Wednesday, August 10, 2022

Comments by Steve McCrea

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  • In other words, our society forces us to adapt to circumstances that we are not adapted to genetically. Reminds me of the book ‘A Hunter in a Farmer’s World,’ by Thomm Hartmann, which critiques how we blame and devalue kids with so-called ‘ADHD’ characteristics for not fitting into a world they were not designed to fit.

    Notwithstanding this important point, genetics are still the part we can’t change. Why not work on helping people figure out how to adapt better, or even work on creating a more flexible society where we appreciate and value differences and create niches where everyone can find a place to fit? Open classrooms for ‘ADHD’ sufferers is one very good example. The idea that all kids must ‘learn’ in a standard classroom and that those who don’t are ‘ill’ is simply nonsense. We force them to attend classrooms that are specifically designed to frustrate and defeat them and are surprised when they end up feeling frustrated and defeated?

    Genetics may help explain certain problems raised by modern society, but it doesn’t do much to help us solve them, except by perhaps reminding us that rigidity of expectations is bound to reduce the quality of life for all of us in the long run.

  • Plus genes are the one thing in the equation that we can’t ever change! Why spend billions studying genetics and getting tiny little ‘correlations’ from sets of hundred of genes, when we KNOW that certain environmental conditions will cause or exacerbate these problems and those CAN actually be changed?

    A great example is the so-called ‘ADHD’ child. It was shown in the 1970s that such children to incredibly much better in an open classroom, to the point that professionals can’t tell them apart from ‘normal’ children in that setting. Yet we spend tons of money promoting ‘genetic’ explanations that can never seem to be proven, instead of spending a lot less creating open classrooms as an option for kids who struggle in standard classroom settings.

    Sometimes I think the only reason they are so married to genetic explanations is because it lets the adults off the hook for trying to fix anything. ‘Oh, well, it’s just genetics, nothing we can do about it.’ Highly irrational!

  • Psychosis is a definable phenomenon. It can be seen, felt, observed, verified by discussion.

    Schizophrenia is a concept, and idea, that idea being that people who experience a very real psychotic phenomenon are ‘ill’ with a specific ‘disease’ or ‘disorder’ which is caused by a purported ‘chemical imbalance’ that can’t be seen or measured in any way and is now being denied by psychiatrists they ever claimed was true. Clearly, something is happening when a person is experiencing psychosis, and no one can rationally deny that. But for medical doctors to claim that they know this phenomenon is caused by a ‘disease state’ in the brain is reaching far beyond what any kind of scientific or observable data can tell us. It also gives power to the psychiatric system to claim the need to force ‘treatment’ on those who don’t want it or have observed already that it doesn’t help them or makes their situation worse.

    So in my view, anyone claiming psychotic experiences don’t exist is full of crap. But it does not follow that those experiences are definable as ‘schizophrenia’ as described in the DSM, nor that they are caused by faulty brain chemistry, nor that drug ‘treatments’ will automatically help the person experiencing psychosis.

    Again, I’d go to the mat to protect YOUR right to call the phenomenon whatever it is you believe best explains it. I do NOT support the idea that someone else can tell YOU that something is wrong with you called ‘schizophrenia’ until and unless they can objectively define this condition in ways that can be validated and verified objectively.

    Perhaps an easier analogy is the term ‘ADHD.’ Do kids act in the ways described as ‘ADHD’ in the real world? Of course, they do. It is a very common set of behaviors, especially in boys. Does the fact that they wrote down descriptions in the DSM and voted on how many ‘criteria’ are needed for a ‘diagnosis’ mean there is anything at all ‘wrong’ with kids who happen to fit that description? Absolutely not. It doesn’t even mean that kids who act that way have anything in common at all – they may each act that way for totally different reasons, and assuming that just because they act that way means they are ‘mentally ill’ is ridiculous.

    Same holds true in my mind for ‘psychosis.’ There may be one or ten or a hundred reasons why this phenomenon occurs. Maybe SOME such people really DO have a chemical or structural problem in their brains – but we don’t know if they do or which ones do. They may in fact be reacting to stress, but assuming ALL are that way because of stress is, as you correctly observe, not close to a valid inference. There may be thyroid problems, brain tumors, head injuries, huge anxiety, nutritional deficiencies – who knows? Because all they have done is collect a bunch of thoughts/emotions/behaviors that tend to occur together, described the behaviors and claimed it is an ‘illness.’

    So no, saying that the DSM-invented description of ‘schizophrenia’ is not an illness does NOT mean someone is saying that people who have psychotic symptoms are making it up or should just get over it or are all victims of trauma or any such thing. It is simply saying that there is no scientific proof that all or most people fitting that description can be claimed to have something specific in common that is ‘wrong’ with them that can be measured, identified, and ‘treated’ by a doctor.

  • Do you think ‘mainstream physics’ is pretty much the same in all countries, or ‘mainstream biology’ [Q] [sorry my question mark isn’t working] If psychiatry is a scientific endeavor, as it claims, it is fair to assume that variance from country to country would be cultural, not in the mechanics or philosophy of psychiatry itself. Psychiatry portrays itself as the ‘scientific’ approach to ‘mental health’ and promotes very much the same messages around the world. How that is applied, of course, varies by country and community and even by facility to facility. But it is most definitely fair to say that ‘mainstream psychiatry’ is pretty much the same in all countries, as to its objectives and fundamental beliefs. Or all ‘developed’ countries anyway. It is interesting to note that recovery rates for schizophrenia in ‘less developed’ countries are far better than those getting the ‘full benefit’ of ‘mainstream’ psychiatry. When it comes to psychiatry, it seems that the dictum ‘less is more’ is supported by the data.

  • I agree with your sentiments in a lot of ways – insurance companies do drive what ‘services’ are available and reimbursable. However, if we really want to ‘just be friends,’ it is going to require an acknowledgement of psychiatry’s role in perpetuating a lot of dishonest nonsense. There is good quality evidence, not even disputed among research psychiatrists, that antipsychotics don’t have long-term benefits and probably decrease chances of survival over time, that the ‘seriously mentally ill’ die 20-25 years younger than their non-diagnosed counterparts, and that the drugs play a role in shortening lives, that antidepressants’ effectiveness is pretty limited and fades with time, that some who take antidepressants become manic and often end up with ‘bipolar’ diagnoses, that there are no long-term outcomes that are improved by long term use of stimulants, and on and on. When these studies and reviews are brought to light, just as with Johanna’s honest hard work, the authors are attacked with accusations of connections with unsavory or dishonest people, their motivations are impugned, their characters are attacked, their observations are minimized, and they are ridiculed and often shunned for speaking the truth.

    Having any kind of respectful relations begins with psychiatry’s leaders agreeing to acknowledge and abide by honest research findings instead of trying to spin everything to make psychiatry look right and anyone questioning their absolute authority to declare what is ‘true’ as insane or ill-intended. And I don’t see that happening any time soon. Psychiatry in the institutional sense has cast their lots in with the pharmaceutical industry, and many people’s reputations and standing in the medical community depend on maintaining the fiction of the DSM and the fictionalized ‘research’ that is used to back it up. I’m not opposed to folks on the front lines who are trying to do the best they can. I am opposed to the massive amounts of false information that is forwarded and enforced on those who do have to do that hard work up front.

  • Still sounds like straight up philosophy to me. I have never doubted the value of instincts, but while they are an excellent guide to personal action, they don’t provide a structure to build a mutual understanding upon. To claim a scientific explanation for emotions, we need some kind of verifiable agreement, whether by measurement or by predictive ability or elegance of explanatory power – like the sun-centered view of the planets – which is clearly simpler and more useful in predicting future events. It seems you have an interesting hypothesis and some possible theories on how it might apply, but I don’t see a useful explanation of the origins and location of emotions that helps understand and predict emotional events and outcomes in the future.

    Best to you in your future.

  • OK, I did a quick search for concrete evidence of 4e cognition and found exactly nothing. I found a LOT of philosophizing on the ASSUMPTION that cognition is a full-body process, but there is nothing I’ve seen so far that even slightly approaches a falsifiable premise, let alone an actual experiment. To suggest that this very arcane theory is a scientific explanation of emotion doesn’t appear to be close to a valid claim, from what I’ve read so far. Perhaps you can direct us to an article that exemplifies an actual scientific experiment demonstrating the validity of 4e cognition and its applicability to emotions.

    Sorry, my question mark doesn’t work. I urgently need a new keyboard.

  • There have been plenty of groups of ‘scientists’ who have been dead sure and published lots of papers and so on. Sorry, but if this makes any kind of sense, it ought to be readily explainable to the lay person. Einstein’s theory of relativity is as complex mathematically as any theory known to man, but it can be explained in terms of bending space and the effects of travel as the speed of light is approached, etc.

    I have yet to hear anything from you that suggests any kind of grasp on the practical implications of this philosophy. Surely, you can come up with a simple example showing how this approach works out in the real world. But I am skeptical that such a thing can really be done, as we simply haven’t the vaguest idea what a ‘mind’ is or how it ‘arises’ or where it resides. Nothing, not a clue.

    I will give this a quick look, but it sounds like a very complex and difficult theory to explain, and in the end, good science tends to provide simpler solutions, not more complex ones. In any case, we really need to see a falsifiable premise that is vigorously tested before admitting something to be scientifically valid. I see no such premise here. The idea that the mind is distributed throughout the body is not one I can see being testable. Though I’ve been wrong before, I’ll have to see the actual hard testing before I get too excited about a particular philosophical viewpoint.

  • I am not saying you are wrong. I’m just saying we’re not talking science any longer. When you have to talk about moving away from Cartesian dualism and ‘centering’ the mind in the body, not to mention declaring that something is ‘all the rage,’ we are definitely not talking about straight science anymore. We are talking about philosophy. Nothing wrong with talking philosophy, in fact, one of psychiatry’s most fundamental weaknesses is its lack of any coherent philosophical agreements and structure, but a possible viewpoint on what the mind or a thought or an emotion might be is a very far cry from a scientific understanding of it. I defy you or anyone else to design a scientific experiment to prove where the mind is located. I guarantee you can’t do it. So whether the mind is in the brain, in the body as a whole, or impinging on the body/brain from some exterior viewpoint, is simply not a question science can answer at the moment, and may never be able to answer.

    But I am still interested in hearing the ideas involved. I love philosophy, actually.

  • COMMENTING AS MODERATOR – I appreciate the exchange here, but let’s not get too far off of the focus on mental/emotional wellbeing. We all know this is a hotly contested topic and that there is little chance that a lengthy discussion will lead to anything but a lot of conflict and disagreement. Everyone’s entitled to his/her opinions and views, but I don’t want to get into the kind of back-and-forth where one person’s opinion has to dominate and the other person has to be ‘wrong.’

  • Hey, Nick,

    I really appreciated the first part of your comment – I agree that psychiatry has relied on ‘naming’ and ‘categorizing’ to the detriment of understanding and using actual relationships between two human beings as the primary ‘healing’ agent. But of course, it should be understood that relationships are not really within the aegis of medical practice in the first place, so perhaps the first error is for medical folks to try and ‘heal’ emotional/spiritual/relationship concerns.

    As to your second statement, your explanation of emotions seems extremely shallow and limited, and not particularly scientific. ‘Seeing’ ‘mind’ as located in the body sounds a lot more like philosophy, as does ‘describing’ emotions in terms of ‘subtle neurological-muscular movements.’ I don’t think it’s fair to claim an irrefutable or even generally agreed-upon scientific understanding of emotions. Sure, there are lots of theories, but all that I’ve seen doesn’t come close to a fully tested falsifiable understanding of what emotions really ARE.

  • The ‘conservative media’ is honestly not much better. Both ‘sides’ are owned by their big corporate supporters, and greed and graft knows no political affiliation. I know of no nationally recognized leader who has a clue or gives a crap about the plight of the ‘mentally ill,’ on either side of the aisle, beyond the idea of giving more money to the ‘mental health’ authorities or refusing to do so.

  • Such a mass action would require the current beneficiaries of SSRI sales to agree that such a mass action would be beneficial, or for society at large to strip such people of their power to insist that we use “antidepressants” widely regardless of their actual utility and risks. That is the reason that “logic” becomes important in such cases, though it must be admitted that logic and facts don’t seem to have much effects on the beneficiaries mentioned above.

  • Your answer is disrespectful and invalidative of my personal experience, and that of anyone else who has had a positive experience. How is it possible for you to know if my therapy experience was or was not helpful to me? You have decided what you believe to be true and insist that the world conform to your belief, even if the evidence suggests a more nuanced approach would be closer to the truth.

    Your contention is: “What the psychotherapist does is make you afraid of your feelings and instincts. It is very much like the religious doctrine of original sin. You are to believe that there is something innately wrong with you.” My therapist did none of those things. In fact, she encouraged me to believe in and respect my own experience and emotions and instincts, and to discard all kinds of crappy ideas I’d amassed to protect myself from those emotions and instincts. So she actually did the exact opposite of what you claim “the psychotherapist” does. By the end of our association, I felt a lot more “right” about myself than I ever had. It was the adults around me who wanted me to believe there was something innately wrong with me, and my psychotherapist who supported me in discovering that there was nothing “wrong” with me at all.

    And ironically, with these comments, you are the one telling me there is something “wrong” with me for following my own instincts in evaluating my own experience, telling me that I should disrespect my own feelings and instincts.

    I don’t think we help anyone by being as rigid and judgmental and bigoted as those we are criticizing. If we are going to defeat psychiatry as you say you want to, we can’t dismiss the experiences of its users as “you can’t have benefited, because it ruins my thesis.”

    As I like to say, “Generalizations are always wrong.”

  • It should not surprise us that benzos, at least, will of course increase the rate of traffic accidents, as the effects and mechanism of action are very similar to alcohol. But this seems to be a very general increase, suggesting that at least in a fairly high proportion of users, a level of intoxication and impairment results from ‘therapeutic’ doses of these drugs. Of course, leaders in the psychiatric world would want this to come out. But I have long had concerns that many long-term benzo users are on the roads under the influence. Now there is even more to worry about!

  • I think the more relevant fact is that a century ago, most “depressed” people recovered without any help from the “authorities.” Depression as a “chronic condition” was very, VERY rare back in the day. The frequency of chronic “depression,” however defined, has only increased since the helpful insistence of giving everyone who feels bad a ‘diagnosis’ and prescribing drugs that can be harmful and giving up on the idea that a person has the resources to address their own emotional condition, even if they may need some assistance with that. Trying to redefine episodes as really ‘mixed’ vs. ‘manic’ vs. ‘depressed’ is very much an act of rearranging deck chairs on the Titanic. The iceberg has long since been hit and we should be trying to help people escape rather than sorting them out into which room they are to go down in.

  • I’m afraid I can’t agree with you. I had a very good psychotherapist. I would not be who I am today without her support and intervention. Sure, most of them these days are dogs, but it’s not right that there is no such thing. I think that is a bias you hold, but the evidence speaks to the contrary. I’m sure others here will agree with me that such people DO exist, however rare they may be today.

  • I’d more refer to that as “social problems that have medical consequences.” Defining the problem as “medical” is the first mistake. Feeling bad is not a medical problem. It could be the result of a medical problem in some cases, but emotions themselves are not medical problems. If it’s a social problem, no amount of “medical treatment” will solve it, and their pretense to the contrary is making things worse.

    On the other hand, it’s also possible (and I think likely) that the “treatments” that have “improved so much” are actually making the situation worse, above and beyond any social problems that do exist. At least treatment for resperatory conditions improves those who are treated. In psychiatry, it may mean you die 25 years sooner with “successful” treatment.

    I know you’re not arguing with me about these things, I’m just responding to the “Devil’s advocate” position you put out there.

    Maybe I’m just not feeling too inclined to be “fair” to the psychiatric profession today!

  • I think that is a very insightful comment. It is the judgment about a particular mechanism adding emotion that seems to make it “automatic” and unable to be rationally processed. There is nothing wrong with having mechanisms to deal with reality. Feeling we HAVE TO or CAN’T or “SHOULD” or “SHOULDN’T” with intense emotion is what gets us stuck, I think. I can say in my own case that learning to view such mechanisms more dispassionately (“What was I trying to accomplish with that approach? Why did I choose to handle it that way? Did it work? If so, what makes me keep trying to use that approach?”) has been what has helped me gain more control of my life.

  • Alice Miller and I would both agree with you on that last point! In fact, I think one of the very worst aspects of the DSM is that it enables the “professionals” to blame the “clients” for their own (the professionals’) discomfort with the helping process. It is not only not helpful, it seems to me that the very WORST thing one can do in such a situation is to put the client at a distance by providing a label and to call his/her experience “symptoms” caused by a “faulty brain” that need to be suppressed! In actual point of fact, it is almost always the SUPPRESSION of their own emotions and experience that CAUSES their “mental illness” in the first place! Other than “surgery” on the brain, it’s hard to think of anything worse that one could do than the label/blame/drug model that the DSM was constructed to encourage and justify.

  • You are far from alone. I used to work at a crisis line (a volunteer-based one), and people would report calling us because they knew they couldn’t talk to their therapist or else they’d be sent to the “hospital.” This was especially true for people who cut on themselves and were not in any way suicidal. We never would send out police on those calls, but we did sometimes trace suicidal calls on those who appeared to be about to act on a plan to kill themselves. I know that this and other hotlines have been “professionalized” (no longer volunteer based) and are much more likely to send the police on callers than we were. I volunteered for a hotline here in Olympia, WA, who did not ever trace or dispatch on anyone unless they asked us to do so. But such hotlines seem to be disappearing. I also have known many who found being hospitalized so traumatizing that they’d rather suffer their “symptoms” forever rather than risk being sent there. It is a sad commentary on the level of “help” that is currently available.

  • Exactly! Every “mechanism” has a motivation behind it. Most of them made some sort of sense when we invented them, but aren’t very useful today, or we use them when they aren’t helpful. I think that’s most of what is classified as “crazy” in the DSM, people using coping mechanisms they once found helpful in places where they’re not helpful any longer.

  • Well, to me, it’s just a habitual thing we do with our minds to accomplish something. ‘Survival’ and ‘coping mechanisms’ that you mention would qualify in my view. In my analogy, it would be the equivalent of the “program.” I think there are mechanisms that are conscious and intentional (like how do you drive a clutch car, or how do you make a curried chicken dish). And some are unconscious (like how to deal with someone who tries to make you feel small, or how do you deal with your sister tattling to your mom). I think we get fucked up most by the unconscious kind, because we don’t remember why we feel like we have to “run the program,” but we just know we HAVE to. Conscious ones we can change if circumstances require it (like I buy an automatic!)

    That’s how I think of it, anyway. Don’t mean to speak for lecox or anyone else. It’s definitely NOT a physical universe thing to me!

  • I don’t think that’s necessarily true. “Mental mechanisms” may have zero to do with the body. The “mind=body” equation is central to psychiatry’s worldview, but there is no reason to believe that “mental mechanisms” don’t exist entirely independent from biochemical operations. To use the hackneyed computer analogy, there can be lots of mechanisms in a computer program that are completely undetectable in the physical operation of the machine. From the outside, the computer looks the same no matter what program or calculation is going on. Just ones and zeros and switches and connections. But the code that is run is vastly, perhaps infinitely flexible. I don’t at all believe the mind is a computer or even like one, but I think the analogy is apt. Messing with the “hardware” is a dumb way to solve a “software” problem, let alone a problem with the programmer him/herself!

  • No specific “thing” causes “depression.” Depression is a state of mind, not a medical entity that can be “caused.” Many things may “lead to” depression, but this research thoroughly disproves that any commonality in serotonin processing or levels has the slightest thing to do with it in a general sense. Researchers need to get a clue and start looking for subgroups who might actually have things in common with each other.

  • So their final recommendation is, “We have to do something, so let’s do something stupid that makes things worse, because otherwise we’d be ‘turning a blind eye.'” How does that make sense?

    I also noticed that the study doesn’t mention the very high possibility that screening led to SSRI “treatment,” which is associated with INCREASING suicide rates, especially in youth. This seems a likely explanation for at least some of the increase in ED visits.

  • It is beyond silly to “screen” for something that you can’t objectively detect, and for which you have no effective “treatment” or intervention to offer. Such “screenings” are clearly an effort to increase their client base, and fit better into the rubric of marketing than they do of medicine. I recall a doctor once saying, “So I got a positive screen for depression. Now what am I supposed to do about it?”

    Depression screenings are a scam and should be illegal.

  • I think it is unconscionable that they would increase your medication levels without so much as a “by your leave.” I wish I found it shocking. What is your best response to this? If you let them know your strenuous objections, are they responsive in backing off to where you were most comfortable? You are a voluntary patient – they ought to be consulting you at every turn in the road.

  • I agree 100 percent! People need HELP, but not because they are BROKEN and need some sort of “repairs.” They need compassion and interest and maybe a few ideas for new perspectives. And they need some HOPE for a better future. Some people can be helpful, but a big part of being helpful is NOT thinking that you know better than the person needing the assistance. The person him/herself is the only one who knows what is going on or what will end up being helpful. The best we can do is facilitate the process.

  • It has to be OK for people to experience suffering without having it “fixed.” Psychiatry’s main thrust is to STOP people from feeling x or doing y. Good therapy should rather make it safe for people to experience whatever they are experiencing without judgment or a need to “fix it.” A person isn’t broken because they are suffering. They are just suffering. It’s part of the human experience.

  • That is also my general experience. Once someone is labeled “borderline,” they are sometimes the butt of denigrating “jokes,” and are often spoken of in condescending terms, and regarded as “problem clients” who can’t really be helped. Not everyone behaves this way, but such behavior occurs without sanction or challenge, it is accepted to trash talk “borderlines” in a most dehumanizing manner.

  • It seems you will not be able to understand and/or accept what I am saying, as your response appears to again criticize without specifics, and does not seem to address what I see as the central conflict we are having. So I will choose to back out of this conversation. I would just appreciate it in the future if you do not accuse me of offensive behavior without giving a specific example and a specific reason, but if you do continue to make such nonspecific accusations, I will choose to ignore them.

  • I am concerned that you are making assumptions about the meaning of my comment that are not my intentions.

    I have never stated or implied that TREATMENT BY SOCIETY is better/kinder/not abusive in every tribal culture. What I said was ONLY that the content of voices is affected by culture, per the studies I have read:


    I find that fact very interesting. I think it adds some complexity to the picture of how one might best approach someone who hears voices to get a better idea of what might be helpful. It is not meant to disrespect your views of your own situation.

    I have also not heard people here “denigrating your schizophrenia” in general, and I certainly have never meant to do so. There is general disagreement about whether “schizophrenia” is the name of a “disease” or “disorder” or merely a description of phenomena which really do occur but are not attributable to one, concrete, biological “disorder” or possibly a wide range of causes, such that one case may have little or nothing to do with another. This is very different from specifically attacking or “denigrating” you for your view of your own situation.

    With all due respect, we all have a right to disagree about things that are not determined to be “factually true” in a general sense. I have never once disrespected your right to label yourself with “schizophrenia” and to believe that you personally have a problem with your brain that causes your voices and other symptoms to occur, and in fact have state repeatedly that you absolutely have that right and that I do not question it. I also agree with you 100 percent that bullying others into agreeing to comply with someone else’s belief system is a huge problem. I would like you to grant me and others the same right to believe differently than you about THE CONCEPT OF SCHIZOPHRENIA IN GENERAL, without taking it to mean I intend some criticism of you individually and your beliefs. In truth, I find it likely that some people do, in fact, have difficulties with brain functioning that lead to some cases of “mental illness” as described in the DSM. I just don’t believe that we can define a “disease” for OTHER PEOPLE by looking at their thoughts, emotions and behaviors. Until there is some way to distinguish which people have or do not have a biological problem, and what exactly that problem may be, I’m afraid the final assessment will remain up to the individual client, not to the psychiatric “thought leaders” or individual mental health professionals.

    My objection is not YOU believing in schizophrenia and biological causation for you, and I have no criticism of you for choosing to approach the situation in ANY way you feel would be helpful. My objection is to DOCTORS and other MENTAL HEALTH PROFESSIONALS telling their CLIENTS that they “have a chemical imbalance” and “need drugs” when they have no real idea what is going on with that particular person. I have NO problem with the CLIENT identifying as “ADHD” or “Autistic” or having an “anxiety disorder.” I just don’t think it’s someone else’s job to pretend that they know things about the client that they do not.

    If you believe I have in some way “denigrated your schizophrenia,” I would appreciate you directly stating exactly what I (or someone else) might have said that you find denigrating. That way, we might be able to come to some kind of an understanding. But I really don’t like being treated as if I’ve done something wrong without knowing specifically what it is that you are objecting to and why.

  • An interesting fact you might want to know is that studies of voice-hearing people in cultures where hearing voices is accepted or viewed as a gift have their voices say a lot more positive things. There is excellent evidence from the WHO studies that people in developing countries have MUCH better long term outcomes, despite (or because of) using a lot less psychiatric drugs in the process. Culture and expectations apparently DO have a very significant impact on how “schizophrenia” is experienced.

  • The comment makes it sound as if stigma “rubs off” on the providers, when in actual point of fact, the providers themselves create the stigma they are complaining of. The main reason psychiatry is viewed as a sketchy, unscientific, unprofessional branch of medicine is because psychiatry IS sketchy, unscientific, and generally unprofessional. Psychiatry has earned and deserved the reputation is has. Its patients have not earned or deserved the prejudice and discrimination that the psychiatric “profession” has brought upon them by their own unscientific and unprofessional behavior.

  • I would have to disagree that these drugs are not coerced or that there is no visible violence, except to the extent that folks who have never seen the inside of a psych ward have not witnessed such violence being applied. There are tables in there with wrist and ankle and waist restraints, and people get wrestled into them, or held down and injected with psych drugs (as “masculine” an act as I could ever imagine.) Additionally, mothers do not own the market on telling people they aren’t responsible for their actions.

    Perhaps more importantly, history shows us that women are, in fact, the targets for certain interventions, in particular ECT, and for certain diagnoses, in particular, “Borderline Personality Disorder,” among others. Phyllis Chesler has written extensively about this in “Women and Madness,” but she is certainly not the only one.

    Finally, psychiatry is fully the invention of white European males, with very little contribution from other sources. While it has become more “diverse” as the decades have passed, the basic assumptions, particularly the idea that a “sane” practitioner can determine the “insane” patients by observation and can use force or coercion to get them to behave “properly,” have never actually changed. The more recent marriage to the pharmaceutical industry to use drugs and ECT to alter someone’s brain to stop them from feeling the “wrong” things and/or behaving the “wrong” way certainly fits with a historically “patriarchal” worldview, namely that the “authorities” get to decide what YOU ought to do, and dissenters are to be punished. It’s true that the “punishment” has taken on a different color, mostly due to the presence of mass media and drug company marketing of “diseases,” but when push comes to shove (sorry for the ironic analogy there!), psychiatry is a top-down, fully authoritarian effort to “make people behave,” and it is very much backed up with the full use of government and social force to make its pronouncements stick OR ELSE.

  • That is pretty damned offensive – makes “the seriously mentally ill” (who of course could be anyone “the authorities” so deem, given there is no objective way to assign such a label) sound like the enemy and psychiatry frustrated to be unable to defeat them and their “unattractiveness.” This kind of comment reveals a lot about the contempt in which such people are commonly held by those running “the system” that is supposed to be there to help them.

  • I agree, it’s worse in a way. Kind of like how the culture of Nazism in WWII allowed more “normal” Germans to feel OK about committing atrocities against Jews and Gypsies and so on. An individual narcissist can be dealt with once you know who and what s/he is. A culture set up with discriminatory rules is much harder to fight!!

    And of course, it does make it easier for true narcissists to find a spot to do their dirty work!

  • I think you hit the crucial point here: the person has REASONS they choose to ignore the evidence, and WE DON’T KNNOW WHAT THEY ARE! Calling something “delusional” is a judgment placed on them by the “experimenter,” and as soon as that is done, we stop being scientific.

