Talking to Critics of Psychiatry (Antipsychiatrists)
One of the challenging things about being a person with a mental illness who talks about psychiatry (and doesn’t hate it) is that all those people who do hate psychiatry perk up and get mad. These people often identify as “antipsychiatrists” and I’m not their biggest fan. While I consider it quite reasonable to question your doctor, psychiatrist, treatment, therapist and other treatment aspects, I consider going after an entire branch of medicine ridiculous. There is no “antioncology” faction in spite of the fact that a large percentage of people with cancer die (depending on the type, of course).
And this manifests in many of our lives. It’s not that antipsychiatrists just attack me; it’s that people of that mindset attack your average person who is just trying to deal with a mental illness. It’s the people who say, “mental illness doesn’t really exist” or “psychiatric medicine doesn’t work” or many other things that many of us hear online and in our real lives all the time.
So how do you talk to these people who have decided that your disease doesn’t exist and you shouldn’t be in treatment?
Mental Illness Doesn’t Exist
I’ve written several articles on how ludicrous a statement this is. Of course mental illness exists. And I don’t mean it’s just “in your head” I mean it physically exists as a physical, brain illness. We have brain scans that show it. We have genetics studies that are working towards pinning it down. We know that there are all sorts of differences between a depressed/bipolar/schizophrenic brain and a mentally well one.
So you could mention that to someone. I recommend pointing them to this article on the neurobiological evidence of depression, for starters.
You Shouldn’t Be in Treatment
This one is tougher but luckily, a recent meta-analysis looked at the efficacy of antidepressants, antipsychotics and many other types of medications used in internal medicine and determined that psychiatric medication is about as effective as other medications used in internal medicine. In fact, drugs like antidepressants are considerable more effective than some other drugs like statins. The meta-analysis is found here. Is insulin for diabetes more effective? Yes. But are psychiatric medications effective? Absolutely. (Discussion on the meta-analysis found here.)
Talking to Antipsychiatrists
But here’s the thing, while I have supplied you with two good sources of information, it’s likely that no matter what you say, you will not be able to convince most people of the scientific realities of mental illness. Why? Because many people are zealots and these people aren’t interested in rationale or reasons. These people are interested in bashing you about the head with their point, whatever that may be.
So my best advice is simply not to engage. When things get particularly acrimonious (and they do where many of my articles are concerned) I simply step back. I don’t have to defend myself. I don’t have to defend my position. I don’t have to defend my life choices. What other people think of me is none of my business. So let them rant. It really only makes them look bad.
Focus on what works for you. If treatment is working for you – great – nothing they say can change that. Moreover, it’s not your job to convince them of your reality. You’re working on recovering from an illness. That’s what matters. Not what the naysayers say. Take care of you. Ignore the rest.
Tracy, N. (2012, June 17). Talking to Critics of Psychiatry (Antipsychiatrists), HealthyPlace. Retrieved on 2022, September 24 from https://www.healthyplace.com/blogs/breakingbipolar/2012/06/talking-to-critics-of-psychiatry-antipsychiatrists
Author: Natasha Tracy
I'm glad you don't deny that some people have been harmed by psychiatry / pharmaceutical companies. However I find the tone of this article very patronizing - particularly your philosophy of "non-engagement" with anyone who might have a perspective different than yours.
I will review the studies you linked (thanks) but you - and others like "Sarah" - would do well to remember that much of the progress that has been made has been because of the "antipsychiatrists".
In my view there's a concerted effort (funded in part by those vested interests) to label all criticism - valid and otherwise - as "anti-psychiatry" so as to categorize all opposition as pseudo-scientific and silence victims.
Let's debunk this whole bipolar is unreal/real nonsense in one swift go.
Bipolar type II (I'll focus more specifically on this one) is a diagnosis...
First point: a diagnosis is NOT a disease. A diagnosis is a technical tool, that is supposed to undertaken objectively on valid observations. That's not always the case... by the way. But let's assume everyone, doctors, patient, and "beloved ones" are 100% truthful. The diagnosis of bipolar II when done properly segments a population that appears to suffer from similar symptoms and signs. That population has a label, that is unfortunately misconstrued as a disease. I'm being rather simplistic, but that's basic SCIENCE.
