Reddit reviews Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America

It's may be partly because depression is over-diagnosed.

This book argues that we're now diagnosing normal self-limiting periods of grief or stress as mental illness.

For example, if your spouse dies and you experience symptoms of major depression for several months, do you have a physiological illness called depression, or are you going through a completely natural grieving process?

The book also suggests antidepressant use may be perpetuating depression, rather than treating it successfully in the longterm. People may experience symptoms of depression or anxiety during the withdrawal process, think that's their normal state, and go back on the drug to stop the symptoms.

That's not to discount people who legitimately suffer longterm symptoms of severe, unexplained depression and suicidal tendencies.

All of these psych drugs (stimulants like riddalin or adderall, antidepressants like effexor or prozac, antispycotics like seroquel and risperdol, mood stabilizers like lamictal, and benzos like klonopin or xanax) are addictive, and the body reacts to them exactly like it would any street drug. The brain is capable of recovering in some circumstances, but lingering effects can last for years or be permanent. Psych meds are incredibly powerful substances that in some cases can be more powerful than common "street drugs". These are not medications. Instead, pyscg meds are powerful neuroactive substances that are poorly understood. In US society, these drugs are heavily prescribed to all sectors of the population. Including children and pregnant mothers.

In a social sense, these drugs are convenient "control" mechanisms for prisons, psych wards schools. They are also heavily prescribed for depression, anxiety etc. Most of this occurs in the USA, in other countries (excluding the UK) prescription rates are fairly low. Women account for something 2/3 of all psych med drug use, and women are usually responsible for drugging their children.

Riddalin is a common "entry" drug for children. Adderall, vyvanse and provigil are also quite common now. It rarely ends with these stimulants and often progresses to the more powerful antidepressants, antianxity, and antipsycotic medications. That's when the long term and life altering damage can occur.

There's considerable evidence both in the scientific literature and NUMEROUS anecdotal stories on the internet for people who get severe withdrawal from the antianxiety, antidepressant, and antipsycotic drugs. As such, they are not treatment for a disorder, but cause their own dependency and addiction profiles. Psych meds are powerful substances that severely affect the body just like any drug or toxin. There's studies on the long term side effects, and how difficult it is to stop taking the drugs. Sexual side effects can be permanent. This condition is called post-SSRI sexual dysfunction and primarly affects those who take antidepressants.

Some people recover, others never recover. Children almost certainly get permanent damage as their brains are still in development. Lots of dumb ass women take these drugs during pregnancy, damaging their kids brains before they're even born. Then the dumb cunts take it after they give birth, so they are shit mothers doped out on drugs. These are the same dumb cunts who will quickly go to a doctor and start poisoning their kids once the PTA meeting goes badly. Then they'll bitch and moan like the cunts they are about why the kid isn't getting better. Eventually, the poor kid will probably fail to do well in school because the drugs cause brain damage, and the dumb bitch will make his life even more difficult until he escapes at the age of 16 or 18. With brain damage and a dumb bitch as a mother, his life is going to be very difficult. Life is hard enough, life with withdrawal or brain damage can lead to homelessness, jail, lifetime of addiction, and worse. Homelessness due to psych med withdrawal and long term side effects is extremely common for men.

Women have it easy. Even if a young girl gets brain damage, no one will care - standards are so low, and any guy will fuck a girl if she's wet between the legs (or use lube if she can't get wet). If she's got a pulse, she'll never be homeless. Even a heavily brain damaged girl will get a job and a college degree no matter how badly damaged they seem to the world. IF that doesn't work out, she'll just find some dude to take care of her. These drugs primarily affect men, because society puts so much pressure on them. Even small amounts of brain damage, or withdrawal can fuck their careers and futures up permanently.

Scary shit, good reason to never ever send your child into a public school system if it can be helped. Public schools have gotten worse since I was a child. Pyschiatrists and other such doctors"child psychiatrists" are all greedy cunts who want to poison your kid so that they can make some extra money. Most psychiatrists are too brainwashed to understand how the drugs really work, and believe everything the pharmaceutical company tells them like idiots.

Most parents are blue pilled faggots who will listen to the female's desire to do the "right thing". Doing the "right thing" is brain damage to young children with fragile brains. If your child survives the brain damage, he will be prone to addiction and other emotional issues for a very long time. These drugs affect every single part of the brain and especially affect the emotional and sexual portions of the brain.