  • Well, that’s what I eventually had to decide. I realized that it wasn’t because they “didn’t understand” that their interventions were harmful. The people in charge actually believed that “stopping symptoms” was the actual GOAL and that quality of life issues or trauma history or WHY people had the feelings they had were actually not relevant. I remember talking to one psychiatrist about the “medical model” and drug “solutions,” seemed like a perfectly nice person, and I asked him about PTSD. I said, “Well, at least for PTSD, we can say with certainty that it is caused by traumatic events, not malfunctioning brain chemistry.” And he said, “But not EVERYONE who is traumatized gets PTSD! So there must be SOMETHING different about their brains that makes them vulnerable!” I gave up on the conversation at this point.

    But this guy was not “narcissistic” in his presentation in any way. I think he was just trained by and believed in a system that treats ‘the mentally ill’ as objects or lesser humans. As I’m writing this, I think that’s the basic problem. There are plenty of non-narcissistic people who believe that black people “should get over slavery,” that feminism means hating men, that gay people are dangerous pedophiles, and all sorts of stupid things, because cultural prejudices allow them to entertain these beliefs without challenge. Bottom line, the system trains people to DISCRIMINATE against “the mentally ill,” and those who resist are themselves ostracized, ignored, or attacked for challenging the system. It’s not a matter of individual narcissism in most cases. It’s a culture of bias and disrespect and prejudice that these individuals are participating in that makes them feel OK about treating “the mentally ill” as “less than” without any pangs of conscience disturbing them. And of course, Alice Miller’s considerations play strongly into this, as the culture provides ample cover for the “professionals'” need to punish or silence their clients for making them feel uncomfortable with their drama.

  • In fairness, I started out in the “mental health” system because I wanted to help people, as I had been helped by my therapist, who frankly did a great job in many ways and really helped me get onto a new path in my life.

    Of course, I was never a “follower” and always was suspicious of the “medication” advocates and the DSM never made sense to me, and was viewed as a rebel and often tossed monkey wrenches in the system, but still I had opportunities to be helpful in a genuine way, and people seemed to appreciate what I could do, so I continued for over 10 years in the profession. It wasn’t until I worked doing “involuntary detentions” and saw what happened to people in psych wards and how many “mentally ill” people were labeled, drugged and forgotten, their quality of life total shit but their caseworkers interested only in whether they were “on their meds” and what their “symptoms” were, that I felt I had to get out for ethical reasons. Don’t get me wrong, the people who got me for their “evaluations” were quite fortunate, I had by far the lowest rate of detentions in our agency, and I sprung some inmates from the joint as well, but I could not ethically hold people against their will in such horrid conditions as prevailed in the psych wards.

    So people do learn and grow and sometimes grow out of their excuses or explanations for overlooking the real horrors of the “mh” system. Of course, the system is far worse today, and I doubt I’d have lasted 3 months, but there are people in the “system” who don’t really believe in it fully, and we ought to give them some credit for operating behind enemy lines. It’s not a fun role to play!

  • I’m not totally sure about that. I think it may be that a certain “brand” of narcissist is attracted to the field, kind of like police and the military. There are also lots of people approaching it with good intentions, but the DSM does make it easy to indulge in narcissistic fantasies. It’s also true that when things get difficult in a “therapeutic relationship,” there is, in my experience, a very strong drive to “fix it” because it is VERY uncomfortable to have to sit with someone else’s pain right in front of you. But I’ve found the key to success is being WILLING to tolerate that pain being there and NOT knowing what to do about it and letting that be true while looking around and exploring what that pain is looking like. The DSM/drug model unfortunately allows someone looking for an “out” to simply say, “Wow, you must have ‘major depression'” or “I think you need antidepressants” instead of hanging in there and believing that a good direction will emerge if we are patient and willing to sit with that discomfort for a while.

    So I think the major challenge is that therapists enter in totally unprepared, have NOT done the work to deal with their own pain, have that pain brought back to the surface by their client, and then feel they have to stop the client from having those feelings because they want to feel better themselves. And the label-and-drug model makes it all too easy to act out those “savior” fantasies within the expectations of your supervisor or “the system.” It’s pretty much a setup for failure. I admire those who are able to work within that system and still help people. I finally gave it up and decided advocacy was the better path for me to go.

  • I don’t think that diagnosis is a priori wrong in the “mental health” area. I just think that such diagnoses should represent something actually distinguishable from a different “diagnosis.” The DSM itself admits it fails to do this (actually that it doesn’t even ATTEMPT to do this) in its introduction. CBT is just a way of engaging a person’s thinking process in interfering with their habitual behavior. It’s possible it may be more effective in disrupting anxious thoughts than in stopping, say, hyperactive behavior, but that’s just a percentage based on the kind of “symptom” we are dealing with. The fact that CBT may be more useful for someone feeling anxious does nothing to confirm that anxious people are anxious for the same reason, that anxiety is de facto a “disorder” or “disease” state in all or in fact in ANY case, and studying “anxiety disorders” means studying people who most likely are quite diverse and heterogeneous, meaning that even if 80 percent of people can apply the list of definitions and come up with the same “diagnosis,” there is no reason to believe that these people have anything in common other than the fact that they happen to fit the list. It’s sort of like saying that if 80 percent of people can be identified as suffering from “knee pain,” it means that “knee pain” is a valid diagnosis. Of course, it’s nothing of the sort. Knee pain can be caused by a score or two of different actual diagnoses, including a bruise, water on the knee, arthritis, a torn ACL, MCL, or other ligament, a torn cartilage, etc, etc, etc. “Knee Pain” is simply not a useful diagnosis. Pretty much every psych diagnosis is similarly useless. What if one person is depressed because of thyroid issues, one because of childhood abuse/neglect, one because he’s in a dead end job, another because she’s suffering from domestic abuse, another because he can’t figure out the meaning of his life, another because he just got diagnosed with cancer, and another because she’s got severe anemia. Feeling depressed, losing sleep, losing joy in things we used to like, these are subjective, almost arbitrary items that could all be caused by dozens of reasons. It’s scientifically incredibly weak to try and do “research” on these so-called “diagnoses,” not because diagnosis is wrong but because these diagnoses don’t provide any explanatory model for what is wrong and what might be done about it, except on the most superficial level. It’s very much like diagnosing “knee pain disorder.” If we accepted that as a diagnosis, guess what would always be the most effective “treatment?” That’s right, drugs. Do you think the “atheoretical” diagnostic plan was created by accident? Or is it perhaps intentionally done to make marketing biological “solutions” a lot easier.

  • Actually, advanced imaging has contributed to proving that the DSM concept of “mental illnesses” is complete bunk for almost all so “diagnosed.” It is showing that folks with the same diagnosis have almost nothing in common, except for common damage from the drugs they may be taking.

    And my retort to your neurologist relative is this: I’m a very smart person. If you can’t explain it to me, it’s probably not because I can’t understand it. It’s because either you don’t want me to know, or you don’t understand it yourself.

  • By the way, I do support doing research on “diagnoses,” but only for the purpose of demonstrating the fecklessness of “diagnosing” people in this slipshod manner, or the lack of effectiveness of a given “treatment” for such “disorders.” I consider any research done using the DSM categories to be prima facia false, as the groupings of people on that basis have no scientific validity (they are heterogeneous groups having no known, measurable qualities in common). The main error in the DSM is assuming that people who have the same “diagnosis” have something wrong with them, or the SAME thing wrong with them all. The DSM itself even admits to this failing. But what is the use of a “diagnosis” that groups together people who have nothing in common? It is literally possible for two people to have “Major Depressive Disorder” or “Generalized Anxiety Disorder” and have not one single trait in common with each other! From a scientific viewpoint, the DSM is utter garbage!

  • How can a “diagnosis” be reliably made when the criteria are totally subjective in almost every case? What is the standard for reliability, merely that other people’s opinions agree with yours? And if that’s the case, shouldn’t we be using language such as “people typically labeled as ‘bipolar'” or “people typically labeled with ‘major depressive disorder?'”

  • I found the same thing with foster youth or their parents or foster parents. No one was really given informed consent. One facility had a “clients’ rights” sign on every wall that said they had the right to know the intended benefits and potential adverse effects of any medications they were given. When my CASA volunteer asked the therapist when that had happened for her charge, the therapist said, “No, we never do THAT! They might pretend they had the side effects or decide not to take the medication!” Which is kind of the point of “informed consent,” isn’t it? That was the attitude I met every day. Doctors knew best, people needed to do as they were told or horrible consequences would ensue, and anyone who said otherwise was brainwashed or “anti-science” or just didn’t understand how important these “meds” were. Yet 9 out of 10 kids stopped their “meds” or cut down to one almost immediately after they escaped foster care, and very few that I knew of suffered any adverse effects in the long run. And when asked at multiple “foster youth panels” what kind of intervention they found most helpful, not one of them ever mentioned “medication” as a key to their success. It was always a person or a relationship that they identified as what helped them through. Sometimes a therapist, but never once a psychiatrist or his/her “medications.”

  • Part of the problem is that “overdiagnosis” and “overmedication” are not concepts that can be applied to psychiatric “treatment,” because there is no objective way to determine who does and does not qualify for a “diagnosis” made from a checklist of behaviors. So we decry “overmedication,” but the next person who comes in “depressed” for whatever reason can be reasoned to “qualify” for “major depressive disorder” and thereby be drugged once again. Add in the strong financial incentives to drug anyone who comes in the door, and you get the disaster that is “mental health treatment” today.

  • I notice that you seem to continue to view clients from a viewpoint of “diagnosis” and “treatment.” CBT to me is simply one of many techniques that can help certain people get a perspective on what THEY can to do improve their lives in ways that they find helpful. I never cared one whit what “diagnosis” they had. All I cared about was what THEY saw as the problem (often requiring some pretty good interviewing skills to help them figure out) and what THEY felt was helpful in moving forward. Sometimes CBT was perfect, sometimes it was useless, not depending on the “diagnosis” but on the person’s personality and goals and viewpoint on what they are trying to accomplish. Similarly, some people did REALLY well with regressive techniques, others wouldn’t consider it or it wasn’t really realistic given the circumstances or timeline or it just plain didn’t work. Some do well “brief therapy” techniques (what did you do the last time this happened?), while some find them insulting. Sometimes I made stuff up on the spot specific to that particular person. My primary rule was, “Gather information. Try something that seems to make sense. If it works, do it more! If it doesn’t, stop doing it, gather more information, and and do something else!”

    Milton Erickson said that therapy needed to be “reinvented” for every client/case. He was correct. I tried to approach each case with a “Beginner’s Mind,” as they say in Buddhist teachings, open to experiencing what is before me, no preconceptions or judgments or plans. I found that “diagnoses” did nothing but confuse and distract me from getting to know the PERSON in front of me, which was the key to my success in the field. The question to me was never, “What is his diagnosis” or “what is wrong with her?” or “what school of therapy should I follow?” It was more like, “Who is this person? What’s important to them? What are their goals and what do they see as barriers to those goals? What kind of fixed beliefs or behavior do they seem committed to that don’t make sense to me, and why do they make sense to them? How can I assist them in stepping out of their normal ‘scripts’ and see what alternatives might exist?” There is no formula for doing this – one has to simply roll up one’s sleeves and be humble enough NOT to “know” things about this client that you really don’t know at all.

    People are mysterious. Psych “diagnoses” don’t help us understand the mystery, they trivialize and confuse the real issues that we ought to be looking at. If I were you, I’d consider dropping them from your vocabulary.

  • We definitely agree on that, and that’s a good start to a deeper conversationn. It’s very important to understand not everyone has your kind of experience. I have thankfully never been held against my will, partly because I’m older and grew up in an era where “mental health professionals” were more interested in relationships and experience and less in proving biological causation, and because I lucked out and got a really good therapist on the first shot. Plus I am a white male with a college education, privileges the majority of those held against their wills don’t have. But in today’s environment, it’s quite possible I would have been “hospitalized,” because I definitely did express feelings of suicidal ideation during my therapy. I’m happy to have dodged that bullet. Others are not so fortunate.

    My distrust/disdain for psychiatry is not based on my personal direct experience as a client, it is actually based on comparing the conclusions of real scientific research to what front-line psychiatrists and “thought leaders” tell us is true. It started with “ADHD.” My son clearly fit the criteria, and I was concerned it would come up when he got to school age, so I did some research on long term outcomes. I was STUNNED to find that there was no long-term research suggesting that ANY long-term outcome, including academics, school completion, college enrollment, delinquency rates, teen pregnancy rates, social skills, or even self-esteem, was improved for “ADHD” kids taking stimulants vs. those who don’t or who take them only short term. I’ve tracked on the research since then, and that continues to be the case. Yet I heard psychiatrists and school personnel saying things like, “Untreated ADHD leads to school failure and higher delinquency rates,” when “treatment” did nothing to improve those outcomes!

    I have since tracked research on antidepressants, anti-anxiety drugs, antipsychotics, and to a lesser extent, “mood stabilizers,” and the exact same pattern emerges. Antidepressants are insisted on as “life-saving” for suicidal people, yet there is no evidence they reduce the suicide rate, and suggestion that they may actually increase it. Antipsychotics are supposed to be essential long term to prevent “relapses,” yet those who take them long-term are MORE likely to be re-hospitalized or otherwise deteriorate than those who use them short term or not at all (see Harrow’s work, referenced in Anatomy of an Epidemic). These are large scale studies of many people, and don’t imply that no one is helped by these interventions. It means that on the average, people are better off not taking any of these drugs for the long term. And people are not told this, and ought to be.

    So the reason I distrust psychiatry as a profession is because they’ve been dishonest. They’ve claimed that all their DSM diagnoses are entirely or primarily biological in origin, despite a lack of research suggesting this is true, and a commonsense critique that claiming the same cause for everyone’s “depression” or “anxiety” flies in the face of reason. They’ve lied about the research that IS done, and have attempted to suppress real data that comes out which contradicts their desired narrative (Harrow, Kirsch, the WHO intercultural studies, etc.) They accuse people like Robert of being antiscientific or cultists just because their findings challenge that narrative. So no, I don’t trust them, and it’s not for emotional reasons, though I consider a person having been personally brutalized an excellent reason to distrust them anyway. But I’m not one of those. I worked IN the system for years, and I saw what really happened as a result of this system. Not saying that all psychiatrists are evil or stupid, nor that people for whom these treatments work should be denied access to them. But I don’t think medical professionals should lie to people about what they “know” in order to get them to agree to a particular approach. Do you think it’s OK for an entire “medical” industry to misrepresent the facts in order to increase their market share? I don’t, and that’s why I have no trust or respect for psychiatry as a profession, regardless of my positive interactions with some psychiatrists and the reported successes of some percentage of patients.

    I hope that makes things clearer on where I’m coming from. If you haven’t read Anatomy of an Epidemic, you really ought to. It is very well researched and non-emotional in presentation, and might help you understand the “rest of the story” for people who have not been as fortunate as you and I have.

  • I challenge you to show me hard evidence that there is “some kind of chemical disruption in the brain” of all or most people who fit the criteria for “MDD.” The idea of the “chemical imbalance” theory was disproven back in the ’80s, before Proac even came to market. Even mainstream psychiatrists are disavowing this theory and claiming that they never supported it. They’ve moved on to the idea of “circuits” and of “genomic analysis” because their original theories on cause have never panned out.

    Of course, nobody knows if it’s nature or nurture, and as in pretty much everything, including hard biological illnesses like cancer, diabetes, and heart disease, it’s no doubt a combination of both. The “diagnosis” is not made by any kind of brain scan or measurement of brain chemicals or EEG or any kind of measurement – it’s just a list of “symptoms,” and most doctors don’t even bother using those. How would it be possible to distinguish “clinical depression” (supposedly caused by biology) from any other kind of depression just using a checklist of symptoms?

    Your case may be particular, you may have some biological vulnerability, but I would bet that no one has shown you what exactly is wrong with your family inheritance. In any case, just because your case may be biological doesn’t lead to the conclusion that any other case is biological. The psychiatric profession makes a common but serious scientific error in assuming that all subjects with similar presentations have the same problem. This is, of course, nonsense scientifically, as something like a rash can be caused by dozens of things, including poison ivy, prickly heat, the measles, or syphilis. I’d sure want my doctor to be able to tell the difference before they started ‘treating’ my rash!

    The other interesting scientific question is: If there is no objective way to tell who “has” “clinical depression” caused by a “chemical problem,” how would anyone be able to determine what “overprescription” would mean? What’s an appropriate level of prescription look like for a disease that has no reliable physical markers whatsoever? That’s one of the biggest problems with the DSM approach – no one can really tell if the doctor is right or wrong, because it’s all a matter of “clinical opinion.”

    Again, I support anyone who finds antidepressants useful, or anything else that helps them. I don’t deny that depression can be a HUGE problem in a person’s life – been there, done that. But that doesn’t make it a medical problem. The burden of proof should be on those claiming it is, and they haven’t met the standard.

    Additionally, the article itself makes it clear that most people do NOT benefit from antidepressants. Why do you think that is, if it’s a biological problem? Or how can you distinguish the bio-depressed from the psycho-spiritually depressed? Or those depressed because their lives are depressing? How can you tell?

  • Just to be clear, Maggie, I don’t think anyone here thinks a person should “just get over it.” That’s a trope that is tossed out by the psychiatric industry to try and discredit their critics, pretending critics are saying, “There’s nothing wrong, just quit whining.” But that’s not the critique here. The proble is the CLAIM that “depression” is a DISEASE STATE without providing any evidence that this is the case, and then pretending they can somehow TELL who “has clinical depression” and “needs medication” while in practice recommending drugs for pretty much every single case they run across.

    I have suffered a lot from chronic depression and it took years, decades really, to truly get a handle on it, and it still is a problem sometimes for me. But I don’t hold that I have a “disease” that can be somehow cured by messing with my brain functioning, because there is no evidence that either of those things are true. I also know that some people find antidepressants helpful on a personal level, and I have no concern about that. But I do have a concern about professionals making claims of scientific support for something they have no actual understanding of, particularly when they approach it in a completely biased manner and deny evidence that really IS scientific, such as the fact that most people do NOT get better on antidepressants, as this article shows us.

  • The most obvious one was the Germanwings aircraft murder/suicide. The guy TOLD his psychiatrist he was having trouble with his “meds” and asked for her help. I don’t think she did anything but continue him on the same drugs. And 150 people died needlessly. But his “mental disorder” was blamed instead of the psychiatrist’s mapractice and neglect.

  • “Treatment resistant” is such a ridiculous term! It implies that EVERYONE should respond to “treatment,” and that anyone who doesn’t is either personally resisting, or their “disorder” (a mental construct!) is resisting! Why not just say, “Our treatment failed” and leave it at that?

    What would you think if you took your car into the garage, the guy worked on it for two weeks and then gave it back and said, “The problem is, you have repair-resistent fuel injectors! I can’t fix them, but if you come back once a week we can treat the symptoms…” You’d get a new mechanic double quick!!!

    “Treatment resistance” is a loaded term meant to blame the client for the doctor/therapist’s failures.

  • No, that is NOT what I want. I simply want you not to classify people who experience hallucinations/delusions as “schizophrenics who believe they have that” or “schizophrenics who believe they don’t have that.” You are ‘diagosing’ that person against his/her will, even if you accept that they “don’t believe they have that.” Why not call it “people with delusions/hallucinations who call it an illness, and people with delusions/hallucintions who don’t call it an illness?”

    It is more like a Muslim trying to convince ME that I have to do Ramadan, because she’s a Muslim and that’s her lens. I hope we are capable of rising above that.

    But thanks for the clarification. I believe I understand your views much better now, and my prior confusion is quite fully cleared up.

  • You are clearly empowered to believe in your doctor – s/he may even be right! What I am saying has absolutely nothing about you or your diagnosis or your belief in your psychotic experiences as an illness or agreeing with your doctor. The objection I have is to you saying that because YOU believe your doctor and his/her diagnosis, it means other people who view it differently are “choosing to believe” something you regard essentially to be wrong. And you’re entitled to believe that, just as others are entitled to believe you are “wrong,” but most of your comments reflect an “open minded” attitude, live and let live, believe as you see fit, which I agree with. I was just pointing out that others should have the same right as you, not to be talked to as if their belief that their situation is NOT caused by biochemistry or is NOT called “schizophrenia” just because the doctor says so is irrational, which is what I was getting from your post. People don’t just have the right “believe their schizophrenia is something else,” they have every right to believe that they don’t have schizophrenia or that doctors’ “diagnosis” of schizophrenia doesn’t meet minimum scientific standards as a “diagnosis,” even if the condition described does exist.

  • With respect, DW, I have to note that you said:

    anyone has schizophrenia and prefers to regard it as not schizophrenia but some other ailment or stress or trauma or government plot or even extra terrestial indoctrination…

    I will be encouraging of this YOUR CHOICE of way you know YOU”

    It seems you are saying that others DO HAVE schizophrenia but are REGARDING it as “not schizophrenia.” This seems to violate your own principle – you are telling them that they DO have schizophrenia even when they don’t regard it that way. You want others to allow you to BELIEVE or ASSERT you have a disease called “schizophrenia.” Why do you not respect others rights to BELIEVE or ASSERT they do NOT have schizophrenia? If you respect that right, how can you say that they “have schizophrenia” by your own or the doctor’s definition and are REGARDING it as “not schizophrenia?” It sounds as if you are saying that you know they DO have it but are willing to tolerate them claiming otherwise. Is that how you see it?

    Or does the other person have a right to DEFINE their experience as they please, since there is no objective way to “diagnose” schizophrenia beyond a list of thoughts and behaviors made up by a committee of psychiatrists? If everyone has a right to their own interpretation of reality, why would you or the doctor be in any position to define their condition as “schizophrenia” and then magnanimously grant them the right to “regard it” as something else?

    Perhaps your concern is not that others won’t allow you to define your own condition, but that others choose to define it differently than you do?

    I ask this with the utmost respect. I have had a hard time understanding where you’re coming from, and I sometimes think I do, and yet you sometimes talk as if you think I don’t. Maybe I didn’t really understand you in the first place? Some clarification would be appreciated!

  • I certainly never said any of those things. What I DID say is that DOCTORS should not be able to tell YOU or ME or ANYONE ELSE what is “wrong” with them when they have no idea or scientific or even intuitive basis for their claims. I get frustrated when you claim I am saying that you have no right to choose your label. I have literally NEVER said that. I have said that no one ELSE has the right to label YOU (or anyone else) without your (or their) agreement. I hope the distinction is now clear.

  • As usual, I agree with you almost completely. The one exception is your comment that you are sure the “mental health” meme was entered into with “good intentions.” Nothing expands that quickly without funding behind it, and that funding comes from our friends in the Pharmaceutical Industry. I am certain this phrase was chosen specifically because it had the effect that was wanted, and it was spread as propaganda through the usual “advocacy” groups and social media sites with the intention of making it ‘popular,’ as a means of marketing their wares. The more “mental health” is normalized, the less people look for other explanations, and the more drugs and “services” are sold. The intentions are NOT good!

  • People who don’t want to change anything should be left alone. I was assuming we were talking about a person seeking assistance. I see no need for an outside “professional” to label their experiences as “mental disorders.” I think it should be up to the person seeking help to define what they want to change and whether or not a particular approach is of interest or appears to be “working.” I hope that is clearer. No one should be forced to entertain “help” for something they don’t want help with, nor should someone else be able to define what “help” looks like for a particular person.

  • Parents don’t have to be monsters to cause harm to their children’s psyches.

    No one is all good or all bad. We are all human and make errors and do good things and mess up and recover. It’s not about good or bad parents. It’s a lot about what adults went through when they were kids and pass on, and about what adults/parents are expected to do in our society and what they are supposed to do with their kids.

    Most people would say my parents were fine people. They did a lot of things right. But they did some things wrong, too. Additionally, schools were full of well-meaning folks who often did a lot of harm because “that’s how we do it.”

    An example: Good parents were expected to leave their kids to “cry it out” in their cribs when I was a baby. They were expected NOT to nurse their babies and to feed them solid food at way too young an age. Some were told that taking Thalidomide was safe and ended up with hydrocephalic babies or other birth defects. All were expected to send their kids to schools without question, even though some of my teachers were absolutely crazy and dangerous. One hit me in the head after she tossed a book across the classroom in second grade and I protested. Was that my parents’ fault? The teacher’s fault? The school’s fault? Society’s fault? It doesn’t matter whose “fault” it was or whether the teacher was a monster or just a sad old lady who never was loved. What matters is that I had experiences that were not healthy for me. They hurt me, whether they were intended to or not. It was helpful to recall those hurts and what decisions I made at the time, so I could learn to make different decisions today. There were no monsters. Just adults trying to do their best. But I still got hurt, and I don’t have to make excuses for them. I can take care of my own needs and let them be upset about it if they want to. Which my parents were, but we healed some as I grew up and was better able to express myself. I loved them, they loved me, and we were better off facing up to the painful moments where things didn’t go so well.

    No blame or monsters or heroes required.

  • I’m not sure they were ever “bedazzled.” If you listen to the discussions around the time of the creation of the DSM III, they were quite blatant about their political goal of establishing psychiatry as a “real science” by pushing claims of biological causation and treatment. Of course, Big Pharma was happy to help out for a price, and they developed a symbiotic economic relationship that continues today. Many lower-level “mental health professionals” are, in fact, bedazzled, but the leadership premeditatedly planned to sell this concept to the public, whether or not it was true, and they have succeeded.

  • Why bother forming a model of a “mental disorder?” The term is already so biased and polluted it’s not worth trying to rescue. Why not simply help people identify what they want to change about themselves and help them find a way to do it? Or work to alter the known social conditions which create such emotional distress in the first place? Why not work on building a world that respects people’s mental/emotional condition instead of making diseases out of them?

    Humans’ biases will not ever allow for a rational “model of the mind,” let alone of “mental disorders,” in my humble opinion. It’s a case of Heisenberg’s Uncertainty Principle brought to life: as soon as a mind starts studying “the mind,” the mind itself is altered by the process.

  • I think you have hit the most fundamental problem with the “helping” professions. Anyone who thinks they can tell another person what is wrong with them, what they need, and/or what they need to do about it is inherently dangerous. People don’t need someone to define things for them, they need someone to help them figure out what they need and how to get their needs met. Humility and empathetic listening, along with a few carefully-selected pointed questions, is what most people find most helpful, whether it’s from a professional, friend, family member, or a stranger on the street. As soon as a person forgets that the only one who knows the ‘right answer’ is the person seeking assistance, they become a hindrance rather than a help. And when they expect the person seeking support to “appreciate” whatever “help” they choose to provide, they become inevitably damaging to the person they are claiming to “help.”

  • It is also very possible that the best of parents make errors and their kids end up hurt. It is very important that parents are willing to take responsibility for their contribution to thhe problem, and the best parents are willing to do that, and make it OK for their kids to give them feedback about their experience as children. You don’t have to be a “bad parent” to contribute to your child’s emotional struggles!

  • I agree, that is exactly what happens, even to other health professionals. We’ve all been taught that “mental illness,” and suicide in particular, is very, very DANGEROUS and that anyone NOT a professional will no doubt mess it up, with the corrolary being of course that you’ll get sued if you don’t get it right. I remember a kid in residential treatment who would claim he was “suicidal” because he knew it meant a trip to the ER and he could get out of a day of school. The res staff were too afraid to handle it until they got approval from the psychiatrist to do a “planned ignore” and not automatically transport him every time he said the “s” word. It really is quite ridiculous – we are removing what is probably the BEST assistance a person thinking of ending his/her life can get – support from friends and loved ones – in favor of forced hospitalization and drugs that present no evidence of doing anything to reduce suicides, and may actually increase them. Who is insane, now?

  • The term “recover” is often used in terms of injuries or illnesses. It is the assumption that a mental/emotional challenge is an “illness” of some sort in the individual that needs to be challeneged. And I would submit that many people need help “recovering” or “recuperating” from the assault on their lives and their integrity that psychiatry itself has perpetrated!

