It sounds like those who did NOT take ADHD drugs had better heart conditions, regardless of whatever caffeine, cigarettes or whatever else they use. It is apparent that the effect is due to stimulant drugs, not other lifestyle issues of non-stimulant users, as these ought to push the needle in the other direction than what they found.
I would also remind you that “people who have ADHD” is not a scientifically definable variable. If you mean people DIAGNOSED with ADHD, it might be a good habit to clarify that. Folks are diagnosed for all kinds of reasons, and again, there is no scientific way to differentiate them from each other as “having” or “not having” ADHD or any of the other DSM “diagnoses.” It is difficult to really evaluate the scientific studies without keeping this important fact in mind. We are not working with a well-defined homogeneous group here, and the only clear variable is drug usage.
I recall some interviews done with working class folks about why they did not relate to therapy. A lot of them said that they’d feel a lot less depressed if they could pay their bills every month and didn’t have to worry about getting food on the table. Talking about how they felt about being poor didn’t really help much!
Are you suggesting that long-term use of psych drugs can cause dependence and that withdrawal can be dangerous as the client’s brain is adapted to having the drug and has a very hard time adjusting to a withdrawal period? I’ve heard from many folks that very slow withdrawal is essential for them as individuals, and also known of a few who really could not get off because the withdrawals were so bad. It’s another great argument to avoid long-term use of these drugs if at all possible, as Whitaker’s research suggests.
I remember reading that the vast majority of doctors don’t believe they are affected by drug company advertising, while the reality is the vast majority are strongly influenced. Believing that one is NOT susceptible to manipulation makes one much MORE susceptible to manipulation!
There is no delete function. Reporting a comment should bring it to my attention, though it doesn’t always work for some reason. If you want to not have a comment published, the thing to do is to contact me via email and let me know the date, time and beginning content of the post, and I will simply not approve it for publication.
First off, I am the last to deny there is real SUFFERING out there. That is not in question. The question comes down to how one views and deals with this kind of “mental” suffering.
ALL of the labels in the DSM are voted on. They are not scientifically verifiable entities, they are the results of clinicians “agreeing” on a particular set of “criteria,” which is generally a very subjective list of behaviors or thoughts or emotions that have no necessary connection to one another or any kind of “illness.” So they have no more legitimacy than “Seriously Emotionally Disturbed,” which basically means the person (usually child) says or does things that we find upsetting, confusing or inconvenient as adults. Take “ADHD” for example – one of the criteria is “acts as if driven by a motor.” Another is “Incapable of staying seated in class.” Another is “squirms when seated or fidgets with hands/feet.” Another one is “Sidetracked by external or unimportant stimuli.” Can you see that these are all simply judgments passed by an adult on a kid’s behavior? How many kids squirm or fidget? Who gets to decide what are unimportant stimuli?
But kids get this label and they are looked down upon, told they have dysfunctional brains, told they CAN’T pay attention, given controlled substances (essentially speed-like drugs) to “control their impulses,” etc. Note that there is NO attempt to ascertain WHY the child might fidgit – bored, uncomfortable chairs, dealing with trauma at home (foster kids get labeled at a MUCH higher rate), simply not a good fit with the teacher’s style? NO, it is all blamed on the kid for being inconvenient.
A similar analysis can be done for any of the labels. Scientific studies show that attributing “mental health problems” to disorders of the brain increases “stigma” (a euphemistic way of saying bias and prejudice and discrimination) and that teachers and other adults treat these kids differently once they know they “have a disorder.” Consider alone the shame of being asked in public by a teacher or parent, “Did you take your meds today?” There is a lot of shaming involved in the process, and since it has no scientific basis, I consider this kind of label just as irrelevant and damaging as saying a person is “Seriously Emotionally Disturbed.” It’s a pejorative disguised as a “diagnosis”. Look at some of the writing about “Borderline Personality Disorder” to see just how bad the discrimination can get.
Again, not saying that these behaviors and emotions don’t exist, or that people don’t need help dealing with difficulties. But the DSM labels are pseudoscientific crap voted on in committees, totally lacking in any scientific validity. Even the one-time head of the NIMH admitted this was true.
Sure, “Bipolar disorder,” “ADHD,” “Major Depressive Disorder,” “Borderline Personality Disorder,” pretty much anything in the DSM is simply a made-up label for a condition that psychiatrists and others don’t actually have the slightest understanding of. These “diagnoses” are arrived at through subjective behavioral checklists that bear no scientific relationship to any bodily process, but are simply behaviors that we find annoying, unpleasant, or difficult to deal with. Not saying that a person labeled “schizophrenic” has nothing wrong with them or doesn’t need our help, but calling them “schizophrenic” provides no additional useful information and makes it easier to dismiss them as having no value or rights to autonomy.
There are several “diagnoses” where two people can have ZERO “symptoms” in common and yet both qualify for the label! The whole thing is a scam in my mind, and is far worse than the dangerous medications these labels are used to justify forcing on an unsuspecting public.
I always find it fascinating how they claim that brain chemistry faults cause “depression,” but when they want to induce depression in rats or other animals, they always put them under stress and fear for their lives! It’s almost as if traumatic experiences cause the animals to be depressed…
Honestly, I agree with you, but “EDP” is in the end no worse than many of the other labels that are considered more “politically correct.” Labeling other people as a means of “understanding” them is always offensive.
I totally get this. It irks me no end when someone who has had PLENTY of the “best psychiatric care” has some disastrous outcome, and they call for more funding for psychiatric care. Robing Williams is a great example. If it worked so well, why did the person choose to end their life? Either it didn’t work, or it CAUSED the damage! More “mental health care” seems the last thing that is indicated!
So sorry you had to go through all that. I hope you’re doing better!
Maybe. Or “Scientism” is one of my favorites – the belief that anything “sciency” must be true, regardless of the facts. If there are a few brain scans in an article, people are apparently more likely to believe it, even if the scans have no connection to the article!
I just want to add that “bad science” is NOT actually science at all. It’s pretending to use science to explain why a person’s viewpoint is true even when the actual science says otherwise. In other words, it’s fraud!
I think “Biological Psychiatry” is much more than that. It is the ASSUMPTION that ALL “psychiatric disorders” as defined by the DSM are CAUSED by biological malfunctions and can only be “treated” biologically. An example is the insistence that “major depression” is caused by a “chemical imbalance” despite decades of evidence to the contrary, an insistence broken only very recently and now replaced with some concept of “circuitry” which again is not actually supported by science. It is the insistence that “broken brains” are the reason for all “disorders,” regardless of social conditions or traumatic history. And yes, there are plenty of psychiatrists who practice exactly in this manner.
I am afraid I have never been in that situation. Maybe some of our other experienced folks can contribute some ideas? I just know it’s often a lose-lose situation without getting some kind of outside advocacy. I have no idea if such advocacy is available to you, though.
I suppose getting an independent doctor who disagrees with the prescriptions or supports your autonomy might also be helpful, but again, I don’t know how possible that is.
Nobody asks if their cancer diagnosis is “beneficial.” It is what it is and is objectively diagnosed and you can’t decide you like or don’t like your diagnosis. (Well, you can, but it doesn’t change it!) The concept that “receiving a diagnosis may be beneficial” shows how far these folks are from an objective understanding of what is going on. But yeah, you often need a “diagnosis” to get help. It’s a very strange phenomenon to me.
But as long as AI is fed “data” from corrupt sources, it will turn out corrupt answers. It will never be in a position to say, “Wait, this asshole is lying to me for his own profit!”
The problem I see is the idea that “peers” should “be included” by… well, by those with the power in the system to decide to include them or not. Peers should not be “included” – the “peer perspective” should be the CENTRAL one that drives what we do. Doctors’ or professionals’ views can be “included” if merited, but only if the clients believe they have value. The basic institutional change we need is to stop giving doctors and other “professionals” the right and the power to decide if the “peer perspective” is worth their time. Peers don’t need to be RECOGNIZED, they need to be EMPOWERED and there needs to be no discussion of whether to “involve them” in decision making. Clients need to BE the decision-makers, or we will continue to have the power-hungry and arrogant “opinion leaders” assuring us with little pats on the head that they’ve “included the peer perspective” while they continue to do whatever they want, however misguided, damaging or corrupt.
I felt I was doing good things. When the bad outweighed the good, I had to stop. But I really respect those who are in the trenches or behind “enemy lines” because people need help NOW and it’s the only way I know those in the system can get support.
I am talking from experience here. I was inside the system with a totally different philosophy than those who were running the show. I was not confused particularly, but I was certainly disheartened by the kind of pressure and discrimination I experienced when I failed to “get with the program.” A lot of it was simply isolation – folks were “He’s an anti-med guy” and ignored many of my comments and observations. I was able to fight for clients in specific situations and provide something that others did not, but it was pretty exhausting. At a certain point, I realized I was supporting an oppressive system by even participating, even if I was doing some effective damage control, and decided I had to get out of there. But I would not say I was confused. Just annoyed, disheartened and infuriated!
