Thursday, March 23, 2023

Comments by DrRomesh

Showing 13 of 13 comments.

  • Thanks, Michael, for your article. It is refreshing to read both the article and so many comments with which I agree, after being confronted by psychiatry pseudoscience for so long. Last week I tried to convince a psychiatry registrar that his theories that low serotonin causes depression and high dopamine causes schizophrenia were simplistic and unscientific. I suggested that he familiarise himself with the work of Robert Whitaker but he confessed to never having heard of him. He also admitted never reading any ‘antipsychiatry material’, countering that he has never read any ‘overtly pro-psychiatry material either’. I had to laugh.

  • I debated chemical imbalance theories with a psychiatry registrar this week. I argued that they were unscientific, while he was of the opinion that low serotonin levels caused depression, high dopamine levels caused psychosis and schizophrenia and a combined high level of serotonin and dopamine caused mania. This was, of course, primarily based on the known pharmacology of SSRI and dopamine blocking drugs.

    I asked him how it was that drugs targeting serotonin were said to be effective for treating psychosis. I also pointed out that dopamine is a vital neurotransmitter for movement and motivation and that blocking dopamine could be expected to decrease motivation, flatten emotions and reduce motivation, causing depression, scientific facts with which he had to agree.

    After causing a supposedly ‘elevated’ person, I argued, the treatment with dopamine-blocking ‘antipsychotic’ drugs predictably causes depression. A single episode of elevated and depressed mood is sufficient for a lifelong disease label of ‘bipolar affective disorder’ (with the stigmatising acronym of BAD). Needless to say the registrar disagreed – arguing that dopamine elevation caused psychosis, and schizophrenia, but that mania ‘involved other neurotransmitters, like serotonin’.

    I suggested to this young doctor that he watch the videos and read the writings of Robert Whitaker, who eloquently argues against such chemical imbalance pseudoscience. He had never heard of him, and admitted that he had never read any antipsychiatry material of any sort, including the writings of psychiatrists such as Szasz and Laing. He retorted that he hadn’t read any ‘overtly pro-psychiatry material either’. I laughed out loud. I hope he doesn’t think I have an elevated mood or inappropriate affect, because he didn’t see how funny what he said was.

  • Here in Australia, involuntary ECT is routinely approved by the tribunals that are supposed to regulate its use. In Queensland, this is the Mental Health Review Tribunal (MHRT) which approves more than 95% of applications for ECT by the hospitals.

    The MHRT’s 2011 Annual Report presents a “case study”, which they describe as “Vera’s Story”, providing an example of the supposed “justice” delivered by the MHRT in the case of a 45 year-old woman who was “very strongly against ECT”, saying that previous ECT had brought on the worst depression of her life.

    According to the MHRT’s presentation of her story, she was a loving and devoted mother of two children aged 8 and 11 and had been diagnosed with Bipolar Affective Disorder (with the unfortunate acronym of BAD) when she was 20. She had decided to stop her medication and was said to be having a “relapse”. The hospital was saying that she was manic and she was being kept in the locked ward (what the MHRT called the “intensive care unit”). This was doubtless to stop her from escaping – the predominant concern of the hospital staff.

    According to this case study, Vera brought with her a lawyer and an “allied person” named Alison to the tribunal. The lawyer merely argued that Vera should be involved in any decisions about treatment and there were less invasive ways to treat her than ECT. Alison, the “allied person” said that Vera was actually very depressed, but wouldn’t admit to the doctors for fear that she wouldn’t be able to see her children (a very reasonable fear).

    The tribunal reported that Vera had “pressure of speech” and was “not able to logically follow through with answers to questions”. This is, of course a classical sign of mania as described in psychiatric texts such as the DSM and ICD, but pressure of speech can also occur through anxiety and Vera had every reason to be anxious. The diagnosis of “mania” requires more than pressure of speech – it is primarily an abnormality of mood – the diagnosis can be made on the basis of an elevated, expansive or irritable mood. Here, Vera’s friend was saying her mood was the opposite of elevated, as would be expected from her circumstances and the imminent threat of ECT. Her pressure of speech is much more likely to reflect anxiety than an “elevated, expansive or irritable mood”.