  • You are quite right. There was a quite open discussion of this back in the 90s. They chose the term ‘medication’ instead of ‘drug,’ and substituted ‘discontinuation syndrome’ for ‘withdrawal,’ to differentiate as much as possible their psychiatric “medications” from their close cousins, street drugs (and sometimes they actually USED street drugs and called them “medications” instead.) There is no doubt what you say is absolutely and intentionally true.

    “Severe and persistent withdrawal syndromes from antidepressants have long been neglected or minimised. Obscuring a potentially serious risk, the pharmaceutical industry coined the term “discontinuation syndrome” to avoid association of antidepressants with psychotropic dependence. This term is unnecessary and misleading, suggesting antidepressants cannot cause dependence and withdrawal.11,16 Thus, patients and prescribers may misattribute withdrawal symptoms as relapse or emergence of new mental disorders.11,16,21”

  • I think for some people, “recovery” means “accepting of diagnosis and taking all drugs prescribed by doctor.” The idea of recovery WITHOUT or IN SPITE OF medical intervention seems to be heretical in some circles. It’s almost like you’re saying it’s not a medical problem at all! Which might suggest that maybe THEIR acceptance of their diagnosis and medical intervention could be called into question. EEEK!!!

  • That meme also assumes that psych drugs always or consistently make people’s “symptoms” better. There are plenty whose “symptoms” get worse, or who get new “symptoms” of new “disorders” that they never had before because of reactions to the psych drugs they were prescribed. Many of the foster kids I worked with got significantly BETTER when taken off their psych drugs that clinicians claimed were so essential to their survival, and there were many more who were no better or worse on or off the drugs, which of course means the drugs contributed nothing to their “mental health!” I’ve seen a girl diagnosed with an eating disorder put on stimulants, after which folks were very alarmed that she stopped eating! Who would have guessed? I’ve seen a girl diagnosed with diabetes, and we advocated for her to be taken of Seroquel, and a few weeks later, the diabetes was GONE.

    Why the assumption that these drugs are always positive, or that the pros always outweigh the cons? It is a very disturbing assumption that harms a LOT of people!


    I’m afraid that the literature shows brain damage to be quite common in ECT. In this review, they suggest some level of damage is always present. ECT “works” by inducing a grand mal seizure in the individual receiving it. When people have seizure disorders, we do everything we can to STOP them having seizures, specifically BECAUSE there is damage to the brain when uncontrolled seizures occur.

    I’m not trying to invalidate your personal reality, because what works for you is what works for you. But it is not accurate to suggest that loads of studies show no brain damage from ECT. It is most likely that any therapeutic effect for ECT is the result of minor brain damage. But sadly, it is not always “minor,” as many survivors of ECT can attest. It is, at best, a very risky procedure whose benefits are unpredictable and generally very short lived. That doesn’t mean that no one finds it beneficial, but it does mean that claims of “safety” are not supported by the scientific literature.

  • I would not call that “overmedicated.” Of course, there is no way to determine the “proper” level of “medication” when the “disorders” they claim to see have no actual, objective definition. But being on 9 drugs is not “overmedication,” it is MALPRACTICE! And I’m willing to bet that despte (or because of) her massive “medication” load, he’s still doing poorly and has a crappy quality of life. That is not healthcare. It’s malpractice.

  • I agree with you for the most part. The only objection I’d make here is that psychiatry is not to me “science done badly.” It is pretend “science” used in the service of marketing drugs. You and I both agree that enforcing drugs on people as “the only solution” is oppressive, especially when done so without the consent of the “drugged.” I am adding that pretending that “science” supports such an action, that the reason you should “go along with the program” is because “you have X disorder” or “you have a chemical imbalance in your brain” is not science, but pure marketing, promoting something they know is NOT supported by science as if it were, because it sells drugs.

    If psychiatrists said, “These phenomena happen to people. We don’t know why, but we have discovered some drugs that may stop some of these phenomena temporarily, with x and y adverse effects,” then they’d be a lot closer to being scientific.

    So a person can believe fully in science as a means of determining the truth (or I should probably say, a means of determining what is NOT the truth, as science is a lot better at that) without having a minute to give for psychiatry’s effort to use people’s vulnerability to sell them drugs. I will add that I don’t worship science and recognize its limitations, and have a full spiritual life and believe in lots of things that Science can’t explain. But psychiatry has nothing to do with science, except to the extent that they can study what effects these drugs actually have on people, and they’re not even honest about that.

    I never confuse psychiatry with science. It’s a marketing scheme, plain and simple. You or anyone else can certainly use the psychiatrists’ framing of disorders or diseases if you choose to, and more power to you for it. I even use some of them on occasion. But I don’t view such “disorders” as scientific entities, any more than describing someone as “courageous” or “a slow runner” or “has lovely hair” as scientific descriptions.

    I don’t mind you viewing yourself as “ill” and describing yourself that way. I do mind a doctor pretending that they have proof that I am “ill” and therefore need to accept their “treatment” of me as a legitimate medical practice, especially in the absence of any evidence that they can identify a definitive cause and test me for it in some objective manner. Just as someone is free to be a Christian or a Muslim or a Hari Krishna if they want to, but I object when they start telling me I have to agree with them, especially if they try to claim that “Science proves that Christianity is the ‘right’ religion.”

    I hope that clarifies the point.

  • I think there is a big difference between one citizen telling another one what to think/not to think about their condition, whatever it may be, which I think would be a bad thing, and a person with big social power, like a doctor or psychologist, telling people that “science” says that you have “X disorder” and that it is biological in nature, and that drugs are the solution, especially when there is no scientific evidence that is the case. So I think the two of you may be talking about different subjects. It seems like DW is not liking it if people tell HER that she “is not ill” or that “schizophrenia is not an illness,” which I completely understand and agree with. What I understand YOU to be saying (and I agree with you 100 percent) is that the PROFESSIONS of psychiatry and psychology have intentionally perpetrated misleading or downright dishonest representations of the truth, and that these misrepresentations have damaged those they claim to help. To me, these are completely different subjects, and I hope we can all be careful to make sure we make that distinction. If DS or anyone else wants to frame their experience as an illness or attribute a biological cause, they are free to do so. When a psychiatrist or psychologist or an MD makes that claim about someone ELSE, then it is THEY who are bullying and telling others what to believe about their own condition, without scientific backup for their position.

  • In fact, the data suggest that antidepressants, far from saving lives, actually INCREASE the odds of someone committing suicide. And the fact that the suicide rate for folks leaving a psych hospitalization is so amazingly high does not speak well of the “treatment” they are receiving.

    There is no drug on the market today that can legitimately claim to reduce the suicide rate. Even the drug companies don’t claim that in their advertisements. They count on psychiatrists to do that bit of marketing for them.

  • I guess we’ll have to agree to disagree. To me, the idea of talking to a “professional” who pretends to some “superior knowledge” in order to “diagnose” me with a “disease or disorder” is VERY different from sharing my experiences with someone who has been there and understands how it feels to be in a similar situation. Human beings have communicated and shared with each other in times of trouble or to mitigate traumatic experiences since the beginning of human language. It is a natural and healthy thing to do. The problem I see is that this natural, human process has been coopted by those claiming special skills or knowledge in the area of “helping,” while presenting no evidence that a degree or professional position confers any kind of advantage in doing so. Folks need to recognize when they’re being scammed. But to suggest that sharing one’s experiences with another human being is ipso facto proof of being a fool or a sucker is just plain nonsense to me. I’m all for fighting back against the system and have done my share over the decades, but I also know that without other caring individuals to listen and help me through life’s challenges, including one very helpful therapist in my 20s, I would not be in the excellent place I am today, and in fact, would never even have fully realized that I needed to fight, and whom I needed to fight against. Dismissing the need for human sharing of experience is simply not a workable theory, no matter how many barriers are manned. But people DO need to learn, or re-learn, since we all once knew how to do this intuitively, how to discern those who we can trust from those who are not really there for us. Many revolutions were brought to a standstill by people’s inability to realize which leader ought to be trusted and which should not, so it doesn’t just apply to therapists or “peer supporters,” either.

  • Actually, I respect people’s inherent ability to discern who are and are not their allies. Unfortunately, that ability has been messed with starting at a very young age, and it is the lack of that ability that allows people to be taken advantage of, including by “professionals.” If people need anything in terms of “help,” the thing they need most is the ability to learn whom they can and cannot trust. If you ask me which is more likely to be trustworthy, a psychiatrist, a therapist, or another person who has “been through the system,” I’d bet on the third by a mile. It’s true many such have been coopted, but that should become obvious in 5-10 minutes of conversation.

    And I’d ask you this: if people are to join in some kind of resistance movement, would that not involve disclosing their affairs to people who may or may not be their actual allies?

  • No we don’t. We want real Peer Support to be paid for by all the money that we save when we fire all the psychiatrists and stop wasting so much money on non-working “Treatments.” I think the objection to referring to “mental health conditions” is mostly that it makes “peers” into automatic subordinates to the “mental health” system. I’d love it if the “system” were subordinate to y’all and especially the clients themselves, but that’s going to require a total re-do of the model where peer support is an “adjunct” or an “alternative” or “supporter” rather than the main deal.

  • I know how ETC “works.” After the “patient” gets 3-4 “sessions, they assure the doctor, “I feel SOOO much better now. THANK YOU for this wonderful experience! I don’t feel even a TINY bit depressed! Now, can you unlock that door so I can get far, far away from you and your ‘help?'”

  • I think it is also important to remember that not all “logic” is logical! But I agree completely, it is the suppression of feelings, not the feelings themselves, that lead to real trouble. Not all feelings need or deserve to be acted upon, but all of them can be safely EXPERIENCED, and in fact, feeling “negative feelings,” as people call them, generally leads to them being LESS likely to be acted upon in a destructive way.

  • You should keep in mind, though, that how a country is RULED (monarchy, etc.) is not the same as how the economy works. Capitalism is an economic model. We kind of know at this point that uncontrolled capitalism leads to monopolies, price-fixing, decreasing wages, and an increasing gap between the “haves” and the “have nots.” At the same time, we know that a fully government-controlled economy does not allow for sufficient freedom and motivation to create solutions to problems. Both are susceptible to corruption, of course. So it’s not a simple question of how the government is organized. Private enterprise has its own set of rules. There are plenty of capitalistic countries that have despotic governments or monarchies or even ostensibly “communist” governments like China or Viet Nam. It’s a very complex problem!

  • Actually, the best “treatment” for childhood trauma has been shown to be a healthy relationship with a caring adult or adults. Dr. Bruce Perry has written extensively on this point, as have others. The psychiatric community, as usual, has focused on the ostensible “brain damage” caused by childhood trauma, but have bypassed (or intentionally ignored) the brain-science solution, namely a safe environment with caring parents, which is shown to heal a good part of the damage you describe.

  • It is also “surprising” because doctors and other “wise ones” have blamed “hormones” for all cases of “postpartum depression,” in the interest of promoting their biological solutions to women’s “hormone problems.” This, of course, is an ancient trope used in service of oppressing women through asserting that their “hormone swings” make them incapable of thinking, voting, holding political office, owning land, etc. The idea that MEN might suffer from “postpartum depression” shoots a gigantic, cannonball sized hole in the side of the “it’s women’s hormones” ship, and so of course must never be considered. If MEN can become depressed after a birth, well gosh, that means it might have something to do with the CONDITIONS new parents have to tolerate rather than some random “hormone imbalances” caused by God’s poor design of women’s bodies.

    Of course, the industry will now embark upon an effort to prove that MEN’S hormones are somehow altered after their partner gives birth, spending millions of dollars and assuring us that “the solution will be right around the corner” instead of observing the obvious and trying to work on improving post-birth support for both men AND women.

  • Good post, Jessica. It might be of interest for you to know that a number of studies in different places in the US and Canada show that simply waiting one year to enroll kids in Kindergarten reduces the “ADHD diagnosis” rate by a third! It should be obvious to anyone that this has more to do with developmental levels and adult expectations not matching, not a “disorder” centered in the child because they can’t do what the adults arbitrarily expect of them. And the worst of it is, “medication” over the long term does not improve ANY outcome that we care about vs. kids who were not “medicated” for the same “disorder.” The whole thing would be funny if kids weren’t getting hurt by it!

  • I appreciate your scientific mindset in not ruling things out when you really don’t have data to draw a conclusion. I wish more folks had that attitude.

    I will add here that it is in my experience very difficult, in fact often next to impossible, to detect “signs of akathesia” beyond a person telling you what is going on. There are sometimes external signs, like being unable to stay in one place for long, or restless legs and that sort of thing, but it is described as an INTERNAL sense of restlessness and agitation. It may or may not be accompanied by obvious externals symptoms, and a meaningful discussion with the subject would be necessary to make a definitive diagnosis. It is also easily overlooked or seen as symptoms of “the disorder” rather than recognized for what it is.

  • I agree absolutely. The veneer of “medical treatment” allow the adults to pretend they don’t really know what’s going on. But the kids pretty much always know, and will tell you if you ask them in the right way. They’ll tell you “I have to take drugs because I can’t control myself” or “They give me these because I get in trouble too much.” They have no illusions about “mental disorders.” Which tells me the adults know this on some level, too, but they’ve learned to suppress their awareness.

  • Oh, steroids are a different question, not pretending to be “medical treatment,” and all done under the radar. I’m talking about creating a “medical diagnosis” that X person has “athletic deficiency disorder” that is caused by “genetic abnormalities” and is “treated” by giving them stimulants. The reason I bring it up is because most people would find such an idea disturbing, but when it is for academic performance, they’re OK with it. They don’t get that it’s the exact same kind of activity, just with a different focus.

  • They would do it if they could get away with it, I’m sure. I think there is a visceral cultural taboo on “performance enhancing drugs,” and I think trying to “sell” that concept would make their intentions and their “treatments” too obviously counterintuitive for the general public, and start some unwanted scrutiny. I think they know this on an intuitive level and so they don’t try that play. Drug-enhanced school performance is OK. Drug-enhanced athletic performance is a no-no. So they go for what sells.

  • Of course, brain imaging has its place and can be valuable. It’s just not valuable when looking at behavioral/mental/emotional/spiritual challenges. Finding that a particular area of the brain is “more active” or “less active” when someone is feeling depressed tells us practically nothing about causality.

  • I particularly agree with your point that everyone’s “cause” is unique to their own life situation, both physiologically and psychologically/spiritually. Trying to come up with one answer for everyone denies this obvious fact. “Depression” is a false category of “disorder.” It is an effect, not a cause. If we want to handle the situation, we have to find the cause, and calling “depression” the problem implies that all “depressions” are caused by the exact same circumstances, which is a silly thing to think.

  • But pretending that we “know” the cause and providing “treatment” on those assumptions clearly leads to destruction. You can provide aspirin or morphine for a broken leg, but you’re not treating “leg pain disorder.” On that basis, getting drunk can be called a “treatment” for “anxiety disorders.”

    And of course, in many, many cases, we DO know the actual cause of a particular case of “depression,” and it is usually NOT due to a physiological event, though sometimes it IS and we know it and we should “treat” the actual problem rather than the “symptoms” (low thyroid would be one example). We certainly know enough to know that “depression” is itself a “symptom” rather than a “disorder” that “causes symptoms.” It would be best for the clients involved if we dropped the whole notion of “depression” as a disorder and started viewing it a symptomatic of something else.

  • I would define it a bit differently – I see “scientism” as being the believe that Scientists are Authorities and that we peons are too stupid to understand their deep wisdom, so we have to simply believe what Scientists tell us and do as they tell us, even if it makes no sense to us at all. Because Scientists are All Wise, and we mere mortals couldn’t hope to understand the depths of what they are telling us about.

  • This was another trope of the psychiatric/psychological community to justify their drug interventions. There was never any means to distinguish “endogenous” from “exogenous depression.” It’s kind of dropped out of use, since it has served its purpose and allowed the drugging paradigm to take full hold. Now most psychiatrists assume that all “depression” is biologically caused, despite still having no evidence to prove or even suggest that is the case. Note at the end it states “The exact cause of depression is still unknown.” Which really means, “We have NO CLUE of the cause of depression, and we’re making this up!”

    “According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), anyone experiencing endogenous or exogenous depression will likely receive a diagnosis of major depressive disorder (MDD).

    Medical professionals no longer give endogenous depression as an official diagnosis, and the DSM-5 no longer lists endogenous depression as a diagnostic category. Still, some researchers and mental health professionals find that locating the sources of depression — internal or external — could help you with finding treatment that best suits the specific needs.

    The exact cause of depression is still unknown.”

  • Don’t think I ever claimed that “liberals” and Democrats have done anything but support psychiatry’s agenda 100 per cent. Most “conservatives” support it just as much, of course, but any of the rare moments of resistance I have seen has come from the political Right, based on the idea of “government overreach” or protecting the rights of individuals. Still, their numbers are tiny, tiny, tiny, and the overwhelming majority of both parties are fully bought off and supportive of the pharma-psychiatric industry.

  • You once again assume the condescending attitude that I somehow “misunderstood” when I have explained myself very carefully. I have misrepresented nothing. I have used quotations from the paper itself. Those who understand the demanding, rigorous logic of the scientific method will know what I’m talking about. And I notice that you did not even bother to try and refute my arguments logically, but resort to ad hominem attacks to try and make your point.

    Meanwhile, it’s clear that you have already decided that you are “right” and are unwilling to accept the most rational possible feedback from me (did you even bother to read and digest my arguments?), so I am not intending to get into further discussion with you about it. The article says what it says, and I have directly responded to the logical flaws and the actual data presented. If that’s not good enough for you, please at least refrain from your condescending swipes at my intelligence and/or integrity. It is not a becoming look on you.

  • I agree completely with you. These attempts to “prove genetic causation” by finding some tiny correlation involving dozens or even hundreds of genetic markers really are a joke and can never prove anything close to what they’re claiming. Especially when we have massive correlations with traumatic events that vastly outstrip the most optimistic (aka delusional) interpretations of the genetics data. Basically, they REALLY REALLY want there to be a genetic basis, they REALLY want it to be true, so maybe if they close their eyes and click their heels together three times and say, “There’s no cause but genes… there’s no cause but genes… there’s no cause but genes…”

  • I have used the analogy, “If children are being hit by cars outside of a school, and 20 percent break their legs and 80 percent don’t, do we do genetic testing to see why some of them have ‘weak leg disorder’ because they can’t stand up to being hit by a car? Or do we figure out how to stop cars from hitting kids on their way home from school?”

  • Just to be clear, “white male authoritarianism” can be and is enforced or enacted by non-white people and/or by women. It is the “thinking” or the philosophy or the “system” behind the actions that is authoritarian, and that system was most definitely constructed by white, male authoritarians over many decades or even centuries. The question isn’t who is doing it, it’s more who is impacted, and history shows us that women are regarded “by the system” as being more “sick” or “disturbed” or “mentally ill.”

    Consider the idea of “hypersexuality.” That concept is almost NEVER applied to men, but is a big “problem” for women, according to psychiatry. This reflects male privilege in our culture, in that men who sleep around are considered “players” or “studs” or “Ladies’ men,” whereas women who do the exact same thing are considered “sluts” or “whores” or “slags” or any number of unflattering things. No man was ever diagnosed with anything because he slept around.

    That’s just one example, and it’s very clear that women have long been a part of enforcing this condemnation of women who are “promiscuous.” The term I think that applies is “internalized oppression,” where members of an oppressed group are expected to enforce “norms” that come from the group in control in order to avoid punishment themselves.

    So in my view, psychiatry incorporates many biases and prejudices about women from the general society, and as a result, is even more likely to attack women than men for being “different.” It is also clear that racism is part of the underlying structure of psychiatry, as the disproportion of black people being diagnosed “schizophrenic” is way higher than the general population. The fact that black psychiatrists may participate in this set of discriminatory practices does not make it any less racist.

    I hope that makes some sense.

  • Just to be clear, Joshua, with almost no exceptions, “conservative” representatives are just as supportive of incarcerating the “mentally ill” as the “liberal” ones. Big Pharma donates big money to both sides of the aisle. I agree that the rare politician who opposes such efforts will likely be on the conservative side, but the vast majority believe strongly that the “mentally ill” are dangerous and need to be locked up. In fact, one of the most common arguments against increased gun control based on mass shootings is that the “shooters” are “mentally ill” and should not be out on the street, hence blaming the shooter’s “mental illness” to redirect attention away from gun availability as a possible cause. I’m not meaning to hash out the gun control debate here, just pointing out that “conservatives” in general don’t give a half a hoot about the plight of the unlawfully incarcerated “mentally ill,” an even less so about the damaging scourge of mindless labeling and “medication” of millions of their constituents.

  • Oh, believe me, I understand only too well how this kind of study is misinterpreted to indicate causation.

    Here is the operative statement:

    “…which damage functioning are found more often in people with schizophrenia than in controls.”

    Clearly, if these genes are only “found more often” in those diagnosed with “schizophrenia,” there are large numbers of controls who have the same genes, and there are large numbers of people labeled with “schizophrenia” who do not have such genes.

    Further, they state: “… here pathological changes in DNA sequence, can at least sometimes result in a severe illness characterised entirely by abnormalities in mental functioning.”

    Of course, this statement is not a legitimate conclusion from the data presented. All that we know is that a certain genetic pattern is associated to some degree with the probability of developing the subjective set of symptoms that are called “schizophrenia” by the DSM’s authors. Since 1) that set of symptoms does not objectively define any specific “condition” that can be tested for and verified, and 2) the pattern is only ASSOCIATED with increased probability, with a huge percentage of the people having this set of genes NOT developing said “condition,” and a similarly large proportion of those “diagnosed” with this “condition” NOT having the set of genes in question, there is no way to conclude that this genetic pattern is causal.

    There is also no specific evidence that the genes in question are “pathological changes,” since they don’t create any kind of “pathology” in the majority of people who have it. The comparison with smoking is, of course, odious, since we are talking about a carcinogenic agent being ingested vs. a genetic pattern possessed by many “normal” people. To claim genetic causality of “schizophrenia,” either all or most cases of “schizophrenia” must have this genetic pattern present, or an objectively verifiable subset of such cases, which can be unequivocally distinguished from those not so affected, would have to all have this same genetic pattern. It is not proper to assign causality to genes which neither cause most cases of the “condition,” nor which are present in large numbers of people without the condition applying.

    Note that I predicted this would be the case before I even read the article. All recent claims of such “causality” are based on the same flawed “logic,” confusing correlation with causation, I would at this point say intentionally.

    Do you always assume that someone disagreeing with your viewpoint can only do so because they “don’t understand?” I personally found that assumption both condescending and insulting, and I strongly suggest you avoid making such assumptions in the future. I am correctly interpreting the data presented in the study, and comparing it to prior efforts to make the same arguments, all of which fail for the reasons identified above. You may choose to disagree with my evaluation, but I think my reasoning is quite solid and disagreement would be difficult to rationally accomplish given the barriers cited above. You’re welcome to give it a try, but trying to deny the premise that causal conclusions can only be drawn when all or the vast majority of such cases have the specific genetic variations in question seems to be an unconquerable flaw in this and other such claims’ reasoning.

  • Honestly, I do think there is such a thing as “good therapy.” The problem is, there is no guarantee nor even probability that anyone advertising as a “therapist” has any clue how to do it. And there are any number of non-licensed, non-trained people who are quite capable of assuming an effective helping role. I think we need to respect folks who say they had a good experience (I did, 40 years ago, and I can still see how it was very important to my growth), but it appears that such experiences may be the exception rather than the rule. And it’s certainly not wrong to say that being randomly assigned to “a therapist” is potentially quite dangerous!

  • First off, there have always been claims of “causes” for schizophrenia and other DSM-identified “conditions,” and none so far have panned out. These “genes that contribute” will undoubtedly contribute in a small way to a limited number of cases, and such genes will no doubt appear in many in the general population who do NOT “have schizophrenia,” and will NOT be present in many cases who “have schizophrenia.” This is not to say there may be a small subset of people so diagnosed who will have a large genetic contribution to their situation, but so far, we have at best tiny correlations with large sets of genes, all of which overlap to a huge degree with the “normal” population.

    Whereas correlations with events like sexual abuse, early childhood neglect, domestic violence, head injuries, sleep loss and others are much, much higher than any genetic correlation to date. So why are we spending so much time finding tiny correlations with genes when we have HUGE correlations with traumatic events?

  • Seriously! I always find it oddly hypocritical for the psych professions to claim that all of our “mental illness” is biologically based, and yet create their model animal subjects by scaring the shit out of them! Why don’t they just find some “genetically ill” mice to test their drugs on? Oh, wait, is it because they actually realize that the main cause of “mental illness” is being terrorized, tortured, or ignored or mistreated, and know that there are no “biologically ill” mice (or humans) in the real world?

  • He didn’t so much moderate this view as recant his earlier theory, which was of course very much on the right track, but made Victorian male society VERY uncomfortable (especially as so many of them had themselves engaged in sexually abusing girls and young women). He was roundly attacked by his colleagues and society at large for putting forward a theory that put the blame on the more powerful members of society, and under this pressure, he backed out and came up with a theory that was less threatening to the status quo. It was almost 100 years later before the incredible frequency of childhood sexual abuse and its connection to what is now called “mental illness” was finally revealed. Even today, there is great resistance in many quarters of the psychiatric world to understanding and attributing causality to childhood abuse and neglect when discussing ‘mental illness.’ It’s always easier to blame the victim.

  • To be clear, I never meant to suggest that YOU said anything about charlatans’ use of diagnosis. I am merely pointing out that there is a difference between YOU selecting the descriptor(s) or terms that YOU want or relate to, and other people (like the psychiatric hegemony) pushing diagnostic labels on people and NOT giving them the opportunity to choose. Based on what you have said many times, I think we agree wholeheartedly on this point.

  • I am kind of appalled by the invalidative attitude you take toward those youth who happen to reside in residential treatment facilities. I have known dozens and dozens of such youth, and have found them no less reliable in general than the staff who report on them. They have no particular motivation to lie to perfect strangers, and I’m quite confident that the collective statistics are indicative of a very real phenomenon. Their comments are also quite consistent with my own experiences that show psychiatrists in particular to overlook or minimize the importance of traumatic phenomena and cast blame upon the patient/client and/or their “disorder” or their brain for otherwise obvious connections between a child’s behavior and events in their lives.

    I agree that these kids are often coerced into agreeing with statements their caretakers/doctors are forcing upon them, but that argues 100% in favor of the above observation, as the “mental health” personnel are usually very invested in proving their “diagnoses” are correct and explain everything, and that their “medications” are 100% justified, even if the kid is deteriorating in front of their eyes. The days of therapists coercing their clients into admitting to “abuse” are long gone. They are much more likely to coerce them into the idea that they have “bipolar disorder” and that the fact their father sexually abused them (or continues to do so) isn’t really that important.

    And while I am not sure the 80% figure is verifiable (though SomeoneElse provided a link supporting that claim), there is no doubt in my mind that a large majority of those diagnosed with “mental illnesses” have experienced multiple “ACEs,” as the current parlance calls it, which contribute massively or actually are the primary cause of their distress. This is based not only on research, but on decades of personal and professional experience. The percentage of women I interviewed diagnosed with “bipolar disorder” who had enormous histories (and sometimes current experiences) of abuse as a child or young adult is probably at least into the 80s. Even higher for people diagnosed with “Major depression” or “anxiety disorders.” And there is plenty of evidence that the likelihood of childhood abuse (especially sexual) in diagnosed “schizophrenia” cases is many times the population average.

    What you seem concerned about was common in the 80s, when everyone’s problems were attributed to bad mothering. Now parents are totally off the hook – it’s all the fault of the brain or the “disorder.” As you say, no one knows what a “disorder” really is, and yet these vague, spurious “disorders” seem to have amazing powers! In the 80s, a kid who never was sexually abused was convinced that s/he was in order to feed the egos of the psychologists/psychiatrists. Nowadays, a kid who WAS sexually abused is “diagnosed” with “ADHD” or “bipolar disorder” and no one bothers to look any further. That’s the current reality, at least in my very broad (25+ years) experience. Things are VERY different today than they were in the days of the McMartin Preschool!

