Foreign Correspondents

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.

The simple act of defining doctors or patients concerned about adverse events as “critics” is a rhetorical stroke that marginalizes concerns – makes you a one-percenter rather than one of the ninety-nine percent. The pharmaceutical market is the least free market on earth.

We are among an increasing number of people around the world who know the importance of holding on to a humanistic idea, and of keeping in mind that people need—first and foremost—other people. People who are willing to take part, to share with us the horror and confusion, to invite the telling of a narrative, and to keep the hope alive.

The International DSM-5 Response Committee, sponsored by Division 32 of the American Psychological Association — the Society for Humanistic Psychology — now has an online petition against the DSM-5.  This is a truly international effort. Please support the petition by signing it at http://dsm5response.com

The American Association of Suicidology (AAS) has created a blog for suicide attempt survivors. By seeking out and actually welcoming the survivor voice, for the first time anywhere in the world by a mainstream suicide organisation, this represents a global breakthrough in the field.

At a time when psychiatrists are considering whether suicidal behavior constitutes a disorder rather than a symptom, there is strong evidence that physicians have far higher rates of suicide than the general population, with psychiatrists found to be at the highest risk of suicide. In light of this information, you may be asking yourself, as I am, whether it would be wise to conduct a brief mental state examination of any physician we consult (particularly any psychiatrist) as a way of ensuring our physical and emotional safety? To this end I have prepared a quick diagnostic test that you may carry in your pocket or purse for easy administration next time you are visiting a health professional.

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.

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?

There are terms in psychiatry that are designed to portray violent and distressing events as benign, and normal human rights, feelings and behaviours as threatening – things I think we need to name for what they are. The term ‘antidepressant’, for instance, shapes the way we think of these drugs. It renders the fact that they can worsen depression and cause suicidal thinking and behavior counter-intuitive, and makes people skeptical of claims they don’t work and make distressed people feel worse.

Denmark is now screening pregnant women for depression. Given the clear risks and the unclear benefits of antidepressants, the process of screening pregnant women for depression can take on a bizarre dimension. Here, Peter Gøtzsche imagines one of the conversations that might take place.

Large numbers of studies are being conducted with many claiming internet use causes structural changes in the brain similar to those found in the brains of drug addicts. No snorting, smoking or injecting required. You just have to look at this drug for long enough and your brain is damaged. Is it possible your laptop and mobile phone are the crack cocaine of gadgets?

During the past 29 years I have been diagnosed with anxiety, depression, PTSD, Biploar II and complex PTSD. I have tried numerous drug combinations and have been through ECT several times. None of this helped me. My road to recovery started when I decided to rebel against conventional psychiatry.

In an era of prescribing rights for psychologists will psychology become a more marketable, less tarnished version of psychiatry, a target for pharma marketing and a new distribution channel for psychotropic drugs?

ADHD (or “Attention Deficit Disorder” - with or without Hyperactivity) is not among the “cutting-edge pathologies” of contemporary clinical practice, such as the addictions, eating disorders, narcissistic disorders, chronic fatigue syndrome, or fibromyalgia; however, in my view ADHD is paradigmatic of the contemporary ethos that some have described as hypermodernity. The advocates of ADHD explain to us that a hyperactive child with an attention disorder is a disturbed and often disturbing child, who does not comply with the adults’ rule, often has his own idea of development, and whose problems, unless they are treated, threaten to undermine his autonomy and self-esteem; the two supreme values of the hypermodern society.

Around the world, drug regulatory agencies spend billions of dollars engaged in activities which purport to ensure the safety, efficacy and quality of legal drugs. If the goal of regulation is to protect public health and safety, there can be no argument that it has failed. Safe drugs are not associated with annual rises in mortality and morbidity, effective drugs are not associated with increased prevalence of the conditions they are designed to treat and with greater chronicity of those conditions, quality drugs are not discovered to be contaminated with solvents months after their manufacture and release to the market. Effective regulation does not see companies repeatedly breaching standards and shrugging off sanctions.

A century ago Freud and Jung made us aware of the biases underpinning what patients say. Not everything should be accepted at face value. In particular claims of abuse may not be based on reality. We needed experts – analysts – they claimed, to tease out what is real from what is not. The Catholic Church was once intensely hostile to Freud, but when it came to child abuse adopting a Freudian approach was very convenient. But while Freud essentially denied that real abuse was taking place and got away with it in his life-time, the Catholic Church has learnt to its cost that many claims of abuse are real.

The controversy over “Study 329” on the effects of Paxil in teen depression has raised questions about the state of ALL medical research. I decided to look at the research for the most recent psychiatric drug approved by the FDA, a new antipsychotic called cariprazine or Vraylar.  I located twenty studies of Vraylar on www.ClinicalTrials.gov, the U.S. government-sponsored registry for clinical trials.  Three were still in process, and seventeen were completed.  Not one had shared its results on the government website, a supposedly mandatory step.

‘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.

Global leaders in the critical psychiatry movement met on 18 Sep 2015 for a one-day conference to address an urgent public health issue: the iatrogenic harm caused by the over-prescription of psychiatric medications. We were treated to an expert review of the ways in which the widespread use of harmful and barely (if at all) helpful medicines has become the mainstay of psychiatry’s contribution to society. At gatherings such as this, when people discover I am a psychiatrist I often become a lightning rod for their anger and frustration. It’s okay; it comes with the job, but a couple of things happened at Roehampton which reminded me why this can happen, and why all of this is so much more complicated than the simple black-and-white “Pharma and psychiatry bad, everyone else good.”

Study 329 seems to fit the classic picture: It has Big Pharma ghostwriting articles, hiding data, corrupting the scientific process and leaving a trail of death, disability and grieving relatives in its wake. But is it at fault alone? Both Big Pharma and Big Risk (the insurance industry) were once our allies in keeping our hopes alive – in keeping our children alive and well. They are now a threat. And of the two – Big Risk is the bigger threat.

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.

"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.

It was May 19, 2003, in San Francisco; the first-ever (we think) symposium on micronutrient treatment to be on the schedule for the annual meeting of the American Psychiatric Association. There was moderate interest. This year, the two of us (both psychologists) presented many, many studies on the use of micronutrients to treat anxiety, stress, depressive symptoms, ADHD, aggression, mood, and addictions. The amount of data differed dramatically from 12 years ago, but the biggest difference was the response from psychiatrists!

Today I paid a visit to the Managing Director of Mylan Pharmaceuticals, Lloyd Price. Mylan is the company that manufactured the antidepressant Fluox1 which, according to the NZ government, is the most likely cause of my son's suicide. My dealings with Mylan in the time since Toran died have not been entirely fruitful.

Three weeks ago What would Batman do Now covered the issue of suicide in the military – an issue that had Batman missing in action, and...