Also note: there's no such thing as a child dose for these drugs in the literature. They're designed for adults. It's literally GUESSWORK, and everyone reacts differently to different doses. It's a real fucking mess, but doctors pretend they know what they're doing, and are protected from legal repercussions from any consequences these drugs may have on children.

Very few if any studies have been done on children for more than 6 weeks. This is true for stimulants, antidepressants, antipsycotis, mood stabilizers and benzos. There's not much scientific understanding about how these drugs actually work, and there's even less understanding about their long term effects on adults. For children the knowledge is even less thorough.

There's a handful of studies that have been carried out on these drugs for more than 6 weeks in adults, and I don't believe there's ever been one carried out long term in children. The fact is that almost EVERYONE takes these drugs for more than 6 weeks, so there's very little knowledge about how these drugs actually work long term. There is also plenty of evidence that these drugs are no more effective for treating their make believe "diagnoses" than a placebo pill.

There's literally studies that have been carried out which demonstrate that placebo and antidepressants or ADHD meds are equally effective over the longer term. In some studies, patients actually do BETTER for more than 6 weeks on the placebo and those on the drugs do considerably worse. This also holds true for benzodiazepines, and antipsychotic medications as well.

A pulitzer prize finalist (male author) has published two very informative and scientifically based books on the subject of psychiatry and psychiatric medications. He's not a scientologist, just a concerned journalist.

Here's the links for those who are interested:

https://www.amazon.com/Anatomy-Epidemic-Bullets-Psychiatric-Astonishing/dp/0307452425/ref=sr_1_1?ie=UTF8&qid=1527721857&sr=8-1&keywords=anatomy+of+an+epidemic

https://www.amazon.com/Mad-America-Medicine-Enduring-Mistreatment/dp/0465020143/ref=sr_1_fkmr1_2?s=books&ie=UTF8&qid=1527721886&sr=1-2-fkmr1&keywords=made+in+america+robert+whitaker

TLDR: All pysch meds are poorly understood in adults, and very few if any studies have ever been conducted in children. In adults, psych meds can cause severe withdrawal reactions, nerve damage, and permanent sexual dysfunction in both men and women. There's considerable documentation that placebo pills are more effective than psych meds for treating the "diagnosed condition". Robert Whitaker's two books are excellent, easy to read documents that can explain far more than I can on a reddit post.

"I'm on a 10mg daily dose right now, do I even have anything to worry about?"

Longterm benzo use is going to make your anxiety vastly worse than it was to start with. That's why you're never supposed to take them for more than ten days. Time for you to find a new doctor.

But if you want an answer to your question, yes they cause brain damage, and they're also extremely addicting -- more than heroin. (Whereas heroin withdrawals are over in three or four days, longterm benzo users are often completely unable to sleep or think and function properly for up to a full year.)

If you want a good book on the subject, I'd recommend Anatomy of an Epidemic:

http://www.amazon.com/Anatomy-Epidemic-Bullets-Psychiatric-Astonishing/dp/0307452425/ref=sr_1_1?s=books&ie=UTF8&qid=1347671582&sr=1-1&keywords=anatomy+of+an+epidemic

The claim that mental disorders are caused by imbalances in the brain has been heralded for decades in research paid for by pharmaceutical industries. However, the evidence substantiating those claims is very sketchy. Take a look at Robert Whitaker's Anatomy of an Epidemic for a comprehensive overview of the scientific evidence. It strongly suggests that the claim for mental disorders being cause by faulty brains is not consistent with the best evidence.

Dr. Raine,

Kudos to you sir, rarely is an IAMA filled with so many thoroughly well-informed students of the OP's area of expertise. You have an erudite fan base.

My question -
Are you familiar with the book Anatomy of an Epidemic? (My guess is yes,.. if only due to the similarity in titles!)

Do you have an opinion on the argument that Mr. Whitaker put forth that the application of psychiatric drug-based interventions with the goal of improving mental health appears to result in (on average) dramatically worse long term results? Perhaps even driving patients further up the scale of mental illness in the interests of relieving short tern symptoms.

Mr. Whitaker puts together a convincing (to me, a layman) foundation of studies and research that seem to show we are "re-wiring brains" and not for the better with drug interventions.

Follow-up question -
I have ordered your book (just now) so perhaps you address this there. In your synopsis you say that your studies may help "identify violent offenders early in life [potentially informing] crime-prevention policies" - are you concerned about the inefficacy of intervention-directed policies in the hands of government bureaucratic oversight?

