Why can’t we treat depression as an illness with your six natural antidepressants as the primary treatment? Pharmaceutical antidepressants have their place too, but they should not be given so blindly. At the same time, they should not automatically be ruled out because they can help people.

Joanna Moncrieff, herself a psychiatrist at University College London, has written a truly wonderful book: The Myth of the Chemical Cure (2009). She has this to say:

“My thesis in this book is that the disease-centred model of drug action has been adopted, and recently widely publicised, not because evidence for it is compelling, but because it helped promote the interests of certain powerful social groups, namely the psychiatric profession, the pharmaceutical industry, and the modern state. Therefore, I offer the following study as an example of the way in which vested interests and the political environment can distort knowledge, in this case successfully deluding most of society for over half a century.” (p 13)

And later in the same volume:

“The data surveyed in this book suggest that psychiatric drug treatment is currently administered on the basis of a huge collective myth; the myth that psychiatric drugs act by correcting the biological basis of psychiatric symptoms or diseases. We have seen that for the three main classes of drugs used in psychiatry there is no evidence to substantiate this view. Instead, the evidence suggests that these drugs induce characteristic abnormal states that can account for their so-called therapeutic effects. This book has been about how and why this myth of psychiatric drugs as ‘chemical cures’ was constructed and sustained.” (p. 237)

Robert Whitaker has two books in print on these topics: Mad in America (2002) and Anatomy of an Epidemic (2010).

You mention the question of suicide, and of course this is the bio-psychiatric contingent’s trump card. Nobody wants to have a suicide on their conscience, and the bio-psychiatric lobby has established the myth that anti-depressant drugs are the best way to prevent this – indeed the only way. Robert Whitaker devotes a good deal of attention to this question in Anatomy of an Epidemic, and it is clear that the efficacy of anti-depressant drugs in this regard is not as straight-forward as the pharmaceutical companies would have us believe. In fact, there are indications that some anti-depressant drugs increase the risk of suicide.

As a general principle, I refer to pharmaceutical products that are designed to alter mood and behavior as drugs. Medicines, in contrast, are for treating illness. Encouraging the use of the term “medication” to refer to their psychotropic products is just one of the ways that the bio-psychiatric lobby has developed and promoted their spurious philosophy.

You refer to the myth that “there has been no progress in psychiatry apart from the development of useful drugs.” This is indeed widely believed and actively promoted. In reality there had been some great developments by psychiatrists prior to the drug era. Eric Berne’s Games People Play (1964) was, and is, a classic analysis of human interaction. Harry Stack Sullivan, a psychiatrist who wrote extensively and with insight on human relations, is dismissed by modern psychiatrists as irrelevant. And so on.

The problem for psychiatrists is that the problems they purport to treat are not illnesses. But for turf protection reasons they have to pretend that they are illnesses. The inevitable shoe-horning of ordinary human problems into a medical mold creates an untenable level of tension. I once heard a psychiatrist remark that some day the bio-psychiatric edifice will come tumbling down and “we’ll all have to find honest work.” Well, of course, vast resources are being expended to shore it up. So we’ll see. The fundamental question is: what does one mean by the term “illness.” My definition is: something going wrong with the organism either from internal malfunction or from external attack. But the bio-psychiatric lobby will argue for a much more inclusive definition. In a reply (#2) in the comment section under another post I have discussed the problem with the APA’s definition of a mental disorder. Their definition can be paraphrased as: any problem of living. So, of course, they can expand their turf endlessly.

You are correct in drawing attention to the guidelines of the professional psychiatric bodies, or standards of care. And at present the standards of care in this area enshrine the spurious bio-psychiatric position.

And so it goes. Life’s problems are complex and will never succumb to simplistic explanations or solutions. Once again, thanks for your comment. I believe you are correct in not encouraging or discouraging individuals with regards to anti-depressants. In my experience, some people like to use drugs (street or pharmaceutical); others don’t. Some feel they derive benefit from these products. But there are always costs!

You point out that most children can be seen as meeting the DSM criteria for ADHD. This is one of my major criticisms of the system. The criteria are so elastic that virtually anybody can be embraced.

Your identification of sleep deprivation as a major issue is profound. In my view, lack of sleep plays a major role in many childhood problems. The APA position is that children behave dysfunctionally because they have mental illnesses. My position is that the reason for dysfunctional behavior is almost always something much more mundane, such as ineffective discipline, or, as you point out, insufficient sleep. Tragically, the APA has already trumped this position, by including lack of sleep as a mental disorder in its own right! And of course, the treatment is: sleeping pills. So the dysfunctional behavior is a mental illness, and the lack of sleep is another mental illness! And business is booming for psychiatrists and pharmaceutical companies.

I am glad that your parents had the good sense to reject the “official” medical wisdom and that they didn’t send you down the “primrose path” of diagnoses and drugs. The pressure on parents to toe the line in this area is truly enormous. Parents are told that the child has an “illness” and needs “medication.” “If your child had diabetes, wouldn’t you want him to have insulin? Well this is the same kind of thing.” Etc., etc. The vehemence with which these spurious positions are promoted has to be seen to be believed. So your parents did well to resist this.

Finally, you mention sleep routine. In my view this is a critical component of child-rearing, but one which is often neglected. Children are allowed to stay up very late perhaps to watch a TV show or to finish homework that should have been done earlier, etc. But they still have to get up early to catch the school bus. The results are as you describe.

Once again, thanks for your comment. I’m glad things are going well for you.

You are correct with regards to the so-called mental health statistics. The scary thing, though, is that if the 50+ people you mention were to present themselves at a mental health center asking for any kind of supportive counseling or help, they would all be given a diagnosis. Business is business, and you don’t turn away paying clients. Which, within reason, is fair enough. What I object to, though, is the blatant lie that these individuals have an illness. Tragically, vast numbers of American accept this notion of themselves as somehow “damaged” and some even carry the stigma as a badge. (“I’m bipolar;” “I’m an adult ADHD,” etc.)

Your statement: “Whenever I hit a low, I need to remind myself I must ride it out” struck me as particularly important. In my post on depression I make the point that depression is not an illness, but rather is a message from our bodies telling us that we need to make some changes. If we make some changes and “ride it out” things get better.

Your final paragraph makes a lot of sense, though I would quibble with your use of the word “medicine”. I prefer to describe these products as “drugs”. In my view medicine is something you take when you are sick. Drugs are something you take when you want to chemically alter your mood or behavior. The central theme of my blog is that the so-called mental illnesses are not illnesses at all, but, rather, are problems of living. Anti-depressants, anxiolytics, neuroleptics, etc., are drugs, essentially in the same category as heroin, cocaine, crystal meth, marijuana, etc.. My position is not that people shouldn’t take drugs. People do what they do. My problem is with psychiatrists prescribing drugs to people (including very young children) under the pretense that they are medicating an illness.

Anyway, thanks again for your thoughtful comment which raised interesting issues.