Wow, you ought to submit this as a blog. What a fascinating education! Thank you for that comment!
Why would they have to SAY that patient-reported measures should be “included?” Why wouldn’t they be the MOST IMPORTANT measure in every case?
The difference between a good therapist and a bad therapist is that the good therapist is concerned with the perspective of the client, and a bad therapist is concerned with their own perspective. The bad therapist wants to look/feel good about their work. The good therapist wants the client to regain control of their own perspective. The only valid measure of success in a therapist is the empowered client’s satisfaction with the process.
The difference I see in your analogy is that no one is promoting cigarette smoking as a “treatment” for “ADHD” or any “educational disability.” Drugs can be useful for many things. I’d be dead today without modern medicine. But it sounds like we’d both agree that just because a drugs is perceived as helpful in a particular situation for a particular person, it doesn’t mean that person was “ill” or that the drug “cured” or “treated” a condition.
A shot of Southern Comfort definitely reduces my anxiety, but it’s hardly a medical treatment!
Unfortunately, most people are unaware of their philosophical assumptions, and have a hard time distinguishing these assumptions from fact. I agree, our educational system really needs to make the study of philosophy and its application to practical decisions a priority again. Back in ancient Greece, ALL learning was recognized to be a subset of philosophy. That’s why the highest degree is a Ph.D. – Doctor of Philosophy.
I think a lot of folks have been convinced that it is “unscientific” or “mystical” or superstitious” to entertain any possibility of a spiritual existence beyond our bodies. It’s odd, because most people in the world appear to believe in such a spiritual existence continuing beyond our physical existence in our bodies, yet somehow this doesn’t seem to conflict with claims that ‘science’ does not include the possibility of spiritual existence. I’m personally of the opinion that scientifically, there is no way to rule in OR rule out such spirituality to a certainty. But that means science ought to remain open to the possibility. There are certainly bits of circumstantial evidence, such as the placebo effect and neurofeedback, that suggest there is something about our existence as beings of whatever nature that allows our mental processes to control what happens to the body. How that effect occurs, no one really knows. So discounting the potential that we are spiritual beings that transcend our earthly existence on “scientific” grounds seems ungrounded in factual evidence.
Yeah, let’s not waste our money on the things that have a 50 times greater correlation! Let’s spend more money researching stuff that is barely better than chance at distinguishing “depressives” from “normals.”
You know what my approach was for distinguishing depressed individuals from non-depressed individuals? I asked them if they felt depressed! It was a remarkably accurate “marker.” People who say they are depressed are statistically FAR more likely to be depressed than those who say they feel fine!
It should be clear that any brain-affecting drug could cause brain shrinkage, based on your research. I’ve never found the “neurogenesis” explanation/claim for SSRIs to be particularly convincing. But you are very correct, depression is almost always a symptom of something else. In fact, I think it’s fair to say that “depression” is not the “cause” of anything. It’s an experience people have, which could mean a hundred different things. Calling it a ‘disorder’ is always euphemistic.
“Voluntary” electric shock “therapy” (no, I won’t use the euphemism) is also an abomination, since there is absolutely no way to give “informed consent.” Anyone who really understood what this “therapy” involves would run the other way full speed! Though it seems more than a tad counterintuitive that inducing a grand mal seizure through electrocuting the “patient” would in any scenario be advisable.
We must also remember that psychoanalysis was not accepted until after Freud disavowed his trauma theory and blamed the patients’ woes on his own “complexes” instead of focusing on the causal traumatic factors. I’d say that psychoanalysis was thoroughly defanged before it was allowed to become popular, and hence was reduced to a tiny fraction of its potential effectiveness. The removal of the right of the clinician to “interpret” seems like a critical move. But I wonder how many clinicians are fully capable of resisting the urge to foist their evaluations onto the client.
Remember always that such studies are not always controlling for psychiatric drug use. We know at least in “schizophrenia” that brain shrinkage is causesd by the drugs themselves, and there is suggestive evidence that this happens with stimulants for “ADHD” as well. Any generalized measurements like brain volume are not valid if substance use, legal and illegal, is not accounted for.
I’ll put it on the agenda for my next tour of England!
I particularly find the possessive form, “My mental health” or “My depression” or “My diagnosis” a disturbing trend. As I said once, depression isn’t something you HAVE, it’s something you DO. And framing it that way means you can do something to change it. Whereas if it’s something I simply HAVE, then I no longer have agency, I’m stuck with it, as if my own decisions and beliefs and actions have no chance of altering my fate of having “mental health problems.” I don’t mean to blame anyone for feeling bad, but the idea that someone else is making all that happen and that someone else can “fix” it sells lots of drugs and keeps people dependent for life instead of teaching skills to regain control of our lives.
We do seem to, don’t we?
If you ever come to the West Coast of the USA, I think we’d have a hell of a great lunchtime discussion! I hope we get to meet one day – there are few people who evoke that wish for me, but you’re definitely one of the top!
I agree 100%!
Doing nothing at all is usually a far more effective intervention than psychiatry is able to come up with on its best day.
You know, it kind of sounds like everyone is more or less on the same page – don’t start suddenly, have a plan, adjust to individual needs, listen to your body, the person withdrawing is the best guide. Seems like good advice.
It has always seemed to me that everyone’s body is different, and so a different approach needs to be considered for each person. Psychiatry’s biggest failing is assuming that everyone who feels “depressed” (or whatever other manifestation they identify as “illness”) has the same problem and needs the same kind of help. We should not fall into this trap! I think the advice about starting slowly and observing how much a person can tolerate is very, very important, but assuming that 10% or 5% will work for everyone means that some people who could get off a lot faster are restricted, and others who may find this rate too fast will feel hopeless. I think flexibility and respect for each person’s own sense of what works for them should be the center of any effort to wean off of dangerous drugs.
My feelings exactly!
Yeah, good question, isn’t it? I see this often – the experiment itself proves that there is no point giving antidepressants to teens, say, and yet the conclusion is that we should still do it. Clearly protecting guild interests over patients!
Everything you’ve said is speculative. There is nothing you provide that shows any actual EVIDENCE that a particular chemical problem in the brain is associated with depression. In fact, this idea was disproven way back in the mid 1980s, before Prozac even came to market.
I’m not interested in opinions of people. I’m interested in EVIDENCE. And so far, you have presented anecdotes and opinions. No one is saying that some folks don’t feel better when taking antidepressants. I am contesting the idea that the primary CAUSE of depression has ever been established as being biological.
“The chemical imbalance theory as a cause for anxiety and depressive disorders never was true. In fact, no experiment has ever shown that anyone has an ‘imbalance’ of any neurotransmitters or any other brain chemicals. The entire theory was hypothetical.
Over the last ten years, independent research has continually shown the chemical imbalance theory to be false. Furthermore, independent research has shown medications used to ‘correct’ the imbalance were largely ineffective with many fairing no better than placebo.”
Please read the following for an overview of scientific challenges to the “chemical imbalance” concept.
You might also benefit a lot from reading Anatomy of an Epidemic. It might help you understand the scientific reasons why Bob and others question the standard psychiatric narrative. It does not come from a place of hostility, it comes from a place of wanting to get it RIGHT for people who need the kind of help that drives them to psychiatrists.
Can you please provide citations demonstrating convincingly that, say, “Brain chemistry” or “biological differences” are “causes” of depression? I am very familiar with the research in this area, and am aware of no consistent biological difference that characterizes depression or accounts for more than a tiny fraction of cases of “depression,” even in the most optimistic interpretation. In fact, luminaries such as Dr. Ronald Pies and Thomas Insel have assured us that psychiatry never took the “chemical imbalance” theory seriously, and that it was, in fact, drug companies that made such tropes commonplace beliefs.
On the other hand, I can provide oodles of evidence that the correlation between childhood adverse events and cases of “depression” is extremely high, much, much higher than the most optimistic “biomarker” research has ever been able to accomplish.
You are welcome to your own opinion, but not your own facts. I’d like to see what scientific data you are basing your stated opinion about “causes of depression” on.
I feel I need to add that stating the COVID epidemic contributing to isolation, feelings of hopelessness and self-harm seems to completely undermine the idea that these “mental disorders” are caused biologically. Seems the professionals are talking out of both sides of their mouths here.
I have suggested “Math teaching disability” and the like before, too! If you’re being paid to teach me math, and you can’t do it, why is this my fault?
Maybe they should call it “Co-corruption!”
All too disturbingly true!
That is an excellent point! The opioid/benzo crisis shows that doctors can not be trusted with distribution of dangerously addictive drugs.
Even if there WERE a way to make Ketamine-assisted therapy effective (which I still have very serious doubts about), it is a certainty to me that in the hands of the commercial/economic incentives of today’s system, any chance of general effectiveness will be very quickly overwhelmed by the authoritarian, disrespectful, and degrading conditions that pertain in almost all “mental health” agencies. It seems like another boondoggle for the drug companies and their minions.
An excellent point!
How did you pass it on? It always feels bad if we can’t stop others from getting similarly hurt.
What you observed for decades is absolutely correct. None of this was truly intended to help, except for those low-level people who think that forcing people to do things they don’t want to “for their own good” is some form of “help.” I can see how reading this stuff can bring back the pain, but don’t ever believe anyone who says that your observations were “wrong.” Honestly, I think the first step to healing from crap happening to us is learning to trust that we were RIGHT when we knew we were being fed a line of crap!
Posting as moderator:
To be clear, we welcome those who feel psychiatric diagnoses are “helpful” to them – all are always welcome to post at MIA as long as they follow the Guidelines. We welcome all viewpoints. However, it is important that such posters respect the fact that they will encounter alternative viewpoints here, and to own their own viewpoint as theirs and not try to force is on others or to invalidate others’ attempts to communicate their own views. We are all free to disagree, but with respect. I am getting the feeling that some folks are feeling their views are not being respected. Which is ALSO a free topic of conversation, as long as we make sure it’s not getting to personal attacks on people for disagreeing.
So it is less the existence of these labels than the way they are USED. The DSM was originally used only as an insurance billing document, and no one took the categories as anything but vague categories used for general communication. They evolved into these pseudo-scientific labels which doctors and others can use to avoid looking at causes and to justify the use of drugs. I have never objected to an INDIVIDUAL choosing to identify with a particular diagnostic DECRIPTION. When it become untenable is when scientists pretend that “depression” is a unitary category with a unitary cause which should be “treated” by a unitary “treatment plan.” Such a viewpoint simply invites and justifies ignoring the complex causes and influences on something so universally present and natural as anxiety or depression, and the blaming of the patient as well as using drugs as a first-line intervention. None of this can happen if the DSM doesn’t serve as a means for doctors to justify condescending to their patients and subtly or not so subtly blaming them for feeling “too depressed” or “too anxious” instead of looking at what has happened in their lives (including known physical problems) that might explain one or another particular instance of “depression.”