    What’s wrong with an elevated or expansive mood, anyway? According to the MHRT, such a mood, untreated, can lead to “harmful neurological consequences”. Twice in this case study this claim is made – that an untreated manic episode can lead to harmful neurological consequences – brain damage in other words. Incongruously, the MHRT is deciding, routinely, to authorise treatments that are KNOWN to cause brain damage, supposedly to prevent the brain damage that comes from untreated “mania”. Mania can be diagnosed on the basis of an elevated mood for more than week! How good is ones mood allowed to be?

    The MHRT presents this case as an example of their decision-making process. The tribunal determined that “Vera’s mental state at the time prevented her from discussing and understanding the ECT to the extent that she could weigh up the advantages and disadvantages of the treatment as opposed to oral medication.”

    Siding with the hospital doctors, the tribunal decided that “ECT was the most appropriate treatment in the circumstances having regard to Vera’s clinical condition and treatment history” (the claim by the hospital that ECT had made her “better” in the past, while Vera had said it had made her worse). Approval was given for an acute course of up to 12 treatments with assessments of her mental state after each course, over a 90 day period”.

    This may be a fictionalized case study, but the details ring true as a real woman who came up against the Tribunal. Doubtless her name wasn’t Vera, but there are many people, each with stories to tell of being abused by the psychiatric system in which they are “involuntary patients”.

    Involuntary Treatment Orders (ITOs) can be extended indefinitely with 6-monthly reviews. In 2014, of 7700 ITOs that were reviewed, 7483 were confirmed and 217 were revoked. That’s 2.8% success rate for those trying to escape from the systematic assaults of psychiatry.

  • Kelly, when I read these words I was relieved and alarmed:
    “That antidepressants and antipsychotics, for example, have effects like sedation or blunting of affect, is not a question. That these effects are reversible after long-term exposure is.”

    I was relieved because I was reading another doctor admitting that antipsychotics cause blunting of affect. I have been arguing for 20 years that the “blunted affect” of “chronic schizophrenia”, which was taught to me in medical school was a classical sign of the chronic from of the (supposed) disease was caused by the dopamine-blocking drugs that were used to treat “psychosis”.

    I was alarmed because I am one of the people who continues to be injected against my will with depot antipsychotics. I am worried, especially, about the long term toxicity of even the newer drugs. I have appealed against the Involuntary Treatment Order (ITO) that the local hospital has taken out against me, but the tribunal that decides on the matter has a record of releasing only 3% of those who come before it from ITOs in the Australian State of Queensland, where I live. In other words 97% of appeals against ITOs are unsuccessful, and under the Mental Health Act, ITO can be extended indefinitely (with 6 monthly reviews). They are currently arguing that I have “Psychotic Disorder- Not Otherwise Specified” having previously declared me, at various times, to have schizophrenia,, schizo-affective disorder, delusional disorder, hypomania and bipolar disorder).

    Ironically it was my “delusional theory of motivation” and my “delusional theories on the pineal, autism and schizophrenia” that got me locked up an injected in the first place (back in 1995, when I was 34 years old). My “delusional” theory of motivation was that in addition to territorial and sexual instincts humans also have social instincts such as communication, curiosity and play – and that these can be used to formulate treatment strategies in psychiatry and medicine (I was working as a Family Doctor at the time) – for example I theorised that the instinct for curiosity can be fostered to ward off dementia. I also argued that communication is centred on eye contact which can be taught to people with depression and autism as a means to improving communication. Successful communication, I argued, was an effective de-stressor and helps improve the mood. This was the essence of my “delusional theory on autism” and my “delusional theory of motivation”. There was a bit more to my “delusional theory of motivation”. I theorised that we humans have free will (volition) and that this was ignored in the hoary old “nature vs nurture” debate (In behavioural terminology addition to instincts and conditioning we also have free will and voluntary decisions).

    My “delusional theory on schizophrenia” was, as I said, the theory that chronic schizophrenia is primarily an iatrogenic condition (I now think that the whole label of schizophrenia is unscientific and therapeutically harmful).

