This is a good article. Itās main problem is it doesnāt discuss how the medical profession (including psychiatrists), the pharmaceutical industry and various support services are encouraging the expansion of supposed psychological and physical diagnoses in order to increase their profits.
Another unconvincing article from MIA that tries to associate āmental healthā with āsocial inequalityā.
According to the study discussed in this article only one-third of participants reported mental health issues, which means the survey the researchers conducted is hopelessly flawed. COVID and the isolation it caused affected 100% of the population, though not all of us are inclined to categorize ourselves as mentally ill.
Of course adverse life events will negatively impact an individual. The problem is that all of us experience adverse life events and social science research associating only certain things, like food insecurity, with ā mental illnessā is almost always poorly done.
Solve every social ill (which, of course will never happen) and we will still have numerous problems in living.
This article concentrates too much on social and economic factors that contribute to PPD. I would have preferred an analysis of the effectiveness of this drug. When Zurzuvae was first approved I was very unimpressed by a mostly favorable article about it in the New York Times. So I looked at the Zurzuvae label and calculated that it was not effective for 85% of the study participants when compared to placebo (I did calculations based on Table 5 from study 1). Given that this is a pharmaceutical company study who knows if itās effective at all.
Iām not a statistician and I canāt guaranty that my calculations are correct. But there could be no worse obstetric violence than prescribing an ineffective drug, especially one with significant adverse effects. Whether new mothers should have more support is undoubtedly true but a totally separate issue.
Iām not convinced that there is compelling evidence that the risk of developing mental illness is linked to social disadvantage
I grew up in a lower/lower-middle class family and now live in an upper middle class neighborhood. I canāt say I see a tremendous difference in āmental illnessā in the ādisadvantagedā compared to the āadvantagedā.
Part of the problem is the term mental illness, a vague concept that is almost meaningless when itās contended that 90% of people will become mentally ill. But then all those people to treat means all that money to make, so for lots of professionals itās worth expanding the definition.
As for treatment, I canāt disagree that itās often worthless. But I have seen psychotherapy help some people.
I know this is largely based on personal experience. But I donāt believe thereās evidence that contradicts my observations.
Someone who is ill, depressed and/or anxious may look for reasons for their distress or condition. That alone could explain the results.
This is a study that shouldnāt have been done because it has too many limitations, which the researchers acknowledge. I donāt think we would accept this kind of poor quality research if we were evaluating a study of an antidepressant or antipsychotic.
Well maybe. Mendelian randomization and multivariable Mendelian randomization may suggest that antidepressants are related to cardiovascular disease, but the techniques used here do not seem adequate enough to prove a causal effect.
āIt seems premature to recommend individualālevel interventions to all workers (e.g. NICE, 2022). I concur with reviewers of the field that organizational interventions, such as changes to scheduling, management practices, staff resources, performance review or job design, appear more beneficial for improving wellābeing.ā
Thereās a lot that Robert Whitaker says that I agree with, including the worthlessness of the DSM, the danger and frequent failure of psychiatric drugs, and the role of capitalism in promoting the overuse of these drugs.
I also believe people should have basic rights. My list would include universal health care, decent housing, adequate food, freedom from violence, and equal rights. Not having these things can certainly cause distress. But itās not clear to me that having all of this, and more, will lead to mental well being.
I have observed people who have benefitted greatly from the capitalist system, having wealth and every advantage, yet they still developed āmental illness.ā Is there less mental illness in the upper classes than in those who are struggling financially or who are victims of racism or discrimination? I donāt know, but I donāt think Bob knows either.
There is also the question of how a more equal and just society can be created. Several years ago I read a book that demonstrated that oligarchs have wielded power for thousands of years (Oligarchy by Jeffrey Winters) in many different countries. The power of the wealthy may not be able to be reduced. Revolutions often (usually?) result in one group of oligarchs replaced by another equally bad group.
In my opinion, there has yet to be a theoretically satisfying way to discuss mental illness. Even the concept of mental illness is imprecise. To call society a major cause of mental illness is not convincing.