  • Missing my point. I am not arguing that charlatans don’t use DSM “diagnoses” or generally accepted social concepts to fleece people – they most definitely do, in fact, that’s psychiatry’s stock in trade! I’m saying that phenomena do exist absent the approval or disapproval of a bunch of corrupt old mostly white farts, and the ridiculous behavior of many “modern” “mental health” personnel doesn’t preclude the existence of phenomena they have made such powerful efforts to misunderstand and abuse.

  • Sybil was not by any means the original case of “MPD.” The phenomenon has been reported since ancient times:

    “The amazing history of dissociative identity (DID), some say, dates back to Paleolithic cave paintings in the images of shamans. Others suggest that the history of dissociative identity disorder dates back to reports of demonic possession that are now thought to be incidences of dissociative identity disorder. Either way, it’s clear that dissociative identity disorder has a long history and is not a new concept (while the terminology now used may be new).”

    Of course, like any so-called “psychiatric disorder,” there is no objective way to determine if someone “has DID” or “is faking” or to do anything but express opinions. It is a phenomenon that appears to occur rarely, it has been sensationalized and abused as a concept, and I don’t trust psychiatry’s ability to define or evaluate the phenomenon or any other phenomenon in any meaningful way.

  • Perhaps a little exaggerated, but not by much:

    And we don’t know how the presence of childhood abuse was determined. There are plenty of people who experience childhood abuse and neglect who don’t realize that they have – they view their treatment as “normal” based on their experience. There is also the question of screening. I recall a research study where volunteers went into a children’s psychiatric residential facility and asked questions of the residents. As I recall, about 80% of the residents reported childhood trauma to the volunteers (total strangers to them), and yet less than 25% had this documented in their charts! So either the residents were more comfortable sharing their childhood trauma with total strangers than the staff they see every day, or the staff never bothered to ask, or the staff considered the presence of childhood abuse not to be of sufficient significance to write into the log.

    I worked doing involuntary hospitalization evaluations in Vancouver, WA for a while. I spoke to at least a few dozen women diagnosed as “bipolar disorder” during that time. I’d estimate that 90% of them had significant trauma, right on the surface, which was ignored or never considered by their prior care providers. One girl was a MR/DD kid of 17 whose intellectual level was estimated at age 6. She had been raped a couple years before. For a year or so, she was very depressed and withdrawn, which was very different from her previous personality. After a year, she disclosed her rape to her mom. After this point, she became randomly aggressive at times. Her diagnosis? BIPOLAR DISORDER! I gathered all this information in a 20-minute interview with her mom. I actually got them to change her dx to PTSD, but seriously, how OBVIOUS was it that the rape was the event that caused the distress, as there was no distress before, and as she shifted from depressed to angry after disclosure?

    It is important to be objective, but that also means being honest about the limitations and massive conflicts of interest that are part and parcel of the field. Underestimation of the impact of environmental impacts is absolutely a basic assumption of the current diagnostic system. It claims to be cause-neutral, but in practice, it is extremely biased toward prioritizing biology FAR over any other potential cause.

  • She is talking about the assumption that children exist to meet the needs of adults. Pedagogy is simply a way of codifying the expectation that children will do as they are told “for their own good” (another title of one of her books). Putting adults in the role of helping kids (or other adults, for that matter) figure out what THEIR needs are is a radical action, and people who do so are generally attacked by the society at large.

  • “Works” is the operative term often used by the psychiatry/psychology to justify their “treatments.” They often say, “The drugs work” or “treatment works” without any real criteria for what that’s supposed to mean. If a foster parent says that stimulants are “working” for their foster child, do they mean that the child feels better, the child is being more compliant, the child is feeling more successful, the teacher SAYS the child is “doing better,” the child is less annoying than previously, the child is completing more busywork while not learning anything new, the child is more willing to do things that are boring without complaining… the list of possible definitions is almost limitless. If we don’t ask what “works” means and for whom the intervention is supposed to “work,” we get kids/adults who are nearly catatonic being identified as “treatment successes.”

    I can’t read my prior comment, but I’m guessing by “plays” I meant “participates in the agreed upon social processes/procedures.”

  • Well, I completely agree with you, of course. The overwhelming problem with the whole idea of “what works” is that we’re not talking about something concrete and measurable here. “What works” can be defined in many different ways, and there is no way to determine who is “right” about the answer to that complex, highly philosophical question. And absent agreement on that point, there is really no sense it trying to “scientifically” determine anything about this whole area! “Mind” is a mysterious thing, and “science” hasn’t even begun to touch on the vaguest understanding of “Mind.” Of course, they want to CLAIM that mind=brain, because it feels more “scientific” and less “superstitious,” but that’s really just a philosophical position, not a scientific one.

    The first barrier to understanding anything is deciding that you already know all about it! Humility is in very short supply in the psychiatric “professions!”

  • Mind definitely does affect brain. There was a great study out of the University of Chicago where they did brain imaging on a number of Buddhist monks who mediated many hours a day. The part of their brain associated with calm and focus was significantly larger than those of “control” subjects. WE also know that taxi drivers, for instance, have a bigger part of their brain committed to geographical and spatial reasoning. Also, the folks studying the brain in the “Decade of the Brain” research found that damage can be done to the brain by early trauma, but also that healthy relationships with caring adults can actually heal the physiological damage done by early abuse or neglect (for some reason, that second part of the research always seems to get buried. I wonder why?)

    What we think about and how we behave most definitely affect the brain. I don’t think it’s a “maybe.” There is solid evidence that it’s a “yes!”

  • That study sounds like a bit of semantic hocus-pocus. Of course, “benzodiazepine use disorders” is another loosely-defined, subjective description of behavior that no one can objectively verify. But be that as it may, 17.1 percent acknowledging “misuse” is pretty damned significant. I’d also submit that most who ARE dependent on these drugs are probably not aware of it, and would not be until they tried to come off the drugs. All in all, this article doesn’t seem to contribute much to my understanding of either abuse of or unintentional dependence on Benzos as a social/medical/philosophical problem.

  • It is important not to misinterpret Miller. She’s not saying that our parents are abusive assholes, she’s saying they are suffering from THEIR parents’ shortcomings, who were suffering from THEIR parents’ shortcomings, etc., and that unless the parents are able to face and feel the pain of their own childhoods, they will repeat what happened to them and pass it on to another generation. Blaming parents is NOT what she’s about – the idea is to learn where your parents went off the tracks and EXPERIENCE the pain you were avoiding, so that you have a chance NOT to pass this pain on to others. But if the therapist him/herself has not does their own work, they pass on THEIR parents’ pain and shortcomings (and maybe their therapists’) on to their clients.

    So in the end, it is kind of dangerous to go see any therapist, as they may be working out their shit on you. You’d have to carefully screen for self-awareness, humility, and ability NOT to put their shit onto others before you ever consider a therapy relationship. That’s what I see, anyway.

  • “We don’t know how it works” is quite an admission. I’d challenge the “but it works” part with, “Works for whom?” or “Who gets to decide what ‘works'” means?

    I was an advocate for nursing home residents at one time in my career. I visited one facility because a family member said her dad was overdrugged on Abilify or some other “antipsychotic”. I went to talk to the guy, and he could barely keep his eyes open, couldn’t even stand up without assistance. He had bruises on his forehead from running into the door jamb on the way to dinner. I talked to the activities director, who said a week ago, she’d been hitting a volleyball back and forth in the courtyard with this same guy.

    Did the Abilify “work?” Well, if your intent was to induce a near coma so the guy was incapable of doing anything at all, I’d say it worked great. If the goal was to enhance his quality of life, I’d say it did the opposite. Those who claim it “worked” clearly consider his quality of life to be a secondary concern, or of no particular relevance. So it “works” for them, even though it destroys the client’s life.

    Beware of anyone claiming something “works” on someone else!

  • I also know a person of privilege who had a hallucinatory experience, and was “diagnosed” as “bipolar” and discriminated against in their work and other settings for this label. It was interesting to note that this person claimed that they were “misdiagnosed” and were having a “spiritual awakening,” but continued to believe there were “real” bipolar people out there, only she wasn’t one of them. This person’s emphasis was on proving she was not “one of them” instead of identifying the labeling process itself as opening the door to very real and serious discrimination and abuse, which of course anyone labeled “bipolar” would likely experience, regardless of the reason for their label being attached. I understand why this happens, but I think it shows how hard it is to arrange a sense of “comradeship” when the entire process is so fraught with danger for anyone participating as a “client” or “patient.” When people are scared and isolated, they tend to search for a way to save themselves, and the plight of others may not occur to them until well after the incident, or in many cases, it may not occur to them at all.

  • I think the biggest problems with screenings are a) screeners who don’t care (employed in a cold way is a great way to put it) and b) the person or organization doing the screening has no idea what to do about the situation. I read a doctor one time saying, “So we screen for suicide and the answer is positive. Now what the hell am I supposed to do about it?” Of course, the “right answer” is to refer them to a psychiatrist, but we know that doesn’t generally do much to solve the problem.

  • The problem I see is that there is no way to ever prove them wrong. If they claimed you had high blood pressure, you could have someone measure your blood pressure and say, “See, it’s in normal range.” But with psych “disorders,” it is always a matter of someone’s opinion, and anyone with an MD gets more autotmatic credence than the average Joe, and a LOT more than someone they’ve labeled with a “mental illness.” As long as there are no concrete criteria for deciding who “has” and “doesn’t have” a “mental illness,” the psychiatrists/psychologists/doctors will always be in control!

  • Yeah, I love it when telling them you don’t want their “help” is an indication that you NEED their “help” because if you were “mentally healthy,” you’d automatically agree with them about everything! Talk about “crazy!”

  • In my experience, the act of invalidating someone’s ability to decide what is happening and what to do is the very SOURCE of most instances of what the DSM calls “mental illness.” To provide “treatment” that involves further invalidation and “I know what’s best for you” energy is like putting out a fire with gasoline. It is literally the LEAST helpful thing you can do, besides overtly abusing the body of your patient. Yet people get paid to make other people’s lives worse.

  • I tend to laugh at the idea of “treatment-resistant depression!” As if “depression” is a sentient being that can “resist!” What they mean is, “My approach to helping you failed completely,” but instead of admitting this, they blame the patient. It’s like the car mechanic saying, “Your car has repair-resistant fuel injectors” instead of admitting he doesn’t know how to fix the car. That way, he gets to charge you for it and offer to charge you for another “treatment” next week, even though he hasn’t the first clue what he’s “fixing!”

  • Some patients want someone else to tell them what’s wrong with them, even if doing so is the opposite of helpful. But some most definitely are looking for someone to help them explore their own needs and thinking and emotions to find a better way to live. There is also a group in the middle who are willing to believe the psychiatric story because “they’re doctors” and it sounds very “sciency,” but are to one degree or another disappointed that the promises they were given don’t come to fruition, and eventually, these people rebel, either quietly or loudly, but sometimes it takes years or even decades for them to really “get” what happened.

    I remember when I worked on a suicide hotline, I got a call from a woman who said she’d been trying different antidepressants for over a year. She was quite frantic, saying she was working on her 5th antidepressant and none of them worked, and she told her doctor that it wasn’t working and all he would say was, “You have to give it time” or “let’s try another one.” She was panicked that she’d always feel depressed and be waiting for something that would never happen. I acknowledged that this was very difficult, then asked her a simple question: Had anyone ever told her that there were other things she could do besides taking drugs for depression? She was suddenly calm. She said, “No.” I said, “Well, there are.” She said, “Oh. Well, that’s good!” and then we got to talking about what else she could do.

    I don’t think she “wanted” a diagnosis. She wanted help with a situation she didn’t understand, and the doctor told her what to do, and she tried it, having no other frame of reference. If the doctor had told her something more sane, she would have taken it up in a moment. Her only fault was trusting the doctor, not wanting to avoid responsibility for her condition.

    It is easy to make generalizations, but as I like to say, “All generalizations are always wrong.” People are different, and we ought to consider that when making our analyses.

  • I actually screen my doctors ahead of time. I let them know that I’m in charge of decisions, they’ll advise me but I may or may not take their advice, and if that’s not OK with them, they should let me know right away and I’ll find another provider.

    Though I prefer to avoid doctors altogether. I usually get a nurse practitioner or a physician’s assistant to be my PCP. I actually now have a naturopath as my PCP. The less I see of doctors, the happier I am, generally speaking.

  • A doctor almost killed my father when I was 8, as he was taking blood thinners (which he reported to the doctor) and was prescribed something that created uncontrollable bleeding when combined with blood thinners! His arm bruised if he just set it on the table. If he’d fallen off a ladder or been in a minor car accident, he’d have bled to death in minutes. I learned at that young age never to take ANYTHING I hadn’t personally looked up for adverse effects, no matter what the doctor told me.

  • Ignorance or malfeasance or a combination of both, it doesn’t matter much to the client/patient/victim, they’re still harmed just the same. If they don’t actually know the adverse effects, they should not be prescribing it. It’s like saying, “I didn’t know guns shot bullets.” PUH-LEASE, take a little responsibility, medical folks!!!

  • Nothing irrational about being afraid of people who are dangerous to you!

    As for depression screenings, my understanding is that it’s totally OK to refuse to do them. It is also completely legit to just answer in the way that reflects best on you – they have no right to know your inner thoughts and feelings!!! So if they ask me, “Have you felt depressed in the last three weeks?” of course, I always say, “No” no matter what I’m feeling. I’m sleeping fine, my appetite is fine, etc, etc. until they are done. But the more I think about it, the next time I hear them starting in on this, I’m going to say, “Is this a ‘depression screening?’ If so, I decline to participate and will not answer any questions on the screening.”

    That may or may not be realistic for you. I find it obnoxious that they have the temerity to do such a screening when they have no idea what to do with a “positive” outcome (and of course are screening in the first place for something so vague and subjective that no one can tell if you “have it!”) But I do know I’m in charge of my own medical care, and the more I assert that right, the better I feel about my interactions.

  • “Unaware of adverse effects” is absolutely no excuse – if they don’t know the adverse effects, they have no business prescribing them! And the truth is, most know enough about the adverse effects to know they’re not being honest when they prescribe. I believe point #2 is the main reason – they don’t want the truth to get out because many of their clients would then refuse to take what they prescribe, and that will cost them in some way or another. It’s quite intentionally dishonest.

  • One could almost say there is an effort NOT to understand the cause of severe emotional pain. My experience as a provider was that it was rare that most “clinicians” asked such questions, or if they did, they’d simply “catalog” them along with other “symptoms” in order to claim a “diagnosis.” Very few seemed to understand the significance of such events, and of those who did, most didn’t really know what to do about it. I used to say there’s a one in five chance of getting a competent therapist. Nowadays, I think that would be a gross overestimate!

  • The basic approach of psychiatry is to suppress the brain’s abilities and to impair normal functioning. Kind of like, if your hand hurts, numb your hand. If that doesn’t work, remove it. There is no effort to actually determine WHY your hand hurts or what else might be done. If “depression” is the problem, then the “answer” is to make the person less depressed. So “antidepressants” are the way to go. The idea that a person may have a good REASON to be depressed, or that some other physiological problem is causing it, doesn’t appear to be a relevant concern of theirs.

  • He no doubt overlooks the most obvious reason: more “treatment” CAUSES more suicides and mental distress! The BEST spin you could put on it is that “treatment” is completely ineffective, but there is plenty of evidence to suggest it is more dire than that. Plus the widespread false propaganda that “mental illness” is caused by and helped by physiological processes prevents people from doing things that actually DO work.

    It is my belief and observation that the very act of labeling someone’s problems as an “anxiety disorder” or “major depression” is demoralizing from the get go, and even without the adverse effects of the drugs (which clearly DO make some people worse!), the labeling process most likely contributes both to mental distress AND suicides.

  • My impression was that she died early due to years of “treatment” for “bipolar disorder.” She did some PSAs for “recognizing bipolar disorder” or some such “anti-stigma” memes. She is not alone, as the average lifespan of those diagnosed with “bipolar” or “schizophrenia” is literally 20-25 years shorter than the average person. I wonder why?

  • There is also the question of grouping. If one treatment cures 10 percent of the “ADHD” population, but drugs “reduce symptoms” in 70 percent of the population, the 10 percent treatment will be regarded as “ineffective,” even though it cured one out of 10 people completely. If you have arbitrary and/or purely subjective groupings of subjects, you’re not going to get any meaningful information. A REAL scientist would look at that 10 that WERE cured, and say, “Wow, what is different about these people that treatment X worked so well?” Then they might actually be able to identify a true group that has something in common with each other, and THEN (and only then) can they actually look for causes.

    But too many people are hypnotized by the “Gold Standard” argument and think that anything producing a p value under .05 is “evidence based,” regardless of the triviality of the result or the heterogeneity of the group. It is a setup for drugs to “win” every contest, and I doubt very much if that fact is accidental.

  • “Stigma” really is a euphemism for intentional discrimination. And of course, the ones complaining MOST about “stigma” are the ones who are most committed to this kind of discrimination themselves!

  • “Negatively influencing outcomes?” Don’t they mean “Negatively influencing profit margins?” As far as I can tell, outcomes for most any “mental illness” you define either remain the same or get worse with long-term “medication” (aka drugging). Stimulants, antidepressants, antipsychotics, all are associated with either no change or deterioration over time when used long term. Not to mention killing people off 20-25 years younger with the antipsychotics, hardly an “improved outcome!” How do the doctors get away with this nonsense?

  • I agree. It’s also true that correlation can be “significant” in terms of P values, yet there can be enormous overlap between those “having” and “not having” the anomaly in question. To be diagnostic, a particular “anomaly” has to occur in all or almost all of the test subjects, and in none or almost none of the control group. The fact that “ADHD” diagnosed kids have a 5 percent smaller brain volume (notwithstanding the issue of drug effects on brain size) means almost nothing, because 95 percent of the kids will have brain volumes that overlap with the “normals.” So the smaller brain size, whatever the reason, doesn’t indicate “ADHD,” because too many non-ADHD people have the same brain volumes as “ADHD” people. Of course, there is absolutely NO reason to expect that a random-ish list of behavior that adults tend to find annoying would somehow translate into a measurable “brain dysfunction.” So the whole effort is pretty much a waste of time.

  • The problem with this kind of research is that lumping all people diagnosed with “Major Depressive Disorder” together for study is kind of like grouping people by “pain tolerance” or “tendency to breathe deeply” or “having a poor appetite.” The “criteria” for “Major Depressive Disorder” do not distinguish valid groups of people likely to have something neurological in common. The very idea is based on a logical fallacy, and can’t lead to any kind of valid scientific answers.

  • There are lots and lots of citations re: long term outcomes not differing.

    Just a few: (Just ran across this by chance last night)

    The RAINE study in Australia: read the executive summary:

    The Quebec study:

    “We examine the effects of a policy change in the province of Quebec, Canada which greatly expanded
    insurance coverage for prescription medications. We show that the change was associated with a sharp
    increase in the use of stimulant medications commonly prescribed for ADHD in Quebec relative to
    the rest of Canada. We ask whether this increase in medication use was associated with improvements
    in emotional functioning or academic outcomes among children with ADHD. We find little evidence
    of improvement in either the medium or the long run. 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

    Swanson’s “Review of Reviews” in 1993:

    Russel Barkley’s 1978 review: no academic benefits of long-term stimulant treatment –

    The long-term MTA study results show no advantage to stimulant use over time:

    “The latest follow-up, released in March 2017, further confirmed the association between stimulant medications and reduced height; patients who took stimulant medications consistently were an average of 2.36 centimeters shorter than their peers who had stopped taking medication or who took it only sporadically. But, in a confounding twist, the two groups (those who took medication consistently and those who didn’t) showed no difference in symptom severity — though members of the former had, on average, taken more than 100,000 mg. of stimulant medication over the course of their lifetimes.”

    The researchers do some pretty good pretzel twists to try and minimize these results, but it certainly suggests strongly that there are no long-term benefits to stimulant use.,adulthood%2C%20have%20no%20effect%20on

    Another one I just found:

    There is also a comparison study of Finnish vs. US students. Far more US “ADHD” students took stimulants, but there were no differences in outcomes. I can’t seem to find a link to this study.

    So the jury is long since in on this question. There are no long-term benefits of stimulant use for “ADHD” diagnosed kids.

  • The power imbalance is the central conflict in any kind of “therapy.” In my experience, those who can step down from their power advantage are the only ones who are ever successful in helping their clients. People generally don’t need another boss – they need a human being they can feel safe with!

  • The problem is the “honest” part – those benefitting from these “diagnoses” are not interested in having an honest debate, because they know they have no solid data underpinning their approach. But they have the power to deny any other view through use of their “authority” to suppress actual debate and known research.

    It’s not about debate or facts, it’s about power.

  • This has always seemed true to me, but everyone seems to think they are very “sciency.” I remember a study showing that including brain imaging pictures in an article, even if it had nothing to do with the content of the article, made people more likely to find it credible.

    Humans are unfortunately too gullible in many cases.

  • I can’t seem to find it – not sure what I did with my old “ADHD” article copies! I think it might have been done by Dr. Sydney Zentall, because she’s been talking for decades about how changing the environment to create optimal stimulation is best for “ADHD” kids, rather than trying to artificially stimulate them with drugs. But I’m not sure. I’m sad I can’t find those documents! But I assure you, that was the result.

    The other important result, and I can get citations on this one, is that “ADHD” kids taking stimulants don’t do better academically (or on any other outcome measure) than kids who don’t in the long term. So why are we doing this to kids, if it doesn’t even help their long-term academic outcomes????

  • It is somewhat stunning that people can’t see the utter shallowness of the psychiatric/DSM worldview. Just reading the names of the “disorders” is enough to make a rational person laugh out loud! “Oppositional Defiant Disorder?” How do you know you have it? Because you won’t do as you’re told!!! “Intermittent Explosive Disorder?” “Disorder of Written Expression?” How is any of this taken seriously???

  • I think you make an excellent point. “Crazy” behavior is almost always a result of someone feeling trapped or used or as if they failed based on someone else’s judgment of what they ought to be doing. It would have been interesting if you and the teacher could have sat down years later and talked about what happened, and maybe understand what was going on for each of you. But I do hold people in positions of responsibility to a higher standard of controllinng their behavior when vulnerable young people are in their charge.

    I apologize for my use of that language and appreciate your feedback.

  • I have often used the “canary in a coal mine” analogy for the “ADHD” kids. If these kids are having a hard time paying attention, it means that 9 out of 10 of the rest of the class feels the same way, but they are restraining themselves to stay out of trouble. The only “problem” with the “ADHD” diagnosed kid is that they aren’t as skilled at repressing their boredom or sense of frustration or outrage as the rest of us. Hardly a “disease state!”

    I also agree that we do try to change the kids instead of the environment. Some seminal research was done on “ADHD” kids back in the 70s, where two well-matched groups of “ADHD”-diagnosed kids were put half in a standard classroom and half in an open classroom. They then had teachers come in and try to identify the “ADHD” children. In the standard classroom, they were over 90 percent successful. In the open classroom, there was a very slight but not significant trend toward the “ADHD” being picked. In other words, put these kids in an open classroom, and you can’t tell them apart from “normal” children! Now this was done way back in 1978 or so. So why haven’t we created open classrooms for our “ADHD” children? I guess no one profits from open classrooms, while selling stimulants is a lot more profitable. Plus changing the environment means the ADULTS have to take responsibility, while “ADHD” means we can blame the kids and keep doing whatever we want as adults. It’s disgusting to me.

  • Thanks for a great post!

    I’d just add that is possible medical doctors don’t go for “mental health treatment” because they know better than most people how dangerous some of the “treatments” are. If you ever read the entire label for Abilify or Seroquel, or even an SSRI antidepressant, you’d be a lot more careful about ever being “treated” with one of them!

  • I am aware of a case from near the Mexican border, where all angles of “western” psychiatry had been tried on a so-called “schizophrenic” in a hospital there. They brought a shaman from Mexico over the border to do a spiritual exorcism. The person got better.

    There are also shamans involved in the hospital system in Brazil, from what I understand. I don’t have any idea if “spirit possession” is a real thing or not, but spiritual cleansing of various sorts has been arguably more effective than anything psychiatry has to offer. And the side effects appear to be WAY less!

  • I am not sure if the title is meant to be sardonic, but of course, psychiatry’s real failure lies in the last part of the title. If your goal is to “stop” self-harming behavior, you’ve already missed the boat. Self-harming behavior meets a need, and the key is understanding the goal/purpose of self harm and to help the person evaluate for him/her own self whether or not s/he wants to change that behavior. Attempting to force someone to “stop” self harming has been demonstrably destructive any time I’ve seen it attempted. If self harming is about having control of one’s pain, how can trying to force a person to stop be a good idea?

  • Sure. A farmers’ market. People bring their goods, put a price on them, other people decide if they want to buy or not. No fakeo marketing, responsibility to the community putting up the farmers’ market not to violate basic rules, real competition for prices (no monopolies), consumers determine what is too high a price or what is popular enough to bring more of or charge more for. Workers have basic control of their workplace (most work for themselves or family). No money leaves the local community. If you’re mean or pollute the environment or are unsafe, you’re not asked to come back, or no one is willing to buy from you. It’s a nice model of what a free market COULD look like without billionaires and mass marketing and monopolization.

    Hope that clarifies!

  • Right. It appears the only “normal” people are the mildly sociopathic, because they never get too excited or too upset about anything. Looking at the DSM, it appears that having any kind of emotional reaction to anything is the sign of “mental illness.” Even annoying OTHER people makes you ill! Those people with no personalities in “Invasion of the Body Snatchers” or “The Stepford Wives” are the epitome of “good mental health” by DSM standards!

  • The other thing they fail to mention is that these differences are AVERAGES. There are TONS of “depressed” people with higher IQs or larger hippocampi and non-depressed people with smaller ones. If there really WERE some kind of neuropathology, we’d see more like 90% of depressed people having smaller hippocampi, or 85% having much lower IQs. This kind of research is horseshit, but it passes for “scientific” because they can tease out a P value of .05 on an average of hundreds or thousands of subjects. Any meaningful finding would have to clearly distinguish the “haves” from the “have nots.” This doesn’t even come close. It’s a joke.

  • Not to mention having a depressing life: dead end job, stuck in an unhappy or literally dangerous relationship, dealing with childhood abuse and abandonment, or just dealing with the inherently stressful lifestyle that we’re all expected to “love” today, and if we don’t, we’re considered “disordered” for wanting to make major changes in our current reality.

  • Of course, such a project is a failure scientifically before it starts. Because it starts assuming that “Major Depressive Disorder” is a unitary THING that has a unitary CAUSE. Why would we assume that ALL people who fit a subjective list of “criteria” that have little to nothing to do with the body itself would have a “neuropathology” that causes them to fit this subjective list? It would be like asking, “What is the neuropathology of cowardice?” or “What is the neuropathology of spontaneity?” Why would we assume that all depressed people even HAVE a “neuropathology” without evidence that this is the case. It might be viable to ask if SOME cases of “major depressive disorder” might have neurological underpinnings, but we can’t assume the conclusion, as these “researchers” appear to have done. In order to do a REAL scientific inquiry, it would first have to be identified WHICH cases have some kind of neurological problems, how to distinguish them from people who just happen to feel really bad for a long time, and to create a group of people who actually DO have some kind of evidence of neurological “causes” as a study group.

    But instead, these folks just assume that there IS a “neuropathology” and their “research” is to find evidence to support the conclusion they want to find. That’s not science!

  • I know. It’s not really capitalism when it’s part of a local community. The local community asserts its values and requires social behavior of local producers. It’s kind of like unspoken socialism – you have to behave or you are shunned. But that stops working pretty fast when the person doing the production is no longer invested in the community they produce in. As soon as people become expendable, things spiral very quickly out of control.