BTW - I can't speak for Mr. Whitaker or Anatomy of an Epidemic - I hope I have gotten his thesis right in my question.

Dang it, now I have to defend my responses! ; )

There are books and books on psychiatry's history as well as it's problems. I know it sounds like a conspiracy theory but there's just so much to it and there are so many levels. It's very complicated...the bio-medical model is great for treating things like polio, bacterial infections, and stomach aches, but in terms of mental illness there are so many more variables going on. You can't say that something like depression is simply a chemical imbalance and therefor you need medication. That's so reductive it hurts. That's like saying a headache is an Advil imbalance. Brain chemistry is important but it is over emphasized. Also think about the side effects of medication.

I think you missed my last point. Drug companies want wider diagnoses and more loose criteria in the DSM so more people can be diagnosed and prescribed and thus the companies can make more money.

The below book completely changed my view. It documents the rise and history of psychiatry as well as its outcomes. Tons of research backing in the book. It's not just some guy rambling but some guy rambling with research and data to back it up.

http://www.amazon.com/Anatomy-Epidemic-Bullets-Psychiatric-Astonishing/dp/0307452425

I have posted a link here once but don't speak for others in this sub in any way, of course. I am writing off the cuff and won't cite studies, but if anyone needs to corroborate these statements I refer you to Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America by Rober Whitaker for a journalistically sound statement of the argument and some of the relevant studies on the harmful effects of modern psychiatric drugs, as well as a beautiful glimpse at the end of the kind of effective, social treatment that might replace them.

Among other things, I find the zeal with which the psychiatry-marketing complex has defended and continues to tacitly promote the simple neurotransmitter chemical imbalance model of depression and other mental illness fairly disingenuous. This is true especially given its use to justify drugs that are obviously sedatives and tranquilizers, or performance enhancers geared towards reassuring the parents of underachieving students.

The clear and effective purpose of these drugs, in an institutional or community setting, is to make the patient easier to handle, not to cure the disease. By advertising the latter as their intention and promise, drug manufacturers and marketers are opening up a new market of voluntary patients in addition to the existing market seeking sedatives with which to control patients and family members whose symptoms make them hard to handle.

The drugs and their marketers have the effect of converting patients into consumers, not only of drugs for the initial diagnosis or episode but for the drugs used to balance the reaction to those - somehow the option of stopping the first drug in the case of a less than expected response has been virtually replaced by a norm of adding 'complementary' drugs to try and optimize the response.

This flies in the face of common sense trial and error medicine and also creates lifetime multidrug consumers. This pattern is not very flattering for those whose wealth is built on these products.

This process, which thrives on emergency room institutional commitment and justificatory diagnoses, skews the diagnostic methodology as it obscures the quite plausible causal role of the initial drugs in the manifestation of 'symptoms' of a later or conclusive diagnosis. Robert Whitaker conveys the prevalence of this kind of revisionary diagnosis to include symptoms of drug withdrawal or long-term use well in his book and I don't claim to represent it as cogently as is warrented, but I think this aspect reveals some of the nuance in the criticism that distinguishes it from simply believing "that it's all bs".

The suspicion is not that the illness or symptoms do not exist, in the sense that the patient is suffering, but that the worst of them (very frequently not the initiailly displayed symptoms) might be symptoms of poisoning from these other drug treatments or of the combined drug stupor and isolation from community and society. In other words the symptoms might not be the end-all, labeled-and-medicated-for-life huge issue we often treat them as, if the people had adequate social support. We might be creating these lifetime multidrug consumers in direct opposition to their best interests as patients of mental illness.

Unfortunately, these patterns and market forces have inhibited and led to the suppression of those who would carry forth research into the long-term effects of these medications, meaning we cannot yet know how damaging these treatments are in the long term. Abnormal outbursts upon stopping psychiatric medication have been overwhelmingly interpreted as psychotic breaks rather than dangerous somatic reactions to the drug and its withdrawal - again justifying continued medication, often at a higher dose. It appears as though secondary diagnosis has been used to mask what may be long-term damage caused by these drugs, and revelations about the ubiquity and multifunctionality of neurotransmitters in the body make urgent the need to understand the implications of our heavy-handed attempts at 'rebalancing' someone's brain chemistry.

