Here is an update about Monday’s blog that described a mother who was furious after she attended Robert Whitaker’s presentation at the national NAMI convention and her son later stopped taking his medications. Less than forty-eight hours after her son left home, his mother received a call from a social worker at a homeless shelter. Their son was there. A mental health care worker arranged a meeting and the son has agreed to voluntarily admit himself to a hospital.
A number of you offered your prayers and extended offers of help to the family through me. In particular, I received a call from the national NAMI staff offering help to the family in whatever way possible — a gesture that I found especially gracious given the mother’s hostility toward NAMI.
The mother asked me to publicly thank everyone for their kind words and support. At the advice of the mental health professional helping them, the parents have decided to not say anything more about their son or their family so that they can work together to move down a road to recovery.
When it comes to the issues raised in the blog, I feel conflicted. I have divided my thoughts into three categories — those of a journalist, a NAMI member and a father.
As a journalist, I rally in defense of Robert Whitaker. The sharing of information — especially about the effectiveness of mental health treatment — is invaluable to anyone who has a mental illness or loves someone who does. A reporter’s job is to research, find facts and present them to the public. Mr. Whitaker is a widely-respected journalist. He is not a scientist and has not pretended to be one. Consequently, an argument could be made that any scientific conclusions that he reached as a journalist should be reviewed by experts who could put his findings into the proper context. I would argue that was done long before he agreed to speak at NAMI. His books have been widely reviewed by respected professionals in newspapers and scientific journals, and can easily be found on the Internet.
In his opening remarks, Mr. Whitaker noted that NAMI’s invitation to him was rather remarkable given that he has been widely embraced by the anti-psychiatry movement, an embrace that he has warmly welcomed. Many of its members villainize NAMI, believe all of psychiatry is a fraud, and advocate against policies that NAMI supports. I give Mr. Whitaker kudos for walking into the lion’s den.
I did not attend the convention and therefore did not hear his presentation, but based on the reports that were published on this blog and in others, it appeared that Mr. Whitaker was thoughtful, respectful and not at all as unreasonable as he has been painted beforehand.
As a NAMI member, I find the national board’s decision to invite Mr. Whitaker perplexing and questionable. The NAMI board knew an invitation to Mr. Whitaker would be controversial and yet it extended it. Why? We’ve been told that this was a board decision that dovetailed with the overall theme of the convention: “The Many Faces of NAMI.” Clearly the board felt it was time for Mr. Whitaker’s face to be seen.
I would point out that Mr. Whitaker’s speech was sandwiched between presentations made by Dr. Xavier Amador and by representatives from the Treatment Advocacy Center. Those “faces” are very familiar ones at NAMI conventions and ones that present an opposite point of view from Mr. Whitaker’s. Consequently, it would be unfair to claim that the NAMI board favored Mr. Whitaker and ignored more traditional stances.
It is difficult for anyone to argue against NAMI’s wish to become more inclusive, which appears to be the board’s ultimate goal. Only by unifying, cooperating and, at times, agreeing to disagree but always to work together, can reasonable people achieve what is necessary — educate the general public (which doesn’t really care much about mental health) and better serve our loved ones. I believe we need to form alliances and expand our base, as I have written before. I believe there are many roads to recovery, not a single path. I believe we should honor these different roads if they genuinely help individuals recover. This is why I strongly advocate for wrap around services and preach that it takes more than popping a few pills into someone’s mouth to help them recover.
However, NAMI’s call for inclusion can easily become a two edged sword. Not every “face” wants to improve community mental health care services, combat stigma, help the sickest among us, and stop the unnecessary jailing of persons with mental illnesses. There are “faces” in the community who do not believe mental illnesses are real. There are others who refuse to compromise or listen. There are others who don’t support NAMI’s founding principles or basic goals. The question is how can NAMI become inclusive without diluting its primary message and what it represents? Can it become “everything to everyone” without becoming a bickering collection of opposing viewpoints that share no common objective? Or will it represent its members’ wishes?
In short, where is NAMI going with its “Many Faces” theme? Was the choice of Mr. Whitaker an experimental, one time act or a step in a new direction? Was it made by a board that wants to move forward or one that simply decided it wanted to expand NAMI’s vision without putting much thought into what that vision should be? It’s members deserve to know.
This is a question that it’s new executive director will have to answer when he/she is finally hired.
Finally, as a father, I must candidly admit that every time I hear someone question the value of medication, my heart misses a beat. My mind immediately retreats to what happened each and every time my son has stopped taking his medications. Each time has been terrible, each time has caused him more pain, each time has harmed him physically and mentally — and jeopardized his life and future.
That is not an idle fear that I can simply push aside because he now is stable and NAMI wants to become more inclusive. I want him to make his own choices but I also realize that he has a mental illness lurking under his skin that is always waiting to cloud his judgment and steal him away. If you are a consumer, you need a friend, a parent, a family member to stand with you against your mental illness. Yes, you should and must work together, but I see nothing wrong with having someone you can count on at your side especially if you begin to become sick. (This is why I support advance directives!)
I would have been hesitant to take my son to Mr. Whitaker’s lecture, but would have gone with him if he had insisted. What the NAMI board failed to do was anticipate the worst and take steps to insure that resources would be readily available to make certain that consumers and their loved ones had information about how dangerous it is to stop medication cold turkey and how withdrawal needs to be done in as safe a fashion as possible. Knowing that NAMI is still primarily a parent organization, that going “off med’s” is a constant fear of many parents, and that Mr. Whitaker was going to present data that questioned the value of medication, NAMI’s convention leadership and board failed in its primary responsibility to provide its members with tools that they needed to protect themselves and their loved ones.