I don’t agree. I think the system is organized to create confusion, and a lot of folks are simply confused. There are a small but powerful number who DO enjoy creating confusion – otherwise known as “narcissists” in their own parlance. These folks are in charge of the big decisions (opinion leaders) and support and create the system as it is. They are the ones who put out the propaganda and attack those who dare to challenge the “status quo.” Such people do absolutely exist at the lower levels of organization (the system itself attracts such people), but there are plenty who want to do the right thing and are simply confused by the propaganda and peer pressure within these organizations. There are also rebels “behind enemy lines” who do really good work and deserve credit for doing so despite the pressures and discrimination they face.
It is simplistic to assume ALL “mental health” workers have anything in common. It is absolutely not supportable to assume that creating confusion is a goal of all or even most “mental health” workers. I think most of them are more confused than we are!
The best solutions make things feel simpler, not more complex. One of the sure signs that the DSM is off base is the ever-increasing complexity of the system over time. Not to mention the ever-increasing numbers of “mentally ill” according to this system.
Just to be clear, there is no evidence that anyone’s depression is caused by a “serotonin deficit.” Why SSRIs work as antidepressants for some people is not scientifically understood, but it’s not because of a “chemical deficit” in the brain, that much has become clear.
It is an attack to pretend someone is proposing something they are not and criticize them for it. Strawman argument. Study logic sometime. And read the damned book!
It is childish at best to respond to the question, “Why did people with worse prognoses do better on less APs than those with worse prognoses on more APs” with “Longitudinal studies aren’t worth much.” That is an emotional argument not a logical one, which is why I’ve decided there’s no point in trying to have a rational conversation on this subject with you. As a wise man once said, “The first barrier to learning is thinking you know all about the subject.”
See how you attack anyone and anything that you don’t agree with, and use emotional arguments? Did I say to take everyone off their antipsychotics? Why raise these pointless straw man arguments if your case is so strong? Why not just present your evidence?
Of course it’s longitudinal, how else do you look at long term outcomes?????
The facts are there. You don’t care to learn. That’s your choice, but don’t claim I said things I did not.
You clearly didn’t really read Harrow. Whitaker has a fantastic analysis which sinks your argument fully, though clearly the psychiatric establishment grasped at that straw, and I’m guessing that’s what you are responding with rather than your own analysis.
Harrow identified 4 groups: bad prognosis on aps, bad prognosis off aps, better prognosis on aps, and better prognosis off aps. The outcomes sorted this way: better prognosis off aps, bad prognosis OFF aps, better prognosis ON aps, worse prognosis on aps.
If the worse prognosis clients off aps do BETTER than the better prognosis ON aps, that’s the opposite of selection bias.
But I doubt you will bother to revise your statement. So far, you only take positions that support your narrative. If we can’t have a rational exchange about this, I’m done with this conversation. Your position has been thoroughly undermined for anyone who actually cares about science.
They still SOMETIMES work for SOME PEOPLE. And it kind of depends what you mean by “work.” Read up on long-term studies, the folks who manage to avoid antipsychotics or use them sparingly do significantly better in the long run. This is shown in more than one long-term study. Again, your tendency to generalize make a lot of what you say of lesser value than it would be. It’s not so black and white as you want to believe.
I had a client in foster care (we were her CASA advocates) who was diagnosed with diabetes. Here CASA volunteer got them to discontinue her Seroquel (antipsychotic). Next visit, her diabetes was gone. Thank God for the CASA!
In contrast, studies on instances of suicidal behavior from weeks 1 to 10 found no significant difference in efficacy between SSRIs, non-SSRIs, and placebo. These results indicate that SSRIs MAY offer short-term protection against suicidal ideation. However, their long-term effectiveness in mitigating suicidal ideation and preventing suicidal behaviors is limited.
So this is one meta-analysis claiming no INCREASE in suicidal effects on children or young adults. It certainly doesn’t suggest that SSRIs reduce suicide attempts or thinking. Of course, there are other meta-analyses that show that there IS an increase in suicidal thinking, or there never would have been a Black Box Warning in the first place. So your one meta-analysis is evidence, but not much, and certainly does not address your initial claim of decreased suicide attempts/thoughts resulting from SSRI use overall.
“Everyone here” is an all-or-nothing blanket statement, Corey, so it seems you are displaying a bit of hypocrisy yourself here. Plenty of folks, including the Author, Robert Whitaker, (and me) take a much more nuanced approach. Read some of the articles by Johanna Moncrief, for instance.
“Fact SSRIs lower suicidal thoughts reducing suicides.” You believe this, but it is NOT a fact. Look at the work of Irving Kirsh and others. Prozac was initially not approved for sale in Germany due to increases in suicidal and violent thoughts/actions in some people. I am aware of no literature review that concludes “SSRIs lower suicidal thoughts reducing suicides.” (In fact, the best reviews I have seen suggest that only about 30% of users benefit significantly from taking antidepressants.) There is a black box warning about increased suicidal thinking in youth and young adults, hardly evidence of reduced suicides.
Do you have something to share along those lines to prove your claim? Or is that just what you believe to be the case? Have you ever read Whitaker’s work? Maybe you should have a good read before you draw unwarranted conclusions!
It sounds like you are making a lot of assumptions yourself. Why do you feel such an urge to defend these drugs? Why not read and listen for a while and maybe learn that the situation is more complicated than you want to believe it to be?
THAT feels creepy to me! Thanks for sharing your story. If she doesn’t want to take notes, she should use a Dictaphone like doctors always have. AI is NOT appropriate for this!!!!
That one should have to SUGGEST “shared decision making” as if the PRACTITIONER gets to decide whether or not to “share” their power says a hell of a lot about the “diagnostic” and “treatment” process!
The problem with “recovered memories” is when the THERAPIST tells the person they have such memories but doesn’t remember them. People come across incomplete fragments of real memory all the time that can be fleshed out by good listening in the right venue. I had this happen to me – I was hit in the head by a teacher in second grade. I always remembered the incident vaguely until right before the hitting part (including her tossing a book across the room), then blanked out until I was in the hallway. I shared this with another student in the class at my 30th reunion, and she remembered the whole incident, including my being hit by the teacher! After hearing this, I recalled the kid who was tossed in the hallway with me, I recalled being sent to the nurse by the secretary, I recalled being outside the principal’s office hearing him and the secretary chatting, with Freddy sitting next to me. I have no doubt these are real memories I recovered because someone validated MY story. But no one told me they happened, I had to recall them myself.
No one should evaluate someone else’s experience or tell them memories exist that they don’t recall. But it is very much possible to recover memories of things that a person has forgotten. It happens all the time.
You are talking about prejudice. That’s why I hate the word “stigma,” it minimizes the intent and the damage done to people.
You should know that viewing “mental illness” as a biological condition has been shown in multiple studies to INCREASE prejudice and decrease empathy for the “mentally ill” persons.
The problem, Renate, is that not everyone experiences antidepressants the way you do. As I said before, everyone should do what works for them. But because it works for you does NOT mean it works for others, and you should be careful not to state or imply that. If “Depression” were a clear-cut, identifiable disease state, we’d be able to predict who would and would not respond to antidepressants in a positive manner. But we can’t, because “Depression” is a vague and subjective concept that does not describe a group of people who necessarily have ANYTHING in common besides how they are feeling. Just to clarify – you were seriously depressed starting at a young age and have not identified any trigger or event that changed that for better or worse. Do you think that is the same as a kid in foster care being seriously depressed because his mother abandoned him at a young age, or an aging adult who is depressed about his/her life deteriorating and losing abilities, or someone who is in chronic, unresolvable pain and does not want to get out of bed every day because their life seems so hopeless? I’ve seen kids in foster care who are far WORSE after taking antidepressants, including being aggressive, suicidal or psychotic. I’ve seen doctors not listen to them or their advocates because they believed that antidepressants are “the answer” for all forms of “Depression,” regardless of the cause.
You seem an intelligent and rational person. Surely, you can see that “Depression” is far to vague to be viewed as a single entity, and that there can be many reasons for being severely depressed, and as many possible solutions as there are people suffering?
I would never want to take away something that works for you. I just want you to see that other people don’t have the same experience and for good reasons are very suspicious about antidepressants as a solution for ALL cases of “Depression.”
I sort of agree, but I think the process is more one of removing inhibitions based on talking to lots of ‘users.’ I remember one in particular who took Zoloft for migraine headaches, not depressed at all, saying that she’d run into situations and be going over possible solutions and would think, “I could kill myself!” She was shocked at herself for even thinking such a thing, and totally attributed it to the Zoloft.
