Non-drug Approaches

I was a psychiatrist who participated in the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE ETP). Although I welcomed the positive headlines that heralded the study's results, the reports left me with mixed feelings. What happened to render the notion that talking to people about their experiences and helping them find jobs or go back to school is something novel?

A new study on the depression symptoms of over three-thousand patients challenges the criteria used for diagnosing major depression with the latest Diagnostic and Statistical Manual (DSM-5). Current diagnostic systems are based on an assumption that the symptoms of depression point to a common underlying “illness," but research suggests that this framework may be outdated and oversimplified.

The Guardian reports growing concerns from the Buddhist Society conference: “Jon Kabat-Zinn, who created the Center for Mindfulness in Medicine at the University of Massachusetts medical school, warned last week that some people feared a ‘sort of superficial ‘McMindfulness’ is taking over, which ignores the ethical foundations of the meditative practices and traditions from which mindfulness has emerged, and divorces it from its profoundly transformative potential.’”

Robert Neugeboren, who “spent most of his adult life in institutions, often subject to isolation, physical punishment and numbing medication,” was “a celebrity of sorts in the world of the mentally ill: a survivor of the horrors of mistreatment, a case history for those who point to the positive effects of kindness and talk therapy, and, perhaps most of all, the embodiment of the bottomless mystery of the human mind.”

Giving money to people diagnosed with severe mental health issues can significantly improve depression and anxiety. A new study, published in the October issue of the Journal of Community Mental Health, found that giving about $73 US dollars per month for recreational spending can also reduce social isolation and strengthen a sense of self.

New research suggests that more frequent in-person contact lessens the risk of depression in older adults. The study, published in this month’s issue of the Journal of the American Geriatric Society, found that in Americans over fifty the more face-to-face contact they had with children, family and friends, the less likely they were to develop depressive symptoms.

Neuroskeptic weighs in on the controversy over the lack of antipsychotic dose data in the RAISE study and the misleading media coverage. He points out that one of the treatment interventions was a computerized medication management system called COMPASS, which recommends doctors use lower doses than they otherwise might.

Existential therapist and writer, Jason Dias, claims that there is something deeper and more pervasive than guns, drugs, or mental illness at the bottom of the United States’ mass shooting problem. On aNewDomain he writes: “We have to acknowledge that people who are despairing right now, they’re the sane ones, the normal ones. It makes sense to despair when you’re looked down on, tormented, bullied. When you feel different and you’re alienated. When your culture is alienated. When violence is glorified not by movies and games and television, but by the government, by the news. When violence is fetishized by political parties.”

Last Tuesday, The New York Times and several other outlets (including Mad In America) reported on the highly-touted results of a study on psychosocial treatment for patients diagnosed with schizophrenia. Now, claims made about the study, which the ‘Times called “the most rigorous trial to date,” are coming under increased scrutiny.

Minn Post did a feature story last week on Vail Place, an alternative mental health treatment center run on a community “clubhouse” model where the nearly 900 members and staff work side by side to run the center’s activities. Vail Place was founded in Hopkins, Minnesota in the early eighties by mental health activists and family members as a community for psychosocial rehabilitation. “The work isn’t therapy,” a member explains. “It’s growth. It’s ‘I cans’ rather than ‘I can'ts.’ And that’s important for mental health and survival.”

Writing on his critical psychiatry blog, Duncan Double critiques Joe Herbert’s piece on “Why can't we treat mental illness by fixing the brain?” in Aeon. While Herbert admits that there is a "mysterious and seemingly unfathomable gap" between psychology and neuroscience, which "bedevils not only psychiatry, but all attempts to understand the meaning of humanity,” he goes on to speculate that someday psychiatrists will be able to relate symptoms to brain activity.

The Boston Globe highlights a new book, “In the Mind Fields: Exploring the New Science of Neuropsychoanalysis,” by Casey Schwartz, which explores the importance on psychoanalysis in the age of neuroscience. The author explains that the psychoanalytic approach offers “an absolutely incomparable depth and attention to the specifics of each individual person and their reality. This is exactly what’s disappearing in neuroscience: the quirks, the particularities, the subtleties of the individual.”

Writing on his 1 Boring Old Man blog, Dr. Mickey Nardo reflects on the media frenzy around the RAISE study and asks why the prescription data has not been released. He adds skepticism about the political motives of the potentially overblown results, which he sees as a clear push for increased mental health funding.

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?

My opposition to psychiatric drugs is not just that they are harmful, dangerous, and destructive. That would be plenty motivation enough. And it is. But in addition, my profession, which I love and value, has been hijacked by the APA and Big Pharma. It is my goal to return psychiatry to its proper place - where good psychotherapy is understood to be the treatment for human suffering.

Yesterday, the New York Times reported that schizophrenia patients in an experimental treatment program (RAISE) who experienced better outcomes had been on lower doses of antipsychotics than normal. However, the article published in the American Journal of Psychiatry on Tuesday did not divulge any data on the varying antipsychotic drug doses in the different study groups.

The Society for International Psychology, Division 52 of the American Psychological Association, will host a webinar entitled “The Humanistic, Vigorous and Universal Approach of Rational Emotive Behavior Therapy.”

The American Psychological Association is hosting a two and half day interdisciplinary summit on November 3rd through 5th entitled Global Approaches to Integrated Care: Translating Science And Best Practices Into Patient-Centered Health Care Delivery. The summit features presentations and discussions on social determinants of health, demographics, culture and health disparities, and patients’ perspectives, among others. It can be livestreamed here.

Based on the Finnish Open Dialogue approach, the Parachute program is an alternative to current health care systems where a team of health care workers collaborate with families and those in distress to develop a path to recovery. The success of Parachute is now spurring the development of similar programs in the UK.

Results of a large government-funded study call into question current drug heavy approaches to treating people diagnosed with schizophrenia. The study, which the New York Times called “by far the most rigorous trial to date conducted in the United States,” found that patients who received smaller doses of antipsychotic drugs with individual talk therapy, family training, and support for employment and education had a greater reduction in symptoms as well as increases in quality of life, and participation in work and school than those receiving the current standard of care.

People diagnosed with severe depression show the same changes in brain scans when they respond to a placebo as they do when they take an actual antidepressant, according to a new study. Researchers also found that those whose symptoms were decreased by a placebo were more likely to report relief from antidepressant drugs.

Writing for CounterPunch, Paris Williams writes that when an individual is experiencing what has been termed “psychosis,” it is important to recognize that this may also be the manifestation of a breakdown in their larger social groups, the family, society, and even the species.

We first came under pressure to give our developmentally disabled and autistic daughter a psychiatric drug when she was in her mid-teens. She was attending a local school for autistic children but was unable to adapt to their program, and we were urged to consult a psychiatrist. What enabled us to resist the pressure to put our daughter on drugs?

While a great deal of the excitement about advances in psychological treatments comes from the potential for research in neuroscience to unlock the secrets of the brain, many mental health experts would like to temper this enthusiasm. A special issue of the Behavior Therapist released this month calls into question the predominant conception of mental illnesses as brain disorders.

To coincide with World Mental Health Day on October 10th, 2015, Verso Books, the largest independent and radical publishing house released a series of blogs on mental health and critical and antipsychiatry. The posts include pieces on R.D. Laing, colonialism, women’s oppression, delusions and art, “The Happiness Industry,” and social and institutional oppression.