This was not Mr. Whitaker’s fault.
As I have written before, my son is fortunate. Medication helps him with no obvious, dangerous side effects. Does this mean that medication is the cure all for everyone? I am not so arrogant to believe that. At the risk of being redundant, I would be in favor of having every possible treatment option available to everyone who gets sick, regardless of what it might be. However, I resent being told by many of Mr. Whitaker’s most vocal supporters that I am a bad father and my son is making a mistake taking medication. While it may not be effective for everyone and may, as Mr. Whitaker claims, harm some, it has helped keep my son keep sane and he deserves that right without being browbeat, marginalized or condemned for his choice.
That is something that NAMI needs to remember as it welcomes other voices and faces into the fold.
PS — A friend of mine who is much more culturally aware, remarked about the painting that I featured on my blog. I simply chose it after typing “angry letter writer” into my browser. Here is its history. You can decide it if proved to be symbolic.
The Death of Marat (French: La Mort de Marat or Marat Assassiné) is a painting by Jacques-Louis David of the murdered French revolutionary leader Jean-Paul Marat. It is one of the most famous images of the Revolution. David was the leading French painter, as well as a Montagnard and a member of the revolutionary Committee of General Security. The painting shows the radical journalist lying dead in his bath on 13 July 1793 after his murder by Charlotte Corday. Painted in the months after Marat’s murder, it has been described by T. J. Clark as the first modernist painting, for “the way it took the stuff of politics as its material, and did not transmute it”.
As always, I welcome your thoughts and comments.
About the author:
I hope their son does get treatment and that together they can heal and move forward.
Thank you for the follow up. I truly appreciate your 3 sides of this issue. I hope their son gets treatment again. I pray mine does too.
This is great news, I hope and pray that this man gets the help and continued support he will obviously need. Mr. Earley, your views are appreciated. You are far more charitable towards Mr. Whitaker and his research than I would care to be and in that regard I give you credit. You mention a journalist’s responsibility above in presenting facts…widely respected and best selling book aside…for this, I think you let him quite off the hook. It is a shame that this young man did not have the luxury of hearing all
sides and reading critiques of his work by the scientific community
beforehand.
Thank you, Mr. Earley for such a thorough and what I believe to be a calm-minded and just assessment of the situation, not just with Mr. Whitaker’s speech and the unfortunate events for this family, but with NAMI’s responsibilities moving forward. Are you not on some NAMI board yourself? I think, at least with the words you have written, you strike a constructive middle ground that could prove successful in navigating the growth of mental health services in our country.
Thank you again for your compelling words!
Finally, Mr Earley, you show your true colors.
As I survivor, I think that psychiatry is a fraud that has ruined my life and that NAMI is no different than the KKK. An evil, heinous organization that I hope someday will have the same destiny as the KKK.
And now, this is no a stretch of a comparison. The policies that NAMI promotes have resulted in the highest suicide rate ever in America (according to the CDC numbers). Untold numbers of murders have been committed by people under the drugging regimes promoted by NAMI (more recently, Aurora and Newtown).
NAMI is an evil organization, plain and simple.
To be sure, the tragedies that occurred in those cities you mention involved men who (as far as we know) were not receiving any kind of treatment.
What we know is that both the Aurora and the Newtown guys were ON MEDS. For the Aurora guy, he was, or had been recently, on antipsychotics. It never became public what kind drugs the Newtown had been on, only that he had been on. A story that repeated itself in Virginia Tech, Columbine and the Standard Gravure shootings. In fact, Elli Lilly hid from public light information that it had known as back as before the FDA approval of Prozac that fluoxetine make people more violent than other antidepressants or placebo. There is a nice CNN article that speaks to that (you can Google it yourself) that I am not posting because this comment would be automatically moderated.
The victims of NAMI’s policies are numerous, both in terms of the people who have killed themselves while taking psychiatric drugs as well as those caused by people who were on psychiatric drugs when they went into their killing sprees.
This is the kind of inflammatory one-sided comment that is completely useless in this debate. The fact of the matter is that persons have been helped with the practice do psychiatry, and some of them have been harmed. Presumably we all want a wide continuum of treatment options for all who need them. Why deny that there are several sides to this argument?
To be sure, the label “inflammatory, one-sided” also applies to the official NAMI line: all drugged, all the time, by force if necessary. I long time ago reached the conclusion that it is impossible to have an intelligent conversation with any member of any of the three legs of the pharmaco-psychiatric complex (Big Pharma, the APA and NAMI). If the complex had any interest whatsoever in following the scientific evidence, it would have abandoned the abusive policies of forced drugging it endorses long time ago.
Bob Whitaker’s only fault was to believe that it was possible to reason with the zealots that are part of the complex. Big mistake. I hope that he learns the lesson that the only good psychiatrist is he or she who has been striped of all legal authority to impose his/her quackery onto innocent victims. In the meanwhile, people will kill themselves and others under the influence of the psychiatric drugs you guys want to impose onto those whose behavior deviates from the DSM orthodoxy.
Mr Earley,
Thank you for your thoughtful and fair-minded review. I’m sorry to say that my first reaction was a bit sarcastic: better late than never!
My mind still goes back to the time years ago, when I was young and desperately struggling with what even I knew to be a psychotic episode. I suffered for months in silent agony because I knew what would happen if I asked for help: lifelong medication, stigma and helpless dependence on my family and arrogant uncomprehending psychiatrists and their minions. The only thing that kept me from suicide was my two young children who needed a mother.