So if a person is feeling inhibited, as in I can’t stand up to my mom or I feel I have to act a certain way to keep others happy, taking SSRIs might seem like a relief – who cares what mom thinks, those others can shove it! But what if the person is inhibiting wanting to kill themselves, but is staying together by saying, “I can’t do that to my kids” or “I don’t want to leave a mess for others to sort out, it would be selfish?” Removing those inhibitions could result in, “Ah my kids are better off without me” or “It won’t be my problem, I’ll be dead” or similar justifications. And Lord help us in the rare cases where the person is inhibiting the thought of hurting or killing others by thinking it would be too horrible a result. That kind of inhibition, we WANT people to keep!
That’s how I see it working for some people but being a total disaster for others. It depends if removing inhibitions works in your favor or against you. And I have personally seen both happen.
When working with foster youth, I saw a large number of cases where prescribing stimulants led to aggressive behavior. I saw one VERY clear example of psychosis being induced by stimulants. A study I’m familiar with showed 6% or so of kids who were prescribed stimulants had psychotic behavior or thoughts recorded in their files. This is a very real phenomenon.
The conclusion is not that all psychiatric drugs are bad for you, it’s that “information” coming from drug companies regarding their drugs can not be trusted based on long experience. Benefits are overplayed, adverse effects are buried or minimized, and outright propaganda is put out as if it were fact. Everyone has to make their own decision about a particular treatment, and drugs are not “good” or “bad” in the absolute sense of those words. They work or don’t work for a particular person. There is no special way to “diagnose” people and thereby determine who will “benefit” – it is simply a matter of trial and error, and we’d all be better off if doctors were honest about this instead of pitching drug company propaganda (such as the “chemical imbalance” concept) as if it were factual.
You make the simplistic mistake of assuming that all “psych patients” are “mentally disturbed” and do “insane disturbing things.” This is rank bigotry, Andy. The vast majority of “psych patients,” in particular depressed individuals, do NOT engage in doing “insane, disturbing things.” Most in my experience AND in statistical studies are actually quite safe, and are much more likely to be victims than perpetrators of violent incidents. This is particularly true for female patients. School shooters tend to be young and male. There isn’t a lot more that they have in common with each other statistically.
As for SSRIs and violence, this is not new information. SSRIs were initially banned in Germany for inducing violence and aggressive behavior back in the late 80s, in people who did NOT have that kind of problem to start with. I don’t think it’s appropriate to ever pin a particular crime on SSRIs, but the correlation is not made up. It’s a very small number, but it does happen. Look at the Germanwings plane crash for a good example.
I am not a fan of RFK, Jr, but again, “explaining” things by blaming the patients is an immature and cowardly approach to the problem. I think we’d do better to do some honest research and to add appropriate warnings if need be.
Doctors can prescribe any FDA approved drug for any indication they can find. The only way to “take away” a drug is to have the FDA withdraw their approval for that particular drug. Since drug companies contribute to both sides of the aisle heavily, it is very unlikely that any such drugs will be withdrawn from the market. Think how hard it was to even get a well-researched warning put on antidepressants. Banning them? Nothing to worry about, IMHO.
Your premise sounds more like “being male contributes to violence,” not “depression. If young women are equally depressed but NOT committing school shootings, than “depression” per se is not a variable. Being young and male most definitely is.
For the record, #1 is a completely false premise. But I tend to agree with you overall. I’d say that SSRIs play a role in a very small number of cases, and many other factors are involved even if SSRIs do contribute in some way. It’s certainly no argument for banning ADs, but it may be one for adding some informed consent. See the Germanwings plane crash for a fairly clear case of probable SSRI contribution to a disaster.
1) The observed differences are AVERAGES, they are essentially correlations. There are plenty of people diagnosed with “ADHD” who do NOT have the expected differences, and there are people who have the differences who do not display “ADHD” behaviors.
2) These studies rarely if ever take prior medication use into account, which is a confounding factor in a huge percentage of anyone in the diagnosed group. Stimulants have been associated with changes in brain volume and functioning, which have often been attributed to “ADHD.”
3) Many fMRI studies are measuring brain ACTIVITY, not structure. Variations in activity in certain areas may be an artifact of environment and not differences in the brain at all.
Additionally, the fact that some genes may code for more active and less sedentary personality styles does not automatically make such genes “malfunctioning.” Having raised two kids (out of three) who would qualify easily as “ADHD,” I can say with confidence that both have great strengths which the non-“ADHD” population lacks in general. Both ended up being successful in school by using alternative classrooms that allowed a lot more exploration and movement. Both graduated with honors from high school, the youngest graduated with honors from Evergreen State College!
I ran across a VERY interesting study a while back. They set up groups of three kids (elementary age) with one kid diagnosed with “ADHD” in each. Control groups had three kids, too, but no “ADHD” kids. They gave them three problems to solve in a given time. They measured on-task time and successful completion. The control groups scored significantly higher on “on-task” percentage – they kept their figurative noses to the grindstone and worked hard. But none of them solved any of the three problems. Whereas ALL of the study (“ADHD”-including) groups completed at least one problem, and at least one completed all three, even though these groups goofed off a lot more than the control groups!
Of course, if the groups had three “ADHD” kids each in them, they’d have probably got nothing done at all on the problems! But I think the study showed what I believe to be true – we need these active, creative, fun-loving, goof-off moments to have healthy groups of people, and there is nothing wrong with someone who tends to play that role in society. After all, if 10% of people have a particular trait, it must have some survival value, mustn’t it?
None of which argues against your using stimulants, or anyone else, if they feel it is helpful. I think it’s just important to know that there is more than one way to look at this set of traits than to view it as an aberration or disease state.
I hope that was at least an interesting read for you.
It does not. But saying “Correlation is not causation” does not mean the correlated events are NOT causally related, merely that you have not proved it. In my world, it’s the job of the drug manufacturer and the prescribing doctor to ENSURE the drug is safe. If it is not, or is even SUSPECTED not to be, it becomes a matter for informed consent immediately. Something as simple as, “A very small number of people don’t seem to react well to this drug. If you find yourself suddenly thinking about hurting yourself or someone else, please call IMMEDIATELY and we will address it.”
Then, of course, when you DO get that call (like the Germanwings pilot), you have to not pretend “it’s part of the disease” and DO something about it. “Wow, it sounds like you are finding this drug is not working for you! Let’s come up with another plan!”
It’s really not that hard. But it starts with being honest.
I agree 100%. “Wellness camps” sound bad enough if you went voluntarily!
I am opposed to involuntary “treatment” in any circumstance, as I don’t regard it as “treatment” if the client is not a willing participant. I realize that sometimes people have to be prevented from harming others or endangering society (wandering into traffic, etc.) but that does not justify forcing drugs or “wellness camps” on people who are unwilling or uninterested in such “treatment.”
There is nothing wrong with taking pills. MIA’s mission includes scientifically-supported use of medications. Of course, individuals are entitled to express whatever opinions they see fit, including plenty reporting positive results of taking medications. MIA is intended to be judgment free in that regard.
I said nothing of the sort. I said that you can’t extrapolate from your own experience to that of others (which clearly you can not), and I said that no one is coming to take your ADs away from you (which clearly no one is). These are statements of fact. I certainly have no thought that sending you to a “camp” of some sort being advisable, in fact, if you are satisfied with what is happening with your current treatment, why would they want to send you anywhere? They are sounding like the ones with the issues. I fully support you in doing whatever works for you. I just can’t agree to blame violence likely caused or exacerbated in rare cases by antidepressants on those unknowingly taking pills with such adverse effects.
Look into the Germanwings plane crash if you want a really solid example. The pilot TOLD his psychiatrist he didn’t feel right taking these drugs, but the psychiatrist ignored him, didn’t change his regime and continued to allow him to fly. The results were devastating.
That’s what happens when we pretend an adverse effect doesn’t happen when the evidence says it does. It has nothing to do with individual experiences or banning of drugs. It’s just about being honest about the data.
Or, people with ACEs may be more likely to react adversely to SSRI antidepressants and other drugs. I will repeat that the experience of “depression” in particular is RARELY associated with violence of any sort. It is usually associated with withdrawal and passivity. There is absolutely no reason to expect a rash of mass murders from depressed people. SSRIs appear to be a strong variable. They clearly don’t affect the majority this way, but as I noted earlier, Prozac was initially banned in Germany due to causing violent episodes. This is not being made up, and let’s not let SSRIs off the hook for their role in creating a more violent world! Blaming it on the victim once again is not an acceptable explanation.
Just because you love them doesn’t mean others aren’t adversely affected. The percentage who become violent is apparently small but does exist. Prozac was initially banned in Germany because of data suggesting a small but significant number of people who became quite deranged taking them.
Besides which, depression has NEVER been highly associated with aggression and violence. Depressed people tend to be withdrawn and more passive than the average human. You can’t blame “depression” for this result, even if it makes you really uncomfortable.
And BTW, no one is coming to take your SSRIs. So let’s relax and look at the data instead of our emotions!