Now, when you have a set of diagnostic criterions, in order to ensure that they map correctly to reality, i.e. that it carves nature at its joints, you have to undertake SCIENTIFIC STUDIES.
You have to prove many things. Like inter-rater reliability, external validity, etc... The latter MUST be done on epidemiological grounds. (Not only on the grounds that "my drug works", which is way to simplistic and misconstrued as scientific "proofs" of validity. It's not. It's proof, often rather weak proof, but that's all we've got, of how a drug works.)
Proving validity is tough work. For many reasons. And results are often difficult to interpret for many reasons.
HOWEVER. Even if you have proved that bipolar type II is a well grounded diagnosis for a disease, you failed to tackle the real scientific issue: Are we sure that we are doing our best to carve out a diagnostic system (i.e. taking in consideration ALL THE OTHER diagnostic criterions for other conditions that overlaps or excludes bipolar type II) so that it maps reality (i.e. epidemiological studies)? The answer to that is "not really".
Comorbidity (also known as "why do I have so many diagnosis?") is just a clear indication that the diagnostic categories fail to achieve temporal consistency over time. That is, they fail to prove that they are THAT predictive. (They are predictive, but statistically, that means when you take the population as a whole, and usually fail to be hugely predictive in individual cases, which is a real issue). Another clear cut example of the fact that psychiatry is not doing its job in defining these diagnostic categories and refining them over time (as SCIENCE SHOULD!) is that the kraepelinian dichotomy is over 100 years old, and that no matter what evidence you may stack up against it, it's still there. That means, its more TRADITION than SCIENTIFIC WORK.
Don't get me wrong: tradition in medicine is important. We cannot completely work without it as you cannot update the software of 100% of the psychiatrists when new data comes along. But again, it's more an argument that psychiatry (and to some extent the rest of medicine, oncology included...) is a socially constructed tool loosely based on science (which is better than if it were not based at all on science!), rather than the scientific truth that we should bow down to, lest we be accused of being cranks, psychoanalysts, new age ignorants, or scientologists (take your pick here).
Now, here comes the "antipsychiatry arguments". Bipolar II is stress, abuse, horrible things, etc... YES. That kind of things is ALSO backed by science, as far as we can see the data coming in. Whether or not it's chemical imbalance is by the way a straw man from the pro-psychiatry side. Bipolar type II clearly, STATISTICALLY (i.e. not a guarantee on an individual basis), is a neurocognitive condition, with effects on the circadian circuit for instance. For sure... That's chemically mediated, non-controversially. But "imbalanced"? Define that to me before throwing that word at my face. If your definition means "take your meds", then OK, that's not science. It's pragmatic therapeutics disguised as a scientific rationalisation.
Should you take your meds? You should definitely give it a try.
Should you tolerate being blackmailed into taking your meds? NEVER. NOT ONE SECOND!
Does the meds work? Depends what you mean by that. But "yes" is a not so false answer, so we'll stick with that.
Taking your meds is in no way going to stop magically an abuser from abusing you. It's not a silver bullet.
The greatest dangers of a psychiatric label is (1) confirmation bias from Meds on shaky if not outright deceitful evidence and (2) it often obfuscates the real underlying issues on which MDs should focus their attention. Stress reduction and regulating your circadian cycle is a good step, but in no way solves REAL issues that REAL patients have been experiencing in their day to day social interactions.
And not dealing with that is simply foolishness from psychiatrists.
Overstepping the patient's boundaries is also foolishness. And that's a whole other topic on its own.
I never understand what people mean when they accuse of being antipsychiatry.
I can give the most thorough explanation of how psychotropic medications, street drugs as well as other pharmacopeia work. I can refer to the most thorough discussions about the scientific legitimacy of the kraepelinian dichotomy. I know what brain scans show and what they don't show though advertised as showing. I can refer to many, many, many scientific studies in almost any segment of psychiatry. I know that mental suffering, whether you call it illness or not, exists. I know how well diagnostic criterions carve nature at its joints or how it fails to do so. I know what is over diagnosing and underdiagnosing, as I'm suffering from both. I'm as thoroughly rationalistic as Sam Harris can be. I know why I prefer Peter Sedgwick over many iconic so-called antipsychiatry figures. Who by the way were psychiatrists.
I know all that all too well, because I was born from the womb of a psychiatrist.