How many more Whitakers, and how many more suicides and senseless tragedies is it going to take for this profession to see what it’s doing to people? Before it can be persuaded to look at treatment programs like Soteria and Open Dialogue with their 80% success rate?
Mary Newton
Although I have previously enjoyed and respected the thoughtful writing on this blog, and I have similarly enjoyed hearing you (Pete Earley) lecture and reading your book, and I write and post elsewhere daily, I have not posted a comment on this blog before.
I was prompted to come over here tonight by receiving word that you’d used a headline to implicate Robert Whitaker in having “blood on his hands.”
If that is not libelous, it is at the very least an uncivil smear that declares verbal war. Nothing could be more destructive to the dialogue that I had hoped you, Mr. Earley, could and would foster.
I was at the NAMI national convention and attended the lecture by Robert Whitaker. I am the one who responded publicly at the lecture by asking Whitaker (whose work I also know quite well) to address his relationship with his most vocal admirers.
Whitaker told the NAMI audience that he welcomed my question. He said he has always wished to promote civil conversation among people with a variety of perspectives.
He said it surprised him when his “Mad in America” blog attracted and retained predominantly people who want to abolish psychiatry as we know it today. Whitaker said that initially, the blog didn’t have sufficient resources to provide adequate moderation of the comments. By the time a more effective effort was deployed, the more moderate bloggers and commenters had been “driven off.”
Mr. Earley, I’m very, very disappointed in your decision to attack Mr. Whitaker. I look forward to your response.
One of the most eloquent posters in MIA, Anonymous, posted the answer below to Bob’s post. I post it here. It goes without saying that it is not that I wish my father wasn’t Pete Earley. Mine had the same ideas as Pete and the end result is that he lost me for good.
===============================================
From the letter Pete Earley ‘wanted to share’ with his audience:
‘ when we practiced “tough love” and told him he couldn’t live with us unless he got treatment, he walked out and disappeared.
Only a parent who has a child who has disappeared on the
streets can tell you how horrible it is to go to bed at night not
knowing where your son or daughter might be.
So the son didn’t just ‘go missing’, he was threatened with
homelessness, threatened with eviction from the family home, by his
parents, if he refused to be coerced into opening up his
never-proven-diseased body to psychiatric drugging. The mother laments
going to bed at night, not knowing where her son is. She’s also made
clear that if her son’s sleeping body was safe in his bed at home, such a
body, if it didn’t have psychiatric drugs coursing through its
bloodstream, was unwelcome in her home. These tactics are sadly
something that millions of people who have had psychiatric labels
slapped on them have to face, told they are unacceptable, unwelcome both
at home and even in free society, if they aren’t wearing their chemical
leash.
If the son saw a documentary on youtube she’d probably demand it be
taken down. The pro forced drugging, pro ‘brain disease theory’
indoctrinated audience of Pete Earley’s forced drugging lobbyist blog,
has got a problem with Whitaker’s freedom of speech. Has got a problem
with the person labeled “ill” having the right to listen. Even Early
says he’d rather his own son didn’t see Whitaker’s speech. They’ve also
got a problem with innocent human beings owning their own body, that’s
why they seek to increase use of state sanctioned forced drugging social
control techniques. Techniques the UN Special Rapporteur on Torture has
repeatedly condemned.
The forced drugging lobbyists have shown time and again the
underhanded smear tactics they will engage in. Earley, Jaffe, Torrey,
have all shown they will throw enough mud and hope some sticks, hence
the fact Earley has opened himself up as the go-to blog to publish
‘blood on hands’ diatribes from mothers who view their sons as ‘diseased
brains’ needing to be flooded with major tranquilizer drugs. This
really shows their inner anxiety that they are now facing strong
resistance to their anti-human rights pro forced drugging agenda.
MindFreedom founder David Oaks released a statement on Mr. Earley’s
forced drugging lobbying activities some time ago. In 2010, Pete Earley
lobbied against federal funding of the Alternatives Conference for the
thought-crime of having Whitaker, David Oaks, and Will Hall in
attendance. Earley said:
‘But what did trouble me was how this conference was bankrolled.
MindFreedom didn’t pick up the tab, nor Robert Whitaker or Will Hall.
You did.
Yep, the conference was paid for by the United States
Department of Health and Human Services: Substance Abuse and Mental
Health Services Administration, Center for Mental Health Services,
commonly called SAMHSA.’
He went on to lament that SAMHSA dollars weren’t being used in the push to rip away more human rights:
‘Nor do I believe SAMHSA financially supports or endorses my
belief that involuntary commitment laws need to focus on criteria other
than “immediate dangerousness” – to make treatment available to persons
who are clearly delusional but are not dangerous’
Note the classic, banal, forced drugging lobby trick, when he says make treatment available. Yes, forced drugging is simply making treatment available,
like it wasn’t in the Yellow Pages, nobody knew where to get it, until
goons armed with a syringe forcibly stripped them naked and stabbed them
with a needle. This is the disingenuous, hot/cold passive/aggressive
kind of way the forced drugging lobby plays things. We can see the same
tactics with Earley headlining the ‘blood on his hands’ smear, followed a
day later by a coy, disingenuous defense of Whitaker’s free speech and
Earley adopting some pose of journalistic neutrality. Earley is an
active forced drugging policy lobbyist, he couldn’t be less objective if
he tried. He wants to use force, the terrible power of the state, to
make sure there is nowhere to run from a forced needle in all of America
for anyone with a psychiatric label. Note that while he laments the use
of SAMHSA funds to promote alternatives to psychiatric drugging, he has
no problem lobbying for the use of taxpayers money to fund the forced
drugging policies he advocates. Taxpayers have shelled out billions over
the last couple of hundred years to pay the government psychiatrists,
government psychiatric facilities and psychiatric ‘treatments’ that have
seen millions of people lose the right to own their own bodies at the
hands of forced psychiatry.
