Did anyone ask before they did this study that having surgery can make people depressed and depressed people having surgery will probably remain depressed? If you need a study, there is this one that took me 20 seconds on Google to find: https://link.springer.com/article/10.1186/s12893-016-0120-y In an effort to avoid breaking blind, they chose a situation where the participants are all bound to be and remain depressed. Ketamine aside, this shows an inherent problem in many studies of mental states. Being depressed or down when you are in pain or having medical difficulties is how the body is supposed to respond. This type of depression is a non-disease in search of a cure. If it isn’t a disease, you can’t cure it. Report comment
Did anyone ask before they did this study that having surgery can make people depressed and depressed people having surgery will probably remain depressed? If you need a study, there is this one that took me 20 seconds on Google to find: https://link.springer.com/article/10.1186/s12893-016-0120-y In an effort to avoid breaking blind, they chose a situation where the participants are all bound to be and remain depressed.
Ketamine aside, this shows an inherent problem in many studies of mental states. Being depressed or down when you are in pain or having medical difficulties is how the body is supposed to respond. This type of depression is a non-disease in search of a cure. If it isn’t a disease, you can’t cure it.
I’m most intrigued by the last question you asked at the end of the article: “[W]hat impact is it having to be filling those psychiatric inpatient beds with nearly 100,000 people annually who are doing nothing more “dangerous to self or others” than simply calling 988 to discuss their feelings?”
For me implicit in that question is the heartbreaking sense that there is a large segment of the population who just needs to hear another human voice on the end of a telephone line. The bait and switch of a friendly voice to police knocking at your door, practically criminalizes feeling bad enough to call someone for help. It is a sad commentary on our lack of imagination as a society on how we can assist those in emotional distress.
It also raises some interesting due process concerns for callers, particularly if they are falsely informed that the calls are confidential and the service is government based. According to the FCC site (https://www.fcc.gov/988-suicide-and-crisis-lifeline) geolocation is not currently part of the 988 service. I’m assuming that the geolocation is coming from local implementation of the service, but it would be interesting to know which parts of the service are allowing geolocation and compare hospitalization rates to those who don’t.
I enjoyed your review of Wipond’s book. I read it recently and coming from the legal field, the implications are disturbing. It also reminded me that the warning cry against psychiatry as a means of social control, particularly by the government, goes back through the legal history.
Back in 1927, the Supreme Court found forced sterilization to be appropriate for the “feeble minded” in Buck v. Bell in an 8-1 decision. The law has always been used to enforce the current medical trends, not always wisely.
As your review and Wipond’s book illustrates, the people impacted by these policies are those who cannot advocate for themselves, usually because of social status or financial necessity. These are the people being forced into treatment.
I’d recommend reading “The Center Cannot Hold” by Elyn R. Saks. The book portrays her struggle with schizophrenia and her treatment, including forced treatment, as she navigated her way to being a tenured professor at USC, where she holds the Orrin B. Evans Professor of Law, Psychology, and Psychiatry and the Behavioral Sciences chair. While her book is over 15 years old, nothing has changed that drastically in the forced treatment realm.
For an early warning voice on the use of psychiatric control by the government, anything by Thomas Szasz does nicely. Coming from Hungary, he was well aware of the dangers of the “therapeutic state” as he put it in 1963.
I’m always intrigued by how words and tone can be misconstrued in the comment “medium.” As someone who writes, I always found the comment section as a place to clarify and outline my thoughts and try and clear up any misunderstanding.
A reply isn’t even necessarily for the person being replied to, but rather all the readers that come and read the comment thread. If one reader feels strongly enough to make a comment, other, more silent readers may have felt or thought the same thing. No matter how hard you try there are times when the message can get lost over a misunderstood metaphor or word choice.
J.A. used the word “broken” in her original post, not to refer to broken humans, but to a “broken leg” in a metaphor on the current treatment for mental health in the United States and how that treatment is leading to more, not less incapacity overall.
I read this reply to Birdsong as what it was, knowing J.A. so well, not a lecture, but an attempt to clarify, find common ground, and explain those areas where she felt her original comment had been misconstrued.
I think you pointed out very well that criticism of psychiatry as a whole is not a criticism of medication. I also agree that medications change chemicals in the brain, which would be helpful to more people if we actually knew what chemicals needed to be changed, but we don’t. You mentioned that psychiatry was in its ugly “teen” years. I’m guessing the Nobel Prize for lobotomies was its childhood? Yes, the history is troubled.
I disagree with you on really only on one very important point. Medications can and do cause suicide. I know of too many incidents personally and it isn’t a gasoline and car analogy. The medications for some people can be car bombs and in those times medication should take the blame. The clinical trials on the medications show this when the only variable is the drug and the suicides increase, where do you place the blame? (Even more insidious is the withdrawal from the medications can be the bomb.) It is why medications have warning labels, because they can be deadly bombs. Also as shown in the clinical trials for some, the medications may indeed be the gasoline to get them on airplanes and living their lives, but for others it is deadly. People need to be better informed before they put the key in the ignition.
