Alternative perspective on psychiatry’s so-called mental disorders PHILIP HICKEY, PH.D.
I am a licensed psychologist, presently retired. I have worked in clinical and managerial positions in the mental health, corrections, and addictions fields in the United States and England. My wife and I have been married since 1970 and have four grown children.
The phrase “mental health” as used in the name of this website is simply a term of convenience. It specifically does not imply that the human problems embraced by this term are illnesses, or that their absence constitutes health. Indeed, the fundamental tenet of this site is that there are no mental illnesses, and that conceptualizing human problems in this way is spurious, destructive, disempowering, and stigmatizing.
The purpose of this website is to provide a forum where current practices and ideas in the mental health field can be critically examined and discussed. It is not possible in this kind of context to provide psychological help or advice to individuals who may read this site, and nothing written here should be construed in this manner. Readers seeking psychological help should consult a qualified practitioner in their own local area. They should explain their concerns to this person and develop a trusting working relationship. It is only in a one-to-one relationship of this kind that specific advice should be given or taken.
It's no secret that here in America, foster children are being prescribed psychiatric drugs, especially neuroleptics, as a means of controlling their behavior. A great deal has been said and written on the matter. Politicians have declared the practice deplorable. Children's advocacy groups have expressed concern, and, of course, those of us in the antipsychiatry movement have screamed till we're hoarse. But the problem persists. For the past six months or so, the San Jose Mercury News, a California newspaper, has been running frequent articles on this topic, calling for oversight and corrective action.
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Polarization or Compromise
On February 2, Robert Whitaker published an article on Mad in America. The title is Disability and Mood Disorders in the Age of Prozac. The article echoes and updates one of the themes of his 2010 book "Anatomy of an Epidemic": that the steady increase in the numbers of people receiving disability benefits for depression and mania is driven largely by the corresponding increase in the use of antidepressant drugs.
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Antidepressant Drugs and Suicide Rates
In 2010, Acta Psychiatrica Scandinavica published a study by Göran Isacsson et al. The paper was titled Antidepressant medication prevents suicide in depression. Here's the conclusion:
"The finding that in-patient care for depression did not increase the probability of the detection of antidepressants in suicides is difficult to explain other than by the assumption that a substantial number of depressed individuals were saved from suicide by postdischarge treatment with antidepressant medication."
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Dr. Lieberman Is Annoyed
On February 18, Jeffrey Lieberman, MD, Professor of Psychiatry at Columbia University, published a video lecture (with transcript) on Medscape.
The article is titled What Does the New York Times Have Against Psychiatry?, but in his opening paragraph, Dr. Lieberman points out that the piece could be titled “Psychiatry Suffers Another Indignity.”
The background to this is an article by Tanya Luhrmann, PhD, an anthropologist at Stanford University, which appeared a month earlier (Jan 17, 2015) in the New York Times. This article was titled Redefining Mental Illness, and developed some of the themes in the British Psychological Society’s earlier paper Understanding Psychosis and Schizophrenia.
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Thomas Insel: "Are Children Overmedicated?"
Thomas Insel, MD, is the Director of the National Institute of Mental Health. In June of last year, he published, on the Director’s Blog, an article titled Are Children Overmedicated? The gist of the article is that children are not being overmedicated, but rather that there is an increase in “severe psychiatric problems” in this population.
Here are some quotes, interspersed with my comments.
"The latest estimate from the National Center for Health Statistics reports that 7.5 percent of U.S. children between ages 6 and 17 were taking medication for 'emotional or behavioral difficulties' in 2011-2012. The CDC reports a five-fold increase in the number of children under 18 on psychostimulants from 1988-1994 to 2007–2010, with the most recent rate of 4.2 percent. The same report estimates that 1.3 percent of children are on antidepressants. The rate of antipsychotic prescriptions for children has increased six-fold over this same period, according to a study of office visits within the National Ambulatory Medical Care Survey. In children under age 5, psychotropic prescription rates peaked at 1.45 percent in 2002-2005 and declined to 1.00 percent from 2006-2009."
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Recurring Depression
I am 46 years old and have taken antidepressants (Lexapro, Paxil, now Zoloft) for 10 years. But the reason I began taking them wasn’t due to my own need for relief from depression or anxiety. It was actually an effort to improve my relationship with my husband at the time. He suffered from depression and took medication, but said that I was overly critical, driven, intense, etc. and I think he was right. But I was also young and immature, and am an engineer by profession. I do have a critical thought process, no doubt. We were mismatched from the start and separated not long after I started the medication, but have a 11 year old son together. The divorce process, and going back to work full time as a single mom was difficult and stressful. But after taking the Lexapro for over 4 years, I actaully began feeling lethargic and depressed and decided to stop taking it cold turkey. Big mistake, I learned the hard way, and ended up on Paxil after a few months. Now I am having the same problem with the Paxil, and I really just want to get off the medication all together because I feel that it is causing the depression. I was never depressed to begin with, but now I am! After a couple of bad experiences with withdrawal symptoms from coming off the meds, I am really apprehensive about trying to taper off of them, but I want myself back, not this medicated, lethargic, irritable, unproductive person. I was far from perfect, as my ex-husband made painfully clear, but I always had hope for a better future and energy to work for it. I can’t help but feel that the meds have done more harm than good in my particular situation. I just wonder if others have had similar experiences? Thank you and best wishes in whatever you are searching for…
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Cures For Brain Disorders
On January 18, Thomas Insel, MD, published an article on The World Economic Forum Blog. The article is titled 4 things leaders need to know about mental health. Dr. Insel is the Director of the National Institute of Mental Health. The World Economic Forum “is an International Institution committed to improving the state of the world through public-private cooperation.”
Dr. Insel’s paper makes a number of assertions, some of which are misleading. Here are some quotes, interspersed with my comments.
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The Dopamine Hypothesis of Schizophrenia – Version III
On November 27, 2014, the Division of Clinical Psychology of the British Psychological Society published a paper titled Understanding Psychosis and Schizophrenia. The paper was edited by Anne Cooke of Canterbury Christ Church University. The central theme of the paper is that the condition known as psychosis is better understood as a response to adverse life events rather than as a symptom of neurological pathology.
The paper was wide ranging and insightful, and, predictably, drew support from most of us on this side of the issue and criticism from psychiatry. Section 12 of the paper is headed “Medication” and under the subheading “Key Points”, you’ll find this quote:
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Psychiatry's Defense: We're No Worse Than General Medicine
On December 21, 2014, Vivek Datta, MD, published an article on Mad in America. It’s titled Psychiatry and the Problem of the Medical Model –Part 1. The same article appeared the day before on Dr. Datta’s own website.
Dr. Datta begins by stating unambiguously:
"Psychiatry is a branch of medicine. As such, psychiatrists apply the medical model to problems of emotion, thought, behavior, human relations, and living."
He describes this approach as a "narrow gaze" and expresses the belief that it has brought psychiatry "under severe criticism" both from within and without. Here are some quotes from Dr. Datta’s article, interspersed with my comments:
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Exploiting the Placebo Effect: Legitimate Practice or Chicanery?
On June 13, 2014, Psychiatric Times published an article by Steve Balt, MD. The article is titled Assessing and Enhancing the Effectiveness of Antidepressants, and is a good deal more candid as to the efficacy of antidepressants than one normally encounters from psychiatry. Dr. Balt is a private practice psychiatrist in California. He is the editor-in-chief of The Carlat Psychiatry Report.
The article opens with the observation that despite the large number of antidepressants on the market, and decades of clinical experience, no particular product seems to have emerged as substantially better than the rest.
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