The forced drugging lobby’s position is simple. They believe in
psychiatric drugging, they have taken the leap of faith that unusual
behavior is a ‘brain disease’, therefore every man, woman and child in
the land should only enjoy the right to own their own body only at the
pleasure of their local forced government psychiatrist. They believe
that actual physical violence should be used against people who refuse
to consent to psychiatric drugging, forced government injections. Your
heartfelt, well considered, well-evidenced, deeply held position of
informed refusal of consent, and your human rights, are just an
irrelevant barrier to be overcome by a court order, a pack of armed
goons, and a forced needle. Your lifelong trauma after being treated
like a subhuman object, terrorized by the government psychiatric goons?
Well that’s shoved to the side just like they shove the side effects to
the side.
The re-traumatization, stigmatization, and scapegoating that the
forced drugging lobbyists engage in, is so hurtful to recovery, so
destructive of hard-won self esteem in those labeled ‘mentally ill’, so
terrifying, that I cannot even fathom how they are still part of polite
society. I pity any family member of these people. Can you imagine
having a father who makes it his mission to extend the tentacles of
government power by force INTO THE NEURONS! of perfect strangers. This
is pure fanaticism on display folks. Scary stuff.
See what David Oaks had to say of Pete Earley:
“Thank the universe and all the Gods and Godesses and stars in the sky…. that you were never my father. ”
Harsh words, for a harsh opponent of our human rights. I second David
Oaks’ statement and say I am so thankful that I don’t have pro forced
drugging ideologues for parents, for if I did, I’d run away too. The
forced drugging lobby wants to rip away equality and choice, and make
their spurious pseudoscience based beliefs the law of the land, only
unlike Iran, they don’t merely want to force young women to wear a veil,
they want psychiatric goons to be on hand to forcibly pull down the
jeans of 19 year old women, hold them down, ignore their screams for
mercy, and stab needles full of brain disabling drugs into their naked
buttocks when they are at their weakest. This is the proverbial ‘kicking
someone when they are down’. Where they have succeeded, lives have been
destroyed by their forced drugging policies. That all the likes of
Earley, Jaffe and Torrey can talk about is what the proponents of
choice, dignity, and critical appraisal of psychiatric drugging are
saying and doing, shows they are on the back foot. May it long continue.
I pledge to do my best to ensure it continues long after the
increasingly irrelevant forced drugging lobbyists are gone. They are on
the wrong side of history.
Researchers, writers, critical thinkers like Robert Whitaker, like
the dozens of authors who write for this website, like the many, many
people speaking and thinking critically about the status quo in ‘mental
health’, are helping people help themselves. If a young man tries to
help himself a bit too rashly, impulsively, like the son in the letter,
that’s not Whitaker’s fault. And I’m sure being threatened with
homelessness by his mother if he didn’t drug himself played a large part
in that bed in the family home laying empty too. Evasions, flights from
responsibility, smears, cries of ‘Aids denier’, ‘blood on his hands’,
‘scientologist!’ from the forced drugging lobbyist/parent peanut
gallery, is the thanks Whitaker gets for giving people information, that
adults can use judiciously to reorganize their lives after
un-indocrinating themselves from psychiatry’s false assertions.
Earley says on his blog that he resents those he is lobbying against
saying they are glad he isn’t their father. People positing that they
are glad of this fact, is mere speech. He can choose not to listen to
this free speech. What I resent, is Mr. Earley and his collaborators
seeking to use the state to institute policies that see us live in fear,
policies that strip us of our right to own and control our own bodies.
Mere speech, versus actual state sanctioned force. You decide who is
more entitled to be resentful. Who is doing something more invasive.
Speech, versus the forced government alteration of never-proven-diseased
conscious brains of innocent strangers. It’s an absolute horror what
this guy is advocating. Far from blood being on the hands of Whitaker,
we ought to look at the fact those who carry out the violent forced
drugging policies Mr. Earley lobbies for more of, always put latex
gloves on their own hands before they pick up their forced needles. Why
are they wearing rubber gloves? Could it be they don’t want to get blood
on their hands when they are stabbing needles into the forcibly held
down bodies of those they have decided don’t deserve the right to say
no?
We deserve the right to say no Mr. Earley. And while you may believe
the violent hands of state force are the best tool to get what you want
(put in others’ bodies), we will use nonviolent persuasion to win our
human rights.
I had a similar reaction to the charisma used by Whitaker. Went off my meds and damn near died. My current psychiatrist says that he has seen many cases like mine in the past few years, people suddenly going off meds, believing the hype, and then getting sicker, more paranoid, and eventually needing hospitalization. It’s a matter of time before his community is outed for the irresponsible messages they propagate. I wonder if somehow people forget that Whitaker is not an MD, nor is he a scientist or scientific researcher, but rather a charming and manipulative salesman. Thank you Pete Earley for speaking up about this unruly bunch.