I agree with you. A reduction in suicide compared to other methods (and how has he measured this? I don’t think he says…) might just as easily mean that fewer people are driven to suicide by this method vs. the standard. No “treatment” could very well still be superior. Since most people spontaneously recover from depressive episodes, our baseline ought to always be “untreated.” But hey, who can make money by NOT treating people? Maybe we should make it like farm subsidies – you get paid for NOT treating patients and leaving them alone!
That’s what is so great about Rat Park! Instead of seeing how they act when abused or neglected, they look at how rats act when treated well in a super supportive, rat-friendly environment!
All pending comments I see of yours have been approved. If I am missing something, please contact me by email NOT via a comment like this one, with date, time and partial text so I can identify the post in question. Asking here why it’s not been approved is a violation of our posting guidelines. Please stop doing this!
Good point. I also note that most apologists for the System will say, “The reason this person committed suicide is because mental health services are underfunded and unavailable.” But most of the time, they’ve had years of “services” before the event. So how is a lack of services the problem? It sounds like the services FAILED TO HELP!
I think you are missing the point. The first mistake is seeing individual humans as “patients” who need “treatment” simply because they are experiencing intense emotions. You seem to be having difficulty accepting that framing of the issue is 90% of the problem. “Medical treatment” is not the answer we are looking for.
As for time and patience, again, we don’t choose our cancer or heart treatments based on whether people find them difficult to implement. We choose them based on whether they work. Taking drugs is easy and quick but it doesn’t work in most cases. In fact, it generally makes things worse and prevents people from choosing the more effective path for them, even if it is harder. I could give you an example or two if it would help you.
We are all responsible for finding our own pathway. All we can do to “help” is to help the person decide. Encouraging them to do the wrong thing because it is easier is foolish in the extreme!
It makes no sense to simply “reframe mental health treatment” in terms the Zulu can accept. We are barking up the wrong tree. We need to shut up and ask THEM what they think would be helpful, and change our model accordingly. But of course, that would mean scrapping our top-down, we-know-best, do-as-we-say approach, which would mean scrapping “mental health treatment” as we know it and starting over.
No, I have plenty of ideas of what is helpful in many situations. However, those situations are NOT defined by “diagnoses” nor subjectable to any kind of “double blind studies” as if humans are some kind of machines who all will respond to a certain approach if they have certain “conditions.” Generally, what is helpful is someone who will take the time to listen and be comfortable with another person as that PERSON figures out what if anything is “wrong” and what needs to change for him/herself. The biggest problem (of many) with the current system is that it attempts to take something like “depression,” a common experience to all humans, and come up with some kind of “cure” that works in all cases, as if feeling depressed (sometimes deeply and sometimes for long periods of time) were not a normal part of the human experience, or that all people experiencing “depression” have something mechanically wrong with their brains or minds that needs to be “fixed” by a doctor.
I’ve found many ways to be helpful to hundreds of people over the years. But every one of them is unique and required me to go into the situation completely open to hearing whatever is being communicated and working to respond appropriately to that particular person. Trying to treat everyone the same and expecting the same result is never going to work. Milton Erickson said that “Therapy has to be re-invented for every client.” I think he was pretty much correct.
I will add that there are plenty of things that are helpful to some but not all which fall outside the realm of “therapy” per se. Buddhism or other spiritual practices are a good example. Also such simple things as walking in the woods, breathing properly, getting good exercise, simply talking to another caring layperson (shown to be generally as effective as “therapy”), and most crucially, having a sense of purpose or intent for one’s life can make all the difference. In addition, altering one’s environment to avoid abusive people or situations is sometimes essential, but no “treatment” will enable someone to do that. It requires a genuine connection with another person or set of ideas that help a person realize they deserve better, and sometimes some very practical help like an affordable attorney or a place to live they can afford or the ability to get away from a negative “treatment” being forced on them.
So no, that’s not at all what I’m saying. I’m saying that medical “treatment” for mental/emotional issues and difficulties is generally harmful, but it takes an individual approach to each person’s situation to find what is helpful, which may or may not look ANYTHING like “treatment” as you imagine it.
There doesn’t need to be an “alternative” if the current paradigm is wrong. Sometimes we don’t know the right thing to do, but we do know that what IS happening is wrong. Should we continue to systematically do something damaging because we don’t have an “alternative?”
So it sounds like a pattern of behavior for you, not a “diagnosis.” That being the case, how can people be accused of not “diagnosing BPD correctly?”
I’d really prefer we dump the label and simply rely on accurate descriptions of people who are dangerous for one reason or another. What a psychiatrist thinks, or frankly what anyone thinks their “diagnosis” is, is of little to no value.
Why do you assume that all or even most medical professionals follow “science?” If you have not read Anatomy of an Epidemic, you have missed the primary explanation for why this website exists, which is specifically because psychiatry has REFUSED over time to use or rationally respond to the “algorithm” known as science. You seem to believe that it does without evidence and attack anyone who disagrees with your assumption. Why not do some listening and exploration toward the very scientific double-blind studies and long-term reviews of the literature on which Mr. Whitaker’s concerns are rationally founded?
I agree 100% that putting down religious beliefs and practices is out of bounds, and I apologize for missing any posts which did so. Please report to me at my email if any other posts of that nature come through and I will re-moderate them for appropriateness.
It is interesting to note how experimenters get mice or whatever into the proper “mental” state to test their drugs. They seem to always STRESS the poor little creatures until they are anxious or depressed or whatever.
See the Rat Park experiment or Harlow’s Monkeys. Environment completely alters animal behavior, for the better or the worse. Clearly should apply to humans…
But there ARE wrong answers! Forcing people capable of reasoning to go against their own wishes IS wrong, whatever might be “right.” The choice of “justice” as a focus implies without question that stopping unjust or “wrong” actions is the main thrust of the effort!
All of these are probabalistic statements. There is no clear connection between a particular genetic pattern and all or even most “cases” of “ADHD”. None of these genetic indicators have ever been used to “diagnose” ADHD, mainly because many people with a particular mutation do NOT “have ADHD,” while many who are diagnosed with “ADHD” don’t have the mutation in question.
Perhaps this begs the larger question: Even if there are genetic associations with SOME cases of “ADHD” that are predictable, why have we decided that these variations in human behavior are a “disorder” or disease condition? Why is there no “Attention excess hypoactivity disorder?” Why is only HYPERactivity considered a problem?
I think we know the answer. “Hyperactive” children are more difficult for adults to manage, as they don’t (by definition) tend to go along with the program, so we decide that the child is the problem rather than examining our own models of education and other societal expectations. This despite reliable research that so-called “ADHD” children are virtually indistinguishable from “normal” children in open classroom settings, and that “treated” children do not in general have any better outcomes than those who are left to their own devices. This doesn’t even begin to touch the other big issue, namely that abused/neglected children tend to have a much higher rate of “ADHD” diagnoses than the general populace. If it’s all genetic, why is it so much more common in the foster care population?
I have no doubt that some kids are genetically “programmed” to be more active than others (though this does NOT come close to explaining “cause” for the range of kids so diagnosed). Maybe a range of such people is necessary for success as a species. After all, species survival depends on sufficient genetic diversity. Or as one wise foster kid put it, “Maybe it’s OK for different people to have different brain chemistries.”
OK, I think we have sufficiently fleshed out this argument. Everyone made their positions clear, and it’s not going to be productive to continue along these lines. Let’s move on!
Thanks for the laugh! I only wish it were not so close to the actual reality of these “diagnoses!”
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It sounds like those who did NOT take ADHD drugs had better heart conditions, regardless of whatever caffeine, cigarettes or whatever else they use. It is apparent that the effect is due to stimulant drugs, not other lifestyle issues of non-stimulant users, as these ought to push the needle in the other direction than what they found.
I would also remind you that “people who have ADHD” is not a scientifically definable variable. If you mean people DIAGNOSED with ADHD, it might be a good habit to clarify that. Folks are diagnosed for all kinds of reasons, and again, there is no scientific way to differentiate them from each other as “having” or “not having” ADHD or any of the other DSM “diagnoses.” It is difficult to really evaluate the scientific studies without keeping this important fact in mind. We are not working with a well-defined homogeneous group here, and the only clear variable is drug usage.
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Hard to come up with anything “right” about it, from my perspective. Pretty much like fixing a computer with a ball peen hammer.
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And financial conflicts of interest of the most powerful sort.
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Right!!!!
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I recall some interviews done with working class folks about why they did not relate to therapy. A lot of them said that they’d feel a lot less depressed if they could pay their bills every month and didn’t have to worry about getting food on the table. Talking about how they felt about being poor didn’t really help much!
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Are you suggesting that long-term use of psych drugs can cause dependence and that withdrawal can be dangerous as the client’s brain is adapted to having the drug and has a very hard time adjusting to a withdrawal period? I’ve heard from many folks that very slow withdrawal is essential for them as individuals, and also known of a few who really could not get off because the withdrawals were so bad. It’s another great argument to avoid long-term use of these drugs if at all possible, as Whitaker’s research suggests.