    My “delusional theory on the pineal” was that with the marketing of the SSRI antidepressants (beginning with Prozac) there was systematic suppression of important information about the pineal and its main neurohormone, melatonin. The information that was suppressed at that time was fact that serotonin is concentrated in the pineal, where it is converted to melatonin. I found that this information and in fact all information about the pineal was completely absent from a range of neuroscience texts that were being used to teach medical students in Australia. At the same time there was a massive propaganda effort, spearheaded by the drug companies to raise the profile of serotonin and promote the “chemical imbalance theory” that links low serotonin with depression. For example, Ronald Kotulak’s ‘Inside the Brain’ (1995) had 20 references to serotonin in the index but none for melatonin or the pineal.

    At the same time there was promotion, in other books and journals, of melatonin for jet lag, seasonal affective disorder and sleep disturbances. There was also research trails on melatonin in Australian universities but the medical students of the time were not learning anything about the known physiology of the pineal. If they did, they would have viewed the SSRIs with more caution.

    I’m not sure about the need for dietary supplements in successfully withdrawing from psychiatric drugs. Especially with melatonin I have concern that external supplementation may suppress endogenous production the same way cortisone suppresses cortisol secretion by the adrenals.

    Overall, I think more attention should be directed by psychiatrists towards what goes into the brain through the eyes and ears than what goes in through the mouth. Words can be healing, but they can kill, too. Convincing people that they have a incurably sick minds can be expected to shorten their lives and cause suffering.

  • Sounds like one more legacy of the MK programs. The psychiatry profession has long been developing expertise in torture and brainwashing. The whole punishment-reward paradigm of the behaviorists has been developed to create maximum suffering without leaving external marks. The brainwashing activities of the psychiatrists are employed to increase the power and influence of the profession. Were the doctors who were instrumental in these torture programs psychologists or psychiatrists?

  • Long before anyone was talking about global warming there were people trying to draw attention to human rights abuses by the mental health system in the USA and around the world. Others were trying to expose the pseudoscience of psychiatry including several from within the profession (who were denounced or more usually ignored by the Australian universities). Despite its lack of scientific methodology psychiatrists are given powers by the state that are not shared by other doctors (however much one thinks a someone needs their appendix removed a surgeon cannot force the decision on a patient).

    Recent reports in the Australian media show that psychiatric patients have a life expectancy 20 years less than the rest of the population. The reasons for this appalling statistic include both the drugs and the “psychotherapy” – when by what is meant by psychotherapy is merely reinforcing the pessimistic disease label applied by the psychiatrist (termed ‘gaining insight’ when it is quite the reverse). If you are manipulated or forced to believe you have an incurable brain disease that requires life-long drugs that actually shorten your life and make you feel unwell it is not difficult to see how this could drive you to suicide.

    Though capitalism is contributing to the problem because of the role of the drug companies, identifying corruption in the medical profession and drug companies (as Professor Peter Gotzsche and others have been doing) is one important means of addressing the problem of ‘unbridled capitalism’. The problem of overdiagnosis of ‘normal’ people that Professor Alan Frances has identified still aims to preserve the foundations of psychiatry – which in my opinion are fundamentally flawed. A case in point is the problem of climate change – the big polluters are under no risk, within the current paradigm, of being locked up and injected for their environmental vandalism – this fate is much more likely to befall a young protester against pollution.

  • About time music was recognised as a standard therapeutic tool, safer and more effective than drugs for a range of mental problems, including anxiety and depression at all ages. I would like to see some studies where music alone is compared with drug treatment – but it needs to be good music therapy. A lot of the ‘music therapy’ that goes on in hospitals is not more than a mediocre musician visiting the ward once a week and strumming a few popular songs and good time oldies for drugged-up patients/prisoners. Then they say that it’s not been shown to be effective.