And Pete Earley is? Give me a break! Do you want to hear the opinion of an MD, if that makes you feel better, listen to Peter Bregin or better, Thomas Szasz. But even mainstream psychiatry is being forced to admit the reality. In a recent JAMA Psychiatry editorial, the very pro drugging McGorry admits,
“In moving to a more personalized or stratified medicine, we first need
to identify the very small number of patients who may be able to recover
from first episode psychosis with intensive psychosocial interventions
alone. For everyone else, we need to determine which medication, for how
long, in what minimal dose, and what range of intensive psychosocial
interventions will be needed to help them get well, stay well, and lead
fulfilling and productive lives. These factors have rarely been the goal
in the real world of clinical psychiatry—something we must finally
address now that we are armed with stronger evidence to counter poor
practice.”
I am a scientist, I know a thing or two about the scientific method. I have listened to the evidence and I have no doubt that psychiatry is a scam . Google “Is medical psychiatry a scam?” by Jerry A. Coyne, who is a very credentialed and published scientist (with papers in Science and Nature). You have been lied to. You probably experienced withdrawal symptoms. When I quit my own drugs cold turkey, I felt terrible for 3-4 weeks, but after a while, all withdrawal symptoms go away. I have never looked back.
Ok, ‘cannot say,’ clearly I am not listening to you before I listen to my doctor, who has actually earned my trust, and who respects what I say without dismissing it. This is exactly the kind of unruliness I was referring to, thankyou for demonstrating. At this point even if you were an MD PhD I would still run the other way if I had to meet you face to face. Whatever credibility you claim to have you lose by your own show of character.
In response to antipsychotics the brain sprouts about 50 percent extra dopamine receptors. People that go abruptly off of the antipsychotic drugs, do tend to have severe relapses. The relapse may have been from drug withdrawal.
and how many patients have you treated and seen?
This is Jerry Coyne Ph.D, a Professor in the Department of Ecology and
Evolution at the University of Chicago and a member of both the
Committee on Genetics and the Committee on Evolutionary Biology, critique’s of psychiatry. Cannot be more credentialed that this!
===============
Is medical psychiatry a scam?
A while back I did some research on the genetics of mental illness,
and was appalled to discover some disturbing things about medical
psychiatry (by “medical psychiatry” I mean psychiatry centered on drug
therapy rather than talk therapy). First of all, for the vast majority
of drugs used to combat mental illness—and especially depression—the
doctors had no idea how they worked, yet they pretended they did.
Patients were regularly told, when prescribed antidepressants like SSRIs
(selective serotonin reuptake inhibitors; Prozac is the classic
specimen) that their depression was due to a chemical imbalance in the
brain. SSRIs, for example, increase the amount of the neurotransmitter
serotonin in the synapses (gaps) between neurons by preventing its
reabsorption by the neurons. Because these drugs seemed to work (more
on that below), doctors and pharmaceutical companies blithely concluded
that depression resulted from a deficit of serotonin. But that’s
ludicrous, for just because a drug alleviates a symptom doesn’t allow
you to conclude that the symptom was due to the deficit of that drug.
It’s like saying that headaches are caused by a deficit of aspirin! As
Marcia Angell notes in her reviews below, “. . . instead of developing a
drug to treat an abnormality, an abnormality was postulated to fit a
drug.”
An acquaintance of mine, visiting a psychiatrist for depression, was
told that her “brain was wired up wrong”! That verges on medical
malpractice.
I also learned that the genetics of mental illness is a subject rife
with uncertainty and unreproduceable results. For every study
localizing a “gene” or gene region responsible for a condition like
depression, there was a counter-study showing no effect at all.
Nevertheless, medical students in psychiatry are taught that the major
mental illnesses have a genetic basis (I’ve seen the textbooks).
Despite all this, psychiatry continues to be increasingly
“medicalized,” that is, talk therapy is replaced by drug therapy
(doctors can make a lot more money prescribing drugs than talking, for
during the hour occupied by a talk therapy session, a psychiatrist could
see and prescribe meds to three or four patients). And pharmaceutical
companies make millions of dollars prescribing drugs for mental
illnesses, so they continually try to expand the range of conditions
that count as drug-requiring “illnesses,” including obsessive-compulsive
disorder, various attention-deficit syndromes, and so on.
The whole mess is encapsulated in the book used by doctors to “diagnose” mental illnesses, the Diagnostic and Statistical Manual of Mental Disorders
(DSM), which is now undergoing its fifth revision. If you ever get a
chance to look at it, do. You’ll find that “diagnosis” is based on
conforming to a certain number of symptoms in a numbered list. To be
diagnosed with a “major depressive episode,” for example, you need to
have five out of the nine symptoms described by the DSM.
But what if you have only three or four? Then you don’t get your
meds. It’s all quite bizarre, and I concluded that the whole
drug/genetics/diagnosis nexus is driven by three things: the desire of
psychiatrists to be like “regular” doctors who treat well defined
illnesses with well defined medications, the nebulous and ill-defined
character of mental illnesses, and the desire of pharmaceutical
companies to milk the public out of as many dollars as possible. This
does not deny, of course, that mental disorders are often serious and
life-threatening conditions that require some type of treatment or
intervention.
And these conclusions—and other ones just as dire—are shared by Marcia Angell, author of two new articles in The New York Review of Books “The Epidemic of mental illness: Why?” and “The illusions of psychiatry”
(they’re free, so have a look). Angell is a pathologist with an M.D.,
studied microbiology, and was the first woman editor of The New England Journal of Medicine. Her piece is basically an essay centered on four books, The Emperor’s New Drugs: Exploding the Antidepressant Myth, by Irving Kirsch, Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, by Robert Whitaker, Unhinged: The Trouble with Psychiatry—A Doctor’s Revelation about a Profession in Crisis, by Daniel Carlat, and the latest DSM, Fourth Edition, Text Revision (DSM-IV-TR), published by the American Psychiatric Association.