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I remember reading that the vast majority of doctors don’t believe they are affected by drug company advertising, while the reality is the vast majority are strongly influenced. Believing that one is NOT susceptible to manipulation makes one much MORE susceptible to manipulation!
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OK, I’ll give it a try.
First off, I am the last to deny there is real SUFFERING out there. That is not in question. The question comes down to how one views and deals with this kind of “mental” suffering.
ALL of the labels in the DSM are voted on. They are not scientifically verifiable entities, they are the results of clinicians “agreeing” on a particular set of “criteria,” which is generally a very subjective list of behaviors or thoughts or emotions that have no necessary connection to one another or any kind of “illness.” So they have no more legitimacy than “Seriously Emotionally Disturbed,” which basically means the person (usually child) says or does things that we find upsetting, confusing or inconvenient as adults. Take “ADHD” for example – one of the criteria is “acts as if driven by a motor.” Another is “Incapable of staying seated in class.” Another is “squirms when seated or fidgets with hands/feet.” Another one is “Sidetracked by external or unimportant stimuli.” Can you see that these are all simply judgments passed by an adult on a kid’s behavior? How many kids squirm or fidget? Who gets to decide what are unimportant stimuli?
But kids get this label and they are looked down upon, told they have dysfunctional brains, told they CAN’T pay attention, given controlled substances (essentially speed-like drugs) to “control their impulses,” etc. Note that there is NO attempt to ascertain WHY the child might fidgit – bored, uncomfortable chairs, dealing with trauma at home (foster kids get labeled at a MUCH higher rate), simply not a good fit with the teacher’s style? NO, it is all blamed on the kid for being inconvenient.
A similar analysis can be done for any of the labels. Scientific studies show that attributing “mental health problems” to disorders of the brain increases “stigma” (a euphemistic way of saying bias and prejudice and discrimination) and that teachers and other adults treat these kids differently once they know they “have a disorder.” Consider alone the shame of being asked in public by a teacher or parent, “Did you take your meds today?” There is a lot of shaming involved in the process, and since it has no scientific basis, I consider this kind of label just as irrelevant and damaging as saying a person is “Seriously Emotionally Disturbed.” It’s a pejorative disguised as a “diagnosis”. Look at some of the writing about “Borderline Personality Disorder” to see just how bad the discrimination can get.
Again, not saying that these behaviors and emotions don’t exist, or that people don’t need help dealing with difficulties. But the DSM labels are pseudoscientific crap voted on in committees, totally lacking in any scientific validity. Even the one-time head of the NIMH admitted this was true.
So see if that makes sense to you.
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You miss the point, by a long ways. I don’t think I can explain it to you.
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The product insert says no more than two WEEKS consecutive use of benzos, as I recall.
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Sure, “Bipolar disorder,” “ADHD,” “Major Depressive Disorder,” “Borderline Personality Disorder,” pretty much anything in the DSM is simply a made-up label for a condition that psychiatrists and others don’t actually have the slightest understanding of. These “diagnoses” are arrived at through subjective behavioral checklists that bear no scientific relationship to any bodily process, but are simply behaviors that we find annoying, unpleasant, or difficult to deal with. Not saying that a person labeled “schizophrenic” has nothing wrong with them or doesn’t need our help, but calling them “schizophrenic” provides no additional useful information and makes it easier to dismiss them as having no value or rights to autonomy.
There are several “diagnoses” where two people can have ZERO “symptoms” in common and yet both qualify for the label! The whole thing is a scam in my mind, and is far worse than the dangerous medications these labels are used to justify forcing on an unsuspecting public.
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But if it is that common, why don’t more people have it?
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I always find it fascinating how they claim that brain chemistry faults cause “depression,” but when they want to induce depression in rats or other animals, they always put them under stress and fear for their lives! It’s almost as if traumatic experiences cause the animals to be depressed…
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You do realize The Onion is satire?
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I am surprised not to hear your agreement about other labels besides “emotionally disturbed.”
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Did you read the rest of my comment? You seem to have ignored it.
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Honestly, I agree with you, but “EDP” is in the end no worse than many of the other labels that are considered more “politically correct.” Labeling other people as a means of “understanding” them is always offensive.
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I totally get this. It irks me no end when someone who has had PLENTY of the “best psychiatric care” has some disastrous outcome, and they call for more funding for psychiatric care. Robing Williams is a great example. If it worked so well, why did the person choose to end their life? Either it didn’t work, or it CAUSED the damage! More “mental health care” seems the last thing that is indicated!
So sorry you had to go through all that. I hope you’re doing better!
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Maybe. Or “Scientism” is one of my favorites – the belief that anything “sciency” must be true, regardless of the facts. If there are a few brain scans in an article, people are apparently more likely to believe it, even if the scans have no connection to the article!
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I just want to add that “bad science” is NOT actually science at all. It’s pretending to use science to explain why a person’s viewpoint is true even when the actual science says otherwise. In other words, it’s fraud!
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I think “Biological Psychiatry” is much more than that. It is the ASSUMPTION that ALL “psychiatric disorders” as defined by the DSM are CAUSED by biological malfunctions and can only be “treated” biologically. An example is the insistence that “major depression” is caused by a “chemical imbalance” despite decades of evidence to the contrary, an insistence broken only very recently and now replaced with some concept of “circuitry” which again is not actually supported by science. It is the insistence that “broken brains” are the reason for all “disorders,” regardless of social conditions or traumatic history. And yes, there are plenty of psychiatrists who practice exactly in this manner.
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Wow, good job AI!
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I am afraid I have never been in that situation. Maybe some of our other experienced folks can contribute some ideas? I just know it’s often a lose-lose situation without getting some kind of outside advocacy. I have no idea if such advocacy is available to you, though.
I suppose getting an independent doctor who disagrees with the prescriptions or supports your autonomy might also be helpful, but again, I don’t know how possible that is.
I’m so sorry you have to go through this crap!!!!
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The title actually says the “restless legs syndrome DRUG [emphasis mine].”
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Nobody asks if their cancer diagnosis is “beneficial.” It is what it is and is objectively diagnosed and you can’t decide you like or don’t like your diagnosis. (Well, you can, but it doesn’t change it!) The concept that “receiving a diagnosis may be beneficial” shows how far these folks are from an objective understanding of what is going on. But yeah, you often need a “diagnosis” to get help. It’s a very strange phenomenon to me.
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Might as well try to predict Santa’s arrival with the toys. Makes exactly that much sense to me.
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But as long as AI is fed “data” from corrupt sources, it will turn out corrupt answers. It will never be in a position to say, “Wait, this asshole is lying to me for his own profit!”
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The problem I see is the idea that “peers” should “be included” by… well, by those with the power in the system to decide to include them or not. Peers should not be “included” – the “peer perspective” should be the CENTRAL one that drives what we do. Doctors’ or professionals’ views can be “included” if merited, but only if the clients believe they have value. The basic institutional change we need is to stop giving doctors and other “professionals” the right and the power to decide if the “peer perspective” is worth their time. Peers don’t need to be RECOGNIZED, they need to be EMPOWERED and there needs to be no discussion of whether to “involve them” in decision making. Clients need to BE the decision-makers, or we will continue to have the power-hungry and arrogant “opinion leaders” assuring us with little pats on the head that they’ve “included the peer perspective” while they continue to do whatever they want, however misguided, damaging or corrupt.
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Me, too!
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I felt I was doing good things. When the bad outweighed the good, I had to stop. But I really respect those who are in the trenches or behind “enemy lines” because people need help NOW and it’s the only way I know those in the system can get support.
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I am talking from experience here. I was inside the system with a totally different philosophy than those who were running the show. I was not confused particularly, but I was certainly disheartened by the kind of pressure and discrimination I experienced when I failed to “get with the program.” A lot of it was simply isolation – folks were “He’s an anti-med guy” and ignored many of my comments and observations. I was able to fight for clients in specific situations and provide something that others did not, but it was pretty exhausting. At a certain point, I realized I was supporting an oppressive system by even participating, even if I was doing some effective damage control, and decided I had to get out of there. But I would not say I was confused. Just annoyed, disheartened and infuriated!
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I don’t agree. I think the system is organized to create confusion, and a lot of folks are simply confused. There are a small but powerful number who DO enjoy creating confusion – otherwise known as “narcissists” in their own parlance. These folks are in charge of the big decisions (opinion leaders) and support and create the system as it is. They are the ones who put out the propaganda and attack those who dare to challenge the “status quo.” Such people do absolutely exist at the lower levels of organization (the system itself attracts such people), but there are plenty who want to do the right thing and are simply confused by the propaganda and peer pressure within these organizations. There are also rebels “behind enemy lines” who do really good work and deserve credit for doing so despite the pressures and discrimination they face.