    To be clear, I’m saying I have no problem with the local farmer bringing in food to sell, and using his money to buy shoes at the shoe store, with farmer, shoemaker, and whomever profiting from their honest labor. That’s the level where I see the “free market” working. As soon as the rich guy can move out of town and pollute the river or undercut local businesses to create a monopoly without any fear of community consequences, we are in trouble.

  • I don’t disagree with you, but I am quite sure that psychiatrists in both the Soviet Union and Nazi Germany made plenty of money. It is true, their malfeasance and ill intent appears to go well beyond that simple motivation, but my original point was that the psychiatric profession has absolutely no intellectual or philosophical connection to Marxism. It seems to be quite adaptable to whatever form of government is present, which I suppose provides more evidence that the intent goes beyond cupidity. But there is no question that greed plays a very large role in the current application of psychiatry, and the “profession” (if we may use that term VERY loosely) would be quite upset if a Marxist revolt took away their gravy train.

  • Do you not see pharmaceutical corporations as fully complicit in the structure and marketing of psychiatry in the 21st century? Or the 20th for that matter? How could psychiatry sell its wares without Big Pharma? And is not Big Pharma the ultimate end game for corporations – almost unlimited profits with almost no accountability? Isn’t this where unfettered capitalism inevitably leads? What forces oppose this natural tendency of corporations to get bigger and richer and to eliminate the competition? Isn’t that what international Corporate Capitalism has always brought us?

    I think capitalism can work on a very localized scale, but only because there is a natural set of checks and balances whereby the local population can call the capitalists to account. If the local mill is dumping waste into the river, the citizens downriver can get together and say, “Hey, knock that shit off” and they have to listen, because they are neighbors and if people get pissed at them, they will stop buying from them. But if someone in Taiwan or Chicago or London is polluting my local river in Washington, what the hell can I do about it? There is no one to complain to, and the big company doesn’t give a crap if I live or die, as long as the money keeps coming in.

    That’s why I see psychiatry as a fully capitalist enterprise they exist to make PROFITS, they collude with others making even BIGGER profits, and they are utterly unaccountable to the population they claim to serve. That’s as capitalist as it gets in my book.

  • Nobody’s saying the current system is working, Richard, or I’ve certainly NEVER said anything remotely like that. I told you I agree with Marx’s analysis of capitalism, which was and is indeed genius. I just don’t see him providing a workable alternative system, that’s all. Maybe more practice is needed, maybe I’m too cynical about “human nature,” maybe I can’t envision enough people being educated (or even interested) enough to learn the reasons why cooperation matters. My observation is that current society requires a HELL of a lot of cooperation, yet this is all very much taken for granted and people are easily manipulated and taken advantage of by posing “us vs. them” scenarios. I would love to see the “workers unite” and create some better conditions. I just don’t see Marx as providing us a pathway there. I get stuck in how the “Dictatorship of the Proletariat” leads to the classless society. It has not yet happened in reality. Israeli Kibbutzes are probably the very best example to date, but my understanding is that they are now a very tiny part of Israeli society.

    You’re free to disagree, but I think you could ease off the suggestion that I think “capitalisms is the highest pinnacle of human organization.” You know very well I never said that, so please refrain from “strawman” arguments in the future.

  • Marxism as practiced has been a disaster. I think Marx’s analysis of what was wrong with capitalism was quite accurate, but his solution fails to take human nature into account. Humans need to feel like they are competing in some way, that their individual efforts make a difference. They don’t do very well working for “the good of the collective,” much as many like to think they do. Collective farming was the best example – production was very low, until they gave everyone their own 10 acres or whatever to farm. The productivity on the private land was many times that of the collective farms. I suppose you could say that people need a game of some sort, a way to “win” or “lose,” and collectivist farming doesn’t seem to provide it.

    But of course, the other verity of humans is that “power corrupts,” and it was ironic to see the Communist Party leaders hanging out in the same dachas of the aristocracy they claimed to want to get rid of.

    So sure, communism in practice was a total failure, and led to dictatorship in seemingly ever case. But that doesn’t make psychiatry communistic. It’s just plain authoritarian, and so naturally will do well in either fascist or communist or any other authoritarian state where the need to control other people is prominent. However, it should be observed that while the communists USED psychiatry to keep their rebels under control, psychiatry was part and parcel of the planning and implementation of Nazism in Germany, up to and including mass murder. So I’d still say psychiatry proved a better “fit” with fascism overall.

    Regardless, it appears to me that psychiatry is less interested in economic theory and primarily concerned with making money and establishing power over others. They will do so in whatever economic system is in use. They are very, very comfortable with capitalism, as drug company profit margins on psych drugs should make very clear. Communists are anti-capitalists. Psychiatry, simply put, is not.

  • It is always ironic when they go on and on about the dangers of Vitamin B3 or others because they “haven’t been fully tested,” while they give out drugs that they KNOW reduce people’s lifespans by 20-25 years. Hey, I think I’ll take my chances with the “untested” vitamin B3!

  • I have a hard time seeing anything “Marxist” about the “mental health” system. There is no effort or intention to create equality between workers and the wealthy, nor any effort to redistribute control of the means of production to the masses. If psychiatry had “Marxist” roots, it would create collective wards where no one had any economic incentives to push drugs on another person.

    Psychiatry is a strictly capitalist enterprise. It is about making profits, regardless of the effect on the “consumers.” It is about projection of the power of the wealthy over the rest of us. Nothing Marxist about it, in my view.

  • Posting as moderator:

    We are now getting off the topic pretty far. I will allow this statement, but I do not want to deteriorate into a hostile exchange about COVID or about Gavin Newsome, and I see this as a very real possibility, based on past experience. The article is on “The Danger of Marginalizing People,” and comments need to be focused on that topic, specifically as it regards the “mental health” system. If we get into political discussions of other topics, I will intervene to keep the discussion on topic.

  • Well, of course, I agree 100%, a “personality” can’t have a “disorder,” it is not a thing of the physical universe, it’s a consequence of thought and decisions made by a person. And I’d say that of course, a personality CAN be changed – I see it more or less as an invention a person creates to deal with the decisions they need to make to survive in the physical universe. I like the question of “genetically inherent” or “culturally inherent.” I might also add “spiritually inherent,” because I see it as entirely possible we bring some history with us when we arrive on the planet. But that’s getting deeper than we need to here. The very idea that a “personality” is something that can be “ill” or “disordered” is pretty outrageous, and yes, obviously has to come from someone else judging a person’s “personality” as being good or bad or inadequate. It is observable, but I don’t think anyone but the person him/herself is in a place to judge the quality or usefulness or need for change of the personality. It’s something we own completely ourselves. Criticisms of a set of “personality disorders” is rank prejudice and nothing more.

    So I’m totally with you – psychiatry is utter bullshit, because it starts from a false premise that there is a “right” personality or “right” mind that only THEY can determine, even when they have no idea how they possibly could begin to make such judgments. Such is the hubris of psychiatry!

  • Yes, I most definitely have considered that question in detail. I think you ask an excellent question, and one to which I nor anyone else I know of has a real answer. It could be viewed as a metaphor, certainly. I think it is one of those things that we only observe by seeing the results of it, kind of like magnetic force or gravity – you only know it’s there because of what effects it has on objects within its sphere of influence. That being said, the “mind” is a similarly problematic force. Assuming that the “mind” is simply an effect of the brain leads us to psychiatry or other empty conclusions. It appears there is something that is able to INFLUENCE the brain, to the point of actually altering its STRUCTURE (look at the studies on altered brain structure in meditating Buddhist monks, for instance), yet no one can really say what it is?

    But I’m not one to say something is “bullshit” just because I can’t explain it. That’s not really scientific, either. I am much more inclined to simply say that personality is a pattern of behavior that a person tends to engage in, sort of the interaction between his/her mind and the environment s/he encounters, that some of it appears to be “inherent” and some learned, but that we don’t really know what it is or how it comes to exist, any more than we know what the mind is or how it comes to be. It’s a mystery, and I’m OK with that.

  • Eh, I still think you’re talking about rearranging deck chairs on the Titanic. “Effectiveness” is a very problematic term when your “diagnoses” are voted on by committees and there is no objective way to create any kind of legitimate study groupings. Beyond that, the concept of a treatment “working” requires some agreement on desired outcomes, and no such agreement exists in psychiatry/psychology, nor probably ever can or will. For instance, is the goal of working with an “ADHD” child to make them “less hyperactive, distractible, impulsive?” If so, then stimulants seem to “work” pretty well. But if the goal is to have them become more academically competent, stimulants are a complete bust, may actually make things worse in some cases. So what’s the goal? We all know that in practice, the goal is to make the kids more compliant (dosing studies bear this out in every case). Is that really a legitimate measure of “working?” If it is, gagging and tying someone to a chair would also be judged to “work.”

    Psychiatry has massive philosophical conflicts preventing it from successfully studying anything it its realm of interest. I don’t see that changing any time soon.

  • HiTop still doesn’t bother to look at the causal factors in whatever presentation is seen. Ten people could all exhibit “OCD” symptoms for 10 different reasons and need 10 different interventions. Until a “diagnostic” system is based on finding the actual CAUSE of something, it is worse than useless. And since the causes of so-called “mental disorders” primarily exist in a realm called the “mind” which psychiatry has not the vaguest understanding of (still confusing “mind” and “brain” and insisting they are the same), the odds that they will somehow sort this all out are about zero.

  • I have talked to plenty of adults and kids before and after stimulants. Some do talk like you do about it. Of course, these are the success stories. Most in my experience appear to view it as a somewhat helpful intervention in the short term, but complain a lot about the costs. A small number complain that it nearly destroyed their lives. You appear to communicate mostly with people who found it worked for them, so you have clearly decided that this is “reality” and other people who have different experiences are “wrong.” That’s what I’m objecting to. I’ve never said that you or others like you did not have positive experiences. I have said that these experiences are not uniformly positive. I’ve also said that other people have managed to have very positive experiences without drugs. What is wrong with that? Why are you unwilling to hear that viewpoint, if this stuff makes you “listen better?” Not everyone has your experiences.

    I’ve also shared hard research with you backing up my viewpoint that a) not everyone benefits, b) most benefits are short term, and long-term outcomes have been shown over and over again not to be altered by stimulants or the lack of stimulants, and c) there are other things that you can do besides/in addition to stimulants that really do help.

    Again, what is your problem with any of that? Do you NOT want there to be other ways to help? If some kids can do well without stimulants, why do you begrudge them that opportunity? Why not keep a child back a year and see if they do better after a year of maturity? Why not put your kid in an open classroom if kids like him/her do well in that kind of classroom? Why take the viewpoint that a person (me) who has raised his kids successfully without stimulants has somehow deprived his kids of “clear vision” when it’s obvious they are none the worse for wear? Why can’t you simply allow that what you did worked for you, but others may take different approaches? I have NEVER told you that your approach was wrong, or that people who medicate their kids with stimulants are abusing them or doing them harm. Why am I and others like me not afforded the same decency from you?

    Please don’t respond with more insults. I need an acknowledgement that your way is not the only way, and that people who use other approaches are not wrong for doing so. If you can’t manage that, please don’t say anything at all.

  • I think that comment is very telling, and it supports my contention that most of the suffering that occurs to the “ADHD” child is due to the unrealistic expectations adults put on them in order to attend school, as I stated above. This comports 100% with the observation that ADHD-diagnosed kids are found to be essentially “normal” in open classroom settings where they are encouraged to move around and have more control of their environment (fewer unreasonable expectations). That approach certainly worked wonders for our kids.

    It also helps explain why a third of the ADHD diagnoses go away if kids go to school a year later – they are older and more developed and it’s easier for them to follow the expectations set for them by the school. It also helps explain why so many kids “grow out of it” in their teen years – they are developmentally older and more ready to adjust to outside expectations of the school and others (this was certainly true for my oldest).

    More importantly, it also explains why kids who take stimulants over the longer term don’t actually end up with better outcomes, even though their grades and adult approval ratings are better on stimulants. The stimulants make the adults happier and less concerned with the kid. The child’s learning environment is not improved, he is not doing anything different than his non-stimulated ADHD classmates, but “everybody else is being a lot nicer.”

    So effectively, stimulants create an environment where the adults are more willing to leave the poor kid alone!

    I know this is a perspective that you, Donovan, may disagree with, but I think the logic presented here is very consistent with Insel’s report from his son. The main benefit to his son was not being able to concentrate or learn more, it was that others were nicer to him! I hope you are able to listen and hear this perspective as I have listened to and heard yours.

  • I agree with you. It is pure “cultural bias” to believe something like “borderline personality disorder” even exists at all. It is clearly skewed against women for starters. And how can you “overdiagnose” something that is not objectively diagnosable by any known standard? It’s like saying that beauty or cowardice or kindness is “overdiagnosed.” If there is no objective standard, there is no meaning to “over-” and “underdiagnosis.” We’re just making shit up, and no one’s “diagnosis” should be invented arbitrarily. But if it IS invented arbitrarily, it’s nonsense to talk about “overdiagnosis!”

  • I also find it fascinating that the Industry wants us to believe all these conditions are “biologically based,” yet when they do animal tests, they have to terrorize and traumatize the animals to induce the proper “mental state.” One might get the idea that these “mental illnesses” they are testing are, in fact, the result of terror and traumatization!

  • I am glad that you found stimulants helpful to you. But you continue to argue a point no one is making. And you are now getting insulting implying that those making these arguments don’t give a crap about the children involved. I can tell you that I spent over 30 years in the field of helping children and saw and talked to hundreds and hundreds of kids diagnosed with “ADHD,” as well as their parents, their teachers, their counselors, their siblings and others involved with them on a daily basis. So I am not basing my opinions on some intellectual exercise. They are informed by much direct experience, including with my own kids, and calling me “criminal” for drawing the conclusions I have made after decades of research and direct personal experience is most definitely beneath you.

    Additionally, your personal experience is important, but does not mean that your own experiences are “average” or “expected” from all or most “ADHD” diagnosed people. In fact, decades of evidence show that there are no reliable improvements in ANY long term outcome areas for long-term stimulant use, including academic test scores, high school graduation rates, college enrollment, delinquency scores, social skills, employer satisfaction, or even self-esteem. However YOU may feel about YOUR treatment, or others you know, you can’t claim that children are being cheated out of this special advantage that science says does NOT happen for the large majority of recipients.

    I’d really appreciate it if you can constrain yourself to presenting your personal experiences and such scientific data as you feel you’d like to share, as well as directly addressing the science and experiential data that has been presented to you in good faith, and leave off on the disparaging comments on individuals who happen to disagree with you, especially when those objecting have presented their own data to which you could choose to directly respond.

    Bottom line, you have your experiences, others have their experiences, they aren’t going to be the same, and all such experiences are welcome to be shared. Please be respectful that not everyone is going to see things your way, and that disagreeing on science is not a personal thing.

  • I have never said that stimulants can’t be effective for people in the short term. My premise, if you will read more carefully, is that the appearance of stimulants “working” doesn’t mean there is something biologically wrong with the subject. Alcohol is an excellent “antianxiety” agent – used to calm me right down in social situations. Why? Because that’s what alcohol does. Not because I had some “diagnosis” that alcohol “treats.”

    No one is arguing that psychotropic drugs don’t affect people in certain ways that some people will find helpful. I am trying to separate that easily observable fact from the scientifically tortured concept that we can somehow “diagnose” someone with a “medical disorder” based on a subjective list of behavior, or from their response to certain drugs, as you seem to be claiming is true.

    As for humiliation, I want you to consider carefully how much of the “humiliation” that kids experience is based on how others treat them for not ‘fitting in’ with the schools’ expectations rather than because they “cannot concentrate as they need to.” There are kids younger than TWO YEARS OLD being “diagnosed” and “treated.” How on Earth can this serve the needs of the toddler to “concentrate as they need to?” Aren’t we talking about inappropriate developmental expectations at some point? Also, did you know that a couple of good experiments with open classrooms have shown that “ADHD” kids who are put into such an environment are almost impossible to distinguish from “normal” children? Or that a number of good studies in various locations have found that comparing kindergarteners who are 5 vs. almost 6 when entering Kindergarten consistently shows a 30% reduction in ADHD diagnosis rates SIMPLY BY WAITING A YEAR LONGER BEFORE ENTERING SCHOOL! And this finding has been replicated in a range of different geographic settings in different states and countries. That’s what I call a robust finding! Why aren’t we simply delaying the entry of kids diagnosed with “ADHD” for a year, or sending them to open classrooms, when that would give us a 30% cure rate?

    If “ADHD” were a detectable biological problem, why would it matter what kind of classroom the kids are in? Why would waiting a year to enter school suddenly eliminate a third of these “biologically deficient” children? Isn’t this proof that maturation and developmental expectations play a huge role in who gets labeled “ADHD?”

    Now, if you’re just going for the idea that, “We should be able to give kids stimulants if it makes it easier for them to fit into the classroom, and if they and their parents don’t mind,” that’s a very different argument. But the fact that some kids/adults happen to find the effects of stimulants desirable means absolutely NOTHING about the condition of their brains. It just means they like the effects, just like I like the effects of alcohol. Read some stuff from Johanna Moncrieff on the “drug model” rather than the “disease model” – she describes this WAY better than I can. You don’t have to have a “disease” for a drug to have an effect, and just because a drug HAS an effect doesn’t mean there’s something wrong with you. I hope you can agree to this rather obvious and scientifically unarguable premise.

  • They are “suggesting” that the structure of the brain is a problem. But there is no evidence whatsoever that this suggestion is accurate in the slightest degree. When the brain is compromised, you see a neurologist. “Mental illnesses” are not “brain abnormalities,” however much the psychiatric profession continues to pretend that is true. There is not one single “mental illness” in the DSM where most or even a significant minority of people so diagnosed have any physiological problem in common. And this is not for a lack of trying. They’ve been searching for DECADES for “brain problems” that explain “mental illnesses,” and have found nothing of the sort. Absent actual PROOF, the “suggestion” you mention is as useful as the idea that there are living inhabitants on Mars.

  • Great article, as usual. The one thing I might have included is the multiple studies on “ADHD” diagnosis and admission to school, showing that a one-year delay in school entry leads to a 30% reduction in “ADHD” diagnoses. This both undermines the idea that “ADHD” is something objectively diagnosable, and also extrapolates to say that if you just leave these poor kids alone, a third of them will most likely “grow out of it” in a given year. Probably even a higher percentage of preschoolers. Which anyone with “common sense” would expect. Though I guess it isn’t as “common” as it used to be!

  • Again, I think you miss my point completely. It is not scientific to ASSUME that a cluster of behavior/emotion/thoughts that tend to occur together are a “diagnosis” that is caused by something biological. You are taking a PHILOSOPHICAL position, called Materialism, in assuming that there is no other possible cause. What EVIDENCE is there that any two cases of “depression” have or need to have a common cause? I already gave you a half a dozen reasons why a person might be feeling despairingly hopeless. Are you really suggesting that a person who is depressed because they feel trapped in a domestic abuse situation should have the SAME DIAGNOSIS as someone who is depressed because they are suffering from a low thyroid situation or Lyme Disease or a head injury? Do these cases have ANYTHING in common other than the similarity of emotional reaction? Would any sane person prescribe the same “treatment” for all four situations? If you gave antidepressants to a person in a DV situation, and they suddenly felt more comfortable being abused by their partner, could you consider that a good result? Are there times when feeling anxious and/or depressed is a NECESSARY, NATURAL process that helps humans decide to alter non-optimum living or social situations?

    I am certainly not asserting that there are not biological correlates to the actions/experiences of the mind. For instance, we know that Buddhist monks who meditate regularly actually CHANGE THE SIZE OF PARTS OF THEIR BRAINS. But consider what that means – their CHOICE of mental activity alters the physical structure of their brains. So how can we assume that the brain is entirely causing their mind’s actions if their mind can alter the structure of the very brain it is supposed to be created by? Clearly, there is something far more complex going on here. Is the “biology” of depression (which btw has never been found to consistently exist for depressed people) the CAUSE of a person being depressed, or is it the RESULT of their framing of events as hopeless? If the mind is just a function of the brain, how is it that ASSUMING A DIFFERENT VIEWPOINT can “cure” depression or anxiety without any physiological intervention whatsoever?

    It is incredibly simplistic to believe that there will EVER be a simple, scientific, objective, biological explanation for why people get depressed, because the number of variables is ENORMOUS, including the direct impact of the MIND on the BRAIN. Of course, being a materialist, you no doubt reject my premise that the mind can transcend the brain and act upon it, but that is again a philosophical and not a scientific position. You can provide no proof that people who meet the criteria for “Major Depression” have anything in common at all, and the DSM itself admits that the “diagnosis” does not lead one to that conclusion. So what’s the point of grouping those who feel depressed together at all? Wouldn’t it make a lot more sense to group together people who have domestic abuse histories with others who do, even if some are angry, some are depressed, some are anxious, and some are feeling pretty objective about the situation? But of course, being a “domestic abuse survivor” will also never be a biological “diagnosis,” because it’s not a biological condition. It’s a social one.

    I hope I make myself clear.

  • They work short term the same on everyone. Judith Rapoport et al showed this way back in about 1978. They gave stimulants to non-diagnosed people to test the “paradoxical effect” theory. She found that non-“ADHD” kids on stimulants had longer attention spans, were harder to distract, and lower motor activity levels, all the same things they do for “ADHD” kids. She said the reason people though the “ADHD” kids were reacting differently was because people were LOOKING for these changes and so found them, but would not notice on kids where they were not trying to “solve” attention problems. This issue was laid completely to rest scientifically at that point, and anyone being honest these days will tell you that you can’t “diagnose” someone by their reaction to stimulants, because most people react the same way, diagnosed or not.H

    “However, it is now established that the focusing effects of stimulants in ADHD are not paradoxical; these agents have the same effect in ‘normal’ human subjects (albeit a more subtle response given ceiling effects) (Rapoport and Inoff-Germain, 2002).”,Inoff%2DGermain%2C%202002).

    Also, Rapoport’s original study from 1978:

    It has come to my attention that this mythology is still promoted by many sites who pretend to be objective about ADHD, but the science has long since proven them wrong. There is no “paradoxical effect.”

    As to longer-term effects, I think we’ve exhausted the literature on that point.

    Enrico, please give it a rest. You will not convince me by repeating the same things over and over again. I heard you, I read your evidence, I acknowledged your position, I’ve established mine with the necessary evidence. I’m sure I won’t change your mind, and you won’t change mine. Let’s just stop arguing!

  • Just to add a little extra evidence, I looked up “causes of depression” on Google. Here is a list of the titles that turned up:

    The 4 major causes of depression
    The 7 major causes of depression
    3 major causes of depression
    The 8 forms of depression
    The #1 cause of depression (Research suggests that continuing difficulties – long-term unemployment, living in an abusive or uncaring relationship, long-term isolation or loneliness, prolonged work stress – are more likely to cause depression than recent life stresses.)

    That’s on one search. Doesn’t sound like anyone has a grip on what “causes” depression, and there are as many theories as their are people tossing the label around. I think it’s because depression isn’t a “thing” that has one “cause.” It is an EXPERIENCE that can have hundreds of potential causes, and depending how it is handled, can lead to deterioration or to the opening of new perspectives on possible interventions that may improve one’s life. Any attempt to try and come up with one “diagnosis” for such a varied and nuanced experience is doomed to failure.

  • I think you are overlooking a rather obvious point – the manifestations called “diagnoses” in the DSM, however real the suffering involved, are assumed to be (even by you) some sort of physiological experience. Hence, if the person’s brain were “right,” they would not be depressed, anxious, intense, or whatever. This is an absolutely nonsensical assumption! These “illnesses” are “intangible” because they don’t actually represent physiological illnesses at all. These diagnoses represent a potpourri of different emotions and behavior that are literally VOTED into or out of existence. The emotions and behaviors so designated are all things that occur with some frequency in “normal” people, and the “criteria” are very much arbitrary distinctions between “normal” and “abnormal,” which the DSM itself admits in the introduction are not able to distinguish groups of people having actual problems in common with each other.

    “One of these innovations was that the new DSM was “a descriptive approach that attempted to be neutral with respect to theories of etiology” (p. xxvi). So, even though diagnosis is the identification of the nature and cause of a phenomenon, the APA somehow reconciled publishing a diagnostic manual that made no reference to the cause of that which was being diagnosed.”

    [Direct quote from the DSM:] “In DSM-IV, there is no assumption that each category of mental disorder is a completely discrete entity with absolute boundaries dividing it from other mental disorders or no mental disorder.” (APA, 2000, p. xxxi). So, the categories that DSM offers us do not have boundaries demarcating one disorder from another or, indeed, one disorder from no disorder. This is an extraordinary revelation. This means, according to the DSM, there is no assumption that the category “schizophrenia” has boundaries that separate it from other mental disorders or from not having schizophrenia.”

    In other words, the distinctions in DSM diagnoses are ARBITRARY, they are not based on any legitimate grouping of people who have a problem in common.

    Take “Major depression” for example: It COULD be caused by physiological events, such as drug side effects, low thyroid, anemia, Lyme disease, brain tumors, etc. It could be caused by social events: death/loss, current abusive relationship, unemployment, neighborhood violence, racism or other discrimination, being stuck in a dead-end job, poverty, etc. It could have psychological causes, such as a particular attitude toward life and events, high stress, prior abuse/trauma history… you get the idea. It is just SILLY to think that a person who is depressed because his mother died when he was 17 and he’s feeling a deep sense of loss has the same needs/problems as a person who is currently being abused by her partner, or has the same needs/problems as a person who was just diagnosed with cancer and is having side effects from chemotherapy. These people CLEARLY do not fit into the same category for either study or for planning, and yet the DSM makes absolutely no distinction between these groupings – these people, if they meet the criteria, are “diagnosed” with “major depressive disorder,” regardless of the cause or what their actual needs of the moment are.

    Now I’m not saying that individual practitioners don’t make these finer distinctions. I hope that most of them do. But the DSM itself is useless as a “diagnostic” manual if it can’t distinguish between a cancer patient taking drugs that affect the mind (not to mention having a big existential problem regarding their prospective death), and a person whose mother just died and a person who has a malfunctioning thyroid.

    That is what people mean when they say “mental heath diagnoses are not real.” They’re not saying that people don’t experience depression or anxiety at sometimes severe levels. They’re saying that the DSM “diagnoses” are of no value in establishing either cause or optimum “treatment” or prognosis. They are scientifically meaningless labels that are at best useless except to bill an insurance company, and at worst can be extremely destructive by papering over the real issues involved and invalidating the knowledge and experience of the client.

    Given all that, I very much doubt that a “more objective diagnostic system” can ever be achieved, because the very idea that people who have difficulties emotionally or behaviorally are medically “ill” is absolutely without basis in reality. There may be a very small subset of these conditions that can be attributed to actual medical problems, and they should be, but calling everyone who finds life pointless at a particular moment “ill” as if someone whose mom just died is supposed to be cheerful is an absurdity that is not redeemable except by scrapping that concept and starting over.

  • I am certain he deserves firing, as this was hardly “one misstep.” He really should have been fired long, long ago for corruption. He is almost singlehandedly responsible for making the “juvenile bipolar” craze happen, by creating a justification for millions and millions of unnecessary and damaging prescriptions. He actually PROMISED the drug company funding one of his trials that the trial would be positive for their drug, BEFORE the trial even started.

    Maybe this particular tweet could be forgiven, but his other crime can not. He ought to be in prison, IMHO.

  • How about providing them with every other possible source of non-drug support possible, including full physical workups, checking for ongoing abusive relationships, nutritional analysis, exercise, spiritual guidance, support groups, reading, music, art, coaching, etc, before even considering giving drugs that by their very nature disturb the normal functioning of the brain and nervous system?