A fictional example: an initial, often childhood diagnosis of AD(H)D for manic symptoms, treated with amphetamines (known to cause distinct crashes), precedes the appearance of depressive periods or lethargic moods, followed sometime later, likely in middle or high school, by a diagnosis of manic-depressive (bipolar) disorder for which antipsychotics or sedatives are added to the mix. Because he began medication as a child, the patient has no regular pattern of talk therapy where he can hash out his moods and feelings with an informed professional, and he is alienated and simultaneously romanticizes his condition and flaunts his medication schedule (or seeks higher dosages and sells a portion of his prescription) as he sees fit, confusing his medical history. Enough hospital-worthy episodes later, with increasing (drug-induced?) delirium, or perhaps when he has an episode that threatens his college graduation or career, and the patient is likely to be deemed schizophrenic and the drug cocktail made stronger and more hallucinatory.

Eventually, when his family supports wither and he is alone, he falls through the cracks and ends up committed. His diagnosis justifies his lifetime institutionalization and continued, expanded medication - now with even less input from the patient and far less credibility given to his personal narrative, which by this point has been strung out on multiple drugs for years. His symptoms, or possibly the consequences of a childhood and adolescence spent on multiple psychotropic drugs, have impeded the development of healthy living habits and social literacy, which further justifies his need for 'assisted living' and forced medication in a locked ward, at the expense of family members or insurers once the patient's own estate has been expended.

This illustration sounds extreme in a few paragraphs but it is not so far from how these things play out all too often in the US right now. And the age of initial diagnosis is creeping younger and younger at an unsettling rate. Part of why I follow this sub is to keep abreast of changes in diagnostic criteria like the introduction of childhood flavors of adult mental illness.

In response to your first question, although I am not any authority in this sub at all, I think it's important to realize the difference between 'anti-psychiatry' and 'anti-psychology' - I, for one, believe that talk therapy, proceeding from potentially multiple psychological traditions, can be very effective treatment and possibly sufficient for most, except for the very real expense involved in providing the time and attention that would be effective and the pursuant difficulty in reaching the most vulnerable populations. Every one of us, and especially those who have been cut off from normative communication with society by mental illness, need the loving attention of the people in their lives in order to flourish and function healthily in the group, and in an ideal world I think we would do well to provide psychologists where family supports are lacking or inadequate.

On the other hand mass psychiatry, the medicalizing of societally unfit personality presentations and subsequent drug treatment, feels like a dangerous road for us to travel, a shortcut to a numb consumer populace and a profit venture masquerading as individualized mental healthcare.

TL;DR: Critical of motivations and methodology as well as the existing diagnostic criteria born of those.

There's a fantastic book that addresses a lot of these points: https://www.amazon.com/gp/aw/d/0307452425/ref=tmm_pap_title_0?ie=UTF8&qid=&sr=

While I wholeheartedly agree psychiatric drugs should not be the go-to for children, talking to a therapist or another mental health professional can be highly beneficial, and drugs don't even need to be in the equation. In fact, Amber said "i want you to talk to a therapist" not, "I want you to see a psychiatrist." Also, Gary doesn't seem to be providing any coping mechanisms, whereas Amber says "There's things we can do to take your mind off it"

The most scathing critiques of psychiatry are from people who have been maimed by it.

This book can change one's view of the benevolence & competence of the enterprise. "Religion" has nothing to do with it.

> these people were prescribed ADs for a reason, no?

Check out Anatomy of an Epidemic by Robert Whitaker - https://www.amazon.com/Anatomy-Epidemic-Bullets-Psychiatric-Astonishing/dp/0307452425

Yes, but probably not the reason you're thinking. The answer is $$$$, control and the belief that a pill will be a panacea for all of life's problems.

This matches with what I recently read in Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America by Robert Whitaker where he shows that the number of people labeled as disabled due to mental illness has tripled during the past 20 years.

If they are "disabled" then they certainly are a part of the increased burden on the system.

Yeah, I get that. I think one of the major successes in the 20th Century was the movement toward medicalizing mental health issues so that they were given the credit they deserve. We know these experiences are a problem, and people having them are subject to many layers of oppression and human rights violations, and psychiatry has made a lot of strides towards these issues being taken far more seriously. I do also believe that psychiatry and pharmaceuticals do help some people. It is one option, and many people find their life more manageable because they have taken that route, and that's a beautiful thing and I'm very happy for anyone who has found solace there. But it is not universally true, and one of the reasons for that is how imprecise the science actually is on what is going on with the mind, and what the drugs are actually doing. The most famous example is the notion that depression is the result of lower than usual seratonin levels in the brain, which was actually the result of an ad that was using a study that had found that more people with depression in the study had higher levels of seratonin. But they had a drug that dealt with lower seratonin levels, so that's the narrative that was created (links below). Point being, (and see The Anatomy of Melancholy by Robert Burton on this), there is no chemical test for depression because there are many potential causes, and remedies. Psychiatry and the DSM have categorized these experiences, which I agree is a necessary thing to research them, but then got fully entwined with pharma. Now policies and laws impose that one narrative onto people who are going through these experiences, even though they often get it very wrong.