Itās simplistic to divide people (worldwide no less) into right and left wing. Iāve seen many left wingers support forced psychiatric treatment. For example in 2023 California passed a law that could result in more people with untreated mental illness and addiction issues to be detained against their will and forced into treatment. On the other hand RFK, who endorsed Trump, has criticized the overuse of prescription drugs for children, teens and adults. Both right and left legislators supported the 21st Century Cures Act, which has made it far easier for the FDA to approve ineffective drugs.
To associate overmedicalization with capitalist injustice is another oversimplification, especially when left wing critics are idealized as the good guys and right wing critics demonized as the oppressors. It is sad to me that MIA has become so increasingly politicized.
I read Born TogetherāReared Apart when it first came out. I found the bookās methodology to be poor. For one thing Segal contends, without proof, that the twins exchanged no information because they understood how important it was not to do so. Also, the book examines dozens of the twins’ traits. When that many comparisons are made at least some of the positive heritability correlations are going to be due to chance. This is not dealt with.
It also annoyed me that at one point homosexuality is discussed under the heading of psychopathology.
There are so many other problems, Itās hard to understand how this study could have any credibility at all.
Yet my comment, which was very critical, was published (see what I wrote above). I also responded to a primary care doctor who commented that he was aware of the facts in the article and discussed them with his patients. I told him that was unfortunate because the article had so much misinformation in it. After a brief delay, that, surprisingly, was published.
I donāt know why some comments get in and others donāt. A while back, I had a comment in the NYT published and then removed a couple of days later despite numerous likes. I think use of words like fraud, or arguing that facts are being kept from the public will almost guarantee rejection.
Surely I have misunderstood this study because it is so poorly conceived. The study claims that in identical twins, even ONE adverse childhood event results in a likelihood of a subsequent diagnosis of a mental disorder. What isnāt wrong with this?
First, even identical twins may have different genetic makeups. Second, even in the same household, experiences can be very different. Third, the study does not examine ACEs but the recollection of ACEs and itās not convincing to claim that a large population size would mitigate against this problem.
In addition, we have no convincing definition of a mental disorder. Also comparing the experience of identical twins to that of fraternal twins is not illuminating.
There are an awful lot of poorly done studies, but psychological studies seem worse than most.
Actually we do know that the benefits of many treatments are exaggerated. Take the highly promoted statins, for instance, without pre-existing heart disease 98% of people do not benefit at all from statins. Statins do not extend lifespan. Even with preexisting heart disease, one study found that 96% saw no benefit from statins over 5 years.
Thereās no doubt Americans are over medicated and that drugs cause deaths, with psychiatric drugs being among the worst. But thereās no research that proves drugs are the leading cause of death. Thatās because a personās death may have numerous causes with the drug being only one factor In addition, a toxic drug may eventually kill someone, but the patient may have succumbed to their illness sooner if they hadnāt been taking the medication. Iām not convinced, for example, that statins, blood pressure medications or diabetes medications are completely safe, but theyāre supposed to extend lifespans. Maybe they do or maybe they donāt, but thatās the argument for them.
One other point, people, such as those with dementia or a terminal illness, may be medicated to keep them comfortable even if the drug may shorten their lifespan.
This study is so poorly conceived it should never have been used to criticize the DSM, bad as that text is.
An online survey is highly unlikely to be accurate, especially one with such a small sample. In addition, trying to measure the traumatic impact of race, gender, and something called cisheterosexism is simplistic. Thatās because it doesnāt consider adverse effects of numerous other characteristics, for example, shyness, intelligence, socio- economic status, illness, and so on.
If MIA wants to show the impact of society on mental problems, it needs a far more sophisticated and complex approach.
This is a good article. Itās main problem is it doesnāt discuss how the medical profession (including psychiatrists), the pharmaceutical industry and various support services are encouraging the expansion of supposed psychological and physical diagnoses in order to increase their profits.