It is simplistic to assume ALL “mental health” workers have anything in common. It is absolutely not supportable to assume that creating confusion is a goal of all or even most “mental health” workers. I think most of them are more confused than we are!
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I agree wholeheartedly. There is no such thing as “involuntary treatment.” It’s an oxymoron.
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The best solutions make things feel simpler, not more complex. One of the sure signs that the DSM is off base is the ever-increasing complexity of the system over time. Not to mention the ever-increasing numbers of “mentally ill” according to this system.
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Just to be clear, there is no evidence that anyone’s depression is caused by a “serotonin deficit.” Why SSRIs work as antidepressants for some people is not scientifically understood, but it’s not because of a “chemical deficit” in the brain, that much has become clear.
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Sadly, you again are quoting propaganda. The Black Box warnings did NOT increase the suicide rate. Read the following:
https://www.madinamerica.com/2018/08/adolescent-suicide-and-the-black-box-warning-stat-gets-it-all-wrong/
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Because you say so.
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It is an attack to pretend someone is proposing something they are not and criticize them for it. Strawman argument. Study logic sometime. And read the damned book!
It is childish at best to respond to the question, “Why did people with worse prognoses do better on less APs than those with worse prognoses on more APs” with “Longitudinal studies aren’t worth much.” That is an emotional argument not a logical one, which is why I’ve decided there’s no point in trying to have a rational conversation on this subject with you. As a wise man once said, “The first barrier to learning is thinking you know all about the subject.”
Steve out.
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See how you attack anyone and anything that you don’t agree with, and use emotional arguments? Did I say to take everyone off their antipsychotics? Why raise these pointless straw man arguments if your case is so strong? Why not just present your evidence?
Of course it’s longitudinal, how else do you look at long term outcomes?????
The facts are there. You don’t care to learn. That’s your choice, but don’t claim I said things I did not.
Done wasting time on you.
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You clearly didn’t really read Harrow. Whitaker has a fantastic analysis which sinks your argument fully, though clearly the psychiatric establishment grasped at that straw, and I’m guessing that’s what you are responding with rather than your own analysis.
Harrow identified 4 groups: bad prognosis on aps, bad prognosis off aps, better prognosis on aps, and better prognosis off aps. The outcomes sorted this way: better prognosis off aps, bad prognosis OFF aps, better prognosis ON aps, worse prognosis on aps.
If the worse prognosis clients off aps do BETTER than the better prognosis ON aps, that’s the opposite of selection bias.
But I doubt you will bother to revise your statement. So far, you only take positions that support your narrative. If we can’t have a rational exchange about this, I’m done with this conversation. Your position has been thoroughly undermined for anyone who actually cares about science.
Seriously, Corey. Read the book!!!
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Harrow is the best example of how long-term antipsychotic use leads to worse long-term outcomes. Take some time and look it up!
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They still SOMETIMES work for SOME PEOPLE. And it kind of depends what you mean by “work.” Read up on long-term studies, the folks who manage to avoid antipsychotics or use them sparingly do significantly better in the long run. This is shown in more than one long-term study. Again, your tendency to generalize make a lot of what you say of lesser value than it would be. It’s not so black and white as you want to believe.
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I had a client in foster care (we were her CASA advocates) who was diagnosed with diabetes. Here CASA volunteer got them to discontinue her Seroquel (antipsychotic). Next visit, her diabetes was gone. Thank God for the CASA!
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From your own study (emphasis added):
In contrast, studies on instances of suicidal behavior from weeks 1 to 10 found no significant difference in efficacy between SSRIs, non-SSRIs, and placebo. These results indicate that SSRIs MAY offer short-term protection against suicidal ideation. However, their long-term effectiveness in mitigating suicidal ideation and preventing suicidal behaviors is limited.
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So this is one meta-analysis claiming no INCREASE in suicidal effects on children or young adults. It certainly doesn’t suggest that SSRIs reduce suicide attempts or thinking. Of course, there are other meta-analyses that show that there IS an increase in suicidal thinking, or there never would have been a Black Box Warning in the first place. So your one meta-analysis is evidence, but not much, and certainly does not address your initial claim of decreased suicide attempts/thoughts resulting from SSRI use overall.
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“Everyone here” is an all-or-nothing blanket statement, Corey, so it seems you are displaying a bit of hypocrisy yourself here. Plenty of folks, including the Author, Robert Whitaker, (and me) take a much more nuanced approach. Read some of the articles by Johanna Moncrief, for instance.
“Fact SSRIs lower suicidal thoughts reducing suicides.” You believe this, but it is NOT a fact. Look at the work of Irving Kirsh and others. Prozac was initially not approved for sale in Germany due to increases in suicidal and violent thoughts/actions in some people. I am aware of no literature review that concludes “SSRIs lower suicidal thoughts reducing suicides.” (In fact, the best reviews I have seen suggest that only about 30% of users benefit significantly from taking antidepressants.) There is a black box warning about increased suicidal thinking in youth and young adults, hardly evidence of reduced suicides.
Do you have something to share along those lines to prove your claim? Or is that just what you believe to be the case? Have you ever read Whitaker’s work? Maybe you should have a good read before you draw unwarranted conclusions!
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It sounds like you are making a lot of assumptions yourself. Why do you feel such an urge to defend these drugs? Why not read and listen for a while and maybe learn that the situation is more complicated than you want to believe it to be?
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THAT feels creepy to me! Thanks for sharing your story. If she doesn’t want to take notes, she should use a Dictaphone like doctors always have. AI is NOT appropriate for this!!!!
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That one should have to SUGGEST “shared decision making” as if the PRACTITIONER gets to decide whether or not to “share” their power says a hell of a lot about the “diagnostic” and “treatment” process!
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The problem with “recovered memories” is when the THERAPIST tells the person they have such memories but doesn’t remember them. People come across incomplete fragments of real memory all the time that can be fleshed out by good listening in the right venue. I had this happen to me – I was hit in the head by a teacher in second grade. I always remembered the incident vaguely until right before the hitting part (including her tossing a book across the room), then blanked out until I was in the hallway. I shared this with another student in the class at my 30th reunion, and she remembered the whole incident, including my being hit by the teacher! After hearing this, I recalled the kid who was tossed in the hallway with me, I recalled being sent to the nurse by the secretary, I recalled being outside the principal’s office hearing him and the secretary chatting, with Freddy sitting next to me. I have no doubt these are real memories I recovered because someone validated MY story. But no one told me they happened, I had to recall them myself.
No one should evaluate someone else’s experience or tell them memories exist that they don’t recall. But it is very much possible to recover memories of things that a person has forgotten. It happens all the time.
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You are talking about prejudice. That’s why I hate the word “stigma,” it minimizes the intent and the damage done to people.
You should know that viewing “mental illness” as a biological condition has been shown in multiple studies to INCREASE prejudice and decrease empathy for the “mentally ill” persons.
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The problem, Renate, is that not everyone experiences antidepressants the way you do. As I said before, everyone should do what works for them. But because it works for you does NOT mean it works for others, and you should be careful not to state or imply that. If “Depression” were a clear-cut, identifiable disease state, we’d be able to predict who would and would not respond to antidepressants in a positive manner. But we can’t, because “Depression” is a vague and subjective concept that does not describe a group of people who necessarily have ANYTHING in common besides how they are feeling. Just to clarify – you were seriously depressed starting at a young age and have not identified any trigger or event that changed that for better or worse. Do you think that is the same as a kid in foster care being seriously depressed because his mother abandoned him at a young age, or an aging adult who is depressed about his/her life deteriorating and losing abilities, or someone who is in chronic, unresolvable pain and does not want to get out of bed every day because their life seems so hopeless? I’ve seen kids in foster care who are far WORSE after taking antidepressants, including being aggressive, suicidal or psychotic. I’ve seen doctors not listen to them or their advocates because they believed that antidepressants are “the answer” for all forms of “Depression,” regardless of the cause.
You seem an intelligent and rational person. Surely, you can see that “Depression” is far to vague to be viewed as a single entity, and that there can be many reasons for being severely depressed, and as many possible solutions as there are people suffering?
I would never want to take away something that works for you. I just want you to see that other people don’t have the same experience and for good reasons are very suspicious about antidepressants as a solution for ALL cases of “Depression.”
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I sort of agree, but I think the process is more one of removing inhibitions based on talking to lots of ‘users.’ I remember one in particular who took Zoloft for migraine headaches, not depressed at all, saying that she’d run into situations and be going over possible solutions and would think, “I could kill myself!” She was shocked at herself for even thinking such a thing, and totally attributed it to the Zoloft.
So if a person is feeling inhibited, as in I can’t stand up to my mom or I feel I have to act a certain way to keep others happy, taking SSRIs might seem like a relief – who cares what mom thinks, those others can shove it! But what if the person is inhibiting wanting to kill themselves, but is staying together by saying, “I can’t do that to my kids” or “I don’t want to leave a mess for others to sort out, it would be selfish?” Removing those inhibitions could result in, “Ah my kids are better off without me” or “It won’t be my problem, I’ll be dead” or similar justifications. And Lord help us in the rare cases where the person is inhibiting the thought of hurting or killing others by thinking it would be too horrible a result. That kind of inhibition, we WANT people to keep!
