thousands of studies costing millions of dollars, and endless predictions that the genetics of schizophrenia would shortly be revealed, the field has so far failed to identify any genes that substantially increase the risk of developing schizophrenia.

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’.

Odysseus was in his 70s. Coming up to the 50th anniversary of a very happy marriage. He had formerly been a respected professional, a...

Everyone in the world is either touched by their own mental health issues or have had a family member affected. What if they directed their buying power to an organization that would use the profits to fund exciting mental health & recovery projects both in the developing world and in their own countries; projects that would be ethical, non-coercive, personal recovery-based, and were aimed at creating recovery communities? What if they could buy products, crafts, services, art, music, books from people who had experienced mental health issues, enabling them to set up their own businesses or buy from social co-operatives that enabled distressed people to work and earn a living wage?

For several decades, since the days when I was a patient, I have seen and heard how an obsession with questions damages psychiatry. Many of us have been asked the same questions day after day, year after year: ‘Do your thoughts seem faster than normal?’, ‘Do you ever have thoughts in your mind which are not your own?’, ‘Do you feel anxious?’, and so on. Hearing only what a patient says under questioning when frozen by paralysis, or subject to the hyper-arousal of anxiety, the professional misses the opportunity to hear the threads of something new, the possibility of weaving with the patient a narrative of hope and recovery.

What distinguishes the pharmaceutical industry from the producers of other potentially harmful products, is the fact that, governments have passed legislation allowing detention of potential customers and forced administration of its product to consumers who do not wish to purchase it. Imagine if goverments passed laws allowing other industries to detain potential customers and force them to use their products.

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.

A little over a year ago, there was consternation in psychiatric circles as a French psychiatrist, Daniele Canarelli was found guilty after her patient hacked a man to death. She had not recogized the hazard he posed. Doctors didn’t like the implications they saw. In a series of lectures I have raised the question as to how long it might be before doctors would be found guilty for a suicide or homicide linked to an antidepressant, given that we have known that these drugs can cause suicide or homicide for over 50 years.

Every year about this time I review my template file for new client notes. It has blank sections for name, presenting concern, history, plan, and a number of other categories. This year I found myself staring at it, considering whether a revision was in order. And the category that leapt out at me was “Diagnosis.” The truth is, I seldom use it any more.