So I have no hostility or disrespect for someone who calls himself/herself “ill” or “depressed” or “schizophrenic” or “autistic” if those labels work for someone. I do have a big problem with a doctor or other authority figure telling someone ELSE that they “have depression” or “have schizophrenia” as a means of labeling and downgrading the client’s experience without any actual scientific basis for their claims. It is very different to say that no one has the behavior labeled “ADHD” (which is NOT true) and to say that “ADHD” is not a valid scientific entity for a doctor or anyone else to assign to a person who presents to them, particularly over the client’s objection.
That is my experience as well. Blame the client, then drug them. If that doesn’t work, label them “treatment resistant” and refer for ECT.
Hard to imagine calling someone “paranoid” when the staff really ARE spying on them!
“You are too complex” seems to me to translate into “I don’t have the skills to figure out how to help you.” Same facts, very different framing. If you take your car to the mechanic, and he says, “You’re engine is too complex,” you’re going to know he means, “I don’t know what the fuck is going on.” There is no difference, except that MH “Professionals” are allowed to get away with it.
It is a very disturbing practice, surely violating the rights of the patients. They are not under arrest, after all! But it seems that almost anything can be rationalized in the name of “mental health treatment” no matter how brutal or disturbing.
I think the goal is seldom to make people feel better. I think it is to STOP people from feeling certain things, which eventually devolves into stopping people from feeling anything at all. This is the only way that anyone could look at a semi-comatose person slumped in a chair and consider it a “treatment success.”
Hey, not criticizing, just piling on!
Wow, great post! I’d only add that involuntarily committed people should not ever be charged for their “care.” This would remove a big financial incentive for locking people up. Prisoners don’t pay for their imprisonment, neither should psychiatric inmates.
Yeah, why don’t they tell you they’re “still learning” when they’re pretending they know you have a “lifetime biological brain disease” and that you have to take the drugs for the rest of your life and there is nothing you can do about it? Might be helpful to know that they might have no idea what they’re talking about!
Trade protectionism there. Not surprising.
But yeah, the Native American Church is just the kind of approach I’m talking about. What was it they did in Saskatchewan?
Thanks, Ed. I have read parts of the article, though it is quite long. I get the idea we’d probably agree on a lot of things. I do think it feasible that psychedelics can be used in a helpful way, but there is little to no chance that the psychiatric profession, or even the profession of psychology, will be able to use it in a helpful manner. Psychiatry in particular specifically denies the validity of the spiritual world, while those who HAVE used psychedelics historically in a helpful fashion are shamans or other spiritual leaders who are helping expand one’s viewpoint of the world, not trying to “cure mental illnesses” that don’t even exist. Without a big change in viewpoint and philosophy, I believe psychedelics will be as dangerous in the hands of psychiatry as any of their “medications.”
True dat!
Wow, that’s an awesome article! This guy sounds a lot like Bob Whitaker. My only objection is the use of the term “overprescription.” How can you “overprescribe” when there is no ability to determine what the “proper” amount of “prescribing” would be? But besides that, he hits on the key issues of ineffectiveness, permanent damage, long-term deterioration, and removal of personal agency. I’d love to see this guy write an article for MIA!
Without even reading the article, I found I objected to the title. Why are we calling this “psychedelic medicine?” It is NOT medicine! It is at best “psychedelic therapy,” not a medical intervention at all, but a mental/spiritual one. I find it continuously offensive when things that are potentially helpful to our spiritual needs are coopted by the medical establishment, such that going for a hike becomes “nature therapy,” and doing fun things becomes “occupational therapy” and on and on. “Psychedelic therapy” is distorted enough – PLEASE let’s get away from calling it “medicine!”
Similarly, taking the flashback phenomenon and giving it a “medical” name does nothing to advance our understanding of what is going on. Flashbacks are pretty mysterious, there appears to be no understanding if there is any physical reason for flashbacks, let alone what it might be. People who have flashbacks aren’t “HPPD patients,” they are people who have experienced flashbacks. Why do we feel this need to dehumanize folks by grouping them together, as if experiencing flashbacks is again a failure of the “patient” to respond “properly” to “treatment?” Just as we excuse the failure of antidepressant “treatment” by calling the victim “treatment resistant” instead of just admitting that the drugs have failed to help or have harmed the recipient?
I know that “medical language” tends to get things published, but it’s an insidious slippery slope away from treating people as human beings. I’m not categorically opposed to the idea of using psychedelics to help people find some level of mental/emotional perspective, but the idea that it can become some kind of standardized “medical treatment” is a very damaging absurdity that could very well ruin any chance that the use of psychedelics can develop into something that might actually be helpful to people’s spiritual growth.
No problem. You have been deeply traumatized by people you should have been able to trust, and it sounds like the destruction was massive in your case! I admire you for pressing on despite it all. That takes a lot of courage!
You got it. He was blowing smoke out his ass. I’m sorry you didn’t get the right information before you encountered him. But thanks for taking up the sword for making it better!
Are you trying to say that it is somehow arbitrary to say that amphetamine is safe when you get it from Big Pharma but not safe when you get it somewhere else? That’s CRAZY talk!
Don’t forget, Methamphetamine (under the name Desoxyn) is also sold as a “medication” for “ADHD.” So it’s also healthy only when Big Pharma is profiting from it.
That’s a great description! A map of nowhere, with all kinds of directions to get from no-place to nowhere else.
Western psychology can also rip Westernized families apart. For whom does the DSM model really work?
More stunning research! This is somewhere on the level of “serious injury to the knees is associated with increased knee pain later in life!” Seriously, is anyone surprised that having major frightening experiences earlier in life might make it more likely that one is more easily frightened? “People who have been major car wrecks are shown to be more worried about getting in car wrecks.” And they get PAID to do this research???
Let’s assume our desired conclusion and then collect data in a biased manner to try and prove it. VEEEERY scientific!
Sociopaths working together. Ugh! Do they just like to do the opposite of what you ask for, just to prove they can?
It does take courage, but there are many who do take that stand. They need more support for doing so!
If such studies existed, you’d think he’d have the decency to refer to at least one of them in his retort. But of course, he does not, because such studies do not exist, or if they do are not able to be replicated. He’s using the “resort to authority” approach to prevent further investigation into what is actually going on.
There has never been any good evidence, or even mediocre evidence, for the use of antidepressants in kids. There was one study that showed Prozac to have some positive effect on kids over 12, but that study had significant flaws and was never replicated. It seems to be pretty clear that prescribing antidepressants to kids is malpractice, plain and simple. But apparently, if enough doctors do something, no matter how stupid, it becomes “standard practice” and can’t be called malpractice for legal purposes.
The only issue I’d take with your comment is that some adults DO believe that restraining kids chemically IS “helping” them. Clearly this applies to people who don’t really like children very much. But such people do exist in significant numbers.
This is just a comment on the comment I just read, not a critique of anyone’s arguments.
I think it is relevant to note that “placebo effects” have taken on (largely due to pharmaceutical company pressures and narratives) a negative connotation, the implication being that “placebo effect” are not real or are imaginary. Placebos of many kinds, including group rituals, can have very powerful, very real effects. The only relevance of calling it a “placebo effect” is that the effect is not caused by the drug or whatever specific intervention is being looked at. I think this can create a negative emotional reaction when people hear “X appears to be a placebo effect” about something they’ve seen be effective.
I think the placebo effect is FASCINATING and says a lot about what’s wrong with psychiatry’s narrative. If believing something can actually change outcomes, even if the “something” has no direct effect on the brain or body, it suggests that what we believe or imagine or strive for is FAR more important than the “brain=mind” theory can possibly begin to explain.
Sounds so VERY therapeutic! Really, how can these people take themselves seriously? An 8 year old child would at least know to say, “Why are you sad?”
Wow. Well said! I have nothing to add!
It is interesting that clinicians are feeling the same kind of life stress and burnout that many if not most of us in late stage corporate capitalist societies are experiencing. It is a shame that the real causes are right in front of us, but that the mental health industry as a whole continues to pretend it doesn’t exist.
I think it helps people to avoid dealing with real but semi-conscious conflicts that are really at the root of feeling hopeless about life in many cases. Certainly was true for me! It’s a lot of work to re-think one’s view of life and one’s habitual behavior. It’s easier to blame it on the brain and take the pill. At least in the short run. Especially if someone in authority is doing the hard sell on it. I did not WANT to get therapy – I NEEDED to, but it took two other people dragging me kicking and screaming to get it started. Very glad I did.
Of course, a lot of “therapists” these days don’t do what I consider therapy. Many seem to use a forced and very shallow form of “cognitive behavioral therapy” and aren’t interested in childhood trauma or internal conflicts. I was very fortunate in getting a good one on the first shot, but it still wasn’t any fun, and I felt like quitting partway through. A pill would have been a LOT easier, but of course would never have been a tenth as beneficial in the long run.
Including “no treatment” when the “condition” is a result of normal reactions to external problems, such as child abuse, poor parenting skills, or dull and rigid classroom environments that lack the necessary stimulation for a bright and curious child.
How can you have “overdiagnosis” or “false positives” when there is no objective means to determine who HAS and DOES NOT HAVE a particular diagnosis? Isn’t the main reason for “overdiagnosis” the fact that there is no line between the “ill” and the “normal?”
I would say that physicians almost NEVER direct someone to discontinue ANY psychiatric drug. Additionally, “return of symptoms” is often a euphemism for “withdrawal symptoms” occurring upon withdrawal. Support is, indeed, needed, but medical providers almost never provide the kind of support that is helpful. If we all waited for a physician to “direct” their patent to withdraw, almost no one would ever get off psych drugs, no matter how bad the effects of the drug in question.
I never knew he was so frank about his chicanery.
Wow, some really radical thinking there! You mean that people get depressed because their lives kind of suck? NAH, COULDN’T BE! If their brain chemicals were adjusted properly, they’d be HAPPY that they were poor, homeless, raped, sexually abused, abandoned or whatever. EVERYONE knows that!
Just to be clear, I’m not calling the article disempowering, I’m saying the concept of “shared decision making” presumes that decision making is normally NOT shared with the client, but made by the doctor without any input from the client whatsoever. And doctors are arguing as to whether they SHOULD consider “sharing” what is really the client’s decision with the client. I don’t see it as a salvageable concept, as it is tainted with the idea that sharing decision making with the client whose life is being impacted is somehow optional!
As I’ve said before, the very framing of this as “shared decision-making” is disempowering by definition. They are talking about DOCTORS deigning to “share” THEIR decision making with the client! And the doctors are ARGUING about this! The decisions should always be the CLIENT’S decisions, unless the CLIENT wants to share it with the doctor or someone else! The fact that they even need to TALK about including the client in the decisions, and that NO ONE sees this as hypocritical, shows just how far into authoritarianism the medical establishment has sunk.