That’s how I see it working for some people but being a total disaster for others. It depends if removing inhibitions works in your favor or against you. And I have personally seen both happen.
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When working with foster youth, I saw a large number of cases where prescribing stimulants led to aggressive behavior. I saw one VERY clear example of psychosis being induced by stimulants. A study I’m familiar with showed 6% or so of kids who were prescribed stimulants had psychotic behavior or thoughts recorded in their files. This is a very real phenomenon.
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The conclusion is not that all psychiatric drugs are bad for you, it’s that “information” coming from drug companies regarding their drugs can not be trusted based on long experience. Benefits are overplayed, adverse effects are buried or minimized, and outright propaganda is put out as if it were fact. Everyone has to make their own decision about a particular treatment, and drugs are not “good” or “bad” in the absolute sense of those words. They work or don’t work for a particular person. There is no special way to “diagnose” people and thereby determine who will “benefit” – it is simply a matter of trial and error, and we’d all be better off if doctors were honest about this instead of pitching drug company propaganda (such as the “chemical imbalance” concept) as if it were factual.
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You make the simplistic mistake of assuming that all “psych patients” are “mentally disturbed” and do “insane disturbing things.” This is rank bigotry, Andy. The vast majority of “psych patients,” in particular depressed individuals, do NOT engage in doing “insane, disturbing things.” Most in my experience AND in statistical studies are actually quite safe, and are much more likely to be victims than perpetrators of violent incidents. This is particularly true for female patients. School shooters tend to be young and male. There isn’t a lot more that they have in common with each other statistically.
As for SSRIs and violence, this is not new information. SSRIs were initially banned in Germany for inducing violence and aggressive behavior back in the late 80s, in people who did NOT have that kind of problem to start with. I don’t think it’s appropriate to ever pin a particular crime on SSRIs, but the correlation is not made up. It’s a very small number, but it does happen. Look at the Germanwings plane crash for a good example.
I am not a fan of RFK, Jr, but again, “explaining” things by blaming the patients is an immature and cowardly approach to the problem. I think we’d do better to do some honest research and to add appropriate warnings if need be.
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Pure speculation. This is not helpful to those who are truly suffering. Blaming the victim is never a good plan in my view.
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Doctors can prescribe any FDA approved drug for any indication they can find. The only way to “take away” a drug is to have the FDA withdraw their approval for that particular drug. Since drug companies contribute to both sides of the aisle heavily, it is very unlikely that any such drugs will be withdrawn from the market. Think how hard it was to even get a well-researched warning put on antidepressants. Banning them? Nothing to worry about, IMHO.
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“When someone is treated with a medication there is a reason.” False premise!
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Your premise sounds more like “being male contributes to violence,” not “depression. If young women are equally depressed but NOT committing school shootings, than “depression” per se is not a variable. Being young and male most definitely is.
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For the record, #1 is a completely false premise. But I tend to agree with you overall. I’d say that SSRIs play a role in a very small number of cases, and many other factors are involved even if SSRIs do contribute in some way. It’s certainly no argument for banning ADs, but it may be one for adding some informed consent. See the Germanwings plane crash for a fairly clear case of probable SSRI contribution to a disaster.
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Three issues with these fMRI studies:
1) The observed differences are AVERAGES, they are essentially correlations. There are plenty of people diagnosed with “ADHD” who do NOT have the expected differences, and there are people who have the differences who do not display “ADHD” behaviors.
2) These studies rarely if ever take prior medication use into account, which is a confounding factor in a huge percentage of anyone in the diagnosed group. Stimulants have been associated with changes in brain volume and functioning, which have often been attributed to “ADHD.”
3) Many fMRI studies are measuring brain ACTIVITY, not structure. Variations in activity in certain areas may be an artifact of environment and not differences in the brain at all.
Additionally, the fact that some genes may code for more active and less sedentary personality styles does not automatically make such genes “malfunctioning.” Having raised two kids (out of three) who would qualify easily as “ADHD,” I can say with confidence that both have great strengths which the non-“ADHD” population lacks in general. Both ended up being successful in school by using alternative classrooms that allowed a lot more exploration and movement. Both graduated with honors from high school, the youngest graduated with honors from Evergreen State College!
I ran across a VERY interesting study a while back. They set up groups of three kids (elementary age) with one kid diagnosed with “ADHD” in each. Control groups had three kids, too, but no “ADHD” kids. They gave them three problems to solve in a given time. They measured on-task time and successful completion. The control groups scored significantly higher on “on-task” percentage – they kept their figurative noses to the grindstone and worked hard. But none of them solved any of the three problems. Whereas ALL of the study (“ADHD”-including) groups completed at least one problem, and at least one completed all three, even though these groups goofed off a lot more than the control groups!
Of course, if the groups had three “ADHD” kids each in them, they’d have probably got nothing done at all on the problems! But I think the study showed what I believe to be true – we need these active, creative, fun-loving, goof-off moments to have healthy groups of people, and there is nothing wrong with someone who tends to play that role in society. After all, if 10% of people have a particular trait, it must have some survival value, mustn’t it?
None of which argues against your using stimulants, or anyone else, if they feel it is helpful. I think it’s just important to know that there is more than one way to look at this set of traits than to view it as an aberration or disease state.
I hope that was at least an interesting read for you.
Steve
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Very well said!
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It does not. But saying “Correlation is not causation” does not mean the correlated events are NOT causally related, merely that you have not proved it. In my world, it’s the job of the drug manufacturer and the prescribing doctor to ENSURE the drug is safe. If it is not, or is even SUSPECTED not to be, it becomes a matter for informed consent immediately. Something as simple as, “A very small number of people don’t seem to react well to this drug. If you find yourself suddenly thinking about hurting yourself or someone else, please call IMMEDIATELY and we will address it.”
Then, of course, when you DO get that call (like the Germanwings pilot), you have to not pretend “it’s part of the disease” and DO something about it. “Wow, it sounds like you are finding this drug is not working for you! Let’s come up with another plan!”
It’s really not that hard. But it starts with being honest.
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I agree, however, we should not be killing people while looking for root causes!
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I agree 100%. “Wellness camps” sound bad enough if you went voluntarily!
I am opposed to involuntary “treatment” in any circumstance, as I don’t regard it as “treatment” if the client is not a willing participant. I realize that sometimes people have to be prevented from harming others or endangering society (wandering into traffic, etc.) but that does not justify forcing drugs or “wellness camps” on people who are unwilling or uninterested in such “treatment.”
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There is nothing wrong with taking pills. MIA’s mission includes scientifically-supported use of medications. Of course, individuals are entitled to express whatever opinions they see fit, including plenty reporting positive results of taking medications. MIA is intended to be judgment free in that regard.
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I said nothing of the sort. I said that you can’t extrapolate from your own experience to that of others (which clearly you can not), and I said that no one is coming to take your ADs away from you (which clearly no one is). These are statements of fact. I certainly have no thought that sending you to a “camp” of some sort being advisable, in fact, if you are satisfied with what is happening with your current treatment, why would they want to send you anywhere? They are sounding like the ones with the issues. I fully support you in doing whatever works for you. I just can’t agree to blame violence likely caused or exacerbated in rare cases by antidepressants on those unknowingly taking pills with such adverse effects.
Look into the Germanwings plane crash if you want a really solid example. The pilot TOLD his psychiatrist he didn’t feel right taking these drugs, but the psychiatrist ignored him, didn’t change his regime and continued to allow him to fly. The results were devastating.
That’s what happens when we pretend an adverse effect doesn’t happen when the evidence says it does. It has nothing to do with individual experiences or banning of drugs. It’s just about being honest about the data.
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Or, people with ACEs may be more likely to react adversely to SSRI antidepressants and other drugs. I will repeat that the experience of “depression” in particular is RARELY associated with violence of any sort. It is usually associated with withdrawal and passivity. There is absolutely no reason to expect a rash of mass murders from depressed people. SSRIs appear to be a strong variable. They clearly don’t affect the majority this way, but as I noted earlier, Prozac was initially banned in Germany due to causing violent episodes. This is not being made up, and let’s not let SSRIs off the hook for their role in creating a more violent world! Blaming it on the victim once again is not an acceptable explanation.
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Just because you love them doesn’t mean others aren’t adversely affected. The percentage who become violent is apparently small but does exist. Prozac was initially banned in Germany because of data suggesting a small but significant number of people who became quite deranged taking them.
Besides which, depression has NEVER been highly associated with aggression and violence. Depressed people tend to be withdrawn and more passive than the average human. You can’t blame “depression” for this result, even if it makes you really uncomfortable.