Report comment
Another unconvincing article from MIA that tries to associate āmental healthā with āsocial inequalityā.
According to the study discussed in this article only one-third of participants reported mental health issues, which means the survey the researchers conducted is hopelessly flawed. COVID and the isolation it caused affected 100% of the population, though not all of us are inclined to categorize ourselves as mentally ill.
Of course adverse life events will negatively impact an individual. The problem is that all of us experience adverse life events and social science research associating only certain things, like food insecurity, with ā mental illnessā is almost always poorly done.
Solve every social ill (which, of course will never happen) and we will still have numerous problems in living.
Report comment
This article concentrates too much on social and economic factors that contribute to PPD. I would have preferred an analysis of the effectiveness of this drug. When Zurzuvae was first approved I was very unimpressed by a mostly favorable article about it in the New York Times. So I looked at the Zurzuvae label and calculated that it was not effective for 85% of the study participants when compared to placebo (I did calculations based on Table 5 from study 1). Given that this is a pharmaceutical company study who knows if itās effective at all.
Iām not a statistician and I canāt guaranty that my calculations are correct. But there could be no worse obstetric violence than prescribing an ineffective drug, especially one with significant adverse effects. Whether new mothers should have more support is undoubtedly true but a totally separate issue.
Report comment
Iām not convinced that there is compelling evidence that the risk of developing mental illness is linked to social disadvantage
I grew up in a lower/lower-middle class family and now live in an upper middle class neighborhood. I canāt say I see a tremendous difference in āmental illnessā in the ādisadvantagedā compared to the āadvantagedā.
Part of the problem is the term mental illness, a vague concept that is almost meaningless when itās contended that 90% of people will become mentally ill. But then all those people to treat means all that money to make, so for lots of professionals itās worth expanding the definition.
As for treatment, I canāt disagree that itās often worthless. But I have seen psychotherapy help some people.
I know this is largely based on personal experience. But I donāt believe thereās evidence that contradicts my observations.
Report comment
Someone who is ill, depressed and/or anxious may look for reasons for their distress or condition. That alone could explain the results.
This is a study that shouldnāt have been done because it has too many limitations, which the researchers acknowledge. I donāt think we would accept this kind of poor quality research if we were evaluating a study of an antidepressant or antipsychotic.
Report comment
Another worthless study that even the researchers point out has severe limitations.
MIA should stop publishing unconvincing, but socially correct research. You can do better. I hope.
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Well maybe. Mendelian randomization and multivariable Mendelian randomization may suggest that antidepressants are related to cardiovascular disease, but the techniques used here do not seem adequate enough to prove a causal effect.
Report comment
āIt seems premature to recommend individualālevel interventions to all workers (e.g. NICE, 2022). I concur with reviewers of the field that organizational interventions, such as changes to scheduling, management practices, staff resources, performance review or job design, appear more beneficial for improving wellābeing.ā
Completely agree.
Report comment
Thereās a lot that Robert Whitaker says that I agree with, including the worthlessness of the DSM, the danger and frequent failure of psychiatric drugs, and the role of capitalism in promoting the overuse of these drugs.
I also believe people should have basic rights. My list would include universal health care, decent housing, adequate food, freedom from violence, and equal rights. Not having these things can certainly cause distress. But itās not clear to me that having all of this, and more, will lead to mental well being.
I have observed people who have benefitted greatly from the capitalist system, having wealth and every advantage, yet they still developed āmental illness.ā Is there less mental illness in the upper classes than in those who are struggling financially or who are victims of racism or discrimination? I donāt know, but I donāt think Bob knows either.
There is also the question of how a more equal and just society can be created. Several years ago I read a book that demonstrated that oligarchs have wielded power for thousands of years (Oligarchy by Jeffrey Winters) in many different countries. The power of the wealthy may not be able to be reduced. Revolutions often (usually?) result in one group of oligarchs replaced by another equally bad group.
In my opinion, there has yet to be a theoretically satisfying way to discuss mental illness. Even the concept of mental illness is imprecise. To call society a major cause of mental illness is not convincing.