Antidepressants and anti-anxiety drugs are so widely prescribed in
America that if you’re not taking them yourself, you certainly know
someone who is, so you owe it to yourself to have a look at these
articles. Among Angell’s eye-opening statements and conclusions are
these:
Mental disorders are increasing at a furious rate in America,
especially for children. While 1 in 184 Americans qualified for
government disability aid for mental illness in 1987, the number more
than doubled (1 in 76) by 2007. In children, the rise was an
astonishing 35-fold! This almost certainly reflects not a genuine jump in disorders, but an increase in the frequency of diagnosis.
As we all know, psychiatric talk therapy has been largely supplanted
by the use of drugs. Medical students are now given minimal training
in talk therapy and maximal training in how to prescribe drugs.
There is no substantive evidence that mental illness is caused by chemical imbalances in the brain.
Antidepressants are far less effective than people think: in fact,
they may not be effective at all. Trials are typically only a month or
two long, and I am not aware of any long-term tests of these drugs.
More disturbing is that the drugs are barely better than placebos.
Pharmaceutical companies doing blind testing of antidepressants are
required to submit only two blind clinical studies with positive
results, and these could be out of a much larger number of studies showing no positive results.
That, in fact, seems to be the case. When Irving Kirsch investigated
the studies, he found that while antidepressants were three times as
effective as no treatment at all, they were only marginally better than
placebo drugs, which “cured” depression at a rate 82% that of real
antidepressants. Moreover, when you look at the degree of
improvement of antidepressants over placebos, the difference, though
statistically significant, is miniscule. Few people taking
antidepressants know these depressing statistics.
Doctors observed that other drugs with no effect on serotonin, like
synthetic thyroid hormone, also appeared to relieve depression. What
these drugs had in common was that they all had side effects.
Was it the side effects, then, that helped depression? Sure enough, when
doctors used placebos that had side effects (“active placebos”; one of
these is atropine) rather than inactive placebos, they found no
difference between antidepressant and placebo. A reasonable conclusion
from this study is that patients, when they experience side effects,
think that they’ve “broken the blind test,” and are taking the real
drug. They then improve simply as a result of realizing that they’re
taking something that’s supposed to help them.
Whitaker’s book reaches an even more depressing conclusion. He
realized that the “natural history of mental illness” has changed over
the decades: while schizophrenia and depression, for instance, used to
recur episodically, separated by periods of normality, now they are
“chronic and lifelong”. Whitaker concludes that psychoactive drugs
actually change the brain in a way that prolongs and intensifies mental
disorders, for the brain tries to compensate, ineffectually, for the
chemical imbalances induced by drugs. Here is a really disturbing
passage from Whitaker’s book:
“Imagine that a virus suddenly appears in our society
that makes people sleep twelve, fourteen hours a day. Those infected
with it move about somewhat slowly and seem emotionally disengaged. Many
gain huge amounts of weight—twenty, forty, sixty, and even one hundred
pounds. Often their blood sugar levels soar, and so do their cholesterol
levels. A number of those struck by the mysterious illness—including
young children and teenagers—become diabetic in fairly short order…. The
federal government gives hundreds of millions of dollars to scientists
at the best universities to decipher the inner workings of this virus,
and they report that the reason it causes such global dysfunction is
that it blocks a multitude of neurotransmitter receptors in the
brain—dopaminergic, serotonergic, muscarinic, adrenergic, and
histaminergic. All of those neuronal pathways in the brain are
compromised. Meanwhile, MRI studies find that over a period of several
years, the virus shrinks the cerebral cortex, and this shrinkage is tied
to cognitive decline. A terrified public clamors for a cure.
Now such an illness has in fact hit millions of American
children and adults. We have just described the effects of Eli Lilly’s
best-selling antipsychotic, Zyprexa.”
The DSM book resulted from a deliberate decision by the
American Psychiatric Association (APA) to “remedicalize psychiatry” in
the late 1970s. Each time it is revised, the number of disorders
included increases drastically: the latest has 365, more than doubling
the 182 in the DSM-II. Angell notes a serious lack of scientific
underpinning:
“Not only did the DSM become the bible of
psychiatry, but like the real Bible, it depended a lot on something akin
to revelation. There are no citations of scientific studies to support
its decisions. That is an astonishing omission, because in all medical
publications, whether journal articles or textbooks, statements of fact
are supposed to be supported by citations of published scientific
studies. (There are four separate “sourcebooks” for the current edition
of the DSM that present the rationale for some decisions, along
with references, but that is not the same thing as specific
references.) It may be of much interest for a group of experts to get
together and offer their opinions, but unless these opinions can be
buttressed by evidence, they do not warrant the extraordinary deference
shown to the DSM.”
The connection between drug companies and psychiatrists has always
been congenial—I would call it corrupt. The companies pay for the
doctors to go to conferences, often in vacation-y places, they sponsor
their research, and give them huge fees as consultants and speakers.
Angell notes that in states that must reveal financial connections
between drug companies and doctors, psychiatrists get more largesse than
any other group of physicians. And 20% of the funding of the American
Psychiatric Association (which, of course, publishes the DSM) comes from drug companies.
More than half of the contributors to the new version of the DSM
(95/170) have financial ties to drug companies, “including all of the
contributors to the sections on mood disorders and schizophrenia.”