Great paper! Reminded me of some stuff I used to know about those Prozac trials. Amazing that these “peer reviewed” studies ever saw the light of day!
It shows intent to bias and deceive from the get-go. This is not science, it’s marketing!
That’s always been my biggest challenge with this whole “chemical cure” mythology. If I take a pain reliever and I still have as much more more pain than before, do I have “treatment resistant pain?” Or did the drugs fail to have the advertised effect? If I take an antidepressant and am still depressed, THE ANTIDEPRESSANT DIDN’T WORK! It’s not because I’m “resistant” or “need an adjunct medicine” or whatever. It means the treatment FAILED!!! Why is this not obvious? Why do intelligent people fail to observe this rather obvious conclusion?
Here is an article covering the issue of so-called “discontinuation syndrome” (aka withdrawal). I found this in a 10-second search. Many other articles on the topic are readily available in the mainstream psychiatric publishing world.
Do you actually want to know the answer to that question?
I would guess that most doctors have not ever read the 35 pages of warnings and could not tell you half of it. My father was almost killed by a doctor prescribing something when he was on blood thinners after a heart attack. He told the guy exactly what he was taking, and the drug warnings included a BOLDFACE warning NOT to prescribe this second drug with blood thinners because DEATH MAY RESULT! Yet the doctor prescribed it anyway, and my father luckily noticed he was getting bruises by simply resting his elbow on the table or pressing his arm with his finger. HE looked the drugs up in the PDR (the “internet drug site” equivalent of the 1960s) and discovered that the doctor had acted incredibly irresponsibly and could very well have killed him. A minor car accident, a fall in the garden, the most minor injury could have resulted in death. I have heard stories and had direct experiences myself over time to reinforce the idea that doctors don’t, and given the volume of new drugs, really CAN’T, know and convey the actual dangers of these drugs. I will NEVER take a drug that I have not personally checked out on more than one source.
So no, it is not hard AT ALL to imagine doctors either not knowing these things, or not caring to communicate them, or intentionally NOT communicating the possible dangers because they are worried that the patient would decide not to take the drug if they knew the actual risks. I would assume it far more likely than not that the doctors would NOT communicate such things to me, based on personal experience.
I’ll leave it to others to explain what ACTUALLY happened to them on antidepressants, though of course, you can easily find that out for yourself by searching this site. Sometimes other people have different experiences than you do. Maybe you could generate some interest in listening to them instead of dismissing their experiences as “hard for you to understand.”
How do they, Enrico? You don’t know any more than I do. Nor do you even know that cells DO create thoughts. That’s what you believe. There is no proof or evidence of what thoughts even ARE, let alone what creates them. You believe the brain creates them, because you are a MATERIALIST philosophically. Not everyone in the world is a materialist, and materialism isn’t inherently more “scientific” than any other philosophical viewpoint. There are other philosophical viewpoints that are just as valid as yours.
You are sharing your beliefs, not scientific verities. Which is fine, as long as you allow that every other person here is just as entitled to share their views and beliefs as well, and you don’t somehow entitle yourself to be the arbiter of truth when you’re sharing your personal views. I don’t see you granting others that right very often. I more commonly see you presuming to know more than those who are here, and talking down to others who don’t agree with you. It is not a very respectful way to conduct a conversation, in my personal view. I guess that’s philosophical, too – one philosophy is that conversations to be “won” by trying to overwhelm or dominate the other person until they submit. I don’t take that philosophy. I like conversations to be a sharing of information from different viewpoints so I can learn things and expand my viewpoint to include more data and observations and experiences beyond my own narrow path in life. You have a great opportunity here to open your mind and learn from others who have had different experiences than you have, to actually WANT to know why some people find the very things you consider to be miraculous advances in science to be sketchy, unscientific, and even dangerous and destructive. Do you want to know? Or are you primarily engaged in trying to convince the “misled” or “misunderstood” on this site to the “real truth,” which of course means the “truth” you’ve already decided is “right?”
The point re: Insel’s comments is a case in point. You “don’t understand” the relevance. Do you WANT to understand it? What if you actually asked the poster to HELP you understand it, and tried to put yourself in his shoes and see it from his viewpoint? I’d say the reason is quite obvious: Insel RAN the NIMH for years. He spent lots of time doing the kind of research you seem to value (at least when it fits with your narrative), and at the end of his tenure, states that the DSM approach has led to literally NOTHING of lasting value. That one of the key thought leaders in the psychiatric community would publicly announce this should be of GREAT interest to anyone with a real scientific bent. The fact that he was called on to walk back his comments by that very psychiatric community he is a part of should tell you a LOT more. My read is that the psychiatric community knows that the DSM is not worth the paper it’s written on, but they can’t admit it to themselves, or they don’t want the word to get out. Does it seem POSSIBLE to you that this explanation makes some sense? What is YOUR thought on the significance of the lead psychiatric researcher in the #1 center of psychiatric research in the USA says that the DSM actually makes it harder to make sense of “mental illness?”
I have noticed again and again that you do not respond to solid, well-argued, positions that don’t correspond to your views. Will this again be the case with this one? Will you pretend that I didn’t write this because it’s too uncomfortable to face the truth contained herein?
Are you now denying what the entire psychiatric research world now admits? That “discontinuation syndrome” (aka WITHDRAWAL) and Tardive Dyskinesia and Neurological Up- and Down-regulation are very real? One study is enough when the study agrees with you, but massive data over decades is not enough to convince you when it disagrees with you?
Yeah, sorry, I’m spoken for! But thanks for the chuckle!
I am saying it is a contributing factor, and that at least SOME of the high rates of smoking among those diagnosed “schizophrenic” are due to the “treatment.” I’m also pointing out the irony of the psychiatric industry using “treatments” that are known to reduce lifespan, and yet trying to blame it on habits that their own drugs actually encourage/reinforce.
But you’re right, poverty, discrimination, and trauma are related to “poor lifestyle choices” AND to being swept up by the psychiatric industry as a “patient.” It is a very complex system. But a part of that system is a “treatment program” that doesn’t actually work in the long run in many if not most cases, and which can create or exacerbate the exact “symptoms” they claim to “treat.” And meanwhile reducing people’s quality of life and life expectancy, while trying to deny this is true.
I certainly believe you, Gina. And I think the vast majority of MIA posters believe you, too. Many of them have experienced similar things. Psychiatry sucks!
Writing just as me, here, not as a moderator.
Why do you continue to post here if you find the basic premise of the site to be so wrong? Do you really think you’re going to convince your audience? Why not go somewhere else where people who agree with you share their views? I don’t see much interest on your part in hearing anything anyone else says, or learning anything you don’t already believe you know. So why are you posting here? What is your purpose? I’m not being snide, I really want to know what you’re trying to accomplish?
I would bet my bottom dollar you’ve never even read Anatomy of an Epidemic or Mad in America. Am I right?
I don’t believe from my observations here that you really want to engage in a conversation about any of these topics. I assume from your behavior that you mostly want to tell us all that none of us know what we’re talking about and you know better than us. Am I correct?
I predict that you will not respond to this question.
I understand that since cigarettes increase dopamine, and the antipsychotics massively decrease dopamine, many antipsychotic users (forced or voluntary) smoke in order to reduce the side effects of the antipsychotics. Many probably don’t even know that’s why they do it, they just feel better when they smoke. So ironically, the psychiatric industry wants to blame shortened lifespans in the “severely mentally ill” on “lifestyle issues” like smoking, while the drugs used to “treat” these “disorders” in fact dramatically INCREASE the rate of smoking among the “treated!”
Man, that IS depressing!
Scientifically speaking, there is no need to “prove that ADHD isn’t real.” And the existence of people who fit the description is not proof of anything. It is the responsibility of those claiming it is a disease state to prove that it IS a disease state. Anyone can describe a condition and claim it is a “disorder.” As I’ve said before, genetic diversity is the key to species survival. I’ll remind everyone of the study where groups of three kids having one “ADHD” – diagnosed child were WAY BETTER at solving problems than groups of three who did NOT have an “ADHD” child in their group.
The point is not to prove that people can be identified as “fitting the criteria” that were chosen to describe “ADHD.” The point is to prove that such people a) have significant things in common besides acting a certain way, b) that there is some means of objectively distinguishing those so identified from the general population, and c) that the variation is a malfunction rather than simply a variation in genetic inheritance.
For instance, running slowly has a very large genetic component. Failure to be able to run quickly leads to significant psychosocial distress, as any such person who has had to go to PE classes can testify. Giving stimulants to such people would improve their running speed to some degree in most cases. Is slow running a disease state? Who would need to provide proof of this? Would I have to prove that it WASN’T a disease? Or would someone claiming it was be responsible for the proof?
Thanks for sharing this – it includes some good information that is new to me.
I would pose this question to you: if, as you show above, fluoridation of the water supply can significantly effect the rates of “ADHD” in the population, how does that jibe with your earlier researcher’s claim that it is entirely caused by a mutation in a certain gene? Does this not suggest that the environment can and does have a huge impact in the expression of one’s genetic inheritance? Does it not suggest that people who do NOT present as “ADHD” to begin with can BECOME “ADHD” cases due to environmental influences?
Taking this further, could there not be “psychologically toxic” environments that might “cause” a person to “become ADHD” when they otherwise would not have presented that way? Does it not similarly follow that there might be “psychologically healthy” environments that, if applied systematically, would REDUCE the likelihood that someone would present with “ADHD” syndromes or would reduce the severity of these “symptoms?”
Doesn’t it make more sense to suggest that a person may inherit a “vulnerability” or a “tendency” to engage in this kind of behavior, but that the expression of this tendency is strongly affected by the environment they are forced to contend with? That it is not a “nature vs. nurture” situation, but rather a combination of nature/nurture, as most behavioral syndromes (and even major physical health problems, like heart attacks and diabetes) appear to be?
If this is the case, which do we have more control over, nature or nurture? Genes or environment?
I would ask why do we spend so much of our time and money focusing on the one element in the equation, the genetics, that can’t be changed? If we really want to help these kids, why would we not focus our energies and attention on altering the environment to improve these kids’ lives?
Examples might include NOT fluoridating the water, creating open classrooms for kids who find them more workable, teaching parents how to handle these kids without accidentally reinforcing negative behavior, valuing and taking advantage of the kids’ strengths, and even holding kids out of school for an extra year to allow additional maturation?
(Did you know that there is a 30% reduction in “ADHD” diagnoses for kids who start in school one year later? THIRTY PERCENT! We could avoid a THIRD of “ADHD” diagnoses by keeping kids who aren’t ready out of school for a year! Why aren’t we doing this?)