I’ve said it elsewhere in the comment section, but Ms. Armstrong in her writing, particularly her book, publicized and glorified extreme psychiatric treatments. I really believe that both psychiatry and society should have been able to come up with a more compassionate method for Ms. Armstrong to quell her emotional pain.
KC, I made it clear in the comments and it is actually clear in the original article as well — this was based off of Ms. Armstrong’s book and her touting of the psychiatric cure, a cure she said worked for her in the book and that she wrote at the behest of a therapist for other people in need.
As many of the comment thread have stated, including the author of the article, we aren’t in a position to say what would push someone over the edge into suicide. There is probably a myriad of causes, but one you didn’t mention are the tardive (late appearing and chronic) impact of psychiatric medications — tardive effects that often lead people to seek out something to quell the pain.
J.A. and I know this well. We had Kratom that sat unused in our nightstand for a couple of years as we tried to deal with tardive akathisia caused by psychiatric drugs. The withdrawal effects from the psychotropics were so severe, we looked everywhere. J.A. decided not to try Kratom, not for any moral reason, but we already felt like we had been playing Russian Roulette with pills and drugs. The psychiatric model is the same model as substance abuse — ingest something to make you feel better. Following that model leads to tragedy.
The one thing we know is Ms. Armstrong at one point touted extreme psychiatric treatments and took many psychotropic medications and that it did not work. The extreme steps she took with substances weren’t socially sanctioned, psychiatry was.
Eddie, the “take” was on her book, which I did read. There was no conjecture, it was based on Ms. Armstrong’s words. J.A. wrote the article because I was too busy to repurpose my review in a manner that would be appropriate when someone takes their own life. My review, in full, was a little too glib for such a serious matter. As I said in the review that J.A. quoted, I prefer to be skeptical rather than dogmatic, whether that be about religion or psychiatry.
The ultimate take away is the life that is lost, from which the natural human response is to search for reasons. For much of her life, Ms. Armstrong touted psychiatry as her savior. To point out that this faith may very well have been misplaced is not pathetic, but rather empathetic and compassionate to those who might still be suffering.
You describe with your son, what I would characterize as what is (or at least should be) the current best practices for psychiatry — therapy with minimal, if any drug intervention, and if drugs are used, only for the short term and then a gradual taper. I’m so happy that it worked out for both you and your son.
Understanding the article easily comes with a little more understanding of what Ms. Armstrong wrote prior to committing suicide. Based on the book that she wrote about her experiences with psychiatry, she did not get the type of treatment you described for your son. Her treatments were heavy on the drug and medical interventions. This was a treatment regime that resulted in the worst clinical outcome. It is an outcome that Ms. Armstrong did not deserve, nor does any family deserve to have that kind of suffering.
There are things we know about Ms. Armstrong that we do not know about other suicide victims. It is also why this isn’t a post about confirmation bias. We know she took the medications because she told us. We know that she was treated by psychiatry, including extreme near death inducing treatments because she told us. We know that she promoted these treatments to the people who followed her writing. We also know that almost no discussion is taking place on the efficacy of these treatments for the long term treatment of people suffering from psychological pain. We know Ms. Armstrong had the worst clinical outcome. The assuredness you captured from J.A.’s writing is the assurance of these facts, nothing more.
I read your post with some interest. I did not follow Ms. Armstrong’s blog, but I did read her book. One difference between books and blogs is books tend to stick around longer and be referred to more than internet postings. You can’t easily pull a book off everyone’s shelf if there is a public outcry. For better or worse, Ms. Armstrong’s book encouraging submission to extreme psychiatric treatments is out there and given the tragic recent events, that book’s premise deserves to be questioned publicly. This isn’t dangerous or focusing on a vulnerable population, in fact it is the opposite. This is also an article on a website specifically focused on questioning psychiatric drugs and urging caution on drugs whose own manufacturers label them as causing suicidal thoughts and actions.
I know that for both myself and J.A. the lack of disclosure and understanding about how difficult and dangerous withdrawal can be from psychiatric drugs is possibly the largest part of the psychiatric drug problem. Your recounting of the post made on Ms. Armstrong’s blog about the inefficacy of antidepressants actually misses a fine, but important point about psychiatric meds–going off the meds, especially abruptly, can be deadly. It was also exactly why both J.A. and I “knew” the cause of death from the headline before actually reading it in the New York Times. There is something disturbing about a system that can put those in pain on medication who, if they ever withdraw or withdraw improperly, could die.