There are alternatives, and the Soteria house project by Lorne Mosher was one of the most interesting, where they took people with severe schizophrenia and had a virtually drug free approach, and their results were better than the alternatives. The problem for scaling up was that it did not put people on a lifelong hook for medication. So, I guess it's not about wanting to tear it all down, but I think people should know what's up, they should be informed about all the studies done on the chemicals they are taking, what all the side affects might be, and, ideally, alternative approaches that may benefit them in the long run. I think people going through these experiences should be given the rights and power to make decisions, including whether or not they will self-identify with the DSM categories at all.


I cannot stress the following enough, the result of extensive studies by the World Health Organization, as articulated by Robert Whitaker: "Most Americans are unaware that the World Health Organization (WHO) has repeatedly found that long-term schizophrenia outcomes are much worse in the USA and other developed countries than in poor ones such as India and Nigeria, where relatively few patients are on anti-psychotic medications. In undeveloped countries, nearly two-thirds of schizophrenia patients are doing fairly well five years after initial diagnosis; about 40% have basically recovered. But in the USA and other developed countries, most patients become chronically ill. The outcome differences are so marked that WHO concluded that living in a developed country is a strong predictor that a patient will never fully recover."

Sources:

Lorne Mosher's resignation letter from the APA

The Icarus Project (theicarusproject.net): "We are a support network and media project by and for people who experience the world in ways that are often diagnosed as mental illness. We envision a new culture that allows the space and freedom for exploring different states of being, and recognizes that breakdown can be the entrance to breakthrough. We aim to create a language that is so vast and rich that it expresses the infinite diversity of human experiences."

Soteria: From Madness to Deliverance, by Lorne Mosher

Mad in America by Robert Whitaker

Anatomy of an Epidemic by Robert Whitaker

The Anti-Depressant Era by David Healy

The Invisible Landscape: Mind, Hallucinogens, and the I Ching by Terence McKenna

The Archaic Revival: Speculations on Psychedelic Mushrooms, the Amazon, Virtual Reality, UFOs, Evolution, Shamanism, the Rebirth of the Goddess, and the End of History by Terence McKenna

The point is to try and empower people to improve their lives, and since we don't know how to do that universally, giving people the power and options to be able to choose methods that work for them is a vital part of maintaining their autonomy and preserving their fundamental human rights. I find this subject is very difficult to discuss without it getting heated. Please understand I have so much sympathy for your experiences. I have tried to take care of people while they were in the midst of full psychotic breaks, I have had to call the police, I have had to participate in the forced hospitalization of people I have known, I have lost too many people to suicide. I know these things and they still hurt and I am welling up thinking about all of them. And I care about you too, and you're not alone.

Sorry re length.

-unless they voice the want to be off of them. In which case they will need your support.

Edit: Allow me to direct all of you to this book which I found recommended on Reddit concerning mental illness and medication. It gives a good objective exploration of the history of mental illness and its treatment, and the history of the varying medications itself. As a sufferer, I find it very informative. It's helped me come to important decisions for my own foture.

I think I read about it in this book... https://www.amazon.com/Anatomy-Epidemic-Bullets-Psychiatric-Astonishing/dp/0307452425

I used hyperbole and satire on purpose. At some point I realized I cant even convince people in person, with sources. They WANT to believe the pills will work as it gives them a sense of hope and security. On the surface it appears to be cognitive dissonance, but in reality I have come to believe ignorance is bliss. It is too much a leap of the imagination to even entertain the idea that consumers and their doctors have been mislead for the sake of obedient workers and corporate profits. On a side note, Prozac LITERALLY turns people into zombies, that is not hyperbole.

But fuck it, I can try again. Lucky for the lazy, 2 of 4 sources are videos.

Article 1) The Strange Powers of the Placebo Effect (video)

Article 2) Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration


>Conclusion: Drug–placebo differences in antidepressant efficacy increase as a function of baseline severity, but are relatively small even for severely depressed patients. The relationship between initial severity and antidepressant efficacy is attributable to decreased responsiveness to placebo among very severely depressed patients, rather than to increased responsiveness to medication.
Ergo: Antidepressants are no more effective than placebo except in the most statistically extreme cases. In those cases, drugs do not perform better but placebo performs worse.