Drug companies also give a ton of money to patient advocacy groups,
like the National Alliance on Mental Illnesses—groups whose agendas
include a strong push for drug therapy for mental disorders.
Perhaps the most disturbing thing in Angell’s articles is the huge
increase in drug therapy for mental disorders in children, who are often
treated with drugs not approved by the FDA for their diagnosed
disorder. “Juvenile bipolar disorder” increased 40-fold
between 1993 and 2004, and autism more than fivefold. As Angell notes,
“Ten percent of ten-year-old boys now take daily stimulants for
ADHD—’attention deficit/hyperactivity disorder’—and 500,000 children
take antipsychotic drugs.”
Angell and the authors she reviews describe further disturbing
things, like the drug industry’s illegal push to get doctors to
prescribe drugs for conditions for which those drugs haven’t been
approved by the FDA (American Food and Drug Administration). If you are a
patient, or know someone who is, you must have a look. These articles,
and the data presented by Angell, have convinced me more than ever that
medical psychiatry is largely a scam, a rotten-to-the-core coalition
between psychiatrists and pharmaceutical companies. Now I know that
many psychiatrists are deeply motivated to help their patients, for
mental disorders are among the most frustrating and recalcitrant
conditions faced by doctors, and many patients indeed need urgent
medical or therapeutic attention. But the way it’s being done now is
not only ineffective, but positively harmful—although lucrative for
doctors and drug companies. The few researchers and psychiatrists
crying out against the madness, as in the three books under review, are
largely shouting in the wilderness.
UPDATE: To the readers who are taking medications for mental disorders, do not take this post as an incitement to quit your medications.
I hope nobody interpreted my piece this way, but I wanted to make that
crystal clear. I am not a physician and am merely recounting my own
experience, conclusions, and the article of Dr. Angell. But I do urge
you to read that article, whether or not you’re a patient.
I would add, though, that personal testimony that a drug has “helped”
a person is not the same thing as positive results in a double-blind
study. Many people claim that they have been helped by homeopathic
medicine or other “cures” that can’t be documented scientifically. The
placebo effect (which must be operative in homeopathy) is well documented.
Finally, for similar views on the self-serving behavior of the
pharmaceutical industry with respect to treating mental illness, see
Frederick Crews’s (open-access) 2007 NYRB piece, “Talking back to Prozac,” a review of three books on psychiatry and “Big Pharma.”
This is outrageous. You don’t know anything about my depression, keep spouting your propaganda and you’ll be the next who is guilty of misleading a vulnerable person who has sought help and is receiving it well enough.
That’s great, Elliot, that you sought and found help that you want and I’m happy for you. That’s not what this debate is about, though. What about the people who are forced into “treatment” that doesn’t help and that they don’t want? What about the documented long-term and devastating side effects and diminished clinical outcomes? And, what about the misdiagnosed?
“Cannot be more credentialed that this!” says it all. Yes, sir, once can ACTUALLY be a bit more credentialed, though you won’t believe it.
Elliot, your answer to my other comment below says it all,
” At this point even if you were an MD PhD I would still run the other way if I had to meet you face to face”
You are speaking out of “faith”, not reliance on scientific evidence. That has been one of my points all along; psychiatry can be defended as a belief system (just as some people defend their respective faiths or atheism or people stick to homeopathy even though it lacks scientific validity). That is something that I can respect and I see room for regulating psychiatry the way homeopathy is regulated. But the recognition that psychiatry is not scientific should result in it losing all its coercive powers. Those who trust psychiatrists, the way some trust practitioners of homeopathy, should be free to do so. For the rest of us, we should be legally protected from the psychiatric quackery.
“””What the NAMI board failed to do was anticipate the worst and take steps to insure that resources would be readily available to make certain that consumers and their loved ones had information about how dangerous it is to stop medication cold turkey and how withdrawal needs to be done in as safe a fashion as possible. Knowing that NAMI is still primarily a parent organization, that going “off med’s” is a constant fear of many parents, and that Mr. Whitaker was going to present data that questioned the value of medication, NAMI’s convention leadership and board failed in its primary responsibility to provide its members with tools that they needed to protect themselves and their loved ones. “”
Why is the responsibility of the NAMI board? This discussion should be started by every psychiatrist who prescribes any kind of meds. It should go something like this – “Do not cold turkey meds under any circumstance or you greatly risk developing rebound symptoms of withdrawal that will cause alot worse problems than your current situation. If you want to get off of meds, please call me and we will have a serious honest discussion about the issue. If you decide want to get off of them, I will strongly urge a very slow taper that will give you the best chance of success since your body needs time to adjust to a decrease. Meanwhile, I will strongly urge you to develop as many support systems as possible to make this transition as successful as possible.”
Unfortunately, Pete, that is not happening and as a result, people are doing what that mother’s son did. As long as psychiatry takes the all or nothing approach to meds, these stories will sadly continue and it has nothing do with what Robert Whitaker or the NAMI board should have allegedly done.
Also, as revolting as this might sound since Mr. Whitaker isn’t very popular among many people, I strongly urge people to visit his blog and read the entries by Sandra Steingard, a psychiatrist, who is not anti meds. She has spoken about the research that shows that a low dose approach which can greatly reduce side effects is alot more effect over the long run than high doses in case people can’t get off of the meds.
Finally, I don’t think you truly understand why NAMI upsets so many people as this isn’t an issue of being a hater. Thanks to concern about my state passing tougher commitment laws, I worked with a mental health consumers group. These were folks who obviously did not hate psychiatry, ok?