I am not and have never been arguing that some kids don’t often “come that way.” My own kids are a good example – their personalities reflected an intensity, a need to be active and busy, an intolerance of boredom, that were certainly not a result of anything we did or did not do that we are aware of. My point here is that genetic diversity is the key to species survival, and being genetically “different” does not imply being genetically “disordered,” and genetics is in any case the one part of this equation that is completely unchangeable. Why don’t we acknowledge that both nature AND nurture are involved, and spend more time addressing environmental things (like water fluoridation and classroom structure and parent training) that CAN be changed to give these kids a better chance at survival?
I hope everyone will consider the full implications of these findings. Something that is completely genetic in origin (like, say, eye color) would not be so variable depending on environmental impacts. It’s got to be both. Let’s accept that differences most likely exist, but spend our energies on trying to control the environmental variables that we CAN control!
Yet in the 3-, 5- and 8-year follow-ups on this very same study, kids who continued or started to use stimulants did no better (and in some ways worse) than kids who discontinued or never used stimulants. Which fits in exactly with the data I just shared in another post, and which is generally well known but kept very quiet among researchers: stimulants do work to “control the core symptoms of ADHD,” as they usually put it, but have been shown again and again not to lead to any improvement in long-term outcomes. In other words, stimulants can make it easier for you to pay attention to your schoolwork and complete your homework, but apparently, paying attention to your schoolwork and completing your homework doesn’t lead to you becoming more successful later in life.
In fairness, there are many who claim that stimulants destroy kids’ lives, and while that may be true in individual cases, in the collective, there is no evidence of stimulants doing great HARM to long-term outcomes in the collective. But they don’t really help, either, if you care about things like delinquency rates or high school graduation rates or social skills. And there are risks, outlined in my other post, that a rational parent might be well advised to consider when that risk is set against only short-term gains. It is a matter of informed consent, and it’s pretty dishonest at this point to claim that stimulants are going to magically change kids’ lives for the better in the long run. Some may choose to use stimulants for their short-term ability to “reduce the core symptoms of the disorder,” but if they’re aiming for longer-term improvements, it appears they have to look for additional interventions to help.
Drugging a kid means giving a kid drugs for behavioral control.
Sounds like a very idealistic picture. I guess we will see how much of it comes true.
I thought this article speaks to the idea of long-term use and loss of efficacy. Have you considered WHY tolerance develops over time? In the world of substance abuse, tolerance is related to significant brain changes.
Have you ever heard of “neurological down- or up-regulation?”
“In 2013 they compared the brains of kids with ADHD before and after a year of treatment with stimulant medications. The studies showed an increase in the density of dopamine transporters—those molecules that take dopamine out of action—in the brain after treatment. This suggests that the increase of dopamine stimulated by the medication may have prompted the brain to develop more dopamine transmitters to clear it away. How long that change might last is not clear, as the level of transporters in the brain fluctuates. But it could result, researchers note in their conclusion, in the medication not working as well as it had to reduce symptoms over the long run.”
Anybody here want to share your personal experiences with stimulants?
Oh, that is sad! I liked Seth!
As I’ve already demonstrated, long-term studies show no difference between “treated” or “untreated” subjects on all major outcome measures, including academic test scores, high school graduation rates, delinquency rates, college enrollment rates, social skills, and even self esteem, which is the one even I would expect to be affected. I was actually quite stunned when I first discovered this fact way back in about 1989 or so, when I first started researching this topic for my own son’s needs. Stimulant treatment is simply not a major factor in long-term success in “ADHD” – diagnosed children. Other factors appear to completely overwhelm any benefits of temporarily paying more attention to or completing more school work. Stating that certain psychiatrists “believe the evidence proving it is a bio-chemical problem, is overwhelming” is absolutely irrelevant. The data speaks for itself, and saying otherwise over and over doesn’t change the science.
https://journals.sagepub.com/doi/abs/10.1177/000992287801700112 (This is Barkley and Cunningham’s study, where Barkley, one of the biggest ADHD advocates around whose income depends greatly on accepting ADHD as a valid construct, states that the VERY slight improvement in test scores for the “treated” groups was easily explainable by the subjects simply reading the questions a little more carefully than the control group. He called the long-term results “Disappointing.” But that has not stopped him claiming later on that anyone NOT putting their child on stimulants for “ADHD” is committing child abuse!)
“Jacobvitz et.al. acknowledged the short-term benefits outlined earlier but focused on the same limitations of stimulants noted by Schrag and Divoky
(1975), McGuiness (1989), and Kohn (1989). As a conclusion, Jacobvitz et al. urged “greater caution and a more restricted use of stimulant treatment” (p. 685). In contrast, Stevenson and Wolraich acknowledged the limitations outlined here but focused on the temporary suppression of symptoms.”
““Good quality evidence … is lacking” that ADHD drugs improve “global academic performance, consequences of risky behaviors,
social achievements” and other measures.
What is absolutely fascinating is that they revised the report later to eliminate ANY MENTION of long-term outcomes, as if this conclusion were NOT drawn from the study. I think that says more than a bit about the desire of the psychiatric profession to cover up this embarrassing conclusion. (In fairness, they DID find one study of decent quality that showed a reduction in accidents for stimulant users. That was the only positive long-term outcome they found.)
“Our results are silent on the effects on optimal use of medication for ADHD, but suggest that expanding medication in a community setting had little
positive benefit and may have had harmful effects given the average way these drugs are used in the community.”
“No significant differences based on medication-use were noted for the following
measures taken at 14 years of age: depression, self-perception, and socialfunctioning.
• Whilst no statistically significant results were noted, a trend toward slightly higher
depression scores was noted with the use of medication.
• A trend toward slightly lower self-esteem and social functioning was also noted with
medication use at one time point or two time points. However, consistent medicationuse at all time points, including at 14 years, trended toward slightly improved selfperception and social functioning.” There was also a finding of a MUCH higher percentage of grades repeated for those taking stimulants.
I can’t find the USA/Finnish comparison study right now, but it showed that medication rates were MUCH lower in Finland, yet outcome measures like delinquency and school failure were no different in these comparable populations.
The studies referenced above involved MANY THOUSANDS (probably more) of “ADHD” diagnosed children in the USA, Canada, Finland, and Australia. The OSU study looked at every single reference they could get their hands on at the time that had to do with stimulants and ADHD. There is a mass of strong evidence that stimulants don’t alter long-term outcomes, and at this point, most research psychiatrists have accepted this as factual.
This Web MD article is most significant in what it does NOT say about long-term outcomes. If there really WERE known benefits in the long term, don’t you think they’d mention them right here? But they don’t, do they? I wonder why?
“Long-term effects. Some children continue taking ADHD drugs as adults. Decades of research has found no major negative health effects from taking them for a long time. Some studies have suggested that children who keep taking stimulants into adulthood may grow up slightly shorter. But other studies have found no link between medication use and adult height.”
The lack of long-term benefits from stimulant drugs for “ADHD” diagnosed children is an open secret. It is known but not talked about. Anyone claiming there IS some benefit for any of these long-term outcome measures has a big hill to climb. Simply stating that “I believe that” or “Dr. So-and-so says that…” is not going to come CLOSE to cutting it in this case.
For those who actually believe in unbiased scientific analysis, the jury is IN on this question. The burden of proof is now on anyone claiming some long-term benefit. Stimulants are effective in short-term suppression of “ADHD” symptoms in the majority of children so diagnosed. That’s about all that can be said. Depending on one’s philosophy of education, and to some extent, on available educational options, this may or may not be considered beneficial. But claims of long-term benefits are mythological, not scientific.
Don’t forget the “placebo washout” strategy. They do whatever they can to reduce placebo effects and maximize the chance of a positive P value.
In a very small number of cases. VERY small.
You state that as if it would be wrong to believe that, no matter what the actual data. Science is not a religion. See my other post.
The average lifespan of the “seriously mentally ill” has steadily DECREASED since the advent of psychiatric drugs. Such people now die 20+ years younger than their non-diagnosed counterparts. A significant part of that decrease in lifespan is the result of treatment with antipsychotics. As many as 14.5 years lifespan may be attributed to antipsychotic use.
Well said. The only caveat, and a big one it is, is that whatever philosophical approach one takes, the results have to reflect some apparent improvement, at least within your own philosophical structure. It becomes a BIG problem when one becomes so committed to his philosophical views that actual data that doesn’t support one’s theories is ignored or minimized or denied.
I have seen way too many kids “flip” to bipolar in my career as an advocate for foster kids. It is not rare that a kid gets aggressive in response to stimulants, but it is unfortunately VERY rare that doctors see that for what it is, and it almost always leads to more drugs and more serious diagnoses, instead of saying, “Gosh, those stimulants seem to have made things worse! Maybe we should stop and start over!” I had one who went two years deteriorating, until she herself decided to stop all three drugs she was on. She had become psychotic and aggressive on the stimulants, but when she stopped, she was back to her old self within days. But the doctors never had a thing to say about it. Did not even acknowledge they’d done her wrong. That happens WAY too often for my comfort!
COMMENTING AS MODERATOR:
Hi, Gina,
I have moderated the comments you reported, as I understand in context why these might have come across as offensive to you. I am sorry we didn’t catch them sooner.
In the future, please email me rather than posting complaints about posts in the text of a comment. I am very responsive to such complaints, but it doesn’t help the community at large to have to process these complaints publicly, and as such, it is stated in the Posting Guidelines to handle such complaints by talking to the moderator or simply reporting them through the “report” function at the bottom of every post.
Steve
Let’s agree to both ignore each other, eh?
I think another vitally important question is how/why the current “mental health” apparatus does not SEE the very obvious connection between childhood adversity and adult “mental health” diagnoses. They spend decades researching the “biological underpinnings” of these “disorders,” and come up with 2, 3, 5% correlations, when childhood abuse/neglect/abandonment has associations at 80% or higher to most “disorders.” Seems like a case of intentional blindness. We’ll never be able to teach kids sufficiently about neurodiversity and the importance of healthy child rearing when the bulk of the “mental health” industry appears committed to denying that it matters!
One study by one person does not begin to compare to 4 long-term naturalistic outcome studies and 4 comprehensive literature reviews. The jury is IN. There is no long-term outcome that is consistently improved by stimulant treatment. It’s a fact.
Wow, you ought to submit this as a blog. What a fascinating education! Thank you for that comment!
Why would they have to SAY that patient-reported measures should be “included?” Why wouldn’t they be the MOST IMPORTANT measure in every case?
The difference between a good therapist and a bad therapist is that the good therapist is concerned with the perspective of the client, and a bad therapist is concerned with their own perspective. The bad therapist wants to look/feel good about their work. The good therapist wants the client to regain control of their own perspective. The only valid measure of success in a therapist is the empowered client’s satisfaction with the process.