Article 3) Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America by Robert Whitaker

Article 4) RSA Animate - Changing Education Paradigms by Sir Ken Robinson (video)

IF you think I am a crazy loon, click article 4 first, and just watch.

I suggest everyone considering the possibility that their doctors opinion is bought and paid for. Said doctor may not realize they are a pawn and may honestly believe they are helping you. Also understand there is little law requiring they stay up to date on modern studies after they receive their certification. You may be receiving information which has long since been disproven, yet the drug companies have no reason to spread such information.

A conspiracy theory explains an event as being the result of an alleged plot by a covert group or organization or, more broadly, the idea that important political, social or economic events are the products of secret plots that are largely unknown to the general public. Just because you're paranoid, doesn't mean they're not following you.

Your alternative option is to believe there is no conspiracy. Because they clearly know what they are talking about, and I am a kook/crank. If you cannot even hypothetically enter into a though experiment on the subject and temporary accept my premise for the sake of a socratic dialog, I have wasted my time for the system has already won and you are no longer a free thinker.

tldr: I give up, satire is the only way to push peoples buttons enough to even get them to look into the issue. Even then no one on pills cares enough.

>I can't speak for medical doctors but it's not widespread in the mental health field which, as I say above, is more focused on the biopsychosocial model.

I'm guessing you're trained in a relatively enlightened form of psychology or social work or another field, rather than psychiatry. Psychiatrists consider theselves in the mental health field, and they go to medical school, so they also consider themselves doctors.

>That isn't to say that it's never right to focus on biological causes of disorders. I'm skeptical of some attempts to support such claims (like saying that since there are brain differences then it must be biological) but that doesn't make it necessarily wrong.
With schizophrenia in particular I was under the impression that there is some good evidence for biological causes. With the exception of people like Mosher and Bentall, I can't think of many researchers that oppose it. Their book 'Models of Madness' was quite good but I think they make similar mistakes in the opposite direction, of presenting bad evidence in support of environmental causes.

It's my understanding that in the olden days, people with behavioral symptoms related to things like viral encephalitis which were clearly biological in origin were considered schizophrenics. (have you read Robert Whitaker by the way? You could probably pick apart his arguments if you want, but definitely worth a read. Anyway, there's definitely biological causes for undesired emotional/behavioral experiences. Interestingly, as soon as one is discovered, those patients are no longer under psychiatric purview - they go to neurologists or infectious disease docs or whatever. I think this reinforces your point that mental health practitioners have a corresponding opportunity to work outside models of biological causality, and are missing the point (or lying) if they're claiming neurotransmitters are the primary cause of mental illness. I think this is also why I get so frustrated and angry when they are so quick to prescribe SSRI's and implying that they are a disease treatment, rather than offering them up as neuroactive compounds that a person may find helpful (as in managing symptoms, not curing disease).

>1) I don't think the DSM encourages any particular treatment option over the other,

Either way, in practice psychiatrists encourage drugs. Their hammer makes your problem look like a nail.

2) even if disorders aren't biological, it doesn't mean biological treatments aren't the best option. Behaviors and thoughts still need to go through the brain and so manipulating the brain directly can be the best treatment option - and not just to "relieve symptoms".

Now here is a fruitful topic of discussion. Key word is "can be" the best option. For some. We need to be honest about the fact that they may also not be for others. I drink coffee routinely to treat my sleepiness and/or lack of motivation, and for now, it works for me. I wouldn't try and strongly suggest that you do the same under the guise of science. Furthermore, there is mounting evidence that these meds (though often effective in a positive way over short time scales) are causing severe side effects over the long-term. Symptoms like akethesia, diabetes, tardive dyskinesia, just to name a few. And we are still using electroshock in this country, which is really saddening to me.

>For example even if ADHD wasn't biologically caused, we still know that medication is the best treatment. Conversely, just because a disorder is biologically caused it doesn't mean non-biological treatments aren't the best option (e.g autism with behavioral therapy).

