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There's an interesting article in Psychotherapy and Psychosomatics.  It's called The Efficacy of Antidepressants on Overall Well-Being and Self-Reported Depression Symptom Severity in Youth: A Meta-Analysis. The authors concluded: "Though limited by a small number of trials, our analyses suggest that antidepressants offer little to no benefit in improving overall well-being among depressed children and adolescents." In the Discussion section of the paper, they stated, "We found no evidence that antidepressants offer any sort of clinically meaningful benefit for youth on self-report measures of depression, quality of life, global mental health, or parent reports of autonomy."

What can we say about the DSM that hasn’t already been said? Quite a lot, actually. The manual (full title: the Diagnostic and Statistical Manual of Mental Disorders), produced by the American Psychiatric Association, is incredibly powerful. It shapes research agendas, clinical practices, social care, economic decision-making and individual experiences internationally. As Rachel Cooper notes in her excellent new book, Diagnosing the Diagnostic and Statistical Manual of Mental Disorders, changes to it impact ‘the lives of as many people as changes in the policies of most countries’ (p. 2). The DSM needs to be talked about.

On July 28, I published a post called Simon Says: Happiness Won't Cure Mental Illness.  The article was essentially a critique of a post written by British psychiatrist Simon Wessely, that essentially said that all psychiatric treatment alleviates suffering and makes people happier.  The falsity and self-serving aspect of this contention is glaringly obvious, and I drew attention to this. My essential point is this:  psychiatric drugs; illegal street drugs; alcohol and nicotine, all have in common that they confer a temporary good feeling.  That's why people use them.  But they also have in common that they are toxic substances, and if taken in sufficient quantity over a long enough period, they will inevitably cause organic damage.

What I find most compelling about the message of RECORD is its reclamation of pain, for the album makes clear that Dylan's is not the story of a journey to happiness and bliss and total peace of mind, but rather, one back to the truth of what it means to be human— pain, anguish, and all. It is an embracing of suffering, not a leaving behind of it, and this, too, has been my journey. This, I believe, is what psychiatric liberation is all about.

From time to time, I find myself feeling the urge to articulate my views and delineate them from people with whom I may be identified. Rightly or wrongly, I feel that way with this website. Although the goal is to have wide ranging goals there is nevertheless a distinct perspective represented here. I feel the urge to articulate where I part ways with some of the views expressed here. I do this in the spirit of discourse. I am not certain I am correct. I may someday change my mind. I am just expressing my perspective.

In the world of emergency medicine time is a critical resource. But Ryan McGarry, ER physician and stage IV lymphoma survivor, understands at the bone that idle minutes mean something very different to a patient. He recalls “waiting on news if the therapy is working . . . is there more disease that we didn’t know about, is it getting bigger . . . the clock was torture, watching that dial go around is torture.” McGarry horridly remembers what it’s like to wait on a simple, overdue dose of anti-nausea medication. He reflects, “You’re clearly at an advantage as a physician or provider at any level if you’ve been a patient. It’s just an unbeatable perspective.”

When I as a European follow American politics I can’t help being amazed by the  - I believe a polite expression would be – colorful personalities in the Tea Party and how they manage to continue to be a powerful part of American politics despite making claims that as I see them reported are easily debunked. American politics does not affect me directly but when I compare psychiatry as a part of the medical science to the Tea Party there are some striking similarities.

How do we distinguish between ordinary feeling down, on the one hand, and depression-the-illness on the other. Psychiatry's answer is that depression-the-illness causes " . . . clinically significant distress or impairment in social, occupational, or other important areas of functioning." This phrase occurs as a criterion feature in almost all psychiatric "diagnoses," and is embodied in the DSM definition of a mental disorder, but is unsatisfactory from a number of aspects. Firstly, the term "clinically" has no meaning, other than a thinly-veiled attempt to lend a medical flavor to the phrase. Secondly, the term "significant" is not defined, and inevitably rests on the subjective opinion of a psychiatrist, who, in many cases, has a vested interesting in "finding" a "diagnosis."

On July 17, I wrote a post on the use of neuroleptic drugs as chemical restraints in nursing homes.  The article generated some comments, one of which touched on some very fundamental issues which, in my view, warrant further discussion. The comment read as follows: "All drugs can be dangerous toxic chemicals when not used appropriately. While many valid points are made in this article, it’s very one-sided and could be considered biased in that it’s written by a psychologist. I’ve seen many patients and families benefit from their use."

Before Michael Pollan gained well-deserved respect and influence authoring five bestselling books about food, he got my attention in the late 1990s writing about American illegal-legal psychotropic drug hypocrisy. Then he stopped writing about it. If he had continued his assault on American drug hypocrisy, he likely would have been attacked by many psychiatric drug users, mistaking his confronting this hypocrisy as challenging their decision to choose psychiatric drugs.

The kinds of experiences we call psychotic are often incredibly scary: people feel they are being persecuted by strange forces, or that their brains have been invaded by demons or riddled with implants from the CIA . . . the list of possible fears is endless, and often horrifying. While standard mental health approaches counter many of these fears, they often create new fears of a different variety.   Wouldn’t it be helpful if professionals were trained in an approach that could help people shift away from both dangerous psychotic ways of thinking and also away from the sometimes equally terrifying explanations which emphasize pathology?

There's an interesting article in the July-August 2014 issue of the AARP Bulletin.  It's called Drug Abuse: Antipsychotics in Nursing Homes, and was written by Jan Goodwin.  AARP is the American Association of Retired Persons.   Jan Goodwin is an investigative journalist whose career, according to Wikipedia, ". . . has been committed to focusing attention on social justice and human rights…" The article is essentially a condemnation of the widespread and long-standing practice of using neuroleptic drugs to suppress "difficult" behavior in nursing home residents.

To the Editor: I’m sorry to see that you did not wait to get feedback from Marcia Meyers and the Rethinking Psychiatry core group before...

I am not comfortable with an all-or-nothing insanity defense that is both legally and socially stigmatizing because it sets the person apart as someone who is legally determined to be incapable of being treated as a moral agent. This stigma spills over onto all people who are psychiatrized, and it is part of the conception of madness that also ends up serving as a justification for civil commitment, since we are perceived (incorrectly) as outside the reach of ordinary law.

Service users and survivors who work in a behavioral health settings are faced with important questions about whether or not to share their lived experience and when. We may ask ourselves: Am I ready? What about the risks and politics of disclosure? How do I address an associated expectation or barrier, or deal with the possibility of discrimination? What kind of support is available to me in the process? I’m pleased to announce Sharing Experience Lived Firsthand (SELF).

On June 18, the British Medical Journal published an article by Christine Lu, et al., titled Changes in antidepressant use by young people and suicidal behavior after FDA warnings and media coverage: quasi-experimental study. < /em>Here's the conclusion paragraph from the abstract: "Safety warnings about antidepressants and widespread media coverage decreased antidepressant use, and there were simultaneous increases in suicide attempts among young people. It is essential to monitor and reduce possible unintended consequences of FDA warnings and media reporting." Note the slightly rebuking tone directed against the FDA and the media.