And that fact is also the reason why I've been severely, severely, severely abused by psychiatry.
And I know all too well how people get sectionned. And that is why I feel obliged to claim that I can make a judgement.
Making that judgement allows me both to bash psychiatry in many ways, and to explain to patients that get sectionned with me why they should calm down. I go through their histories and usually, when there's a mistake or a mess, I can explain to the patient what the misunderstanding or mistake was. And they get reconciled with psychiatry. While at the same time I get mad at the psychiatrists who do not bother to undertake this basic maieutic dialog with patients.
Psychiatric abuse is real. Claiming that does not preclude me from knowing that people who are abused by psychiatry also suffered initially, or end up suffering in the long run.
I'm no fan of the "get me sick so that you can cure me" mentality. It's twisted, and way too common.
I do not know what "antipsychiatry" is when I hear the word, as it often comes from a confused mind, both on the pro-psychiatry side and the anti-psychiatry side. I do know what psychiatry is, and honestly, claiming that people do suffer is in no way an argument that could be extended as claiming that psychiatry has no business in making them suffer.
I'm furious at psychiatry, and I know why. Because it destroyed my family in the most gruesome way, for starters. And because patients usually end up being mind-fucked in the most horrendous way with unsupported allegations. The most caricatural of these is that they are scientologists.
I sure hope it well does help some people like you! I'd be busy bombing hospitals otherwise!
This quote rather efficiently sums up my opinion of the psychiatric mindset:
"“There is a tendency on the left, to think if someone in any way disagrees with the left it must be for the lowest possible reason and if you found the lowest possible motive you have found the right one. Theres this whole culture of no one would leave us or quarrel with us if they weren't a sellout. It is actually a very sick mentality and very widespread.” -- Christopher Hitchens.
You are absolutely correct, Florence. But, just as folks wish to believe that little green alien people visit us regularly and have harvested our organs for their experiments, some folks prefer to believe what they prefer to believe. You can't persuade them on a scientific level. They are not interested in that. They are interested in attention. A good website I recommend is called "What if all your problems weren't problems at all and were instead all bullshit?"
I find this web site devoted to the latest fad fraud bipolar voted in stigma in the junk science DSM to push the latest lethal, brain disabling/damaging drugs on patent exposed by Dr. David Healy's book, Mania, highly offensive and abusive since it is based on fraudulent claims by the biopyschiatry/Big Pharma cartel. The bipolar stigma is psychiatry's new "sacred symbol" that justifies their predation on one and all, because schizophrenia was too limiting with its emphasis on so called psychosis. Thus, we have bipolar disease mongers who have annexed trauma, abuse, the bogus borderline insult, rape, anxiety, "depression," bullying/mobbing AND rape, serial murder and other atrocities so perpetrators and victims are under this one bogus umbrella so all can be painted as "the dangerously mentally ill" subject to the new forced treatment laws you are aiding and abetting by colluding with this fraud.
You obviously have not done your homework and just spout off the horrible bipolar pseudoscience promoted by psychiatry for greed, profit, power, status and social control in the guise of medicine that has created the fascist/therapeutic state with outrageous human rights violations by these criminals.
You should be aware that even some of the most main stream supporters of psychiatry have felt forced to back off and admit the truth since the evidence has mounted so high it's no longer possible to hide it from a growing number of people who choose to do their own research rather than relying on Big Pharma shills.
Dr. Thomas Insel, Head of the National Institute for Mental Health, has admitted that the DSM "bible" of so called mental disorders is more like a dictionary or list of labels. He also admits that none of the stigmas/labels like ADHD and bipolar have any validity or evidence or science behind them thus acknowledging they are bogus!! But, there was no apology or acknowledgement to all those harmed by the decades of evil lies/fraud that so called bipolar is genetic, heritable and other well known lies not to mention the "chemical imbalance" and other fraud perpetrated by psychiatry. Note, Insel says there is NO SCIENTIFIC EVIDENCE for bipolar or other DSM stigmas. So, please face the truth and stop bullying those who have known the truth for decades!!