The difference I see in your analogy is that no one is promoting cigarette smoking as a “treatment” for “ADHD” or any “educational disability.” Drugs can be useful for many things. I’d be dead today without modern medicine. But it sounds like we’d both agree that just because a drugs is perceived as helpful in a particular situation for a particular person, it doesn’t mean that person was “ill” or that the drug “cured” or “treated” a condition.
A shot of Southern Comfort definitely reduces my anxiety, but it’s hardly a medical treatment!
Unfortunately, most people are unaware of their philosophical assumptions, and have a hard time distinguishing these assumptions from fact. I agree, our educational system really needs to make the study of philosophy and its application to practical decisions a priority again. Back in ancient Greece, ALL learning was recognized to be a subset of philosophy. That’s why the highest degree is a Ph.D. – Doctor of Philosophy.
I think a lot of folks have been convinced that it is “unscientific” or “mystical” or superstitious” to entertain any possibility of a spiritual existence beyond our bodies. It’s odd, because most people in the world appear to believe in such a spiritual existence continuing beyond our physical existence in our bodies, yet somehow this doesn’t seem to conflict with claims that ‘science’ does not include the possibility of spiritual existence. I’m personally of the opinion that scientifically, there is no way to rule in OR rule out such spirituality to a certainty. But that means science ought to remain open to the possibility. There are certainly bits of circumstantial evidence, such as the placebo effect and neurofeedback, that suggest there is something about our existence as beings of whatever nature that allows our mental processes to control what happens to the body. How that effect occurs, no one really knows. So discounting the potential that we are spiritual beings that transcend our earthly existence on “scientific” grounds seems ungrounded in factual evidence.
Yeah, let’s not waste our money on the things that have a 50 times greater correlation! Let’s spend more money researching stuff that is barely better than chance at distinguishing “depressives” from “normals.”
You know what my approach was for distinguishing depressed individuals from non-depressed individuals? I asked them if they felt depressed! It was a remarkably accurate “marker.” People who say they are depressed are statistically FAR more likely to be depressed than those who say they feel fine!
It should be clear that any brain-affecting drug could cause brain shrinkage, based on your research. I’ve never found the “neurogenesis” explanation/claim for SSRIs to be particularly convincing. But you are very correct, depression is almost always a symptom of something else. In fact, I think it’s fair to say that “depression” is not the “cause” of anything. It’s an experience people have, which could mean a hundred different things. Calling it a ‘disorder’ is always euphemistic.
“Voluntary” electric shock “therapy” (no, I won’t use the euphemism) is also an abomination, since there is absolutely no way to give “informed consent.” Anyone who really understood what this “therapy” involves would run the other way full speed! Though it seems more than a tad counterintuitive that inducing a grand mal seizure through electrocuting the “patient” would in any scenario be advisable.
We must also remember that psychoanalysis was not accepted until after Freud disavowed his trauma theory and blamed the patients’ woes on his own “complexes” instead of focusing on the causal traumatic factors. I’d say that psychoanalysis was thoroughly defanged before it was allowed to become popular, and hence was reduced to a tiny fraction of its potential effectiveness. The removal of the right of the clinician to “interpret” seems like a critical move. But I wonder how many clinicians are fully capable of resisting the urge to foist their evaluations onto the client.
Remember always that such studies are not always controlling for psychiatric drug use. We know at least in “schizophrenia” that brain shrinkage is causesd by the drugs themselves, and there is suggestive evidence that this happens with stimulants for “ADHD” as well. Any generalized measurements like brain volume are not valid if substance use, legal and illegal, is not accounted for.
I’ll put it on the agenda for my next tour of England!
I particularly find the possessive form, “My mental health” or “My depression” or “My diagnosis” a disturbing trend. As I said once, depression isn’t something you HAVE, it’s something you DO. And framing it that way means you can do something to change it. Whereas if it’s something I simply HAVE, then I no longer have agency, I’m stuck with it, as if my own decisions and beliefs and actions have no chance of altering my fate of having “mental health problems.” I don’t mean to blame anyone for feeling bad, but the idea that someone else is making all that happen and that someone else can “fix” it sells lots of drugs and keeps people dependent for life instead of teaching skills to regain control of our lives.
We do seem to, don’t we?
If you ever come to the West Coast of the USA, I think we’d have a hell of a great lunchtime discussion! I hope we get to meet one day – there are few people who evoke that wish for me, but you’re definitely one of the top!
I agree 100%!
Doing nothing at all is usually a far more effective intervention than psychiatry is able to come up with on its best day.
You know, it kind of sounds like everyone is more or less on the same page – don’t start suddenly, have a plan, adjust to individual needs, listen to your body, the person withdrawing is the best guide. Seems like good advice.
It has always seemed to me that everyone’s body is different, and so a different approach needs to be considered for each person. Psychiatry’s biggest failing is assuming that everyone who feels “depressed” (or whatever other manifestation they identify as “illness”) has the same problem and needs the same kind of help. We should not fall into this trap! I think the advice about starting slowly and observing how much a person can tolerate is very, very important, but assuming that 10% or 5% will work for everyone means that some people who could get off a lot faster are restricted, and others who may find this rate too fast will feel hopeless. I think flexibility and respect for each person’s own sense of what works for them should be the center of any effort to wean off of dangerous drugs.
My feelings exactly!
Yeah, good question, isn’t it? I see this often – the experiment itself proves that there is no point giving antidepressants to teens, say, and yet the conclusion is that we should still do it. Clearly protecting guild interests over patients!
Everything you’ve said is speculative. There is nothing you provide that shows any actual EVIDENCE that a particular chemical problem in the brain is associated with depression. In fact, this idea was disproven way back in the mid 1980s, before Prozac even came to market.
I’m not interested in opinions of people. I’m interested in EVIDENCE. And so far, you have presented anecdotes and opinions. No one is saying that some folks don’t feel better when taking antidepressants. I am contesting the idea that the primary CAUSE of depression has ever been established as being biological.
“The chemical imbalance theory as a cause for anxiety and depressive disorders never was true. In fact, no experiment has ever shown that anyone has an ‘imbalance’ of any neurotransmitters or any other brain chemicals. The entire theory was hypothetical.
Over the last ten years, independent research has continually shown the chemical imbalance theory to be false. Furthermore, independent research has shown medications used to ‘correct’ the imbalance were largely ineffective with many fairing no better than placebo.”
Please read the following for an overview of scientific challenges to the “chemical imbalance” concept.
https://www.anxietycentre.com/articles/chemical-imbalance/
https://www.psychiatrictimes.com/view/debunking-two-chemical-imbalance-myths-again
You might also benefit a lot from reading Anatomy of an Epidemic. It might help you understand the scientific reasons why Bob and others question the standard psychiatric narrative. It does not come from a place of hostility, it comes from a place of wanting to get it RIGHT for people who need the kind of help that drives them to psychiatrists.
Can you please provide citations demonstrating convincingly that, say, “Brain chemistry” or “biological differences” are “causes” of depression? I am very familiar with the research in this area, and am aware of no consistent biological difference that characterizes depression or accounts for more than a tiny fraction of cases of “depression,” even in the most optimistic interpretation. In fact, luminaries such as Dr. Ronald Pies and Thomas Insel have assured us that psychiatry never took the “chemical imbalance” theory seriously, and that it was, in fact, drug companies that made such tropes commonplace beliefs.
On the other hand, I can provide oodles of evidence that the correlation between childhood adverse events and cases of “depression” is extremely high, much, much higher than the most optimistic “biomarker” research has ever been able to accomplish.
You are welcome to your own opinion, but not your own facts. I’d like to see what scientific data you are basing your stated opinion about “causes of depression” on.
I feel I need to add that stating the COVID epidemic contributing to isolation, feelings of hopelessness and self-harm seems to completely undermine the idea that these “mental disorders” are caused biologically. Seems the professionals are talking out of both sides of their mouths here.
I have suggested “Math teaching disability” and the like before, too! If you’re being paid to teach me math, and you can’t do it, why is this my fault?
Maybe they should call it “Co-corruption!”
All too disturbingly true!
That is an excellent point! The opioid/benzo crisis shows that doctors can not be trusted with distribution of dangerously addictive drugs.
Even if there WERE a way to make Ketamine-assisted therapy effective (which I still have very serious doubts about), it is a certainty to me that in the hands of the commercial/economic incentives of today’s system, any chance of general effectiveness will be very quickly overwhelmed by the authoritarian, disrespectful, and degrading conditions that pertain in almost all “mental health” agencies. It seems like another boondoggle for the drug companies and their minions.
An excellent point!
How did you pass it on? It always feels bad if we can’t stop others from getting similarly hurt.
What you observed for decades is absolutely correct. None of this was truly intended to help, except for those low-level people who think that forcing people to do things they don’t want to “for their own good” is some form of “help.” I can see how reading this stuff can bring back the pain, but don’t ever believe anyone who says that your observations were “wrong.” Honestly, I think the first step to healing from crap happening to us is learning to trust that we were RIGHT when we knew we were being fed a line of crap!
Posting as moderator:
To be clear, we welcome those who feel psychiatric diagnoses are “helpful” to them – all are always welcome to post at MIA as long as they follow the Guidelines. We welcome all viewpoints. However, it is important that such posters respect the fact that they will encounter alternative viewpoints here, and to own their own viewpoint as theirs and not try to force is on others or to invalidate others’ attempts to communicate their own views. We are all free to disagree, but with respect. I am getting the feeling that some folks are feeling their views are not being respected. Which is ALSO a free topic of conversation, as long as we make sure it’s not getting to personal attacks on people for disagreeing.
So it is less the existence of these labels than the way they are USED. The DSM was originally used only as an insurance billing document, and no one took the categories as anything but vague categories used for general communication. They evolved into these pseudo-scientific labels which doctors and others can use to avoid looking at causes and to justify the use of drugs. I have never objected to an INDIVIDUAL choosing to identify with a particular diagnostic DECRIPTION. When it become untenable is when scientists pretend that “depression” is a unitary category with a unitary cause which should be “treated” by a unitary “treatment plan.” Such a viewpoint simply invites and justifies ignoring the complex causes and influences on something so universally present and natural as anxiety or depression, and the blaming of the patient as well as using drugs as a first-line intervention. None of this can happen if the DSM doesn’t serve as a means for doctors to justify condescending to their patients and subtly or not so subtly blaming them for feeling “too depressed” or “too anxious” instead of looking at what has happened in their lives (including known physical problems) that might explain one or another particular instance of “depression.”
So I have no hostility or disrespect for someone who calls himself/herself “ill” or “depressed” or “schizophrenic” or “autistic” if those labels work for someone. I do have a big problem with a doctor or other authority figure telling someone ELSE that they “have depression” or “have schizophrenia” as a means of labeling and downgrading the client’s experience without any actual scientific basis for their claims. It is very different to say that no one has the behavior labeled “ADHD” (which is NOT true) and to say that “ADHD” is not a valid scientific entity for a doctor or anyone else to assign to a person who presents to them, particularly over the client’s objection.