And BTW, no one is coming to take your SSRIs. So let’s relax and look at the data instead of our emotions!
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It’s not “broken” if it’s working the way it is designed. I think we all get confused re: the purpose of these “systems.”
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I agree with you. A reduction in suicide compared to other methods (and how has he measured this? I don’t think he says…) might just as easily mean that fewer people are driven to suicide by this method vs. the standard. No “treatment” could very well still be superior. Since most people spontaneously recover from depressive episodes, our baseline ought to always be “untreated.” But hey, who can make money by NOT treating people? Maybe we should make it like farm subsidies – you get paid for NOT treating patients and leaving them alone!
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That’s what is so great about Rat Park! Instead of seeing how they act when abused or neglected, they look at how rats act when treated well in a super supportive, rat-friendly environment!
https://www.psychiatrictimes.com/view/what-does-rat-park-teach-us-about-addiction
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The Rat Park experiment shows the truth of what you are saying!
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All pending comments I see of yours have been approved. If I am missing something, please contact me by email NOT via a comment like this one, with date, time and partial text so I can identify the post in question. Asking here why it’s not been approved is a violation of our posting guidelines. Please stop doing this!
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Their answer will be “more funding for mental health services,” even though it sounds like she was receiving such services for years!
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That makes a lot of sense.
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I think Robin Williams did an ad for that stuff!
https://www.youtube.com/watch?v=XBb5v1sJhuU
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Good point. I also note that most apologists for the System will say, “The reason this person committed suicide is because mental health services are underfunded and unavailable.” But most of the time, they’ve had years of “services” before the event. So how is a lack of services the problem? It sounds like the services FAILED TO HELP!
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Then there are those who go into the field just so they can have power over others. I diagnose them with “BAD” – Basic A**hole Disorder!
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What an awful story!!! Sounds like they were trying to kill you!
You are correct IMHO – Humility is the basic building block of being a helpful person. Without it, practitioners (medical, too) are lost.
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Neither necessary nor sufficient!
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Excellent point!
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I think you are missing the point. The first mistake is seeing individual humans as “patients” who need “treatment” simply because they are experiencing intense emotions. You seem to be having difficulty accepting that framing of the issue is 90% of the problem. “Medical treatment” is not the answer we are looking for.
As for time and patience, again, we don’t choose our cancer or heart treatments based on whether people find them difficult to implement. We choose them based on whether they work. Taking drugs is easy and quick but it doesn’t work in most cases. In fact, it generally makes things worse and prevents people from choosing the more effective path for them, even if it is harder. I could give you an example or two if it would help you.
We are all responsible for finding our own pathway. All we can do to “help” is to help the person decide. Encouraging them to do the wrong thing because it is easier is foolish in the extreme!
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It makes no sense to simply “reframe mental health treatment” in terms the Zulu can accept. We are barking up the wrong tree. We need to shut up and ask THEM what they think would be helpful, and change our model accordingly. But of course, that would mean scrapping our top-down, we-know-best, do-as-we-say approach, which would mean scrapping “mental health treatment” as we know it and starting over.
Don’t hold your breath!
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I am SOOOO sorry! What a sad story. I only wish it were the only time I’ve heard that. We’re here to listen if you want to share!
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I agree 100%!
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No, I have plenty of ideas of what is helpful in many situations. However, those situations are NOT defined by “diagnoses” nor subjectable to any kind of “double blind studies” as if humans are some kind of machines who all will respond to a certain approach if they have certain “conditions.” Generally, what is helpful is someone who will take the time to listen and be comfortable with another person as that PERSON figures out what if anything is “wrong” and what needs to change for him/herself. The biggest problem (of many) with the current system is that it attempts to take something like “depression,” a common experience to all humans, and come up with some kind of “cure” that works in all cases, as if feeling depressed (sometimes deeply and sometimes for long periods of time) were not a normal part of the human experience, or that all people experiencing “depression” have something mechanically wrong with their brains or minds that needs to be “fixed” by a doctor.
I’ve found many ways to be helpful to hundreds of people over the years. But every one of them is unique and required me to go into the situation completely open to hearing whatever is being communicated and working to respond appropriately to that particular person. Trying to treat everyone the same and expecting the same result is never going to work. Milton Erickson said that “Therapy has to be re-invented for every client.” I think he was pretty much correct.
I will add that there are plenty of things that are helpful to some but not all which fall outside the realm of “therapy” per se. Buddhism or other spiritual practices are a good example. Also such simple things as walking in the woods, breathing properly, getting good exercise, simply talking to another caring layperson (shown to be generally as effective as “therapy”), and most crucially, having a sense of purpose or intent for one’s life can make all the difference. In addition, altering one’s environment to avoid abusive people or situations is sometimes essential, but no “treatment” will enable someone to do that. It requires a genuine connection with another person or set of ideas that help a person realize they deserve better, and sometimes some very practical help like an affordable attorney or a place to live they can afford or the ability to get away from a negative “treatment” being forced on them.
So no, that’s not at all what I’m saying. I’m saying that medical “treatment” for mental/emotional issues and difficulties is generally harmful, but it takes an individual approach to each person’s situation to find what is helpful, which may or may not look ANYTHING like “treatment” as you imagine it.
Does that clarify my position?
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There doesn’t need to be an “alternative” if the current paradigm is wrong. Sometimes we don’t know the right thing to do, but we do know that what IS happening is wrong. Should we continue to systematically do something damaging because we don’t have an “alternative?”
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“Behavioral health” always seemed like a bizarre term to me. Behavior doesn’t have health. Beings have health, not actions!
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So it sounds like a pattern of behavior for you, not a “diagnosis.” That being the case, how can people be accused of not “diagnosing BPD correctly?”
I’d really prefer we dump the label and simply rely on accurate descriptions of people who are dangerous for one reason or another. What a psychiatrist thinks, or frankly what anyone thinks their “diagnosis” is, is of little to no value.
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Why do you assume that all or even most medical professionals follow “science?” If you have not read Anatomy of an Epidemic, you have missed the primary explanation for why this website exists, which is specifically because psychiatry has REFUSED over time to use or rationally respond to the “algorithm” known as science. You seem to believe that it does without evidence and attack anyone who disagrees with your assumption. Why not do some listening and exploration toward the very scientific double-blind studies and long-term reviews of the literature on which Mr. Whitaker’s concerns are rationally founded?
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Posting as moderator:
I agree 100% that putting down religious beliefs and practices is out of bounds, and I apologize for missing any posts which did so. Please report to me at my email if any other posts of that nature come through and I will re-moderate them for appropriateness.
[email protected].
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It is interesting to note how experimenters get mice or whatever into the proper “mental” state to test their drugs. They seem to always STRESS the poor little creatures until they are anxious or depressed or whatever.
See the Rat Park experiment or Harlow’s Monkeys. Environment completely alters animal behavior, for the better or the worse. Clearly should apply to humans…
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But there ARE wrong answers! Forcing people capable of reasoning to go against their own wishes IS wrong, whatever might be “right.” The choice of “justice” as a focus implies without question that stopping unjust or “wrong” actions is the main thrust of the effort!
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Dang, how can a guy make money selling cures when people keep getting better on their own?
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“High rate,” “associated,” “potentially,” “often linked,” “may impact…”
All of these are probabalistic statements. There is no clear connection between a particular genetic pattern and all or even most “cases” of “ADHD”. None of these genetic indicators have ever been used to “diagnose” ADHD, mainly because many people with a particular mutation do NOT “have ADHD,” while many who are diagnosed with “ADHD” don’t have the mutation in question.
Perhaps this begs the larger question: Even if there are genetic associations with SOME cases of “ADHD” that are predictable, why have we decided that these variations in human behavior are a “disorder” or disease condition? Why is there no “Attention excess hypoactivity disorder?” Why is only HYPERactivity considered a problem?
I think we know the answer. “Hyperactive” children are more difficult for adults to manage, as they don’t (by definition) tend to go along with the program, so we decide that the child is the problem rather than examining our own models of education and other societal expectations. This despite reliable research that so-called “ADHD” children are virtually indistinguishable from “normal” children in open classroom settings, and that “treated” children do not in general have any better outcomes than those who are left to their own devices. This doesn’t even begin to touch the other big issue, namely that abused/neglected children tend to have a much higher rate of “ADHD” diagnoses than the general populace. If it’s all genetic, why is it so much more common in the foster care population?
I have no doubt that some kids are genetically “programmed” to be more active than others (though this does NOT come close to explaining “cause” for the range of kids so diagnosed). Maybe a range of such people is necessary for success as a species. After all, species survival depends on sufficient genetic diversity. Or as one wise foster kid put it, “Maybe it’s OK for different people to have different brain chemistries.”
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Posting as moderator:
OK, I think we have sufficiently fleshed out this argument. Everyone made their positions clear, and it’s not going to be productive to continue along these lines. Let’s move on!
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