  • “Mental health diagnoses” serve a lot of social needs that have absolutely nothing to do with the health of the individuals so labeled. It has more to do with defining acceptable behavioral norms, removing blame from those in power, and silencing direct or indirect objections to the status quo. A kid gets “diagnosed” with “ADHD,” for instance, not because there is any identified medial problem, but because the child’s behavior is inconvenient for the adults involved. “Diagnosis” enables the adults to name and blame the child without the bother and the risk of finding out what is really happening. This is of course doubly beneficial to those who are guilty of abuse or neglect of the child, because they have something to cover up, and the “diagnosis” provides cover for them to continue to act out their own problems on the child without the danger of being called out or consequenced for it.

  • That, of course, is the total downfall of psychiatry and the DSM – there IS no valid definition of “normal” on the psychological/spiritual/behavioral level. There is no way to extract “normal functioning” from the society and culture in which such functioning is defined. So their definitions are actually simply a collection of social biases described in some fancy language designed to obscure the fact that they’re basically saying, “Stuff that we don’t want” or “stuff that is hard for society to deal with.” And of course, completely denying that our social system itself is the proximal cause of most of the “stuff we don’t want.” The real challenge is why so many people believe this nonsense that is so easily debunked.

  • Hi, Ted!

    Have you ever made the legal argument that a person DOES meet the criteria for civil commitment (danger to self or others), but that this does NOT entitle the “doctors” to force “treatment” on them? It is very much taken for granted that civil commitment automatically confers this right on doctors and removes the “patient” (AKA inmate)’s right to informed consent. But why is this legally valid? It makes sense to get someone off the street if they’re walking in front of cars, but why does that confer anything more than the need to clothe and feed them and keep them warm until the crisis passes?

  • Dang, you got me, Bradford!

    You know, sometimes people who get hit by a truck and have a near-death experience suddenly realize their life priorities have been wrong and make a big turnaround. Maybe we can start pushing people in front of trucks, testing out varying speeds of impact, to see if we can get the right force and level of shock to induce the intended reorientation. It would make as much sense.

    Actually, I think I understand how “ECT” actually “works.” After two or three “treatments,” the recipient says, “Gosh, doc, I’m feeling SOOOO much better now! That ECT really did the trick. I’m TOTALLY healed! Now, can you please unlock the door so I can get the hell out of this place!”

  • It is hard to see how anyone who is in their right mind could possibly imagine that electrocuting someone to induce a grand mal seizure could possibly be “therapeutic!” It take some SERIOUS bending of reality to try and make that one work, yet somehow, they manage to justify it anyway. Fraud is right!

  • It is fascinating how the arrogance and corruption of these “leaders” are there right out in public for anyone to see, and yet so few see them. “Consideration” of the social determinants? As if THEY are in the position of deciding what is true, rather than observing the known facts? And their “customers’ mental health” – are we admitting here that the APA is a trade marketing organization that doesn’t give a crap about science as long as they maintain their market share? And why would a professional want to come and beg these folks to include something in their manual when it’s obvious that they don’t give a half a crap about the patients’ “social determinants” as long as they’re making sufficient profits?

  • Actually, there is no way to judge “overdiagnosis,” because with the utter subjectivity of EVERY DSM “diagnosis,” there is no way to determine what the “correct” level of diagnosis really is. So how can you “overdiagnose?” That’s part of the brilliance of the DSM – you can’t tell the they’re wrong, because there’s no way to prove it!

  • That is true, it should not be. Yet that is all too often what is on offer. My point is that it has to be done in the context of a bigger process of self-discovery. How to create a scenario which is “intellectually satisfying” is, indeed, the challenge. For some, it’s pretty natural, for others, it is quite a foreign concept and a lot of processing needs to happen before this is a reality to them. For others, it simply doesn’t work very well. I think a good therapist has a wide range of tools available, and CBT should just be one of them, and “tool selection” should be based on the needs of the client, not the need of the therapist to feel superior or skilled or whatever their needs may be.

  • It is also often a gross oversimplification. Yes, thinking about your mother having abandoned you IS painful, and it IS over, and you are not benefiting yourself by thinking about it over and over. But there are reasons why we are attracted to events in the past that are painful – we are still looking for some compassionate person to step in and make it RIGHT. And telling a person, “Just think of something else” when there is that much emotional charge on an event, be it fear, anger, grief, apathy, confusion, or whatever, is often counterproductive, leaving the client feeling like a failure for continuing to think “wrong thoughts” and feeling blamed for having “reacted badly” to the very real trauma they experienced. It also adds insult to injury if the “counselor” tells the client which feelings/thoughts need to be changed and/or what they need to tell themselves to change them.

    I certainly used CBT techniques when I used to be a counselor, but only at times when the client appeared to be able to process the past experiences attached first, or was dealing with fairly recent material. I would never try to ‘change the thinking’ of a person to the thoughts I believed they should have, nor would I ever blame their suffering on their own need to process harmful things that happened to them before being able to ‘let go’ of thoughts and feelings they may at one time have felt essential for their survival.

    Nobody should do CBT as a primary therapy approach in my book. It’s a set of techniques that have their place when carefully applied, but therapy had better be a whole lot more than that if you want your client to get anywhere close to where they want to go.

  • And to use science for what science is good for, but not forget that it has its limitations. Science can’t absolve us of the ethical/philosophical activities such as deciding what is good and bad in society, determining the scope of freedom when one’s activities impact another, deciding what purpose society has, whether and to what degree to enforce compliance vs. encourage creativity and free expression, and so on. Science (if used properly) is great at helping eliminate bias when determining truth. But it doesn’t help much with ethical issues where there is no absolute “True” or “False” involved. The entire area of “mental illness” is fraught with these ethical conflicts, such that no real “science” is currently possible in the field, since there isn’t even vague agreement on what a “mind” is, let alone whether a mind can have “health” and what a “healthy mind” would encompass. Not to mention the question of whether having an “unhealthy mind” would ever qualify one for involuntary imprisonment in the name of “health!”

  • True enough! When you are engaged in a very unscientific enterprise, it is almost impossible to define an outcome. But I’d still maintain that under such subjective circumstances, the only one who can even formulate an “outcome” is the client. Of course, any clinician who tries to manipulate his/her client into deciding they had a “good outcome” just to make the therapist feel better deserves to spend eternity in purgatory.

  • It means they’d have to deal empathetically with the patient’s actual needs, and be willing to admit it when they didn’t know what they were doing, which is most of the time. That would be intolerable, because they’d lose their superior status and have to be a vulnerable human being, just like the client is. Ironically, my experience tells me that the key to actually BEING helpful to a client is the willingness to be a vulnerable, genuine, humble, fallible human being who is willing to meet them where they are at and not think you know more than them about their own problems.

  • 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 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.

  • 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.

  • 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.

  • Right! It would be very much like curing “pain” or curing “baldness” or “high blood pressure.” Except that at least baldness and high blood pressure can be objectively measured, but still, something that can be caused by dozens or more different causes and is in some cases normal can’t be “cured” without some kind of rational analysis as to cause!

  • Calvin, it sounds like you were looking for a way to establish more control over your life, and psychiatry gave you the opposite. I found it sad hearing you decided that staying silent was your only remaining way to accomplish that. I’d say your story is far more compelling than you may think it is. I found myself thinking, “Man, if they told me what they told him, and gave me as little hope, I’d have wanted to kill myself, too.”

    You were VERY badly served by psychiatry. They did less than nothing – they undermined your belief that anything COULD be done, and I find that unforgivable!

  • I don’t know why this is published as if it were some kind of new news. The first review of stimuants for academic performance was done way back in 1978 by none other than Russell Barkley, the eventual advocate for putting massive numbers of kids on Ritalin. His review showed kids taking stimulants barely outperformed their non-medicated peers, and commented that the difference was so small it was “easily explained by reading the questions more carefully.” Repeated reviews by Swanson (1993) and by the OSU Medication Effectiveness Study in about 2002 or so found no significant improvement for long-term stimulant use in any academic measure. Naturalistic studies like the MTA, the Raine study in Australia, the Quebec study, the long-term MTA results, and a comparison study between Finnish and US children showed again and again that stimulants provide no improvement in any academic measure, and in fact, no improvement in ANY long-term outcome that adults would wish to see improved by “treatment.” This is just one more nail in that coffin, but the sad reality is that psychiatry has not noticed so far that the patient has been dead for decades.

  • 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.

  • 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.

  • “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.

  • 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.”

  • 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.

  • 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???

  • 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.

  • 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.

  • 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.

  • 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.

  • 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?

  • 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?

  • 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.

  • 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!”

  • 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.

  • 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.”

    More on the long-term alteration of dopamine transmission with long-term use of stimulants over time:

    Anybody here want to share your personal experiences with stimulants?

  • 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. (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 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.” (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.) (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.” (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. (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.”

    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.

  • 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!


    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.


  • 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.

  • Thank you, Jonathan. As I have said, there are philosophical differences that lead to different approaches. Different approaches are absolutely allowable. Claiming that all kids who present in this way “have a biological deficiency” is NOT scientifically valid at this point. It is VERY important to make the distinction between philosophy, which entertains the possibility and effects of different worldviews, and science, which attempts to discern facts and predict precise outcomes. Confusing one with the other leads to a lot of false conclusions.

  • Your comments continue tot be insulting. I never said “no biomarkers exist.” I said that your study did not prove that all or even most cases of “ADHD” are biological. I have also proven again and again that there are other alternatives to stimulant “treatment.” You are assuming the outcome and dismissing my example of my own kids because you don’t want to accept that your viewpoint is limited by your own biases. “Misdiagnosis” is common because there ARE NO OBJECTIVE STANDARDS FOR “DIAGNOSIS.” In fact, if there is no way to know who “has it” or doesn’t “have it,” there is no way to determine if someone is “misdiagnosed.” This leaves the door open to biased advocates to decide that anyone who IS helped by non-chemical methods “must have been misdiagnosed” to preserve their preferred belief system.

    My kids absolutely fit the criteria to a tee. They were helped to lead productive lives with no stimulants. You apologized earlier for minimizing that accomplishment, yet you continue to do exactly the same. You assert that I was making my blind children go around pretending to be able to see. That is incredibly insulting, and you don’t even realize it.

    I don’t “strongly disagree,” I have the best possible example that your generalization, which you repeat over and over again, is not true. I also have presented excellent proof that your insistence that “treatment” with stimulants is essential is absolutely not true, since in the long run, there are no significant advantages to “treatment” over “non-treatment” or “medical treatment” over psychosocial intervention.

    Seriously, PLEASE DO NOT RESPOND if you’re going to keep insisting that I’m a child abuser forcing my blind children to pretend to see! If you don’t agree with me, DON’T AGREE, but I don’t want to hear you telling me I’m wrong. If you can’t accept that the world is bigger and more complex than your data to date, you are no scientist and will fail to ever learn anything about why some people find your approach so horribly offensive.

  • Nonsense. Reviews by Barkley and Cunningham (yes, the same Barkley who makes millions selling the idea that “ADHD” sufferers are being abused if not given stimulants) in 1978, Swanson in 1993 (“Review of Reviews”), and the Oregon State University Medication Effectiveness Project (which looked at EVERY piece of literature on the subject every published in about 2002) ALL concluded that there are no long-term outcomes improved by stimulant treatment when comparing those “treated” and “untreated” who were diagnosed with “ADHD”. Also, long term studies like the Quebec study, the RAINE study in Australia, and the Finnish study (compared kids in the USA with very HIGH “treatment” frequency and duration to kids in Finland with much lower treatment levels, no differences found) ALL found that there was NO long term benefit to those “medicated” vs. “unmedicated.” The highly-touted MTA study showed that the stimulant group had some advantages in reading at the end of a year, but by the three-year followup, that difference had vanished, and later followups showed that those who continued to be “medicated” had DETERIORATING outcomes in comparison.

    Here is a more recent revivew:

    “In the short term, stimulant medication is effective in reducing the symptoms of ADHD and appears well tolerated with relatively minor side effects. In the long term, much of the benefit of stimulant medication disappears after medication is ceased. Studies have demonstrated only marginal improvements in adult outcomes following a period of treatment in childhood.”

    Have you actually READ “Anatomy of an Epidemic?” This is covered in Anatomy, though more data has come in since Anatomy to provide even more support.

    Repeating quotes from some guy with a degree does not constitute evidence. The jury is in – long term “treatment” with stimulants DOES NOT improve long-term outcomes. 40 years of studies should be sufficient to prove this point. If you want to pretend it’s not true, that’s your choice, but don’t try to convince me or anyone actually familiar with the literature.

    I have the data on this, Enrico. Probably best not to try and argue this point, and instead either retreat or consider the real implications of the REAL science, rather than relying on quotes from “professionals” who probably have a conflict of interest.

  • My kids NEVER felt they were lazy, crazy or stupid. Unfortunately, most of the kids I knew (and I knew dozens, probably hundreds) who were “diagnosed” with “ADHD” were pretty sure they were being told they were crazy. Some rebelled against it, some accepted that they were “crazy” or at least “incapable,” none of them I can recall escaped without feeling their “diagnosis” meant they were either dumb or crazy or incapable.

  • “I will state with confidence that those children learned just as much when they were not trained. ADHD is a biological/chemical/electrical/organic malfunction of the brain and training will not and cannot improve concentration.”

    I already gave you a clear and thorough demonstration of exactly how this can be done. Your latter claim is not supported by the literature. As I’ve said all along. It appears you already “know” the answers, so why are you bothering to have a “discussion?” It sounds more like you want to force anyone who disagrees with you into submission.

    If you really care, do your own research. But I don’t think you’d accept it if the results were right in your face.

    And talk about not answering questions – if chemical stimulation to enhance concentration in a regular classroom environment is such a great solution, why is it that study after study shows no improvements in long-term outcomes for medicated vs. non-medicated “ADHD” diagnosed cases? Answer that if you want others to ask your (possibly disingenuous) questions.

  • Or maybe some kids learn differently than is expected of them.

    Look, we’re not going to agree on this. It’s a philosophical problem, not a scientific one. You have a set of assumptions, mostly that kids learn best by doing what they’re expected to in a regular classroom, and that being unable to do that is a problem with the child. I have a different set of assumptions – that it is the adults’ job to figure out the best setting for children to learn in and that adapting your approach to the children’s needs obviates the need to come up with ways to get them to fit into the “normal” classroom. Within our own sets of assumptions, we’re both right. And it doesn’t seem that either of us are ready to accept the other’s philosophical assumptions. And it’s starting to get personal.

    Let’s just agree to disagree and have done with it. Diversity of perspective is the sign of a healthy community.

    All the best to you.

  • How on Earth do you know that my children were “not as limited as many?” How could you possibly know that without meeting my children, and without attempting a similar intensive behavior program based on the individual needs of other similarly “impaired” children and seeing what the results were? Your comment continues to come across as condescending, as I find quite common with people who are advocates for stimulants, rather than objective observers looking for the best approach and open to new ideas.

    Where in my comments have I ever criticized you or said you should hate or disrespect psychiatry or psychiatrists? And I don’t condemn teachers, I am criticizing the SYSTEM of education that requires children to engage in behavior that meets the needs of the adults and not the children. I’ve even given you alternative educational approaches that work for “ADHD” diagnosed children, in which you have shown not the vaguest interest. What would happen to those kids who “can’t learn” in a standard classroom if they were given a different venue to learn in? What if 70% of them suddenly did not “need medication” any longer? Would you consider that a GOOD outcome? Or a BAD outcome?

    And if it’s all biological as you claim, why is it that there is a full 30% reduction in kids getting diagnosed “ADHD” if they wait one year longer to enter school, as has been shown in several quality studies? The 30% figure is remarkably stable over these studies, too. What would happen if these kids were given yet another year to mature before enrolling? Could we reduce that figure by 50%? Would you view that as a good thing, or a bad thing? Especially when there is NO evidence that taking these stimulants over the long term has any positive impact compared to kids who quit early or never took them.

    Your view of the situation is extremely monochromatic. I’m just trying to broaden your perspective, not tell you that stimulants are wrong or bad. I’m encouraging you to take a wider view, instead of assuming that using chemical means to enable a child to sit still and pay attention in a standard classroom is not only the best but the ONLY way to help kids who are struggling to learn in that environment.

    It doesn’t suit you very well to claim you are sorry for condescending and then continue to condescend. But maybe you can’t help it.

    This time I’m REALLY done. I’d appreciate it if you did not add more disrespect and condescension to the pile. Maybe best if you just stop trying to convince me of something I very well have established to be a very narrow and ineffective view of “ADHD” to my own satisfaction.

  • After re-checking my post, I find your diminishment of the accomplishments described to be even more offensive. Did you even bother to read what I wrote? Do you have any comments or thoughts on the idea that using of rewards of intense stimulation to help kids learn new behavior? Do you have ANY experience in behavior change theories? Do you even understand the point I’m making, or are you just choosing to ignore it because it doesn’t fit your narrative?

    BTW, I have used these same approaches professionally with lots of kids, and also with adults, with some modifications. They WORK. It’s not because “my kids didn’t need medical interventions.” It’s because these interventions are smart and on target and very, very effective. But they require analysis, creativity, and months or even YEARS of HARD WORK! Maybe most people just don’t know how or don’t want to do that kind of work, and stimulants give them an “easy answer.” But one thing you have NEVER responded to is decades of research showing that long-term outcomes are NOT improved by stimulant treatment. My way DOES appear to affect long-term outcomes, at least in my kids’ cases. No learning problems, no delinquency, no school dropouts, continued high academic test scores, academic honors, and for one, a complete college education, again with academic honors. Stimulants can make no such claims. If you’re so interested in science, why not look for better solutions? Why spend all your time railing about genetics when it’s the one thing in the equation that can’t be changed?

    I assume you’re aware of the research on brain plasticity, that the environment molds and changes the brain based on how it needs to be used to survived. What if our approach altered the epigenetic conditions in the brain by teaching our kids to use their brains differently? Would that not be a great outcome, and exciting outcome? Why is that not of interest to you?

  • My children functioned without medical intervention, but with a HELL of a lot of non-medical intervention. We EARNED their positive behavior through YEARS of hard work. You are trivializing it by trying to pretend that “they functioned without medical intervention,” as if what we did had NOTHING to do with their success! You are building a strawman argument to bolster your own case, rather than listening to the story and trying to find the core of meaning behind it.

    What if lots of children could function without medical intervention, and nobody ever tried? What then? What if we are exposing children to years of drug side effects without really addressing their issues? What if 90% of those children COULD “function without medical intervention,” yet never had the chance to because people like you insisted it was impossible? Are we not cheating them out of an opportunity to grow and learn by telling them and their parents it is impossible?

  • Poor vision is objectively measurable, and is nearly 100% correctible by lenses. “ADHD” is a social construct “diagnosed” by a list of behavioral characteristics, some of which are, frankly, pretty ridiculous. “Acts like ‘driven by a motor’?” Isn’t that just a BIT different than “Is unable to read letters of X height from a distance of 20 feet?” Additionally, there is a very significant minority of “ADHD”-diagnosed, probably 30%, who don’t even respond positively to stimulants in the short term, some of whom actually get demonstrably worse (aggression, lethargy, psychosis in over 6% – hardly rare, eating problems, growth retardation – the list is pretty long).

    Your comment is clearly disrespectful to those of us who choose not to buy into drugs as the solution. And they ARE drugs. They are generally schedule II controlled substances that can be sold on the street for money. Pretending they are NOT drugs in order to preserve middle-class sensibilities is just plain dishonest.

    But yes, you are being extremely condescending to anyone who disagrees with your approach. “If someone doesn’t want improved vision, fine.” That implies that I have somehow neglected my children by forcing them to go around unable to see. As you can see from the results, my kids are NOT blind or limited in their capabilities in any way. They are just as capable as you or me, absent any stimulant “treatment” in their lives. It appears you are extremely invested in your idea that stimulant drugs are the only answer for kids who have what is at best a behavioral syndrome that is “diagnosed” by utterly subjective means. It’s insulting in the extreme, and I ask you to stop doing it, to me, and to anyone else you meet. Maybe instead of telling everyone else what is “right,” you could start listening and perhaps expanding your viewpoint. Instead of an analogy that I let my kids go around with poor eyesight, perhaps you can open your mind enough to say, “Wow, that sounds like you did a good job! Maybe there are other options I haven’t considered that could work for some kids.” I am not ascribing ANY immoral motives to you or anyone else who chooses to take stimulants, and I made that point more than once in this thread. I have been arguing ONLY from the scientific perspective that one study on a very limited population does not establish a “cause” for “ADHD” nor that it is a biological phenomenon only, nor that it is even a legitimate entity for scientific study. Your comments have been and continue to be dismissive and disrespectful of other viewpoints, and I’m calling you out on it. If anyone is ascribing ill motives to those who don’t agree with them, it is you who is doing so. You might want to take a very hard look at your own behavior instead of spending all your energy criticizing those who have good reasons to disagree with your assertions.

    And I have provided you a VERY concrete example of training that has had proven results. How is that “off the topic?”

    If you want to learn anything, you have to open your mind to the possibility that you have not been told the whole story. So far, I don’t see much if any openness to hear anything that contradicts your own preferred narrative.

  • Just to be clear, there are plenty of women who embrace “patriarchy,” and also plenty of men who don’t. Internalized oppression is a very real thing, and there is no reason that a woman can’t engage in sexist behavior or operate on sexist assumptions and values. Remember Anita Bryant? I’d have to say that even proposing the idea that PTSD is caused by women being on their periods is offensive on the face of it. Though the I agree with the rest of what you said – the lack of “common sense” in such a study is startling!

  • How long to you have? I can write a book on the subject.

    Just for starters: what do you know about “ADHD” kids? They need STIMULATION. They can’t stand boredom and routine. They often create behavioral issues in order to get the reward of adult engagement, even if it costs them getting in trouble. Which reinforces their negative behavior.

    So why not create a situation where they get intense stimulation for DOING WHAT THEY ARE ASKED TO DO?

    Example: My youngest didn’t like to lie still as we got ready for bed (reading time). He’d wiggle around, hide under the covers, smuggle in little toys to play with, and on and on. He was 5 1/2 at the time. I decided to create a program – I bet him a quarter that he couldn’t stay quiet for 1 minute without moving. Of course, he assured me he ABSOLUTELY could do that, NO PROBLEM! The first night, it probably took him 3 minutes to get settled down to the point I could even start the clock. But I waited until he was able to keep some semblance of calm for a minute, then I dramatically expressed GREAT frustration and coughed up the quarter begrudgingly. But I told him, “Tomorrow, we’re going to go for a minute and a half, and I KNOW you can’t do THAT!” We continued this process for a couple of weeks, and worked all the way up to 5 minutes. The last night, he took one deep breath, and completely relaxed, was totally still for five full minutes without a twitch. As I coughed up the last quarter, I said, “Well, I guess I was wrong. You CAN control your behavior, you just have to decide you WANT to do it!”

    Several months later, he and a friend (who happened to be diagnosed ADHD and on stimulants, but I did not know this) were jumping on our trampoline. His friend was violating the safety rules (he was older, more like 7, quite bright, and knew and remembered what the rules were). I reminded him of the rules, closed the door, and a minute later saw him doing the same thing! I went outside again and asked him why he kept violating the rules? He said, “I ate red dye this morning, and it cancels my medication, so I can’t control myself.” And Kevin immediately said, “Yes, you CAN control your behavior, you just have to decide you want to!” This was a very real, very deep learning experience for him which he was now applying to his friend. And all for only
    a few bucks and less than an hour of my time!

    Did this mean he was never wiggly or disruptive or oppositional again? Of course not! But it gave a context to have further discussions and to face bigger challenges building from this solid base. Plus it taught ME an important lesson – he WAS capable of facing pretty significant challenges, if he could WIN at the end, and especially if I got “upset” about his “defeating” me. I used this principle again and again throughout his childhood, and even as he grew older and recognized the “game” behind it, he still was tickled pink when I got “upset” with him for “beating” me, even when he knew I WANTED him to win.

    That’s just one short example of the kind of learning that can happen with a highly “ADHD” child when the adults, instead of getting angry at him for doing bad things, get “angry” at him for doing what we want!

    So rather than deciding to define my kids’ behavior or actually their entire personality as “wrong” or “disordered,” we spent most of our time validating the strengths of their personalities and identifying and helping them overcome their challenges through fun and challenging reinforcement programs. We regarded every moment as a possible teaching moment, and always had a goal and a focus for what we were working on next. I don’t want to suggest this was EASY – it was a lot of work, me made a lot of mistakes, and there was plenty of yelling and tears and accidental reinforcement of bad behavior. But we had a plan and stuck to it, and it worked. Eventually, Kevin himself started to set his OWN goals and pursue them with the passion he always brings to his life. He continues to this day to challenge himself to do better and to discipline himself to make his life the best it can be.

    There was never a need to pathologize their behavior, to label them as this or that, or to provide artificial stimulation through physiological means. We used what we knew about our kids and the behavioral patterns that were common, and we focused on building their strengths and using them to attack their difficulties and challenges.

    Does any of that sound irrational, punitive, or harmful to our kids? I think the success we achieved together speaks for itself.

  • You are assuming that the “ADHD” child WANTS to learn but is UNABLE to learn. If that is the case, why is it that one review after another over decades shows that stimulants create more “on-task” activity but do NOT translate into more learning/understanding in the long run? Is it possible that the child is being forced to do “work” that is not actually educational for them? That they already understand the material and are simply bored by having to “practice” over and over and over again doing something they already have down? Or that if offered a more hands-on, active, self-paced opportunity to learn, they would thrive on it, but such an opportunity is simply not made available to them?

    I’d also ask you to explain why long-term outcome studies show no discernible effect on self-esteem, if these shaming experiences are theoretically reduced in number? Is it perhaps that we are replacing one shaming experience with another, telling a child he “needs his meds” in order to learn things? Singling him out as “disordered,” often in ways that are obvious to everyone in the classroom? What does it do to a kid’s self-esteem when told that his brain “doesn’t work right” and that he needs a drug to “rebalance his chemicals?” What happens later on in life when he discovers that he was actually lied to about that supposed “fact” (because as we should all know by now, the “chemical imbalance” theory is dead, even in mainstream psychiatric research circles)?

    I was a shy kid in school. I had no trouble understanding anything the teachers were trying to teach us, though I did get frustrated at the ridiculously slow pace. Frankly, I was BORED TO DEATH, and no amount of increased “time on task” was going to teach me anything I didn’t already know. And trust me, I daydreamed like mad, and often completely tuned out the teacher droning on about something I already understood. I needed some NEW TASKS in order to learn more, not more time on the same boring tasks that I’d long since mastered!

    I was very good at “complying,” so stayed out of trouble, but was terrified to talk because of the potential shame involved in exposing oneself to possible ridicule from the teacher or the other kids. I got embarrassed, turned red, and could not respond. I was laughed at. I avoided talking so as not to keep having that experience.

    So what was the problem, Enrico? Was I “disordered,” because I was sensitive and easily embarrassed? Was my constant daydreaming an indication of me having “ADD without hyperactivity,” or a sign that I was in an incredibly dull and unstimulating environment for hours on end every day? Was I “disordered” because I didn’t want to risk getting humiliated? Or was the problem PERHAPS that the environment was a complete and total setup for a shy person like me to be exposed to? Was the fact that no one gave a shit whether or not I was shamed or embarrassed, or that the teachers themselves often PARTICIPATED in the shaming behavior perhaps a factor in why I was so reticent? Today, I would no doubt be “diagnosed” with “Social Anxiety Disorder” and efforts would be made to make me more participatory and to be able to “control my emotions” so I was “tough enough” to handle the inevitable shaming experiences that would ensue. My needs would be invalidated, and I would be accused of being a failed person because I couldn’t easily “fit in” to what I was expected to do.

    Kids should not have to learn in a shaming environment. They should not have to learn in ways that risk trauma if they participate. They should be able to learn in ways that work for them, instead of having to be forced into a rigid structure that takes their normal ways of learning and makes them a source of shame and embarrassment? Instead of trying to alter the kids’ personalities, maybe we ought to teach our teachers how NOT to shame kids and how NOT to set up situations where other students can shame them as well?