  • An enjoyable article cutting through the pretensions of the psychiatry profession. Although supposedly more progressive groups of the profession has been professing to adopt a “biopsychosocial model” rather than a more limited “biological model” – in practice this has just meant seconding psychologists and social workers to play their part in enforcing the “biological model” and the “chemical imbalance” with genetic predisposition theories. They add the possibility that non-specific “stress” contributes to the development of the “mental illness” – this is the “psychosocial” bit. Their understanding of the social and familial factors that lead to distress are minimal and their “interventions” compound whatever distress their “patients” have in the first place.

    “Biological psychiatry” is also a misnomer. It has nothing to do with bios – life. In fact it shortens life and worsens its quality. It is actually anti-biological.

  • The marketing of Prozac as a “selective serotonin reuptake inhibitor” – SSRI – was very successful for Eli Lilly (at great cost to society). The neurotransmitter serotonin became a household word, and there were marketing campaigns to convince that depression was caused by lack of serotonin in the brain. This replaced the noradrenaline theory of depression – based on the known fact that the tricyclics target noradrenaline receptors. Meanwhile, the basic physiology and biochemistry of the indole amines serotonin and melatonin were ignored, and did not find their way into psychiatric texts and journals. This included the important discovery from the 1960s that serotonin is concentrated in the pineal gland where it is converted to melatonin at night. The research that Eli Lilly and the psychiatric establishment did on LSD under the MK Ultra program is just one example of systematic secrecy about serotonin and dopamine research.

    There was a similar theory regarding schizophrenia and dopamine that followed the supposed success of treatment of ‘schizophrenia’ and ‘psychoses’ with dopamine-blocking drugs. The simplistic theory put forward by enthusiasts was that drugs that were known to stimulate dopamine receptors like amphetamines and LSD caused a mental state similar to what is termed ‘schizophrenia’. This was a convenient marketing strategy for the numerous dopamine-blocking drugs that have caused so much tardive dyskinesia and Parkinsonism around the world. The problem the psychiatrists are faced with is that the new generation ‘antipsychotic drugs’ are known to affect serotonin receptors more so than dopamine receptors. They have to come up with more pseudoscience to get around the problem.

    Meanwhile the fact that dopamine is the precursor molecule of noradrenaline (norepinephrine) and is known to affect the pituitary as well as the limbic system, basal ganglia and cortex explains the wide range of adverse effects that dopamine-blocking drugs have on brain as well as general metabolism. The end result is that those who are treated with dopamine-blocking drugs have their lives worsened and shortened if they are given in high or ‘maintenance’ doses. (I think there may be a role for these drugs in low dose to treat troubling auditory hallucinations).

    We are told that the ‘new antipsychotics’ that target both serotonin and dopamine receptors (and many others too, no doubt including some that are not known or tested for yet) are “less likely” to cause permanent brain damage in the form of tardive dyskinesia. This is not yet known though, since the drugs have not been used for long enough – what we do know is that the new drugs shorten one’s life, and cause even worse metabolic problems (including obesity) than the old dopamine-blockers.

    Changing names – or adding new alternative names – will not decrease the toxicity of these drugs. It may convince more people to take them, though.

  • Peter, I need your help!

    As a GP in Australia I have been warning about the use of these drugs for much the same reasons since the mid 1990s. My punishment was to be ‘diagnosed’ as being ‘hypomanic’ – evidenced by the ‘grandiosity’ of thinking that, as a GP, I had the right to criticize the fundamental tenets of psychiatry and the disease model of the DSM. Despite the DSM stating that hypomania does not warrant hospitalization and can be accompanied by increased efficiency and accomplishments in some people (a result of increased motivation and excitement) I was ‘treated’ with forced incarceration and drugging with haloperidol, first in 1995, and numerous times since then.

    When I continued criticizing psychiatry and the human rights abuses I observed and experienced as an involuntary patient, this was seen as a sign that I was still not well. My refusal to agree that I was ill was described as “lack of insight”. The hospital psychiatrists, who refused to discuss the scientific reasons behind my opposition to the use of SSRI, tricyclic, antipsychotic, benzodiazepine and stimulant drugs, wanted me to go on lithium or tegretol. When I refused, I was injected with depot injections of haloperidol and flupenthixol. These crippled me for some months.