That is my experience as well. Blame the client, then drug them. If that doesn’t work, label them “treatment resistant” and refer for ECT.
Hard to imagine calling someone “paranoid” when the staff really ARE spying on them!
“You are too complex” seems to me to translate into “I don’t have the skills to figure out how to help you.” Same facts, very different framing. If you take your car to the mechanic, and he says, “You’re engine is too complex,” you’re going to know he means, “I don’t know what the fuck is going on.” There is no difference, except that MH “Professionals” are allowed to get away with it.
It is a very disturbing practice, surely violating the rights of the patients. They are not under arrest, after all! But it seems that almost anything can be rationalized in the name of “mental health treatment” no matter how brutal or disturbing.
I think the goal is seldom to make people feel better. I think it is to STOP people from feeling certain things, which eventually devolves into stopping people from feeling anything at all. This is the only way that anyone could look at a semi-comatose person slumped in a chair and consider it a “treatment success.”
Hey, not criticizing, just piling on!
Wow, great post! I’d only add that involuntarily committed people should not ever be charged for their “care.” This would remove a big financial incentive for locking people up. Prisoners don’t pay for their imprisonment, neither should psychiatric inmates.
Yeah, why don’t they tell you they’re “still learning” when they’re pretending they know you have a “lifetime biological brain disease” and that you have to take the drugs for the rest of your life and there is nothing you can do about it? Might be helpful to know that they might have no idea what they’re talking about!
Trade protectionism there. Not surprising.
But yeah, the Native American Church is just the kind of approach I’m talking about. What was it they did in Saskatchewan?
Thanks, Ed. I have read parts of the article, though it is quite long. I get the idea we’d probably agree on a lot of things. I do think it feasible that psychedelics can be used in a helpful way, but there is little to no chance that the psychiatric profession, or even the profession of psychology, will be able to use it in a helpful manner. Psychiatry in particular specifically denies the validity of the spiritual world, while those who HAVE used psychedelics historically in a helpful fashion are shamans or other spiritual leaders who are helping expand one’s viewpoint of the world, not trying to “cure mental illnesses” that don’t even exist. Without a big change in viewpoint and philosophy, I believe psychedelics will be as dangerous in the hands of psychiatry as any of their “medications.”
True dat!
Wow, that’s an awesome article! This guy sounds a lot like Bob Whitaker. My only objection is the use of the term “overprescription.” How can you “overprescribe” when there is no ability to determine what the “proper” amount of “prescribing” would be? But besides that, he hits on the key issues of ineffectiveness, permanent damage, long-term deterioration, and removal of personal agency. I’d love to see this guy write an article for MIA!
Without even reading the article, I found I objected to the title. Why are we calling this “psychedelic medicine?” It is NOT medicine! It is at best “psychedelic therapy,” not a medical intervention at all, but a mental/spiritual one. I find it continuously offensive when things that are potentially helpful to our spiritual needs are coopted by the medical establishment, such that going for a hike becomes “nature therapy,” and doing fun things becomes “occupational therapy” and on and on. “Psychedelic therapy” is distorted enough – PLEASE let’s get away from calling it “medicine!”
Similarly, taking the flashback phenomenon and giving it a “medical” name does nothing to advance our understanding of what is going on. Flashbacks are pretty mysterious, there appears to be no understanding if there is any physical reason for flashbacks, let alone what it might be. People who have flashbacks aren’t “HPPD patients,” they are people who have experienced flashbacks. Why do we feel this need to dehumanize folks by grouping them together, as if experiencing flashbacks is again a failure of the “patient” to respond “properly” to “treatment?” Just as we excuse the failure of antidepressant “treatment” by calling the victim “treatment resistant” instead of just admitting that the drugs have failed to help or have harmed the recipient?
I know that “medical language” tends to get things published, but it’s an insidious slippery slope away from treating people as human beings. I’m not categorically opposed to the idea of using psychedelics to help people find some level of mental/emotional perspective, but the idea that it can become some kind of standardized “medical treatment” is a very damaging absurdity that could very well ruin any chance that the use of psychedelics can develop into something that might actually be helpful to people’s spiritual growth.
No problem. You have been deeply traumatized by people you should have been able to trust, and it sounds like the destruction was massive in your case! I admire you for pressing on despite it all. That takes a lot of courage!
You got it. He was blowing smoke out his ass. I’m sorry you didn’t get the right information before you encountered him. But thanks for taking up the sword for making it better!
Are you trying to say that it is somehow arbitrary to say that amphetamine is safe when you get it from Big Pharma but not safe when you get it somewhere else? That’s CRAZY talk!
Don’t forget, Methamphetamine (under the name Desoxyn) is also sold as a “medication” for “ADHD.” So it’s also healthy only when Big Pharma is profiting from it.
That’s a great description! A map of nowhere, with all kinds of directions to get from no-place to nowhere else.
Western psychology can also rip Westernized families apart. For whom does the DSM model really work?
More stunning research! This is somewhere on the level of “serious injury to the knees is associated with increased knee pain later in life!” Seriously, is anyone surprised that having major frightening experiences earlier in life might make it more likely that one is more easily frightened? “People who have been major car wrecks are shown to be more worried about getting in car wrecks.” And they get PAID to do this research???
Let’s assume our desired conclusion and then collect data in a biased manner to try and prove it. VEEEERY scientific!
Sociopaths working together. Ugh! Do they just like to do the opposite of what you ask for, just to prove they can?
It does take courage, but there are many who do take that stand. They need more support for doing so!
If such studies existed, you’d think he’d have the decency to refer to at least one of them in his retort. But of course, he does not, because such studies do not exist, or if they do are not able to be replicated. He’s using the “resort to authority” approach to prevent further investigation into what is actually going on.
There has never been any good evidence, or even mediocre evidence, for the use of antidepressants in kids. There was one study that showed Prozac to have some positive effect on kids over 12, but that study had significant flaws and was never replicated. It seems to be pretty clear that prescribing antidepressants to kids is malpractice, plain and simple. But apparently, if enough doctors do something, no matter how stupid, it becomes “standard practice” and can’t be called malpractice for legal purposes.
The only issue I’d take with your comment is that some adults DO believe that restraining kids chemically IS “helping” them. Clearly this applies to people who don’t really like children very much. But such people do exist in significant numbers.
This is just a comment on the comment I just read, not a critique of anyone’s arguments.
I think it is relevant to note that “placebo effects” have taken on (largely due to pharmaceutical company pressures and narratives) a negative connotation, the implication being that “placebo effect” are not real or are imaginary. Placebos of many kinds, including group rituals, can have very powerful, very real effects. The only relevance of calling it a “placebo effect” is that the effect is not caused by the drug or whatever specific intervention is being looked at. I think this can create a negative emotional reaction when people hear “X appears to be a placebo effect” about something they’ve seen be effective.
I think the placebo effect is FASCINATING and says a lot about what’s wrong with psychiatry’s narrative. If believing something can actually change outcomes, even if the “something” has no direct effect on the brain or body, it suggests that what we believe or imagine or strive for is FAR more important than the “brain=mind” theory can possibly begin to explain.
Sounds so VERY therapeutic! Really, how can these people take themselves seriously? An 8 year old child would at least know to say, “Why are you sad?”
Wow. Well said! I have nothing to add!
It is interesting that clinicians are feeling the same kind of life stress and burnout that many if not most of us in late stage corporate capitalist societies are experiencing. It is a shame that the real causes are right in front of us, but that the mental health industry as a whole continues to pretend it doesn’t exist.
I think it helps people to avoid dealing with real but semi-conscious conflicts that are really at the root of feeling hopeless about life in many cases. Certainly was true for me! It’s a lot of work to re-think one’s view of life and one’s habitual behavior. It’s easier to blame it on the brain and take the pill. At least in the short run. Especially if someone in authority is doing the hard sell on it. I did not WANT to get therapy – I NEEDED to, but it took two other people dragging me kicking and screaming to get it started. Very glad I did.
Of course, a lot of “therapists” these days don’t do what I consider therapy. Many seem to use a forced and very shallow form of “cognitive behavioral therapy” and aren’t interested in childhood trauma or internal conflicts. I was very fortunate in getting a good one on the first shot, but it still wasn’t any fun, and I felt like quitting partway through. A pill would have been a LOT easier, but of course would never have been a tenth as beneficial in the long run.
Including “no treatment” when the “condition” is a result of normal reactions to external problems, such as child abuse, poor parenting skills, or dull and rigid classroom environments that lack the necessary stimulation for a bright and curious child.
How can you have “overdiagnosis” or “false positives” when there is no objective means to determine who HAS and DOES NOT HAVE a particular diagnosis? Isn’t the main reason for “overdiagnosis” the fact that there is no line between the “ill” and the “normal?”
I would say that physicians almost NEVER direct someone to discontinue ANY psychiatric drug. Additionally, “return of symptoms” is often a euphemism for “withdrawal symptoms” occurring upon withdrawal. Support is, indeed, needed, but medical providers almost never provide the kind of support that is helpful. If we all waited for a physician to “direct” their patent to withdraw, almost no one would ever get off psych drugs, no matter how bad the effects of the drug in question.
I never knew he was so frank about his chicanery.
Wow, some really radical thinking there! You mean that people get depressed because their lives kind of suck? NAH, COULDN’T BE! If their brain chemicals were adjusted properly, they’d be HAPPY that they were poor, homeless, raped, sexually abused, abandoned or whatever. EVERYONE knows that!
Just to be clear, I’m not calling the article disempowering, I’m saying the concept of “shared decision making” presumes that decision making is normally NOT shared with the client, but made by the doctor without any input from the client whatsoever. And doctors are arguing as to whether they SHOULD consider “sharing” what is really the client’s decision with the client. I don’t see it as a salvageable concept, as it is tainted with the idea that sharing decision making with the client whose life is being impacted is somehow optional!
As I’ve said before, the very framing of this as “shared decision-making” is disempowering by definition. They are talking about DOCTORS deigning to “share” THEIR decision making with the client! And the doctors are ARGUING about this! The decisions should always be the CLIENT’S decisions, unless the CLIENT wants to share it with the doctor or someone else! The fact that they even need to TALK about including the client in the decisions, and that NO ONE sees this as hypocritical, shows just how far into authoritarianism the medical establishment has sunk.
Great paper! Reminded me of some stuff I used to know about those Prozac trials. Amazing that these “peer reviewed” studies ever saw the light of day!
It shows intent to bias and deceive from the get-go. This is not science, it’s marketing!