I don't deny you and others suffer from some typical human stressors or problems like others most likely made much worse by stigma and toxic drugs, but fraudulently labeling it bipolar and forcing toxic, useless brain damaging drugs and ECT to supposedly treat it is malpractice and a gross violation of all human rights. And the idea of forced treatment and commitment in a supposed democracy is part and parcel of our current fascist therapeutic state that uses psychiatry to torture and silence any dissidents, abuse/bully victims of those in power and other abuses making us just like Stalinist Russia.
So you say so called antipsychiatrists upset you??? Have you thought of all the huge harm you are doing by promoting this total fraud and junk science on innocent, ignorant, misguided people rather than growing up, doing your own homework/research and facing the truth like the rest of us who don't wish to be permanent patients or perpetual children controlled by coercive, abusive, traumatizing parental psychiatrists or mental death experts?
The major difference is those against the corrupt biological psychiatry have done their homework while you have not, so until you have done so, I think you should reconsider your attacks on them.
My logic is chemical imbalance cant be the only root cause of the mental illness.
Myself is victim of mystery mental disorder i undergone many treatments to no avail for 20 years. so i did my own investigation so I've learn something which is about inner self of my mind.i simply can't elaborate it to a psychiatrist who got one eye blinded by contemporary psychiatry.therefore nobody believes my definition of mind which is the universal truth.so i am comfortable explaining it here.so here i go mind has two sides in order to function 100% well.
Here is my modern analogy.for eg: let's take a computer what it needs to make it work properly?computer has a hardware side and a software side .from our expireance PC's tend to get slower as we work with it, by ruining various applications especially if we install/unstall apps. which cause file fragmentation in the hardisk and some apps will reside in memory which make CPU threads to become overloaded with junk apps and files.so the mind of the pc become ill.if there are viruses in memory then it become possesed .what about hardware failures.hardware is a platform where apps do handshaking.so both hardware and software issues can make pc sick.so i am not going to explain about pc hardware which is not the objective here.
Now lets talk about human mind.human mind also has physical hardware and intangible software we call it soul.but unlike PC's they were made by mother nature.so we don't know how our brain & soul do handshaking with each other to make our mind 100% healthy.
Unlike computers.what we do when we develop mental illness due to overloaded & fragmented soul(which is the software of mind)in most cases we take pills,injection & electric shocks.we only treat to our hardware brain but not to the soul part of our mind.in this case patient is lucky if illness is cased by only physical brain.what if underlying reason is fragmented soul.in many cases (like in PC's)soul is the root cause of many mental disorders.
i say What ever the case may be giving priority to soul part of our mind has profound effect on patients early recovery.
also like in computers most mental disorders are caused by soul part of our mind sadly thats the only thing we ignore.why.......because unlike computers mind is not made by humans.in computers
if we suspect hardware fault we can replace whole thing and see if fault goes away if it is then fault is hardware same goes for software faults.but in our mind we cant do that so we only treat physical brain.
little more about computers.we do resets or reboots if our PC's get stuck or become unresponsive this can work right? Can we reset or reboot our unresponsive mind? I say yes how ? trained people do that.it is called hitmataizing.we can clear the fragmentation of our soul in some extent by doing it. like in PC's it will not work very well for every case.in pc what we do if reset & reboot wont work due to severe software fragmentation.then we do low level formating,partitioning & re installation of apps right? this will fix all the software faults.
If patients soul is severely fragmented hitmstizing wont help.can we do reformatting,repartitioning,re installation of soul modern psychiatry cant do it.i dont think neither physician nor anyone from medical field can do it.there could be some healers or psychics with higher state of mind may do it.this is just a key for unlocking the mind.so remember mental disorders are caused by both brain & soul.if we can id which cause which then mental disorders are effectively treatable. Old psychiatry is gone we should develop parapsychiatry.
i am here providing some web links which are relevant to the above comments . These are all about spiritual side of our mind-(parapsychiatry)-please read or send it to relevant personal http://www.dissociation.com/ http://www.spiritualresearchfoundation.org/ http://www.spiritrelease.com/cases/sandersonprofile.htm thanks.
I hang out in an Anti-Psych forum but it's not because I identify as Anti-Psych, it is because it is the only place I can discuss my unfortunate experience with healthcare clinicians without getting patronized e.g. being called a "zealot". You have to wonder, if mental healthcare won't listen to clients' complaints (like by dismissing them as mentally ill or calling them zealots)then who will? Mentally Ill people are very easy to exploit. All you have to say about them is that "it's all in their heads" and anyone will believe you, no questions asked.