Another discussion point you raise is the use of alcohol and self-medication. Ms. Armstrong’s alcohol use was prominent in the news articles. You may also miss the strong religious and moral condemnation connotations that we catch here in Utah – “Ms. Armstrong was a sinner drinking alcohol and who left the Church.” Alcohol use is always up for discussion in the media as a scapegoat or contributing factor (especially in Utah), psychiatric drugs are not. If indeed psychiatry is as good as everyone claims, why do so many people feel the need to self-medicate? Something isn’t working. Psychiatry is touted as the secular way people can deal with, as you described, the “insidious shape shifters” of chronic depression and anxiety, but no one is allowed to even question that blind belief, as evidenced by the outcry that forced Ms. Armstrong to take down her post critical of antidepressants. Her followers didn’t want to hear her experience.
I think I understand why the article made you livid. It was a direct challenge to medications that you deeply feel are responsible for your well-being. Neither myself or J.A. would argue with you about that, nor do we want to take them away, but the danger from these medications remains real and remaining silent won’t change that fact. Please know that we are writing and addressing this issue from the perspective of former believers, who lost faith when the drugs acted exactly as stated on the manufacturers’ warning labels.
I agree with you on almost all points, as I’m sure that J.A. does. Medicine is a tool, not a panacea. Close working relationships with qualified and proficient doctors and therapists are vital and it sounds like you are indeed one of those therapists.
The disagreement comes from why this isn’t a risky article, but an important counterbalance to what is already out there in the public sphere, published by Ms. Armstrong prior to her death. She wrote a book touting extreme psychiatric treatments and psychotropic drug cocktails. In the book she portrayed her psychiatrist as caring and qualified, a fact I don’t dispute. The doctor also put her in ten insulin induced comas, taking her to the edge of death and bringing her back, a procedure he stated had a clinical efficacy of 30%. She was writing this to her fan base of struggling mothers. This to me feels far more irresponsible than J.A.’s article reminding everyone that these treatments and drugs are matters of life and death.
Sandra and Kent S,
While J.A. hadn’t read the Dooce blog or her book, J.A. and I had had a lengthy discussion in 2019 after I finished reading book. It also appears to me that neither of you are familiar with her book. Ironically, I had read it searching for treatment options. We discussed the treatments Ms. Armstrong had undergone and the medicines she was placed on after the ten insulin induced comas. We were also very familiar with her from the blogging world of the early 2000s and she was local. When J.A. wrote “I already knew,” it was because she truly knew based on our previous discussions and our experiences, just like I unfortunately knew, when I saw the link in the New York Times the other morning.
I also think it is clear, especially from J.A.’s comments that she isn’t saying psychiatry is solely the ultimate cause of Ms. Armstrong’s death, but it certainly didn’t help. The question and the reason this is important is at least so far, this is the only place that I’ve seen where her treatment by psychiatry has actually even been questioned.
Finally, J.A., much like Ms. Armstrong, has extensively and publicly written about her interactions with psychiatry. Any author who has done this knows that their opinion and views are then open to public scrutiny. In her book, Ms. Armstrong “flat-out admits that she decided to write this book at the behest of her therapist to bring hope to the single moms who are worried they will lose custody due to a mental illness diagnosis or to those who are disenchanted with the medical community.” That quote was from my 2019 book review. It is also exactly why addressing the failure of the medical community for Ms. Armstrong is not only appropriate, but necessary, to prevent further unnecessary tragedies.
John — I take full responsibility for screwing up the title. That was all on me. I think they fixed it though.
Tim, I’m glad the treatments worked for you and saved you. I also hope they continue to save you. I also understand the immense suffering that mental anguish can cause. The reality is, as we are so often told, that the United States in particular, is in a mental health crisis for many of the reasons you suggest. If psychiatry was as successful as you suggest, wouldn’t there be less mental health problems than there were previously? Yes, psychiatry is also another of those institutions that could be contributing to the problem. Capitalism works for a large percentage of the population, but not those living paycheck to paycheck. I’m not advocating, nor is J.A., for the abolition of Capitalism or psychiatry, but pointing out the silence in the media about significant contributing factors skews the conversation, which gratefully, this comment thread seems to be addressing.
Richard and Jim, thank you for your comments.
Marsha, I agree time is immensely helpful and really it was time that put me in a spot to where I could actually contribute. I don’t know that I could have written at the height of the horror.
Gilbert — here on MIA, I think you are preaching to the choir.
And finally, Living Past 27, the duration of the akathisia, particularly if you are off the offending medication, should not only go away on each attack, but the duration and frequency should decline as well. Think of it as a virtuous cycle of gradual healing. I wish you the best in your efforts — and yes, it will go away.
Thank you Sam. I’m hoping I can add more than this introductory piece and I welcome to a future chance to connect.