A Behavioral Approach to Mental Disorders

The FDA recently approved paroxetine (which in higher doses is marketed as the antidepressant Paxil) as a nonhormonal treatment for hot flashes in menopausal women. The drug will be marketed as Brisdelle. According to a New York Times article F.D.A. Approves a Drug for Hot Flashes, the approval was granted despite the fact that FDA’s own advisory committee voted 10 to 4 last March against approval. The reported reason for the negative vote was that in clinical trials, Brisdelle proved only minimally effective. ...

BACKGROUND As I suppose everyone knows by now, psychiatry has been on the receiving end of some very serious criticism in recent years. The criticism has come from many sources, including: survivors of psychiatric “treatment,” non-psychiatric mental health practitioners, journalists, the general public, and even from some psychiatrists themselves. The content of the criticisms has been equally varied, and includes: that the concept of mental illness is fundamentally spurious and devoid of explanatory significance; that psychiatric “treatment” (i.e. drugging people) is ineffective, physically damaging and disempowering; that psychiatry has forged and continues to maintain corrupt and corrupting relationships with the pharmaceutical industry with regards to the peddling of drugs and the hijacking of research for commercial ends; etc… ...

There’s a Mail Online article about high numbers of antidepressant prescriptions in Blaenau Gwent. The article is dated June 29, and was drawn to my attention by Nanu Grewal from Australia. The article is about a town in Wales where reportedly one sixth of the population is taking antidepressants. That’s about 17%. So presumably all these people have brain disease. Or perhaps it’s because the unemployment rate is double the national average. That in itself is depressing, but to make matters even worse, a “diagnosis” of depression can reportedly help a person qualify for additional government benefits – a strong temptation for people living below the poverty line. ...

There’s a must-read article on Leonie’s Blog: The grieving mother is at it again! Leonie lost a son to suicide four years ago. The suicide occurred 17 days after he started citalopram, an SSRI, marketed as Celexa. Leonie heard a ‘science expert’ on the radio this week attributing depression to low serotonin levels in the brain. Leonie asks: "How can these idiots keep spouting the ‘chemical imbalance’ rubbish? It is drug company propaganda at its best and has no scientific basis, no factually based evidence whatsoever to conclude that depression is anything other than a reaction to life itself." ...

Joanna Moncrieff, MD, has an article up on Mad in America. It’s called Antipsychotics and Brain Shrinkage: An Update, and is dated June 19. Joanna Moncrieff is the author of The Myth of the Chemical Cure, a widely-read book which challenges the entire concept of mental illness. In the book Dr. Moncrieff also makes the point that the brain shrinkage associated with a “diagnosis” of “schizophrenia” is in fact caused by the neuroleptic drugs, and is not, as psychiatrists claim, a consequence of the so-called illness. ...

There’s a recent post, The role of the psychologist in social change, on Peter Kinderman’s blog that is well worth reading. Peter begins with Martin Luther King’s 1967 statement: “…there are some things in our society, some things in our world, to which we … must always be maladjusted if we are to be people of good will." It is a fact that many, probably most, of the problems that bring people into the mental health system are rooted in poverty, victimization, discrimination and other negative life circumstances. Peter reminds us that: ...

DSM-5 was published on May 18, 2013, amidst great criticism. The fundamental criticism was, and is, that the problems listed in the manual are not illnesses in any ordinary sense of the term. Other critics focused on the pathologizing of normality, the expansion of the diagnostic net by the lowering of thresholds, and the lack of reliability of the so-called diagnoses. The response from the psychiatric community has been mixed. Some, probably most, psychiatrists are keeping their heads down, getting on with the business of selling pills, and hoping that the gravy train won't derail. Others are busy at damage control ...

There’s an interesting post from Duncan Double, MD titled Why does the APA need new editions of DSM? Dr. Double is a psychiatrist and a member of the Critical Psychiatry Network. In his current article, Dr. Double expresses the hope that there won’t be a DSM-6, essentially on the grounds that none of the revisions up to this time has resulted in any increase in validity. So each revision, in effect, replaces an invalid old manual with an invalid new one. ...

BACKGROUND On 3-4 June, the Institute of Psychiatry in London hosted an international conference to mark the publication of DSM-5. On June 10, Sir Simon Wessely, a department head at the Institute, published a paper called DSM-5 at the IoP. The paper is a summary of the conference proceedings, and also, in many respects, a defense of DSM-5. The article touches on many issues that are central to the current anti-psychiatry debate, and for this reason, I thought it might be helpful to take a close look at the piece. ...

Earlier this year, The American Society of Consultant Pharmacists published a report on the use of neuroleptic drugs in nursing homes. According to this report, 25% of nursing home residents receive neuroleptic drugs. In general, the Centers for Medicare and Medicaid Services (CMS) consider these prescriptions appropriate only if the recipient is psychotic. (Obviously we could discuss this at length, but let’s set that issue aside for now.) What CMS considers entirely inappropriate, however, is prescribing these products to residents with dementia as a way of controlling “difficult” behaviors such as wandering, being abusive, or resisting care. ...