Disagree on all fronts. My brother was diagnosed with ADHD when we were kids, and that altered his identity. To this day his self-confidence in himself is very weak. He never was able to develop tools to focus, or the confidence that he could be a self-sufficient person. Adderall most definitely produces results that parents, teachers, and psychiatrists are going to like. I wouldn't conclude that this is the 'best'. And what's 'best'? By what metric of success? I advocate a flexible model of treatment. If a patient wants to try pills, then go for it; if they want to try CBT or ACT, or meditation and exercise, by all means! When a therapist accompanies a patient through his/her own journey and allows them to grow in self-determination, I almost think THAT's what heals most, and the specific techniques matter much less.

I'm going to bed; this was a good discussion - would be fun to talk more sometime.

>I'm guessing you're trained in a relatively enlightened form of psychology or social work or another field, rather than psychiatry. Psychiatrists consider theselves in the mental health field, and they go to medical school, so they also consider themselves doctors.

Psychology is my field, I don't think I had a particularly enlightened education or career though. And I've known a few psychiatrists but none of them seem to fit the description you have of them.

And yeah they do consider themselves doctors because they are.

>It's my understanding that in the olden days, people with behavioral symptoms related to things like viral encephalitis which were clearly biological in origin were considered schizophrenics.

I can't say for sure as I don't know enough about that specific issue but there's a difference between something being a biological cause of a mental disorder and something being a brain disease.

> (have you read Robert Whitaker by the way? You could probably pick apart his arguments if you want, but definitely worth a read.

I might check it out if I can stomach it but I generally steer clear of Whittaker as he's well known for misrepresenting the field..

>Anyway, there's definitely biological causes for undesired emotional/behavioral experiences. Interestingly, as soon as one is discovered, those patients are no longer under psychiatric purview - they go to neurologists or infectious disease docs or whatever. I think this reinforces your point that mental health practitioners have a corresponding opportunity to work outside models of biological causality, and are missing the point (or lying) if they're claiming neurotransmitters are the primary cause of mental illness. I think this is also why I get so frustrated and angry when they are so quick to prescribe SSRI's and implying that they are a disease treatment, rather than offering them up as neuroactive compounds that a person may find helpful (as in managing symptoms, not curing disease).

As I say above, I think there is a difference between a brain disease and a biological cause. If someone gets syphilis then it's not a mental disorder, but if someone is born with a particular brain makeup that leads to the development of some disorder, then that's a mental disorder.

>>1) I don't think the DSM encourages any particular treatment option over the other,

>Either way, in practice psychiatrists encourage drugs. Their hammer makes your problem look like a nail.

They do as they are medical doctors but that's not their only treatment option and they usually work in unison with psychologists to provide all relevant treatment options.

>Now here is a fruitful topic of discussion. Key word is "can be" the best option. For some. We need to be honest about the fact that they may also not be for others. I drink coffee routinely to treat my sleepiness and/or lack of motivation, and for now, it works for me. I wouldn't try and strongly suggest that you do the same under the guise of science.

Absolutely but this is a well recognised fact. That's why psychiatrists will continually monitor the effectiveness of the drugs and it's dosage, and provide psychotherapies where applicable.

To be clear, I'm talking about good practice here and not suggesting this occurs in every case.

>Furthermore, there is mounting evidence that these meds (though often effective in a positive way over short time scales) are causing severe side effects over the long-term. Symptoms like akethesia, diabetes, tardive dyskinesia, just to name a few.

Definitely! But two points here: 1) all medications have this issue, and 2) not medicating someone has worse consequences than the side effects.

>And we are still using electroshock in this country, which is really saddening to me.

ECT is an effective treatment option which can be a life saver for many people.

>Disagree on all fronts. My brother was diagnosed with ADHD when we were kids, and that altered his identity. To this day his self-confidence in himself is very weak. He never was able to develop tools to focus, or the confidence that he could be a self-sufficient person.

What makes you think that was the drugs and not the ADHD?

>Adderall most definitely produces results that parents, teachers, and psychiatrists are going to like. I wouldn't conclude that this is the 'best'.

The primary measure of success is usually how the patient feels and an effective treatment is one that generally increases their autonomy and ability to function.

>And what's 'best'? By what metric of success? I advocate a flexible model of treatment. If a patient wants to try pills, then go for it; if they want to try CBT or ACT, or meditation and exercise, by all means! When a therapist accompanies a patient through his/her own journey and allows them to grow in self-determination, I almost think THAT's what heals most, and the specific techniques matter much less.

Sort of agreed. Patients should be allowed to choose their path but the professional must ensure that the patient is being given the best information and they recommend treatments that evidence shows will be most effective for the individual.

I don't think it's as widely accepted in science as you claim it is.