    Another interesting study showed that kids diagnosed with “ADHD” actually LEARNED MORE WHEN MOVING AROUND! So by forcing them to sit still and “pay attention” to the teacher talking, we are STOPPING them from learning. If giving them stimulants makes them more willing to sit there and take in all the boring “information” being tossed at them, that apparently doesn’t translate into them learning any more than they would have if they goofed off the entire lecture. In fact, they’d probably learn MORE if they were allowed a half hour of searching the internet and reading about what they’re interested in than they do sitting through a lecture in a chemically altered state.

    I’ll again refer you back to the 1970s era study on “ADHD” kids in open classrooms. They stood out like sore thumbs in a “normal” classrooms, but professionals COULD NOT TELL THEM APART FROM THE “NORMALS” in an open classroom. So instead of drugging kids so they can sit still through a boring lecture and get higher points for “Stayed on task,” why not create open classrooms for anyone who needs or prefers that style of learning?

    Remember also the study showing that these supposedly “disordered” kids were a critical element in groups of elementary school kids actually solving problems. They brought something to the table that three “normal” kids would have benefitted from. Why do we want to suppress that strength, just so that teachers and parents have an easier time?

    The fact that teachers and other students hurt, shame and confuse other kids who don’t function well in a standard classroom is the fault of the teachers and the system they work with. As I’ve said before, my own kids had NO STIMULANTS despite pretty severe “ADHD” symptoms, but both graduated high school with honors and are paying their own way in the world and have functional relationships and goals and are functioning in every way as a contributing member of society. No one today would “diagnose” them with anything at all. What was different? We didn’t try to force our “square pegs” into the “round holes” of the school system until THEY decided they were ready for it. We loved and respected them, but of course taught them things they needed to know, including how to discipline themselves and how to get along with folks they disagreed with. Neither of them were in the tiniest degree unable to learn. In fact, they are both brilliant, fast learners! But they did not learn the way that schools expected them to learn. We never considered that their fault.

    You are asking others to consider your hypothetical scenarios. What about my very REAL scenario of my two kids, and the research that supports what we did to help them mature into functional adult citizens? Does that suggest that alternative viewpoints may not only exist, but in fact be viable ways to view the situation that lead to positive results?

  • This is a nice story, but does not reflect reality in the vast number of cases I see, nor does the research support the “transformed overnight” meme, except in the most mundane of aspects, namely that many kids behave more acceptably to the teacher’s (or parents’ or professionals’) eye on stimulants. Long term studies and literature reviews have repeated ad nauseum that long-term stimulant use does not improve outcomes in academic, social, behavioral, or emotional areas. I’ve listed some of these in another post. Try googling “long-term outcomes stimulants ADHD” and read through the results. There will be a few individual articles claiming positive benefits, but the reviews of the literature and the long-term outcome studies, including the Montreal, Raine, the Finnish study, and the highly touted MTA study, all show “disappointing” results.

    I would also submit that your characterization of how adults treat these hypothetical “ADHD” children amounts to verbal and emotional abuse. Giving drugs to avoid verbal and emotional abuse by adults seems a little ass-backwards to me. Perhaps the parents need to learn how to treat a child who doesn’t naturally fit into the largely arbitrary social expectations foisted on them by schools and often by the parents themselves?

    As I’ve said before, I speak from direct experience in this case. It is VERY possible to create a positive environment that is both nurturing and sets reasonable and attainable expectations for kids based on their personalities. It’s just that very few children ever experience these conditions, because parents are expected to send their kids to schools that are not suited to their needs.

  • I’m not resisting what Birk shows. Saying that this mutation is ONE POSSIBLE CAUSE of the syndrome called “ADHD” is absolutely fine. Saying it IS THE CAUSE of ADHD is not fine. That’s what it sounded like you were saying. The big problem I’m pointing out is taking a single finding and extrapolating it to everyone, going from a subset of “ADHD”-diagnosed people have this particular anomaly to “ADHD” is a disease state that is caused by this genetic mutation. It presents an interesting template for further study. But there are many other interesting templates for examination, including low iron, sleep apnea, nutritional problems, exposure to abuse/neglect, exposure to domestic abuse in the home, inappropriate expectations set on younger children, maturity at admission to school, classroom structure, skills of parents and/or professionals managing these children, and on and on. As I explained to you earlier, I have two of my three boys who fit the “ADHD” criteria to a tee, and both were successful in high school and one in college with no drug intervention whatsoever. Should we not be grateful that at least some “ADHD” kids can be TAUGHT the skills to concentrate when they need to? Would this not be a topic for investigation? Isn’t that information that can be used to help others? Isn’t that what we are all striving for?

  • The point is, response to stimulants is not diagnostic of “ADHD” or anything else except having taken stimulants. Again, if you LIKE the effects of stimulants, you’re welcome to take them. It is completely irrelevant to the question of biological causation.

  • OK, I’m going to try one more thing here and then that’s it for this discussion for me. I will keep it very simple.

    Let’s say we did a study and found that poison ivy causes skin rashes. We had a large sample of people and found that 90% of those exposed to poison ivy got a skin rash.

    Can we now conclude that skin rashes are caused by poison ivy?

    Or can we conclude that a certain subset of skin rashes are caused by poison ivy?

    What would we need to do to demonstrate that ALL skin rashes are caused by poison ivy? Would this one study be sufficient to show that?

    This is what you’re doing here. You are saying that people who have this mutation are likely to fit the description of “ADHD.” This is not something I’m arguing with. I’m asking you how you could possibly conclude from this one study that ALL cases of “ADHD” have this cause?

    The answer is, you can’t. If you can’t see that, you can’t try talking science to me. It’s a fundamental tenet of science – correlation does not imply causation. There could be 500 different, distinct causes of the syndrome called “ADHD,” and this could be one of them. We could do the same with abused children – take 100 abused children and 25 of them are diagnosed with “ADHD.” Does this mean child abuse causes “ADHD?” No. It means at most that SOME “ADHD” behaviors are caused or increased by child abuse. It could even mean that abused kids are more likely to be taken to a psychiatrist for a diagnosis. Or that foster care placement makes kids more anxious and that this creates more “ADHD” symptomology. And there are many people who are diagnosed with “ADHD” that have no child abuse in their background. But it is a factor that contributes. That’s all we can say.

    Like I said, you could be right, maybe every single case of “ADHD” has this mutation. But this study certainly doesn’t come anywhere CLOSE to proving such a thing. It shows that people who have this genetic mutation are likely to show “ADHD” symptoms. And that is ALL it shows. The rest will require further study.

  • Sorry, can’t agree with you here. I can’t argue with the result that a certain very small subset of people diagnosed with “ADHD” had the genetic mutation that Birk has located. I don’t want to argue with that. But science is limited to answering the question asked. This study showed that a small sample of humans diagnosed with “ADHD” had a certain genetic anomaly. That is ALL that it proved, whatever the researchers theorize it means. Science is inherently SKEPTICAL. It is supposed to doubt its own conclusions and try to come up with alternative explanations and to DISPROVE anything that it wants to prove. No real scientist has the attitude that one study, particularly with the small sample size involved, can “prove” that “ADHD” is biological! It’s an outrageous assertion scientifically. Consider that we all “knew” for a certainty the formulas for acceleration and force and the gravitational constant and so forth for CENTURIES before Einstein showed them to be an approximation rather than a precise description of reality. Science is always working to improve itself, and that means questioning assumptions and conclusions that are not established beyond a reasonable doubt, and even those that ARE established as “laws” are STILL subject to revision when contradictory data arrives on the scene.

    Replication is the core of scientific verity, moreover, replication in the face of efforts to establish alternative explanations. You can’t take one study and extrapolate it to apply to the entire population in question, ESEPCIALLY when this population is defined by ridiculously subjective criteria like “displays poor listening skills” or “appears to be ‘driven by a motor’ or is often on the go.” Seriously, “Often on the go?” You think that every child who is “often on the go” would not be “on the go” except for some genetic anomaly? It is absurd to so readily believe that one study, which establishes nothing more than an ASSOCIATION with these “ADHD” traits, proves causality.

    Anyway, you seem to have convinced yourself and are not really interested in discussion. I’m not sure why it is so important to you to make more of this study than it offers, but maybe you’ll be right and I’ll be wrong in the long run. But I certainly will not concede that a single study on a tiny subsection of this population proves “causality” of “ADHD.” Come back to me when you have at least three studies from different, non-biased sources that indicate that over 90% of those “diagnosed” with “ADHD” have this anomaly, and that less than 10% of the general population have the same anomaly, then maybe we can talk.

  • Your comment comes across as extremely arrogant. Neither you nor Dr. Birk has come anything close to explaining why a subjective list of behavior that adults and especially school personnel find annoying is 100% “caused” by a genetic anomaly that is seen in mice.

    I am the first to say that kids (and adults) who have a hard time concentrating on the daily drudgery of the average school classroom should not be abused, neglected or treated as second-class citizens. But the problem in my mind is not the kids, it is the school structure itself and the ongoing justification of mistreating children who don’t do well in that structure that is to blame here. I totally allow that there are some kids who are born not being tolerant of boredom and repetition, not liking to sit still, etc. just because they came that way. Two of my three boys who fit that description. Both of them graduated high school with honors and have social lives and have successful jobs and are no less happy and productive than the average person, despite neither of them ever having had a milligram of stimulants in their lives. We did have lots of frustrations, especially with the older one (we learned so much from him that the younger was MUCH easier!) and I’m certain if we’d sent them to “normal” schools with “normal” classrooms, they’d have struggled and probably learned to hate school. So we didn’t do that. We sent them to alternative schools and homeschooled for several years, and spent a lot of time learning creative ways to approach discipline that worked better for their particular personalities. And yes, they COULD and they DID learn how to concentrate when they needed to, how to alter their approach to relationships, to accept losing and failure as learning opportunities, and even how to accommodate arbitrary restrictions an expectations in order to get what they wanted/needed out of life.

    I would also add that if YOU find stimulants helpful to YOUR life, I certainly have no objection to your choosing to use them in whatever way seems helpful to you. I do object to your attempts to narrow the discussion to Dr. Birk’s single, small-sample, narrow and unreplicated study as some kind of proof that you have all the answers and that everyone else’s conception of “ADHD” is wrong and that it’s 100% biologically caused and that anyone who acts that way has a “disorder” and that anyone who thinks otherwise is sadly ignorant. There is PLENTY to talk about both philosophically and scientifically that is unresolved, and I am extremely well versed in a wide range of research on this topic, in addition to having personal and professional experience over many years in the area. So please, do not condescend to me and pretend that your single study has proven anything. I hear and understand and agree that there are most likely biological conditions that are ASSOCIATED with “ADHD” symptoms. But that is a tiny, tiny piece of a very large and complex puzzle that involves not only biology, but culture, history, sociology, philosophy, and education, among other variables.

    I have not even touched on the very important question of long-term outcomes. There is at this point a pretty solid range of literature showing that stimulant “treatment” alone does nothing overall to improve long-term outcomes like high school graduation rates, college enrollment, academic test scores, delinquency rates, teen pregnancy rates, drug abuse rates, social skills, or even self-esteem (even if they may help one or more of these things in a PARTICULAR person at a particular time). Even if it is absolutely proven that EVERY person who fits the subjective “ADHD” profile has this genetic anomaly, which I hope you are able to acknowledge is NOT claimed nor proven by your Birk study, there is scant evidence that taking stimulants does anything more than temporarily make it a little easier to concentrate (just like it does for most adults, “ADHD”-diagnosed or not – see my other post), which doesn’t even lead to better educational outcomes on more than a short-term basis. So why spend all this time arguing about whether or not “ADHD” is caused by a genetic anomaly while not addressing the major concern that taking or not taking stimulants doesn’t seem to make a big difference in the long term for the “ADHD” sufferer? Maybe we should spend less time on arguing about genetic causation and more on figuring out how to make the school environment more workable for these kids (and for other kids who also find it oppressive but are “genetically” more able to pretend they’re OK with it)? After all, genetic diversity is the key to species survival. Why are we picking on these “ADHD” kids when we know that, for example, putting them in an open classroom environment (that’s what we did for our boys and it worked!) makes such kids virtually indistinguishable from “normal” kids?

    I am sorry you have suffered at the hands of the system. It didn’t have to be that way. But I don’t think the evidence suggests a simplistic, biological answer to what is a complex sociological problem.

    I’ll leave you with this: a recent experiment took groups of three elementary school kids and gave them three problems to solve in a specified period of time. The experimental group had one “ADHD” diagnosed kid and two “normal” kids, while the control group consisted of three “normals.” They were rated on percentage of time on task as well as on how many problems they were able to solve. Not surprisingly, the groups with the “ADHD” kid in them spent considerably more time “off task” doing and saying things that had nothing to do with solving the problems at hand. The surprising outcome (to the experimenters, though not to me) was that NONE of the groups of “normal” kids were able to solve any of the problems they were presented with, while the “ADHD” groups consistently solved one or more of the problems, despite spending less time focused on finding a solution. Of course, if they’d had groups of three “ADHD” kids vs. three “normals,” the results may have been quite different. But I think the lesson from this study is that people who are off-task, silly, have scanning rather than fixed attentional focus, are ESSENTIAL to the survival of our species. They are the ones that come up with new ideas, that “think outside the box,” the ones not constrained by convention but who can dedicate themselves to finding a way to make things work, regardless of what anyone else thinks of their approach. We need these kids and adults!

    Just in case you think I’m making this up:

    It has been observed that folks like Edison and Einstein and Gauss and Lincoln and Van Gough and Leonardo Da Vinci might have been diagnosed with “ADHD.” I have to wonder what marvelous contributions to the world might have been lost if these folks had been “properly medicated” in their day? Maybe the world just needs to make more room for people who don’t like to sit at a desk and do as they’re told all day long. Maybe it IS genetic, but why would 10% of the population have this particular genetic inheritance if it didn’t have a purpose in helping our species survive?

  • Could you PLEASE respond to my very valid points regarding the CDH2 mutation NOT being established to exist in all or most or even any kind of percentage of so-called “ADHD” sufferers? Or help us understand why early childhood abuse and neglect is associated with 4-5 x increase in “ADHD” diagnosis if this is all about the CDH2 mutation? I could add more, but I want to keep it simple so we can see if you have any kind of answer to these key questions. So far, you have avoided them and keep repeating the details of this rather limited study.

  • Just to be clear, Judith Rappoport, et. al., showed unequivocally (back in about 1978) that non-labeled people respond exactly the same way as “ADHDers” to stimulants. She called the claim of differential response “an artifact of observation” due to the fact that people are LOOKING for a particular response from the “ADHDers” and so notice and value that response, while the same response from “normals” doesn’t get any attention because no one is trying to “fix” them. So the improved concentration you attribute to “ADHDers” responding instantly to stimulants is the same improved concentration that ANY PERSON would gain as a result of stimulants.

    “Since the positive effects of stimulants on disruptive behavior were described (Bradley & Bowen, 1941), further pediatric study has been limited almost exclusively to samples of hyperkinetic school-age children. Because these agents normally were viewed as arousing in their effects on the central nervous system, but were calming in their therapeutic effects on these children, stimulant effects on Attention Deficit Disorder (ADD) were interpreted as being ‘paradoxical.’ Investigation of effects in normal children and adolescents and in those with disorders unrelated to Attention-Deficit/Hyperactivity Disorder (ADHD), as well as in young adult samples, however, indicate that stimulants appear to have similar behavioral effects in normal and in hyperactive children. This brief report is an update (as of August 2002) on studies of stimulants in ADHD and normal children, with particular focus on MPH.”

    Since you seem to have respect for researchers in the field, I will assume that we can consider that particular topic closed.



    All comments you have made should be approved at this point. They are not always approved in order they are submitted, as more than one person works on approving comments, and sometimes certain comments require more analysis than others, so their approval may be delayed in some cases. If there are any comments I have not approved, please let me know the thread and some of the content and I will see what has happened to the comment in question.

  • I have made my points, and you appear to have no response other than “Dr. Birk said so.” The fact that Dr. Birk said so is of absolutely no consequence to me or to Science as a whole.

    I don’t need to contact Dr. Birk – s/he has overstated the case by any level of scientific analysis. It appears we will be unable to agree on these points. You are free to believe Dr. Birk’s analysis if you wish, but it is still important for any real scientific discussion to point out the limitations of the research presented. Since you appear to have no interest in responding to the points I have raised, it appears that no further discussion is possible.

    Best to you in the future.


  • Ah, now we get down to it. It is ASSOCIATED with “familial ADHD.” Associated means it occurs with a higher percentage in the “ADHD” population than in the general population. It does not mean it is a cause, as there may be many, many cases of the same mutation in people who don’t fit the “ADHD” criteria. “Correlation is not causation.”

    We know for certain that familial domestic abuse is highly associated with “ADHD.” It occurs more frequently in the “ADHD” population than in the general population. Does that mean that familial domestic abuse causes “ADHD?” What about the many children who are exposed to the same kind of parental behavior who do NOT develop “ADHD” symptoms? What about the large number of “ADHD” diagnosed children who don’t have domestic abuse in their history?

    Other associations are low iron, sleep apnea, younger age of starting school, being in a traditional classroom vs. an open classroom, abuse/neglect at an early age, etc. Are all of these “causes” of “ADHD” because they are “associated” with “familial” ADHD? Does a traditional classroom “cause” ADHD because more “ADHD” behavior is associated with it? Or does a traditional classroom structure simply not WORK for a certain percentage of children, for a wide variety of reasons?

    Correlation is not causation. And you continue to avoid the most important question of why this particular set of subjective behaviors are automatically a “disease state” even if a consistent physiological cause were found.

  • Sounds a lot like “blaming the victim” to me. Of course, people don’t want to feel marginalized. But why is it their job to carve off parts of their personality in order to “fit in?” Why is it not the job of society in general to help people feel more welcome and accepted, even if their behavior is unusual or confusing, yet does no harm to anyone? Isn’t a lot of “mental illness” simply the consequence of society’s narrow view of what is “normal” or “acceptable” behavior?

  • That is more than possible, since they seem to know very little about either on the whole. But I think that would make you more of a shaman than a doctor. Of course, if I wanted to use psychedelics for any reason, I’d of course seek out a shaman and avoid anyone claiming to be a “medical practitioner” using psychedelics as “treatment” for some manufactured “disease” s/he decided I supposedly was afflicted with.

  • Again, claiming “cause” requires establishing that all or almost all “ADHD” sufferers HAVE the CDH2 mutation, and that no or almost no “normal” people have this mutation. To claim this from the data presented is pretty laughable. They’ve shown that a very small sample of people/mice subjectively judged to “have ADHD” without objective measures happen to have this particular mutation. Does EVERYONE with this mutation have “ADHD?” Or is it 10%, 20%, 50%? Does EVERYONE diagnosed with “ADHD” have this mutation? Do some have the mutation and NOT develop “ADHD symptoms?” Is the presence/absence of this mutation determinative of a person’s long-term success in life? Does “treatment” for this putative problem actually do anything to improve long-term outcomes for those so “diagnosed?” Is there even an objective way to determine who “has” or “does not have ADHD?”

    It is scientifically absurd to declare that this mutation “causes” ADHD when the “disorder” itself is not objectively discernible, nor is there any indication that those so “diagnosed” have any kind of physiological problem or are just a normal variation of behavior that doesn’t work so well in modern society. After all, genetic diversity is central to species survival. Why is a genetic variation, even if it is 100% associated with this behavioral syndrome, automatically a “disorder” when our species depends on a wide variation of genotypes and phenotypes to survive?

  • There are no long-term outcomes that are improved by “ADHD treatment” with stimulants. This has been shown by Barkley in 1978, by Swanson’s “Review of reviews” in 1993 or so, and by the OHSU comprehensive study of long-term outcomes, which looked at essentially every study ever published on the subject up to somewhere around 2001. There were NO improvement in long-term outcomes for “treated” vs. “untreated” subjects noted in the OHSU study, including academic test scores, high school graduation rates, college enrollment, delinquency rates, teen pregnancy rates, social skills measures, employer satisfaction rates, or even self-esteem. The only variable that was improved is a slight decrease in accident rates. In Barkley’s 1978 review, he said that the improvements in academic test scores were so small that they were easily explainable by reading the questions more carefully. And yes, this is the same Russell Barkley who has become one of the keenest advocates for “treatment” for “ADHD,” so we can hardly blame researcher bias.

    Additionally, long-term studies like the Quebec study, the Raine study in Australia, the Finnish comparison study, the long-term follow-ups to the MTA study in the USA, all lead us to the inevitable conclusion that long-term outcomes are not positively affected by stimulant treatment. To claim “we know there is a biochemical basis to ‘ADHD’ is, of course, utter nonsense scientifically. But we are not even at the point where we can say that “treatment” leads to any significant long-term improvements in any significant outcomes.

    The small study that is referenced doesn’t even come close to touching any of these long-term effectiveness questions. It ignores the obvious environmental impacts on “ADHD” behavior, including later entry to school, having open classrooms, and the impact of psychosocial stressors on the “diagnosis” (studies have shown “diagnosis” rates of 5-10 times higher in children who have experienced serious abuse or neglect). Nor does it address finding some objective way of even determining who “has” or “does not have” “ADHD.”

    Repeating something over and over again doesn’t make it true. From a purely scientific viewpoint, “ADHD” isn’t even something that can be objectively determined to exist, let alone to be a “disorder” or divergence from “normal.” This study barely scratches the surface on questions of etiology, differential “diagnosis,” and long-term effectiveness of proposed “treatments.” It is ridiculous to claim that this proves any kind of “biological basis,” when the condition you have identified hasn’t even been established to exist in all or most or who knows what percentage of “ADHD” diagnosed people, nor the percentage of the people having this variation who may NOT have any “ADHD” symptoms to speak of. And of course, the entire enterprise is called completely into question by an inability to objectively even define who does or does not qualify for the “diagnosis” of “ADHD” in the first place.

  • Nonsense. We would need to see that all or almost all cases of “ADHD” have this same mutation, and that no or almost no person with this mutation does NOT have the “ADHD” features. Given that “ADHD” is defined by subjective behavior and sociological variables, the odds that EVERY case of “ADHD” so “diagnosed” is caused by this mutation is exceedingly questionable. In any case, this question does not begin to be answered by a handful of mice, or even a very small number of “ADHD” cases studied. We also know that, for instance, waiting one year before enrolling a child in school leads to a 30% reduction in “ADHD” diagnoses (a number of studies confirm this), that sociological stress such as neglect and domestic abuse increases the rate of “diagnosis,” that placing such children in “open classrooms” makes it practically impossible for professionals to distinguish them from “normal” children, and that prior comparisons of “genetic markers” have proven extremely heterogeneous, that is, that many “diagnosed” with “ADHD” did NOT have the markers, and many who were NOT “diagnosed” did in fact have the same markers.

    And of course, the entire line of inquiry ignores the rather obvious question of why a particular challenge in paying attention to boring activities is considered a “disorder” in the first place. I recall an article (which I can’t seem to locate now) that showed employer satisfaction with historically “ADHD” employees did not differ from those not so diagnosed. The explanation offered was that those with this “diagnosis” simply chose employment opportunities that fit with their personalities, rather than being forced, as they are in schools, to do what they are ordered to do with no ability to choose the activities they prefer. This is strongly supported by investigations in the 70s indicating that “ADHD” children are virtually indistinguishable from “normal” children in an open classroom environment.

    In short, there is a huge number of variables involved in this analysis that are ignored, most particularly the problem of “selecting” subjects based on a subjective list of behavioral characteristics that are not truly measurable in any objective manner. This particular study does nothing to answer the bulk of questions that the diagnosis itself raises, yet even within the context of the accepted nomenclature, there is no way to draw the conclusion you claim from the extremely limited study you present.

  • My objections remain unanswered. This is a speculative effort to establish a correlation between “ADHD diagnosis” and a certain genetic pattern. It is performed on a very small number of MICE. It does not address questions of rearing variables, does not establish probability of the “error” being found in the “ADHD-diagnose” population, nor in the general population vs. “ADHD-diagnosed.” It does nothing to establish any kind of “abnormality” of this genetic combination to distinguish it from normal genetic variation. One more “promise” of a “biological cause” which is nothing of the sort.

  • As usual, you are identifying an “association.” Nothing in your article speaks of a “cause,” nor does the degree of “association” appear anywhere here. There is no comparison stating what percentage of people who have this mutation who are “diagnosed” with “ADHD” vs those who are not, nor what percentage of “ADHD” sufferers actually have this particular mutation. To claim “biochemical cause” as you imply in your first sentence, we’d need to know that almost all “ADHD” sufferers had the mutation and almost no one who has the mutation is NOT diagnosed with “ADHD.”

    The article also avoids the very important question of whether or not this is simply a normal genetic variation that has been pathologized because the associated behavior is annoying to adults.

    It is tiresome to keep hearing of these “breakthroughs” which don’t address the most basic scientific questions yet claim “proof of biological causation.”

  • I like some of what you said, but I don’t agree that the DSM would shrink in the absence of child abuse and neglect. The DSM serves a purpose that is very different than helping people recover from trauma. It enables psychiatry to justify intervening in situations where they don’t have the first idea how to help, and it also justifies blaming the victim when their “treatments” don’t work or do harm. There are WAY too many people making money off of the current system to think they’d just back off if humans suddenly became more sane. I think the greater hope would be that humans who were NOT abused in childhood would find it easier to recognize the false “authority” of psychiatrists in the area of “mental health” and that psychiatry would die a well-deserved death in the face of actual approaches that help people learn and grow spiritually rather than ones that try to “help” by disabling people’s brains with dangerous drugs.

  • That data was from two WHO studies in the mid-90s, which Whitaker reports on in Anatomy of an Epidemic. They re-did the same study because the mainstream psychiatrists didn’t believe the results. They still try to explain it away by saying it is due to “cultural factors,” while ignoring the most obvious difference – fewer people on fewer antipsychotics.

    You are fortunate to hear Seikkula in person! I’d love to have that opportunity!


  • That is a pretty MASSIVE disparity! Of course, the psychiatrists would like to blame it on “the disease,” but the almost certain culprit is the drugs they use to “treat” it.

    Would love to see someone do a comparison with “untreated schizophrenia” and see the prevalence in that population compared with those “fortunate” enough to get the best of modern medical “care.”

  • I appreciate that you say you “prefer it.” As I said, we’re talking philosophy here, not science. Until we know something of how neurons “generate inner realities,” we’re speculating. We don’t KNOW a single thing about the “mind” except indirectly by its apparent effects. My opinion is that we will not ever get there, because we’re using the mind to study the mind. The Buddhists have probably come the closest to getting a handle on it, but again, they are focused on effects, not on where the mind actually comes from or what it particularly is.

  • So how have these studies led you conclude that “mind” is an emergent property of neurology? What concrete observations show this to be the case?

    BTW, I admire you commitment to these studies. I totally support the study of the mind/spirit or whatever you want to call “it” by individuals and groups. I just don’t see this leading to any scientific conclusions. But I’m open to new information, of course.

  • But why does the mind as a virtual extension of neurological activity “stand on its own?” It only does if we adopt a “materialist” philosophical viewpoint. Science can tell us that we have a brain and what the brain is doing and how it happens, but so far, it can’t really identify what “mind” really is. So how can we conclude that it’s a neurological phenomenon? That only holds if we pre-judge that it can’t be anything else. Which is not a scientific position, it’s a philosophical one. There are plenty who would say that the world doesn’t make sense without a “creator” on a spiritual level. They don’t have “proof” either but are just as convinced of their viewpoint.