To pound blue:
I am not sure what you mean by "the caucasian system".
I have worked with four psychiatrists in the past ten years. Only one of them was caucasian. Two of them Asian, and another was from India. I never felt that their race, or mine, had any impact on their treatment methods.
If I were judging from my personal experience, and I cared about such things, it would appear to me that "the system" would favour non-caucasians. (3 to 1 ratio)
It seems to me that you are assigning a racial component to abuse that you feel you have experienced.
Possibly your experience, like mine, is individual, and not systemic?
you have to also question why psychiatry does not work for some. psychiatrists remember they are biomedical practitioners, they have training in the caucasian system.
they can be very abusive especially to people of color, with melanin because they have no interest to get to know the person. you can't diagnose a social and economic problem with a pill.
get to know the person, and their social economic conditions. there are also those that like the pill to get their high. psychiatrists can be very abusive and to pass the industry as having no problems is very dishonest.
be honest with yourself.
be considerate of people abused by psychiatry.
Well, I find that it is very apparent that some people should work through a few personal things before disguising their remarks as simple "comments" meant to induce a debate.
I agree with Roberta on my stance. If anything, being Bipolar has taught me that my moods may have extremes, but life itself [for the most part] operates in the gray area.
In the past 3 years, I have been switching from one extreme to the other. I am not going to lie, many people experience mistreatment in the mental health system...and I was no exception. Before medication and therapy, I started to deteriorate rapidly. I was at first vehemently opposed to psychiatry. I tried everything to stabilize my mood--taking herbal supplements, vitamins, certain foods, St. John's Wort Tea, Sam-e, Yoga, Meditation, etc. None of that helped. I eventually became very suicidal and attempted to end my life at the ripe age of 13.
What made my treatment difficult was the fact that I refused to comply with taking the medication and being admitted to hospital. At that time, I was mad as a bat out of hell. I experienced things I never want to experience again...and struggled to accept myself and my illness (seperately and combined).
But you know what?
I am ALIVE. I went through all that pain and suffering, and I have a chance at life again now that I am stable. I gained over 60 lbs from being thrown around on psychiatric medication...but guess what? I can lose the weight. I came across psychiatrists who had heart and those that scarred me for life...but guess what? It taught me that there are people out their who do care about well being. I missed out on college for 3 years because of hospitilizations...but guess what? College can wait...life can't.
I am not saying that psychiatry is better than anti-psychiatry or vice versa--just like many things in life, one shoe dosen't fit every person's foot. I would only hope that people would become more understanding of other people's views and be respectful.
If only, if only, knowledge and wisdom could bring us together instead of drive us apart. -___-
Oh, I meant to mention that 100,000 people in the USA get ECT every year.
I have had ECT, over 50 treatments in 5 years. I have minimal memory loss of inconsequential things. I, however, have a lot of memory loss from the times I was severely depressed and did not form memories... this was before I ever had ECT. ECT IS humane. You are put under anesthesia so you don't feel anything and you are given a paralytic so you don't hurt yourself during the seizure.
I have read a lot of valid, well designed research. Some of it is done on cadavers' brains. Going all the way down to the cell level, no damage was found from ECT.
I know for a fact that for me it was ECT or death. ECT is not a cure but a treatment that works for awhile. It has worked better than any medicine I have taken, although I continue to take medicine while having maintenance ECT.
The antipsychiatric point of view is held by people who haven't had any experience with psychiatrists or those who are treatment resistant. You won't hear it from people who have been treated successfully. I place myself in that group even though I have breakthrough mania and depression.
In the USA, psychiatrists have to complete the same medical school as those who become primary care physicians and surgeons. Then they have internship in which they are cycled through many different specialties. Then, in residency, they have 3 to 4 years of specialized training in psychiatry. Saying and believing that a doctor has one year of training is nonsense.