That’s always been my biggest challenge with this whole “chemical cure” mythology. If I take a pain reliever and I still have as much more more pain than before, do I have “treatment resistant pain?” Or did the drugs fail to have the advertised effect? If I take an antidepressant and am still depressed, THE ANTIDEPRESSANT DIDN’T WORK! It’s not because I’m “resistant” or “need an adjunct medicine” or whatever. It means the treatment FAILED!!! Why is this not obvious? Why do intelligent people fail to observe this rather obvious conclusion?
Here is an article covering the issue of so-called “discontinuation syndrome” (aka withdrawal). I found this in a 10-second search. Many other articles on the topic are readily available in the mainstream psychiatric publishing world.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5449237/
Do you actually want to know the answer to that question?
I would guess that most doctors have not ever read the 35 pages of warnings and could not tell you half of it. My father was almost killed by a doctor prescribing something when he was on blood thinners after a heart attack. He told the guy exactly what he was taking, and the drug warnings included a BOLDFACE warning NOT to prescribe this second drug with blood thinners because DEATH MAY RESULT! Yet the doctor prescribed it anyway, and my father luckily noticed he was getting bruises by simply resting his elbow on the table or pressing his arm with his finger. HE looked the drugs up in the PDR (the “internet drug site” equivalent of the 1960s) and discovered that the doctor had acted incredibly irresponsibly and could very well have killed him. A minor car accident, a fall in the garden, the most minor injury could have resulted in death. I have heard stories and had direct experiences myself over time to reinforce the idea that doctors don’t, and given the volume of new drugs, really CAN’T, know and convey the actual dangers of these drugs. I will NEVER take a drug that I have not personally checked out on more than one source.
So no, it is not hard AT ALL to imagine doctors either not knowing these things, or not caring to communicate them, or intentionally NOT communicating the possible dangers because they are worried that the patient would decide not to take the drug if they knew the actual risks. I would assume it far more likely than not that the doctors would NOT communicate such things to me, based on personal experience.
I’ll leave it to others to explain what ACTUALLY happened to them on antidepressants, though of course, you can easily find that out for yourself by searching this site. Sometimes other people have different experiences than you do. Maybe you could generate some interest in listening to them instead of dismissing their experiences as “hard for you to understand.”
How do they, Enrico? You don’t know any more than I do. Nor do you even know that cells DO create thoughts. That’s what you believe. There is no proof or evidence of what thoughts even ARE, let alone what creates them. You believe the brain creates them, because you are a MATERIALIST philosophically. Not everyone in the world is a materialist, and materialism isn’t inherently more “scientific” than any other philosophical viewpoint. There are other philosophical viewpoints that are just as valid as yours.
You are sharing your beliefs, not scientific verities. Which is fine, as long as you allow that every other person here is just as entitled to share their views and beliefs as well, and you don’t somehow entitle yourself to be the arbiter of truth when you’re sharing your personal views. I don’t see you granting others that right very often. I more commonly see you presuming to know more than those who are here, and talking down to others who don’t agree with you. It is not a very respectful way to conduct a conversation, in my personal view. I guess that’s philosophical, too – one philosophy is that conversations to be “won” by trying to overwhelm or dominate the other person until they submit. I don’t take that philosophy. I like conversations to be a sharing of information from different viewpoints so I can learn things and expand my viewpoint to include more data and observations and experiences beyond my own narrow path in life. You have a great opportunity here to open your mind and learn from others who have had different experiences than you have, to actually WANT to know why some people find the very things you consider to be miraculous advances in science to be sketchy, unscientific, and even dangerous and destructive. Do you want to know? Or are you primarily engaged in trying to convince the “misled” or “misunderstood” on this site to the “real truth,” which of course means the “truth” you’ve already decided is “right?”
The point re: Insel’s comments is a case in point. You “don’t understand” the relevance. Do you WANT to understand it? What if you actually asked the poster to HELP you understand it, and tried to put yourself in his shoes and see it from his viewpoint? I’d say the reason is quite obvious: Insel RAN the NIMH for years. He spent lots of time doing the kind of research you seem to value (at least when it fits with your narrative), and at the end of his tenure, states that the DSM approach has led to literally NOTHING of lasting value. That one of the key thought leaders in the psychiatric community would publicly announce this should be of GREAT interest to anyone with a real scientific bent. The fact that he was called on to walk back his comments by that very psychiatric community he is a part of should tell you a LOT more. My read is that the psychiatric community knows that the DSM is not worth the paper it’s written on, but they can’t admit it to themselves, or they don’t want the word to get out. Does it seem POSSIBLE to you that this explanation makes some sense? What is YOUR thought on the significance of the lead psychiatric researcher in the #1 center of psychiatric research in the USA says that the DSM actually makes it harder to make sense of “mental illness?”
I have noticed again and again that you do not respond to solid, well-argued, positions that don’t correspond to your views. Will this again be the case with this one? Will you pretend that I didn’t write this because it’s too uncomfortable to face the truth contained herein?
Are you now denying what the entire psychiatric research world now admits? That “discontinuation syndrome” (aka WITHDRAWAL) and Tardive Dyskinesia and Neurological Up- and Down-regulation are very real? One study is enough when the study agrees with you, but massive data over decades is not enough to convince you when it disagrees with you?
Yeah, sorry, I’m spoken for! But thanks for the chuckle!
I am saying it is a contributing factor, and that at least SOME of the high rates of smoking among those diagnosed “schizophrenic” are due to the “treatment.” I’m also pointing out the irony of the psychiatric industry using “treatments” that are known to reduce lifespan, and yet trying to blame it on habits that their own drugs actually encourage/reinforce.
But you’re right, poverty, discrimination, and trauma are related to “poor lifestyle choices” AND to being swept up by the psychiatric industry as a “patient.” It is a very complex system. But a part of that system is a “treatment program” that doesn’t actually work in the long run in many if not most cases, and which can create or exacerbate the exact “symptoms” they claim to “treat.” And meanwhile reducing people’s quality of life and life expectancy, while trying to deny this is true.
I certainly believe you, Gina. And I think the vast majority of MIA posters believe you, too. Many of them have experienced similar things. Psychiatry sucks!
Writing just as me, here, not as a moderator.
Why do you continue to post here if you find the basic premise of the site to be so wrong? Do you really think you’re going to convince your audience? Why not go somewhere else where people who agree with you share their views? I don’t see much interest on your part in hearing anything anyone else says, or learning anything you don’t already believe you know. So why are you posting here? What is your purpose? I’m not being snide, I really want to know what you’re trying to accomplish?
I would bet my bottom dollar you’ve never even read Anatomy of an Epidemic or Mad in America. Am I right?
I don’t believe from my observations here that you really want to engage in a conversation about any of these topics. I assume from your behavior that you mostly want to tell us all that none of us know what we’re talking about and you know better than us. Am I correct?
I predict that you will not respond to this question.
I understand that since cigarettes increase dopamine, and the antipsychotics massively decrease dopamine, many antipsychotic users (forced or voluntary) smoke in order to reduce the side effects of the antipsychotics. Many probably don’t even know that’s why they do it, they just feel better when they smoke. So ironically, the psychiatric industry wants to blame shortened lifespans in the “severely mentally ill” on “lifestyle issues” like smoking, while the drugs used to “treat” these “disorders” in fact dramatically INCREASE the rate of smoking among the “treated!”
Man, that IS depressing!
Scientifically speaking, there is no need to “prove that ADHD isn’t real.” And the existence of people who fit the description is not proof of anything. It is the responsibility of those claiming it is a disease state to prove that it IS a disease state. Anyone can describe a condition and claim it is a “disorder.” As I’ve said before, genetic diversity is the key to species survival. I’ll remind everyone of the study where groups of three kids having one “ADHD” – diagnosed child were WAY BETTER at solving problems than groups of three who did NOT have an “ADHD” child in their group.
The point is not to prove that people can be identified as “fitting the criteria” that were chosen to describe “ADHD.” The point is to prove that such people a) have significant things in common besides acting a certain way, b) that there is some means of objectively distinguishing those so identified from the general population, and c) that the variation is a malfunction rather than simply a variation in genetic inheritance.
For instance, running slowly has a very large genetic component. Failure to be able to run quickly leads to significant psychosocial distress, as any such person who has had to go to PE classes can testify. Giving stimulants to such people would improve their running speed to some degree in most cases. Is slow running a disease state? Who would need to provide proof of this? Would I have to prove that it WASN’T a disease? Or would someone claiming it was be responsible for the proof?
Thanks for sharing this – it includes some good information that is new to me.
I would pose this question to you: if, as you show above, fluoridation of the water supply can significantly effect the rates of “ADHD” in the population, how does that jibe with your earlier researcher’s claim that it is entirely caused by a mutation in a certain gene? Does this not suggest that the environment can and does have a huge impact in the expression of one’s genetic inheritance? Does it not suggest that people who do NOT present as “ADHD” to begin with can BECOME “ADHD” cases due to environmental influences?
Taking this further, could there not be “psychologically toxic” environments that might “cause” a person to “become ADHD” when they otherwise would not have presented that way? Does it not similarly follow that there might be “psychologically healthy” environments that, if applied systematically, would REDUCE the likelihood that someone would present with “ADHD” syndromes or would reduce the severity of these “symptoms?”
Doesn’t it make more sense to suggest that a person may inherit a “vulnerability” or a “tendency” to engage in this kind of behavior, but that the expression of this tendency is strongly affected by the environment they are forced to contend with? That it is not a “nature vs. nurture” situation, but rather a combination of nature/nurture, as most behavioral syndromes (and even major physical health problems, like heart attacks and diabetes) appear to be?
If this is the case, which do we have more control over, nature or nurture? Genes or environment?
I would ask why do we spend so much of our time and money focusing on the one element in the equation, the genetics, that can’t be changed? If we really want to help these kids, why would we not focus our energies and attention on altering the environment to improve these kids’ lives?
Examples might include NOT fluoridating the water, creating open classrooms for kids who find them more workable, teaching parents how to handle these kids without accidentally reinforcing negative behavior, valuing and taking advantage of the kids’ strengths, and even holding kids out of school for an extra year to allow additional maturation?
(Did you know that there is a 30% reduction in “ADHD” diagnoses for kids who start in school one year later? THIRTY PERCENT! We could avoid a THIRD of “ADHD” diagnoses by keeping kids who aren’t ready out of school for a year! Why aren’t we doing this?)
I am not and have never been arguing that some kids don’t often “come that way.” My own kids are a good example – their personalities reflected an intensity, a need to be active and busy, an intolerance of boredom, that were certainly not a result of anything we did or did not do that we are aware of. My point here is that genetic diversity is the key to species survival, and being genetically “different” does not imply being genetically “disordered,” and genetics is in any case the one part of this equation that is completely unchangeable. Why don’t we acknowledge that both nature AND nurture are involved, and spend more time addressing environmental things (like water fluoridation and classroom structure and parent training) that CAN be changed to give these kids a better chance at survival?