    Being injected against my will with these drugs gave me first-hand experience of their toxicity. There effects on my movements was very traumatic. Every word had to be forced out. I was emotionally numbed and could feel no pleasure, while shuffling around with Parkinsonism. At the same time I felt an irresistible urge to pace (akathisia) which made me seem mad to the causal observer (and members of my family). My face showed little movement, which made me seem ‘flattened’. Members of my family who saw me in a heavily drugged state in the hospital thought that my new appearance was the result of the mental illness and not the drugs that were forced into me.

    Almost 20 years later I am still battling the psychiatrists in Australia, who are still injecting me against my will under the legal cover of an Involuntary Treatment Order authorised by the local public hospital. A week ago at a Mental Health Review Tribunal hearing at the hospital it was argued by the hospital that I had “Psychotic Disorder – Not Otherwise Specified” for which their plan is to inject me monthly with a new drug called paloperidone, indefinitely . Their previous diagnosis was “schizophrenia” but they have recently been backing away from that diagnosis (since I obviously don’t satisfy diagnostic criteria for the label and I have private psychiatric opinion that I do not have schizophrenia and I don’t show signs of having a ‘mood disorder’ either). They have been injecting me with this drug for the past 8 months and I have gained 10 kg in weight. I also have a strong family history of diabetes.

    Needless to say, these injections have not altered my beliefs about psychiatry and the medical profession in the least. Each injection costs the taxpayer about $400. Most of that goes to the drug company, but the pharmacist gets his cut too. If I refuse the injection (they come to my home to give it to me) I have been told that they will sign an “ATR” (Authority to Return form) and I will be brought back to the hospital by the police. They will use whatever level of force they deem necessary.

    At the last Mental Health Review Tribunal hearing they deferred their decision awaiting another supposedly ‘independent’ psychiatrist’s opinion as to whether or not I have a mental illness (since I appeared sane to the Board and my own private psychiatrist) but the hospital psychiatrist maintained that in his opinion (after meeting me once) was that I probably had schizophrenia based on the number of admissions I had and his scan reading of the files.

    I feel like I’m in Kafka’s Trial. The chance that the new “independent psychiatrist” will share your views on psychiatry and psychiatric drugs, Peter, would be close to zero in my estimate.

  • Thanks Noel, for the interesting piece. I think there are problems with the use of the terms dissociation, psychosis and schizophrenia. Dissociation from one’s surroundings is common when the surroundings are boring or unpleasant, and one can likewise dissociate from traumatic memories. Periods of dissociation are common and ‘normal’ – daydreaming, for example.

    The term ‘psychosis’, often defined as being ‘out of touch with reality’ blurs into dissociation, though the medical profession pretends there is a clear-cut distinction between them. I believe that trauma can cause psychosis, and people labelled with ‘schizophrenia’ experience severe trauma just from the label and the accepted treatment for it. It is very traumatic to be convinced that you have an incurable, progressive brain disease that makes your mind ‘sick’. Refusal to accept this grim judgement of your thinking and behaviour is routinely called ‘lack of insight’ and a justification for forced drugging with chemicals that are known to cause dulling of emotional reactions and ‘flattening of affect’ as well as feelings of dissociation and disconnection from ones surroundings.

    I think the cruel system of hospital-based treatment increases the distress of those who are forced to be in what are essentially prisons where you are routinely drugged with toxic and often addictive chemicals. This, combined with the loss of self-esteem and motivation that comes from believing you are incurably mentally defective, explains much of the phenomenology of ‘chronic schizophrenia’.

  • There is another factor that contributes to the high level and severity of diabetes in Indigenous populations around the world – stress. It is well known that stress elevates the blood sugar level, and Indigenous populations around the world are subject to exceptional stresses, including high levels of poverty and unemployment.

    It is also important that the new, highly-prescribed anti-psychotics are known to trigger diabetes. Here in Australia I remember a young Aboriginal man who had been diagnosed with ‘paranoid schizophrenia’. Whenever he complained that he was subject to persecution based on his race and colour, and that his people were subject to genocide, he was said to be having a ‘relapse’ and was re-admitted and more heavily drugged.