Here is a meta analysis of all of the trials submitted to the FDA for licensing of 4 anti-depressant drugs: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.0050045

They found that when you put all the data together the difference between placebo and anti-depressant is negligible. Even in severely depressed patients the difference was clinically insignificant. In any case if you thought that these drugs were effective then this is not what you would expect after collating all of the data.

Not only that, but there is also evidence suggesting that antidepressants may actually make long term outcomes for patients worse than if they never took any treatment at all.

Here is a page that offers a host of studies into long term outcomes: http://robertwhitaker.org/robertwhitaker.org/Depression.html

If you are really interested in hearing criticisms of the current treatment of mental illness then I recommend you check out some of these books:

Cracked: Why Psychiatry is Doing More Harm Than Good

Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

Anatomy of an Epidemic

The Emperor's New Drugs: Exploding the Antidepressant Myth

The Myth of the Chemical Cure

Deadly Medicines and Organised Crime: How big pharma has corrupted healthcare

> as you can probably tell this is still an issue of much contention for me

Seems like you still are a little unsure about the route you are taking with the psychiatric medications. I'd advise a smart guy like you might want to check out some of the current controversy re: long term treatment with these medications.

"anatomy of an epidemic" by robert whittaker is a great book that tries to look at the evidence base for psychiatric drugs .. written by a reporter.

amazon link : http://www.amazon.com/Anatomy-Epidemic-Bullets-Psychiatric-Astonishing/dp/0307452425/

Read this book: Anatomy of an Epidemic. I ran the medication gauntlet for ten years as well and I can tell you there is a lot of misinformation out there about brains and chemicals.

Lucky for you, 2 of 4 sources are videos.

Article 1) The Strange Powers of the Placebo Effect - http://www.youtube.com/watch?v=yfRVCaA5o18

Article 2) Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration - http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0050045


>Conclusion: Drug–placebo differences in antidepressant efficacy increase as a function of baseline severity, but are relatively small even for severely depressed patients. The relationship between initial severity and antidepressant efficacy is attributable to decreased responsiveness to placebo among very severely depressed patients, rather than to increased responsiveness to medication.
Ergo: Antidepressants are no more effective than placebo except in the most statistically extreme cases. In those cases, drugs do not perform better but placebo performs worse.

Article 3) Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America by Robert Whitaker - http://www.amazon.com/Anatomy-Epidemic-Bullets-Psychiatric-Astonishing/dp/0307452425

Article 4) RSA Animate - Changing Education Paradigms by Sir Ken Robinson http://www.youtube.com/watch?v=zDZFcDGpL4U&t=3m26s

IF you think I am a crazy loon, click article 4 first, and just watch.

You are welcome to talk to your doctor, but I suggest considering the possibility that their opinion is bought and paid for. They may not realize they are a pawn, and they may honestly believe they are helping you. In addition, understand there is little law requiring they stay up to date on modern studies after they receive their certification. You may be receiving information which has long since been disproven.

Your alternative option is to take the advice below. "Go see a medical doctor. There is no conspiracy." Because they clearly know what they are talking about, and I am a kook/crank. This could also serve as a lesson. Just because the majority of people believe something, mass approval does not equate with accuracy.

I do have a source? I just told you. The image is a picture of text that IS from an academic source.

> Being an academic does not make everything you do academia

Ok but being an academic doing academic work does.

> has no peer review process and clearly has an agenda (promoting "psychiatric drug withdrawal). It's not academic. It's simply promoting pseudoscience and selling "education" for $100 a module.

and it links to academic papers... Mad in america is an aggregate for the papers not its publisher...

> If you want to talk goal posting shifting, why are you discussing SSRI's now? They're an entirely different class of drugs and aren't even used to treat adhd. So I take it you don't have anything to add about the long term impacts of stimulants and we'll call that one settled.

Because the discussion was about psychiatric drugs. I have never mentioned stimulants nor do I really care about the efficacy of them.

> Not for adhd. And even for the shift to discussing depression it doesn't support your claim.

Im not talking about adhd, well if that one paper is off there is a whole book on it.

Western mental health services are far more pseudoscience than psychics. Western mental health has little scientific basis. It is also used as a tool of both church and state to punish dissidents.

Read the following before commenting further.

http://www.amazon.com/Mad-America-Medicine-Enduring-Mistreatment/dp/0465020143

http://www.amazon.com/Anatomy-Epidemic-Bullets-Psychiatric-Astonishing/dp/0307452425