Antipsychiatric movement and approaching as well in community isn't new phenomenon one. It existed and would to be alive for many years in the future. But, significant issue is its bad repercussion on the course and outcome of mental disorder to any psychiatric patient. Therefore, it is very important to promote and to affirm in adequate manner the current principle of psychiatric treatment as well as psychiatric management of mental disorders. To achieve this top aim it should practice a professional and satisfying psychiatric performance in the treatment of psychiatric patients. Any misconception and concession in psychiatric working out would rise the influence of psychiatric critics.Psychiatry as the mainstay undertaking in complex mental health care system should to implement in comprehensive way the achievements in neuroscience research, that are of epochal dimensions. This recommendation in daily clinical accomplishment isn't as simple as we can think. There are many prejudices, atavistic and misunderstandings on psychiatry in public opinion that impede seriously up to date psychiatric treatment fullness. Every mental health professionist should take care on this counter-poise fact.
[...] the commenter felt, “. . . And you wonder why are people anti-psychiatry? Because they had horrible horrible [...]
Natasha, time to take your own advice and 'do not engage'
It's not an insubstantial number that were harmed by the psych-os. To incude those psychologically harmed is a staggering proportion of those alive.
"Are there people who have had a bad experience with ECT? Yes. Are there people who have had very bad experiences with ECT? Yes. But then, I was hit by a car, so things happen. It’s not really the car’s fault."
Natasha, I don't really get why you insist on using statements as this over and over. It does come off as uncaring from you. "oh yes, is terrible, so what?". No, bad experience is no "ooops, s*** happens". And you wonder why are people anti-psychiatry? Because they had horrible horrible experience and are consider "oooops" and downplayed number in statistic... could that be?
It's just hard to trust profession that considered being gay disorder not so long ago... and yes, them doctors tried to help gays. I think too many in the profession are people with their problems, determined to "help" no matter the cost, no mattter if you like their help. Because they are the doctor, you are crazy and they think they know better.
And it ain't a hard science, but many psychiatrists and psychiatry lovers love to pretend so, no matter the damage.
Unilateral is done over the side of the brain that doesn't impact on memory (non-dominant). It's one of the primary reasons it was developed and, no, people don't do it on the "wrong" side.
Certainly, you are welcome to call psychiatrists "cruel sadists" if you like but that doesn't convince me of anything. Moreover, it's hard for you to be taken seriously when you don't provide links to research to back up your points. Are there people who have had a bad experience with ECT? Yes. Are there people who have had very bad experiences with ECT? Yes. But then, I was hit by a car, so things happen. It's not really the car's fault.
As for my "caring," you know nothing of the sort. I reach out to people every day and "caring" is pretty much all I ever do - for strangers.
And I won't bother telling you my audience size, but it is not insubstantial. People want to hear what I have to say for many reasons. I understand that you do not. And that's OK.
- Natasha Tracy
Even if all those studies were false which I doubt you'd still have all the reports of peoples severe problems- enough to cause some to suicide. It's clear that Sackheim denied memory loss to ect for decades while all approved research had to meet his decision to fund. Unilateral ect is ofte on the wrong side which is a curious thing since using it on one side damages verbal and analytical skills while tthe other side damages emotion sexuality and spatial reasoning. Pick your poison. I've tried very hard to debate reasonably with you but you seem to avoid all the pernicious aspects of mental illness. The title of this blog is amusing compared to the sadistic cruelty of psychiatrists. Everything I say is downplayed as if I'm and others of my type are bothersome flies. I would like to knw what exactly you cotribute by posting issues of the mentally ill without confronting the problems they have with the reality of a state that treats them as dangerous incompetents or people bent on killing themselves. Maybe they got tired od enduring treatments to correct something they originally valued before before having their brains imbalanced by drugs or bulldozed by ect or lobotomy. But I guess you could care less about them because the real reason you post is partly an addiction to unsafe medical experimentation but more probably as a reaction against those downplaying the swings of your drug induced roller coaster that somehow with all your research have not had the insight to shine the light on yourself. I'm speechless that you devote so much time on here with so little effect with very few people listening to your side.
I notice you have no linked to any of the studies. This makes it very difficult to verify the veracity of these claims. With all due respect, the wiki on anything cannot betaken as a final word as it's not quality controlled at all.
On the other hand, I am aware that bilateral ECT has been shown to produce some cognitive deficits in some people - but it also has bee shown to improve cognition in other areas. Moreover, the same cognitive deficits have not been seen with unilateral ECT - the type now most frequently performed.
I agree, people have a right to all the information. ECT has risks, there is no doubt to that. I just don't believe in overstating them.