I hope everyone will consider the full implications of these findings. Something that is completely genetic in origin (like, say, eye color) would not be so variable depending on environmental impacts. It’s got to be both. Let’s accept that differences most likely exist, but spend our energies on trying to control the environmental variables that we CAN control!
Yet in the 3-, 5- and 8-year follow-ups on this very same study, kids who continued or started to use stimulants did no better (and in some ways worse) than kids who discontinued or never used stimulants. Which fits in exactly with the data I just shared in another post, and which is generally well known but kept very quiet among researchers: stimulants do work to “control the core symptoms of ADHD,” as they usually put it, but have been shown again and again not to lead to any improvement in long-term outcomes. In other words, stimulants can make it easier for you to pay attention to your schoolwork and complete your homework, but apparently, paying attention to your schoolwork and completing your homework doesn’t lead to you becoming more successful later in life.
In fairness, there are many who claim that stimulants destroy kids’ lives, and while that may be true in individual cases, in the collective, there is no evidence of stimulants doing great HARM to long-term outcomes in the collective. But they don’t really help, either, if you care about things like delinquency rates or high school graduation rates or social skills. And there are risks, outlined in my other post, that a rational parent might be well advised to consider when that risk is set against only short-term gains. It is a matter of informed consent, and it’s pretty dishonest at this point to claim that stimulants are going to magically change kids’ lives for the better in the long run. Some may choose to use stimulants for their short-term ability to “reduce the core symptoms of the disorder,” but if they’re aiming for longer-term improvements, it appears they have to look for additional interventions to help.
Drugging a kid means giving a kid drugs for behavioral control.
Sounds like a very idealistic picture. I guess we will see how much of it comes true.
I thought this article speaks to the idea of long-term use and loss of efficacy. Have you considered WHY tolerance develops over time? In the world of substance abuse, tolerance is related to significant brain changes.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3036556/
Have you ever heard of “neurological down- or up-regulation?”
“In 2013 they compared the brains of kids with ADHD before and after a year of treatment with stimulant medications. The studies showed an increase in the density of dopamine transporters—those molecules that take dopamine out of action—in the brain after treatment. This suggests that the increase of dopamine stimulated by the medication may have prompted the brain to develop more dopamine transmitters to clear it away. How long that change might last is not clear, as the level of transporters in the brain fluctuates. But it could result, researchers note in their conclusion, in the medication not working as well as it had to reduce symptoms over the long run.”
https://childmind.org/article/will-adhd-medication-change-my-childs-brain/
More on the long-term alteration of dopamine transmission with long-term use of stimulants over time:
https://www.healthline.com/health-news/mental-long-term-adhd-medications-increase-dopamine-transporters-051613
Anybody here want to share your personal experiences with stimulants?
Oh, that is sad! I liked Seth!
As I’ve already demonstrated, long-term studies show no difference between “treated” or “untreated” subjects on all major outcome measures, including academic test scores, high school graduation rates, delinquency rates, college enrollment rates, social skills, and even self esteem, which is the one even I would expect to be affected. I was actually quite stunned when I first discovered this fact way back in about 1989 or so, when I first started researching this topic for my own son’s needs. Stimulant treatment is simply not a major factor in long-term success in “ADHD” – diagnosed children. Other factors appear to completely overwhelm any benefits of temporarily paying more attention to or completing more school work. Stating that certain psychiatrists “believe the evidence proving it is a bio-chemical problem, is overwhelming” is absolutely irrelevant. The data speaks for itself, and saying otherwise over and over doesn’t change the science.
https://journals.sagepub.com/doi/abs/10.1177/000992287801700112 (This is Barkley and Cunningham’s study, where Barkley, one of the biggest ADHD advocates around whose income depends greatly on accepting ADHD as a valid construct, states that the VERY slight improvement in test scores for the “treated” groups was easily explainable by the subjects simply reading the questions a little more carefully than the control group. He called the long-term results “Disappointing.” But that has not stopped him claiming later on that anyone NOT putting their child on stimulants for “ADHD” is committing child abuse!)
“Jacobvitz et.al. acknowledged the short-term benefits outlined earlier but focused on the same limitations of stimulants noted by Schrag and Divoky
(1975), McGuiness (1989), and Kohn (1989). As a conclusion, Jacobvitz et al. urged “greater caution and a more restricted use of stimulant treatment” (p. 685). In contrast, Stevenson and Wolraich acknowledged the limitations outlined here but focused on the temporary suppression of symptoms.”
https://escholarship.org/content/qt4jr2777t/qt4jr2777t.pdf (Swanson et. al, 2003)
““Good quality evidence … is lacking” that ADHD drugs improve “global academic performance, consequences of risky behaviors,
social achievements” and other measures.
What is absolutely fascinating is that they revised the report later to eliminate ANY MENTION of long-term outcomes, as if this conclusion were NOT drawn from the study. I think that says more than a bit about the desire of the psychiatric profession to cover up this embarrassing conclusion. (In fairness, they DID find one study of decent quality that showed a reduction in accidents for stimulant users. That was the only positive long-term outcome they found.)
https://www.iacaf.org/assets/Uploads/Documents/DERP.pdf (OSU Medication Effectiveness Study)
“Our results are silent on the effects on optimal use of medication for ADHD, but suggest that expanding medication in a community setting had little
positive benefit and may have had harmful effects given the average way these drugs are used in the community.”
https://www.nber.org/system/files/working_papers/w19105/w19105.pdf (Quebec provincial study)
“No significant differences based on medication-use were noted for the following
measures taken at 14 years of age: depression, self-perception, and socialfunctioning.
• Whilst no statistically significant results were noted, a trend toward slightly higher
depression scores was noted with the use of medication.
• A trend toward slightly lower self-esteem and social functioning was also noted with
medication use at one time point or two time points. However, consistent medicationuse at all time points, including at 14 years, trended toward slightly improved selfperception and social functioning.” There was also a finding of a MUCH higher percentage of grades repeated for those taking stimulants.
https://ww2.health.wa.gov.au/~/media/Files/Corporate/Reports-and-publications/PDF/MICADHD_Raine_ADHD_Study_report_022010.pdf (Raine study from Australia)
I can’t find the USA/Finnish comparison study right now, but it showed that medication rates were MUCH lower in Finland, yet outcome measures like delinquency and school failure were no different in these comparable populations.
The studies referenced above involved MANY THOUSANDS (probably more) of “ADHD” diagnosed children in the USA, Canada, Finland, and Australia. The OSU study looked at every single reference they could get their hands on at the time that had to do with stimulants and ADHD. There is a mass of strong evidence that stimulants don’t alter long-term outcomes, and at this point, most research psychiatrists have accepted this as factual.
This Web MD article is most significant in what it does NOT say about long-term outcomes. If there really WERE known benefits in the long term, don’t you think they’d mention them right here? But they don’t, do they? I wonder why?
“Long-term effects. Some children continue taking ADHD drugs as adults. Decades of research has found no major negative health effects from taking them for a long time. Some studies have suggested that children who keep taking stimulants into adulthood may grow up slightly shorter. But other studies have found no link between medication use and adult height.”
https://www.webmd.com/add-adhd/childhood-adhd/adhd-kids-med-use
The lack of long-term benefits from stimulant drugs for “ADHD” diagnosed children is an open secret. It is known but not talked about. Anyone claiming there IS some benefit for any of these long-term outcome measures has a big hill to climb. Simply stating that “I believe that” or “Dr. So-and-so says that…” is not going to come CLOSE to cutting it in this case.
For those who actually believe in unbiased scientific analysis, the jury is IN on this question. The burden of proof is now on anyone claiming some long-term benefit. Stimulants are effective in short-term suppression of “ADHD” symptoms in the majority of children so diagnosed. That’s about all that can be said. Depending on one’s philosophy of education, and to some extent, on available educational options, this may or may not be considered beneficial. But claims of long-term benefits are mythological, not scientific.
Don’t forget the “placebo washout” strategy. They do whatever they can to reduce placebo effects and maximize the chance of a positive P value.
In a very small number of cases. VERY small.
You state that as if it would be wrong to believe that, no matter what the actual data. Science is not a religion. See my other post.
The average lifespan of the “seriously mentally ill” has steadily DECREASED since the advent of psychiatric drugs. Such people now die 20+ years younger than their non-diagnosed counterparts. A significant part of that decrease in lifespan is the result of treatment with antipsychotics. As many as 14.5 years lifespan may be attributed to antipsychotic use.
https://www.hcplive.com/view/is-treating-schizophrenia-with-antipsychotics-worth-the-risk
Well said. The only caveat, and a big one it is, is that whatever philosophical approach one takes, the results have to reflect some apparent improvement, at least within your own philosophical structure. It becomes a BIG problem when one becomes so committed to his philosophical views that actual data that doesn’t support one’s theories is ignored or minimized or denied.
https://www.healthline.com/health/adhd/evolution
I have seen way too many kids “flip” to bipolar in my career as an advocate for foster kids. It is not rare that a kid gets aggressive in response to stimulants, but it is unfortunately VERY rare that doctors see that for what it is, and it almost always leads to more drugs and more serious diagnoses, instead of saying, “Gosh, those stimulants seem to have made things worse! Maybe we should stop and start over!” I had one who went two years deteriorating, until she herself decided to stop all three drugs she was on. She had become psychotic and aggressive on the stimulants, but when she stopped, she was back to her old self within days. But the doctors never had a thing to say about it. Did not even acknowledge they’d done her wrong. That happens WAY too often for my comfort!
COMMENTING AS MODERATOR:
Hi, Gina,
I have moderated the comments you reported, as I understand in context why these might have come across as offensive to you. I am sorry we didn’t catch them sooner.
In the future, please email me rather than posting complaints about posts in the text of a comment. I am very responsive to such complaints, but it doesn’t help the community at large to have to process these complaints publicly, and as such, it is stated in the Posting Guidelines to handle such complaints by talking to the moderator or simply reporting them through the “report” function at the bottom of every post.
Steve
Let’s agree to both ignore each other, eh?
I think another vitally important question is how/why the current “mental health” apparatus does not SEE the very obvious connection between childhood adversity and adult “mental health” diagnoses. They spend decades researching the “biological underpinnings” of these “disorders,” and come up with 2, 3, 5% correlations, when childhood abuse/neglect/abandonment has associations at 80% or higher to most “disorders.” Seems like a case of intentional blindness. We’ll never be able to teach kids sufficiently about neurodiversity and the importance of healthy child rearing when the bulk of the “mental health” industry appears committed to denying that it matters!
One study by one person does not begin to compare to 4 long-term naturalistic outcome studies and 4 comprehensive literature reviews. The jury is IN. There is no long-term outcome that is consistently improved by stimulant treatment. It’s a fact.
Just stop now.