    Psychiatry, in fact, relies on a “materialist” interpretation of the world to conclude that “Mind must derive from brain, therefore Mind can be altered only by altering the brain.” I think it’s important to take a stand that psychiatry has NO IDEA WHATSOEVER what “mind” is. And my observation is that as soon as we concede that a materialist worldview is the ONLY worldview that is “rational,” we spiral very quickly down the slippery slope into pseudoscience and violent acts on the body to affect the mind. So I think it’s essential NOT to accept that we “know” that the mind is a function of the brain, and that it is, in fact, a mystery. I’m not claiming I know any more about it than anyone else, but the truth is, any speculation about the mind is not based on scientific knowledge, because we don’t really know what it is we’re talking about.

    Until you get me a spoonful of “mind” or in some other way demonstrate what it is in a replicable manner, it remains beyond the scope of science to study.

  • There is also nothing to prove that it is an emergent property, nor anything to prove it is NOT of a spiritual nature. The mind remains a mystery which Science has so far not made a dent in. Questions of philosophy must be answered (such as what IS a mind? or Do non-material things potentially exist?) before any claims can be made about the nature of the mind.

    You write as if failure to prove a spiritual reality exists means that it doesn’t. It does not. Most people don’t realize that there are THREE conditions for any scientific question: True, False, and Insufficient Data to Determine. The Mind belongs to the latter designation.

  • They apparently need two “statistically significant” results from two separate studies. Unfortunately, there can be 150 studies showing no response or negative response, and it doesn’t matter. It also doesn’t matter if “statistically significant” changes are meaningful to the patient/client, nor whether the client regards the benefit as not worth the cost. Study dropouts are often not counted as failures in the results, placebo responders are often filtered out at the beginning to give the drug a better chance of “success,” and still the “improvements” are often tiny and not of clinical significance.

    It’s a racket!

  • Reading this has led me to look at my own eating behavior and attitude towards food, and how pervasive this idea of controlling food and weight has become in our culture. It seems to happen without thinking. It seems “normal” for us to be anxious and compulsive about weight gain and about food!

    It seems to me that we ought to be collectively attacking those attitudes, which it appears that many if not most of us share, rather than labeling those at the more extreme end of the spectrum as somehow “deficient” or “wrong” because their particular adaptation to these bizarre expectations and attitude about food and bodies happens to fall into a certain range. I will be thinking differently about my own relationship to food after this. Thanks, Shira!

  • I honestly don’t think they know how to help. They are so busy pretending they do, they somehow don’t notice that they’re making people worse!

  • It’s like trying to find the “cause” of abdominal pain. If you try to find one cause, you’ll be completely baffled and decide it is “incurable,” and spend a lot of money on pain relievers and Ex-Lax. There is no reason to believe that “schizophrenia,” itself definable in so many different ways even within the DSM paradigm, is a “thing” that is caused by another “thing.” It is, at best, a syndrome that could have a wide variety of causes and potential solutions. Should be obvious to anyone who understands science, but apparently a hell of a lot of “mental health professionals” aren’t in that group!

  • What if getting help from the medical field is not going to be that person? Is it possible that someone from a very different background could provide the listening and support you need?

  • I would submit that there is plenty of evidence from many sources indicating that doctors/psychologists/therapists, having an inordinate power balance vis-a-vis their clients, will not infrequently abuse that power imbalance to their advantage, consciously or unconsciously. Why this would somehow NOT apply to therapy using psychedelics would be a big mystery to me. There are capable therapy practitioners out there, for sure, but there is little to no accountability or quality control. Once you have your degree, you can do just about anything that can be framed as “for the client’s good” and get away with it. I am glad you’ve had good experiences, but I don’t think we can assume from either your or Will’s experience that any particular practitioner will not take advantage of his/her position. They may do so without even realizing it, and the client then has no recourse, and often lacks the sophistication to even know they’re being misled or taken advantage of.

  • First off, much of Western medicine is in fact based on fantasy, psychiatric care being the most prominent example. It is a TOTAL FANTASY that we can “diagnose” someone with a “medical disorder” by observing their behavior and comparing to some semi-arbitrary checklist created by someone laden with personal/cultural biases against some of the behaviors on the list. The clearest example is “ADHD.” We take a set of behavior that adults find annoying and put it in a list, and then “diagnose” kids who meet these “criteria,” which were created from whole cloth from the fantasy of the “acceptable student” that the creators have imagined. There is no possible way to prove you DON’T have “ADHD,” because there is no test – it is 100% “clinical opinion.” Moreover, there are studies showing that “ADHD” kids are indistinguishable from “normal” kids in an open classroom, that 30% of “ADHD” kids become “normal” if they just wait a year before starting school, or that groups who include an “ADHD” child in them are greatly improved in solving concrete problems. Yet they are “disordered” because someone didn’t like how they behaved, because they were inconvenient to adults.

    Can’t get much more fantasy-based than that! There is nothing “scientific” about psychiatry when the “diagnoses” are meaningless fantasies from the powerful projected on the powerless. Basically, they have drugs, they hit you with them, they see what happens. Half the time, when it doesn’t work, or makes things worse, they raise the dosage or add more rather than removing the offending drug. There are no real standards and no clear accountability for errors or abuse. No science involved.

    Second, there is plenty of evidence that many folk practices work just fine. In fact, the entire idea of drugs and pharmacies came from the use of herbal medicine, many of which have been in use for tens of thousands of years. I trust 10,000 years of human experience over a couple of biased 6-week trials from drug companies.

    It is simplistic to dismiss 10,000 years of folk medicine and pretend that Western medicine has all the answers.

    Oh, just to add, full operations have been done using acupuncture as anesthesia. Very unscientific? I don’t think so.

  • Wow, that is a horrible story! I am so sorry you have had to deal with this level of abuse and idiocy!

    I really believe the only way any of this will change is when it starts costing them more money than they are making. We need some kind of class action lawsuit where psychiatrists and drug companies and hospitals and insurance companies (especially insurance companies!) have to pay for their errors in big money.

    My sincerest condolences on your loss.

  • There are many who believe that drug residues are stored in our fat cells, and can be released at later time by activities of normal living.

    But half lives have a lot to do with withdrawal symptoms. Short acting drugs like amphetamines act quickly, but also leave the system quickly. The withdrawals can be extreme but the half lives are short, so the recovery is quicker. Long-acting drugs, like “antidepressants” and “antipsychotics,” take a while to build up but have very, very long half-lives. So withdrawal can last a long time.

    This is not even taking into account the brain changes that happen with psychoactive drugs. It can take a much longer time for a brain to fully heal, long after the drugs have mostly left the system entirely.

  • I wouldn’t rule it out – they can make up anything and call it a “disorder” and no one bats an eyelash, no matter how stupid or insipid. Consider that “Intermittent Explosive Disorder” and “Oppositional Defiant Disorder” are assigned with all seriousness by “mental health professionals” despite the ridiculousness of such “disorders.” The DSM is an absurdity, so one more absurd “disorder” won’t make it any worse.

  • It depends on the drug. The best you can do is use the drug’s half-life (the time it takes for half the drug to be eliminated) to make an estimate of how long it’s been in the body. Every drug has its own half life, and if you don’t know the dosage, it may be impossible to tell anything about how long the drug has been in the body at all.

    Is there some reason you need to know this?

  • It seems to me like trying to tell someone it is NOT their decision to end their lives is counterproductive. What is the clinician going to do if they say they want to? The only option is to use force to stop them, which clearly is NOT their decision. So obviously, it IS the person’s decision whether they want to end their lives. When I was a counselor myself, I never told anyone that they should or should not end their lives. I simply asked them what was going on that made suicide seem desirable, or what problem was killing him/herself going to solve? Then we talked, with my effort being simply to understand and explore the pros and cons with the client. It actually was a very effective approach to help people consider other options. Whereas when I saw others take a more authoritarian approach, it tended to escalate the situation. I see no downside to acknowledging reality – it really IS their decision and it’s not the therapist/counselor’s job to “talk them out of it” or stop them.

  • Posting as moderator:

    OK, so is it fair to say that “There are a wide variety of observations and opinions about COVID and vaccines, and we all have to come to our own conclusions. We all hope that folks draw those conclusions from observable data rather than rumor and fear.”

    I think this is as far as I want this discussion to go. It really is off the topic and is starting to move toward that “Right/Wrong” energy that I want to avoid.

    Can we leave it here?

  • I’d be OK with this idea, if the title were changed. It’s not “mentally unhealthy” to be worried about climate change.

    It would be better to entitle it something like, “Climate Change is an Inherently Depressing Concept.” Or “People Feel Bad About the Idea that the Climate Is Deteriorating and there Is Nothing They Can Do About It.” Or “Climate Change is Pretty Fucking Scary!” Something that validates that it is not “unhealthy” to have real feelings about real events.

  • It is very possible to be clear about one’s relationship and still be warm and friendly and caring. You simply have to say what you are and are not willing to do. The fact that a lot of therapists are not good at this doesn’t make it not possible. People are looking for authenticity and genuine caring. They don’t want an artificial relationship with a semi-robot, who asks questions but doesn’t care about the answers. Caring is the essence of being a good helper to anyone else. A person who can’t muster up some genuine caring should do his/her clients a favor and go into some line of work where they don’t have to deal with people in vulnerable situations.


    Thanks as always for everyone contributing their views to this discussion. As I’ve noted before, COVID and vaccines are a complex and controversial issue involving science and sociology and politics, and people have strong and sometimes passionately divergent views on the subject. I want to let people say what they need to say, but this discussion in the past has deteriorated into a very personalized and unproductive discussion. I’d like to make sure that does not happen, and I ask folks to own their own viewpoints and be very careful not to condescend or insult others who disagree with your views. If such a deterioration does occur, I will very quickly stop any further COVID postings as off topic. Though I know there is a relationship via Big Pharma, I’d prefer if we stick to talking about psychiatry!

  • If that is the case, then psychiatry as a whole is provably and undeniably bad. It is well established that those in psychiatric “treatment” for “serious mental disorders” (read “bipolar” and/or “schizophrenia) die an average of 20-30 YEARS earlier than the “untreated” person. I’m sure similar outcomes are observable for “anxiety disorders” and “major depression.” It is the only profession where treatment measurably DECREASES life expectancy!

  • It seems to me that you’re saying a person has a right to view him/herself as ill if he/she sees it that way. I don’t hear anyone arguing with you on this point. I think you may misunderstand that when someone says, “ADHD” is a bogus diagnosis, they don’t mean that no one acts or feels that way, just that labeling that set of behavior and calling it an “illness” is not a scientifically valid undertaking. I’m all for people identifying as they see fit, as long as they don’t do it for someone else. So for you to say you have an illness called schizophrenia is your right. For Doctor So-And-So to tell Mary that SHE has an illness called schizophrenia, despite his complete lack of ability to objectively tell her what that means, THAT is where the problem arises. Some (like you, apparently) don’t mind that label, and that’s all fine for them. But what of the person who doesn’t agree that s/he is “ill” by the DOCTOR’S definition? Where are their rights? By your philosophy, don’t they have a right to refuse that label put on them by a doctor without consultation or agreement?

  • When there is no objective way to distinguish who “has schizophrenia” from who doesn’t, there is no way to actually DO a study, let alone draw legitimate conclusions from one. I agree with you, distinguishing what a person has DONE is much more useful that trying to tell them what the ARE, especially when the definition groups together people who have little to nothing in common other than certain arbitrary “symptom clusters” that are not subject to anything but the opinion of someone with letters after his/her name.

  • Higher standards would be an improvement, in that fewer truly useless drugs will get to market. But it doesn’t really address the fundamental problem in psychiatry, namely that we are dealing with subjective phenomena and pretending that we can objectively “diagnose” something that has no objective reality in the physical universe. So if we say the HAM-D scores need to be a 50% decrease from baseline, there is nothing to stop investigators from diddling with the data to create the apparency that there is such an improvement. There is also the problem of “negative” studies being buried and only the “positive” studies being published. This is, of course, anti-scientific in so many ways, including the idea that a study that proves a drug ineffective is “negative.” We SHOULD be after objective evidence, not a particular “positive” outcome. But that’s just the starter. The whole system is so corrupted, it’s hard to know what can be done to fix it.

  • Honestly, the attitude is worse than the worst of the drugs! You come in and they tell you, “Well, your brain is broken, this has nothing to do with your decisions and/or experiences, and there’s nothing you can do about it except take drugs and hope they work for you.” Talk about discouraging!!!! And then to tell you that “there are no good treatments” to your permanent brain disease? If you wanted to induce suicidal thinking, that would be a good way to get there. Very disturbing to think that is how far our “mental health” system has sunk!

  • It is hard to see what ethical standards can be applied to making a totally subjective “diagnosis” based on somewhat random, subjective criteria and “clinical judgment.” I tend to agree that the truly ethical approach to such assessments would be to simply not do them, or at a minimum, make sure everyone knows that the results are utterly subjective and only as useful as the person receiving the “assessment” chooses to find it.

  • It’s not about “assessments,” it’s about conflicts of interest. Unless those doing the “assessments” are completely free from any financial conflicts of interest, there will be both conscious and unconscious efforts to slant the data toward increased profitability. It’s not realistic to expect people to be objective when their financial well being and status are tied up in a “positive” assessment.

  • I think the real point of The Emperor’s New Clothes is not that the Emperor will become enlightened, but that those in the crowd who were afraid to say what they saw were now free to make that observation, because someone spoke up and validated what they all knew. I think that’s our role here – we have to keep pointing out that there ARE no clothes to new people who feel like something is wrong but haven’t gotten to the point where they feel OK saying it out loud. People will arrive at that point at different times and different ways, but at least when they do get there, they’ll hear someone else saying, “No, you’re not crazy. They really ARE completely clueless AND dangerous, and they ARE making your life harder instead of easier!”

  • OK, good to know. The reason I ask is that I’ve seen some excellent plans and projects funded initially and have great potential, but as soon as they have to compete with “mental health services” for actual dollars, they get defunded pretty quickly. The “mental health” industry is OK with things like this operating as a fringe or “alternative” approach, but as soon as they see their own funding threatened, the gloves tend to come off!

  • “Could have been misdiagnosed?” What a ridiculous argument they make! If you STOP the drugs and you GET INSTANTLY BETTER, they OBIVOUSLY “misdiagnosed” you, because the DRUGS WERE CAUSING THE PROBLEMS! It is well known (and is on the consumer handout) that stimulants can cause mania and/or psychosis at typical, prescribed doses in children. What’s even more stupid is that anyone with the slightest background in brain biochemistry knows that stimulants increase levels of dopamine. Psychiatry’s own self-appointed gurus have long claimed that psychosis is a result of high levels of dopamine in the brain. So they “antipsychotics,” which you were no doubt prescribed, LOWER the amount of dopamine. So you were given one drug to RAISE dopamine levels, then another to REDUCE the artificially high levels caused by the stimulants. And they say you are “in remission?” The lack of responsibility is staggering! But unfortunately, not at all rare.
    This is what happens when you “diagnose” people with purely subjective criteria. Someone’s opinion becomes “your diagnosis,” and you have nothing to argue against them except for common sense. Yet, as we see here, common sense is NOT particularly common amongst the supposed “experts” in the “mental health” system. The most obvious things in the world, such as the induction of psychotic behavior by a drug that is known to induce psychotic behavior, can be completely denied despite an again obvious “recovery” immediately following withdrawal of the offending drug.

    I’m so sorry you’ve been through this. I hope you and your family have drawn the proper conclusion that these people can’t be trusted to have your best interests or even basic logic at heart, and will stay as far away from anyone who tells you “you have X disorder” as you can possibly get.

    Humans survived for hundreds of thousands of years without brain drugs. You can, too.

  • I think it’s a little presumptuous to state that they are “effective regardless of some minor unwanted side effects.” First off, they may be effective for you, but that doesn’t mean they are effective for everyone else, and it feels like it invalidates others’ experience to say otherwise. You wouldn’t want others to tell you they don’t work at all, so I think it’s fair not to tell others that they “work” as if your experience is true for everyone.

    Second, let’s not pretend that the side effects are always “minor!” There are many people on this site who have had awful “side effects,” including loss of sexual functioning, loss of feelings of pleasure, psychotic symptoms, suicidal and/or homicidal feelings, loss of appetite, and many more. Again, you are assuming that other people have experiences similar to yours, and I can assure you that this is by no means always or even most often the case.

    With all due respect, we work to be accepting of everyone’s experiences here. It would be appreciated if you would do the same.

    Additionally, I am not aware of ANY research ANYWHERE that identifies a particular “pathway” or “circuits” (or that even is able to objectively identify a physical “pathway” or “circuit” in any manner) that is associated with ANY DSM disorder. The psychiatric profession has finally disclaimed the “chemical imbalance” theory, only after decades of pressure from many quarters, including researchers themselves. The idea of “circuits” being involved is just another theoretical explanation that lacks supporting evidence. When I see research where a “pathway” in the brain is objectively defined and where some objective measurement of “flow” through the “pathway” is obtainable, I’ll start listening to talk about “pathways.” The psychiatric profession has spent decades manufacturing and falsifying and exaggerating or minimizing research to suit its own agenda. I don’t really care what “the experts” have to say, I want to see the research myself before I believe it.

    Finally, I will submit that, however well antidepressants or any other drug in question work for a particular person or group of people, the very idea that “mental illnesses” are purely physiological phenomena that will admit to a purely physiological cause in all or even most cases is, again, pure speculation, and indeed ignores obvious evidence to the contrary. If it’s all biology, why is it that immigrants and urban populations and people sexually abused as kids have much higher rates of schizophrenia diagnoses than the general population? Why is adult depression and anxiety associated at a 90% or better rate with childhood abuse and neglect? How do people get better without drugs or medical interventions at all? How did I overcome serious depression and anxiety with therapy, reading, and facing life’s challenges with support from friends and family and community? Do you wish to invalidate my experience by claiming that I “didn’t have depression, really” or that “it wasn’t that bad,” or is it that my brain chemistry somehow changed through my own thoughts and relationships and interactions with life? And if my brain chemistry can change (and there’s plenty of evidence that it can) through social experiences and alterations of thought and behavior patterns, why would you insist that drugs are the answer for everyone?

    How do you explain the actual PHYSICAL changes in the brain that happen with meditation or other processes that don’t involve any kind of physical intervention at all if it’s all biological?

    I am glad the drugs have worked for you. You are certainly not alone in saying that. But please, don’t try to talk down to people who have had different experiences. My belief is that “depression” isn’t even a legitimate category of “disorder” – people are depressed for a myriad of reasons, some physical, some psychological, some spiritual, some social. What works for one person doesn’t work for every other person. We all need to find our own paths. You have found yours – let other people find their own and explain to YOU how it is for them, instead of assuming you are in a position to tell the rest of us “what is true.”

  • Out of control children have been managed without a “diagnosis” or drugs since the beginning of human history. I think the problem is not so much one of “out of control children” as isolated parents lacking support. We were not willing to consider any kind of drug intervention for our boys, so we had to figure it out. Much as you did, we used dietary changes, good parenting skills, and a lot of patience. And we read a LOT about how to manage challenging children. They both turned out OK without a milligram of “treatment.” The one who had the most problems was the one who was NOT difficult as a young child! So you’re right, every child is different!

  • “True clinical depression” is completely subjective and indistinguishable from “mere sadness.” Not even the DSM has “criteria” for “clinical depression.” It sounds like a technical term, but it is literally meaningless in terms of any kind of research or statistical purposes, even within the sketchy confines of psychiatry’s own subjective “model” for understanding “mental illness.”

    I also don’t find it convincing that we ought to prescribe drugs “until something better comes along.” There are lots of people (including me) who find their own pathway out of feeling severely depressed. It is an error to assume that all “depressed” people have something wrong with them, or that all who DO have something wrong have the SAME thing wrong and need the same kind of help. “Depression” is a catch-all category that says absolutely nothing about what the person is depressed about or what can or should be done about it. When someone says “depression is a fake illness,” they don’t mean that depression doesn’t happen, they mean that “depression” is not a real entity that is valid for study and conclusions. It is not helpful to group all “depressed” or “clinically depressed” people into the same category when any two “depressed” people may have little to nothing in common with each other beyond how they happen to be feeling.

  • I would say that there IS a consensual psychiatric model. That model assumes that 1) there are such things as “mental illnesses” which are distinguishable from “normal” conditions. 2) these “illnesses” can be “diagnosed” by “professionals” with sufficient training. 3) there are “treatments” available for these “illnesses” that can “reduce the symptoms” of the “illnesses.” 4) These “illnesses” are essentially physiological in nature and inhere in the person experiencing them rather than in the environment/culture or in the relationship between the environment/culture and the person. 5) That these “disorders” can be described and “diagnosed” using the DSM or the ICD or some other “diagnostic system.” 6) That these are “medical” problems that need to be handled by “services” provided by “medical providers” and paid for by insurance. 7) That sometimes, these “disorders” become so unmanageable that “treatment” must be forced on unwilling participants “for their own good.”

    Admittedly, there are plenty of free-floating and irrational interpretations that are pulled out when necessary, but I’d say all of these interpretations are expected to fit into the above. As a former “mental health” professional, I can attest that violating these tenets results in hostility and in some cases even shunning by the system insiders. Not sure how “consensual” it is, but it certainly seems to be expected that people will agree to these basic tenets, and in fact, clients/patients are “diagnosed” as more serious to the degree that they deny the “validity of their diagnosis.” It’s pretty solid in my view.

  • A model is useful only to the degree that it correctly explains predicts the effects of actions we take into the future. The psychiatric model explains nothing, obscures real causes, and fails to predict even the success or failure of its own interventions. Therapy models to date similarly fail to account for observable facts nor are they able to predict the outcomes of their own interventions. I’ve got nothing against models, but they need to work!

  • The other big question that is almost always avoided is, WHAT should the endpoint be? Is a “reduction in symptoms” really the result that is wanted? Is making a person “Less depressed” a legitimate outcome? Would we not want to look at “quality of life” variables as being more important to the client?

    Plus, Irving Kirsch’s work has showed clearly that the FDA rule of submitting two positive studies out of ALL studies being done totally skews the results. How much research is never even released because it doesn’t say what the manufacturer wants it to say? How many drugs are on the market as “safe and effective” when the TOTALITY of the data says that it doesn’t really work or is far more dangerous than claimed (Viiox being a great example)?

    There is much to be answered for in the area of “scientific” research, especially when it comes to psych drugs.

  • Harrow’s study showed that “psychotic” patients with WORSE prognoses did BETTER off drugs than the people with BETTER prognoses did ON drugs. So the idea that those with “less illness” go off the drugs is a marketing scheme. It’s not true.

    I think the answer to the question is either 1) because it doesn’t work, or 2) because the “cure” is worse than the “disease.” As Hemmingway quipped, “It was a brilliant cure but we lost the patient.”

  • As I’ve stated before, the whole idea of “shared decision making” suggests that the CURRENT model is “non-shared decision making,” which equates to THE DOCTOR GETS TO DECIDE! In other words, “Shared decision making” means the DOCTOR deigns to “allow” the patient to “have a voice” in deciding what will happen to his/her OWN BODY! Something is VERY wrong with this whole idea!

  • I’m not sure the system is “broken,” I think it just has hidden objectives that most of us find abhorrent!

    I had the same experience as you back in the 70s. I had a therapist, we met once a week, we talked about my motivations and barriers to my success, we reviewed some traumatic history, I practiced new ways of thinking and acting – no drugs were considered or needed! And I never got an official “diagnosis” from my therapist, though I’m sure she had to submit one to get reimbursed. It just wasn’t important. I wasn’t considered “ill,” I was considered one of the smart ones who realized that he could make his life better. My therapist and I both agreed that it is a lot saner to seek support than to continue pretending things are OK. It was a very supportive relationship – no “stigma” involved, and no drugs needed or wanted.

  • I agree. The news and entertainment media are also a HUGE part of why “everyone believes” in chemical imbalances, while even the most cynical psychiatrists nowadays have to admit it’s kind of a crock of horseshit. The message is out there in many forms, and I think a lot of people get their “Truth” from movies and TV shows. It is a lot to battle!

  • I don’t see this so much as a dilemma. The simple expedient is to treat people who present as dangerous based only on the dangerousness of their behavior, not on any presumed “mental illness.” The truth is, one could say that any person committing a crime is on some level “crazy” because they are risking prison for some drama they want/need to act out. What is to distinguish someone who is willing to hold up a convenience store from the lady who tossed the baby out the window? The only real criterion that makes sense is to say that they did harm or threatened harm to others, and are therefore held in custody until that situation is resolved. “Mental illness” doesn’t have to enter into it at all. And even if we do decide we can “hold” someone for these subjective and legally vague and rhetorically nonsensical “illnesses,” it does not follow that they can/should be forced into “treatment” against their will. Their job is to demonstrate that they are no longer dangerous.

    Of course, help of many kinds can be offered, and people who don’t find a way to alter their circumstances might be incarcerated for some period of time, but that’s the same for any kind of criminal behavior. I’m all for completely decoupling the idea of holding someone for being “a danger to self or others” and the idea of them needing “treatment” of some kind. There is simply no way to figure out who is/isn’t “mentally ill,” let alone who will “benefit from treatment.” That being the case, it seems beyond unethical to force “treatment” on someone based on these totally subjective labels, especially when it’s entirely possible that the “treatment” you’re forcing on them may kill them before their time!

  • I have had similar epiphanies many times in my life. When “everyone knows” that something is “accepted practice” and no one ever provides another perspective, sometimes some very weird or dangerous or just plain oppressive things seem “normal” and people who don’t adapt “abnormal.” Sometimes it’s very odd looking back on it that I’d ever accepted that viewpoint, that the obvious injustice or irrationality of it did not just smack me in the head before the scales fell from my eyes!

  • I found 9.

    The others are probably “antipsychotics” like Risperdal and Seroquel that act on both the serotonin and dopamine systems. It appears that messing with serotonin is what causes the increase in suicidal thoughts/behavior in some of the people who use them. Not that this deters doctors from prescribing them by the millions, mind you. But we all knew that!

  • Again, why the “shared decision making?” I don’t SHARE decision making with my doctor or medical provider. S/he gives me information and advice and I MAKE THE DECISION. There is no sharing, it’s my call, every time. Why is this glaring violation of the rights and the self-respect of so-called “mental health consumers” not obvious to anyone looking at the situation? The very concept infantilizes the clients. And remember, we’re not talking about the client choosing to “share decision-making” with their doctor. We’re trying to convince the DOCTOR that s/he is not entitled to just do whatever the f*&k they want to the client without his/her approval. The argument is now, “Gosh, don’t you think you might CONSULT the client before YOU decide what you’re going to do to them?” This is totally ass-backwards in my world. I will never see a medical professional who thinks s/he gets to tell me what to do, and I’m glad that I have the privilege and the skills to carry out that intention. But many people don’t even see or understand what is being done here, let alone have the courage and ability, or even the legal right in many cases, to tell the doctor to go stick it where the sun don’t shine. That is not an acceptable situation!

  • Of course, I agree with you that most such people are indeed quite uncomfortable. But there appears to me to be a small but solid cadre of folks who actually are quite comfortable believing they are “helping” even when all the evidence points the other way. They are very blithe about explaining away anything that doesn’t support their viewpoint, and seem quite comfortable as long as there are enough people around them to support their viewpoint. Admittedly, there is a lot of anxiety underlying their apparent ease, and that comes up when they are challenged, but their “comfort zone” appears to be quite compatible with people being harmed “for their own good.”

  • The thing about this is, Buddhism and other spiritual approaches aren’t “treatment.” I don’t have a knee-jerk negative response to the idea of “alternatives,” but if they are “alternatives,” they should be alternatives to viewing emotional distress as “mental illness” and alternatives to pretending to provide “treatment” in the medical sense for problems that are not medical in nature.

  • The FDA is populated by people who are part of the drug industry. That’s what I meant by my comment. We need people who don’t have a financial interest in the outcome. There are plenty of scientists in other fields who know enough to evaluate the studies – they don’t have to be doctors or drug company investigators, in fact, we’d be better off if those evaluating drugs had zero attachment to the medical field or drug research at all.