The fear of being forced into the hospital against their will was terrifying to many of these people who had had horrific experiences in that setting. One person had suicidal thoughts every day but was scared to tell her therapist out fear she would be committed against her will. NAMI’s push to make it easier people to get forced treatment has led to this type of situation.
And as you well know, people have posted on other blogs in stating that their in patient hospital experience was so traumatic that they would rather die than seek treatment again. That has nothing to do with being antipsychiatry.
Anyway, I wish this family nothing but the best.
Thanks for your excellent and rational post, AA. You model the kind of calm and compassionate tone that we need in order to have this discussion. I hope others will follow your example. Nobody is trying to hurt people here – everyone is arguing or sharing from their own experience. Anyone who is being fair about reading these should realize that not everyone has the same experience. People really are traumatized in the name of helping, and people really do get better with no medication. And others find psychiatry helpful and feel their medication is necessary for their survival. Those viewpoints are not conflicting, unless we need to believe that our own experiences and beliefs need to invalidate those who experience something different.
Apologies for my grammar mistakes as I didn’t do a very good of editing in my previous post.
Robert has issued a response here: http://www.madinamerica.com/2013/07/my-reply-to-pete-earley-do-i-have-blood-on-my-hands/
Thank you Mr. Earley for writing this article and I agree as a family member who has assisted to keep another family member healthy and surviving for the last ten years. My family member has mental illness and the last ten years have felt like 20, due to the stress experienced when they are not taking meds; or if the treatment needs adjusting by a Dr. until one is found which works. We make the sacrifice of our lives to caretake because we see that when the family member tries on their own, that they do need support that can help make judgement to see, out side of their illness. No one should ever comment, unless they have been in that position -themself. Or gave a damn enough to ensure someone else will survive. If med.’s were not needed -then no one would have mental illness.I work on skid row Los Angeles, for those who would like to see that mental illness exists. We all have lives we want to live, but to not see our loved one in harms way, we extend our love to help them. Not because, we have nothing better to do.
The words of Jerry Coyne via ‘cannotsay’ ring a sad truth.
Desperation, ignorance , and blind faith leads loved ones and their suffering mentally ill to drug first – even be a gunieu pig, for combinations of chemicals that no one has the slightest knowledge of how they affect human pyhsiology! We know more about how alcohol and canabis affects a human than we do any of today’s psychotropics! How disgusting is this? I will go further than Coyne and state that mental illness has been exploited into a factory of “how can we invent more of this feared illness so we, the drug companies, doctors and all that profit can squeeze more profits? ” Play on the fear, the ignorance of mental health issues, turn every spoiled brat into a hyperactive child needing invasive meds, instead of structure, love and common sense. ALL of these children become drug dependant for life.Thatsa lotta dollars. It has been said by Viet Nam Vets themselves, that they were encouraged to drug while in service. The corrupt upper echelon in the USA then had a ready market for the drug trade when they returned. Whether you believe this or not, we need to know that medicine in the U.S. is a dying art. It is now a business and it needs sick people to thrive!!!
If theres a med that helps you to manage your illness, take it. But if you can come to terms with your mental illness without it, then do that.
The travesty – it is easier to write a script. More money in it.
Easier to shut the stigmatizing public up, by drugging the fearsome mentally ill into submission.
The righteous, loving and even holy thing to do would be to learn what causes mental illness, then treat each person individually, as each has a diagnosis as unique as a fingerprint.
To say there is no such thing as mental illness is ridiculous.
There is a balance within the systems of our organism which attempts to balance with our environment and other organisms. This is a fundamental rule. The causes of mental illness are as intricate and many as is required to be in a state of normalcy. In fact, they are the same. What needs to be scientifically addressed is the changes and reactions in our organism that lead toward imbalance. There is far more than chemicals in our brain that contribute to mental illness.
Its the same old story of what perople do to eachother.
“We won’t put you in chains and call you slaves, but we will give you minimum wage and you can still serve us with menial labor”
“We won’t bother to see what caused your mental torment, but we’ll drug you so that the community will feel safe. ! (And we’ll get rich too!)
and if we can figure out how to drug others and make them mentally ill too, who’s gonna stop us?”
This whole series of issues that Pete has raised may seem like a medical and legal issue. It is a moral nightmare. That there are criminals amongst us who develop and dispense drugs of all kinds without knowing their full effects, injuring and murdering many, under the United States flag and with full authorization from our elected leaders is – well – you fill in the blank –
I call it moral decay. The collective and most evil mental illness called greed.
Well Done. As a sufferer of mental illness, I too have questioned the validity of medication from sites such as Beyond Meds and Dr. Whitaker. However with my doctor’s pleading I have decided to stay on it although at times I do feel like I am just perpetuating my doctor’s business and the fear of the unknown of not being on meds is undeniably what keeps me on them. No one wants to be dependant on medication for any reason especially for an illness that is so looked down upon. Please continue your efforts in reform.
I trust the Church of Scientology will not be one of the many faces of NAMI?
My uncle has the schizaphrenia and the scientologists don’t believe in it its sad
If the Church of Sciientology follows the Bible, they would read in the Gospels how Christ healed the mentally ill. Many ancient civilizations hundreds of years B.C.E. document in early written and oral history of mental illness. It was often described as an evil or unknown spirit
possession, as of course, eons ago, our ancestors had little understanding of human science.
I wonder if those who don’t acknowledge mental illness, also denounce the existence of mental retardation and Alzeimers? Hmmm…Perhaps they also believe that psyychopathic serial killers don’t exist?
I hope your uncle is getting the treatment he deserves, and has a right to under our Constitution.