Report comment
Itās simplistic to divide people (worldwide no less) into right and left wing. Iāve seen many left wingers support forced psychiatric treatment. For example in 2023 California passed a law that could result in more people with untreated mental illness and addiction issues to be detained against their will and forced into treatment. On the other hand RFK, who endorsed Trump, has criticized the overuse of prescription drugs for children, teens and adults. Both right and left legislators supported the 21st Century Cures Act, which has made it far easier for the FDA to approve ineffective drugs.
To associate overmedicalization with capitalist injustice is another oversimplification, especially when left wing critics are idealized as the good guys and right wing critics demonized as the oppressors. It is sad to me that MIA has become so increasingly politicized.
Report comment
I read Born TogetherāReared Apart when it first came out. I found the bookās methodology to be poor. For one thing Segal contends, without proof, that the twins exchanged no information because they understood how important it was not to do so. Also, the book examines dozens of the twins’ traits. When that many comparisons are made at least some of the positive heritability correlations are going to be due to chance. This is not dealt with.
It also annoyed me that at one point homosexuality is discussed under the heading of psychopathology.
There are so many other problems, Itās hard to understand how this study could have any credibility at all.
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Canāt argue that taking antidepressants can be risky. Unfortunately hormonal therapy also has risks.
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Yet my comment, which was very critical, was published (see what I wrote above). I also responded to a primary care doctor who commented that he was aware of the facts in the article and discussed them with his patients. I told him that was unfortunate because the article had so much misinformation in it. After a brief delay, that, surprisingly, was published.
I donāt know why some comments get in and others donāt. A while back, I had a comment in the NYT published and then removed a couple of days later despite numerous likes. I think use of words like fraud, or arguing that facts are being kept from the public will almost guarantee rejection.
Report comment
I was also wondering about the role of advertising in what is being reported.
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Surely I have misunderstood this study because it is so poorly conceived. The study claims that in identical twins, even ONE adverse childhood event results in a likelihood of a subsequent diagnosis of a mental disorder. What isnāt wrong with this?
First, even identical twins may have different genetic makeups. Second, even in the same household, experiences can be very different. Third, the study does not examine ACEs but the recollection of ACEs and itās not convincing to claim that a large population size would mitigate against this problem.
In addition, we have no convincing definition of a mental disorder. Also comparing the experience of identical twins to that of fraternal twins is not illuminating.
There are an awful lot of poorly done studies, but psychological studies seem worse than most.
Report comment
Actually we do know that the benefits of many treatments are exaggerated. Take the highly promoted statins, for instance, without pre-existing heart disease 98% of people do not benefit at all from statins. Statins do not extend lifespan. Even with preexisting heart disease, one study found that 96% saw no benefit from statins over 5 years.
Report comment
Thereās no doubt Americans are over medicated and that drugs cause deaths, with psychiatric drugs being among the worst. But thereās no research that proves drugs are the leading cause of death. Thatās because a personās death may have numerous causes with the drug being only one factor In addition, a toxic drug may eventually kill someone, but the patient may have succumbed to their illness sooner if they hadnāt been taking the medication. Iām not convinced, for example, that statins, blood pressure medications or diabetes medications are completely safe, but theyāre supposed to extend lifespans. Maybe they do or maybe they donāt, but thatās the argument for them.
One other point, people, such as those with dementia or a terminal illness, may be medicated to keep them comfortable even if the drug may shorten their lifespan.
Report comment
This study is so poorly conceived it should never have been used to criticize the DSM, bad as that text is.
An online survey is highly unlikely to be accurate, especially one with such a small sample. In addition, trying to measure the traumatic impact of race, gender, and something called cisheterosexism is simplistic. Thatās because it doesnāt consider adverse effects of numerous other characteristics, for example, shyness, intelligence, socio- economic status, illness, and so on.
If MIA wants to show the impact of society on mental problems, it needs a far more sophisticated and complex approach.
Report comment