All the details are here, and no, I don't believe any of it was authored by Sackhiem:
Natasha- I am only saying this to make people aware. Read the wiki article on ect. In the fifties brain studies of rats on ect brain cell studies showed that the ect exposed cat cells could be identified from non ect cates with great accuracy and that the studies of neurons showed changes consistent with structural damage. More recently russian scientist found that ect mice had up to ten percent neuron cell death in the hippocampus. Another study showed that crucial areas of the brain that were susceptible to repeated seizures died from those seizures from ect in animal studies. In humans a reccent study found ect routinely caused global persistent cognitive deficits that suggests brain damage. A recent study at Duke that studied bipolar patients showed significant global cognitive deficits that were not found to be caused by medication or active disease in thos studies but only by ect. The study that found global deficits and in particular deficits in vocabulary and reading comprehension led to a warning from psychiatrists to parents of adolescence and treaters to be advised of risk to being able to function in school. Your study was cowritten by sackheim a member of the internet hall of shame and reading that article on that site is enlightening with regards his denial of patient memory loss from ect but rather that it was the fabrication of unreliable mentlly ill patients. If I may interject with that attitide I see how he was able to continue treating them in spite of evidence of significant possibility of memory loss from researchers around the world- not antipsychiatrists. But it does show the harm not caused by antipsychiatrists but genuine psychiatrists when after the studyon human subjects exposed to ect that showed widespread global cognitive deficits they stated that knowledge wouldn't and shouldn't change the risk reward ratio. Since when were the mentally ill considered commodities? How many doctors have taken extended sabbaticals for their severe depression but have arrogantly refused to consider ect on themselves? And finally another recent Duke study showed that ect patients were not aware of their cognitive deficits. A person who said that evenif the deficits were subtle for a given person it would still lead to difficulties and frustrations over completing routine tasks I believe in being honest and not just screaming that seizures are obviously damaging and I will never for any amount of money work as a psychiatrists in one of those clinics or hospitals or act like Sackheim in suppressing evidence of problems and research that could reveal problems. By reviewing things on just what he said a reader can make up his mind over his honesty.
Just one note. It is _not_ the case that all ECT patients suffer from brain damage. In fact, far from it. In a major investigation and overview of all literature the FDA brought out a report and said there is no evidence of brain damage at all. Yes, I'm aware that some antipsychiatrists make a different claim but there is no science to back that up (that I am aware of) whatsoever.
It's a narrow minded choice by doctors to choose among meds or ect to treat and if one fails they use the other. I personally know some psychiatrists after reading Whitaker's book to use tiny or no dose of neuroleptics to treat schizophrenics who suffer or she uses therapy. Isolated padded rooms can be used for those bent on suicide. But ect is used on elderly women most probably because other meds are not safe. Again more humane methods could be used. All ect patients suffer some brain damage and its not just memory. And you dont know if somebody ultimately will commit suicide. I believe I am objective and not polarising. If people spent more money on humane treatments or volunteered to help the ill humanely instead of the examples of injecting foster children with neuroleptics because they have no parents or the psychiatrist giving drugs to a two year old there would be no question of incompetents, a term I find objectionable because they abuse that term.
I'm glad it's working for you. On meds others and I were always tired and run down and waking up was always like coming out of a coma. And I was only on one med but it was a miserable little pill. I shouldn't tell others what to do with their meds because it keeps some stable. I will say that those symptoms of stopping meds one month later could be rebound effect but it may not be the sole reason for symptom if there is an illness. I talked about bipolar because for all the pardon my term crazy experiences of the illness it' s not psychosis and I wondered ifan alternate therapy would be manageable. Doctors should come out with much advanced treatments in six or seven years when the quantum computer will allow a greater understanding of the brain and body.
I think your blog is excellent. I have looked to see where I can get hold of you privately but cannot see this, so please, please excuse me doing this publicly and on your blog. I run Mentalhealthy.co.uk and have been approached by the International Bipolar Foundation to help them promote a FREE expertly written book for bipolar sufferers and their families. Please can you look at this http://www.mentalhealthy.co.uk/news/1743-bipolar-disorder-book.html and consider linking to it, I am very proud to be a part of this and hope you can help me and your readers too.
I sit here shaking my head, both as a long time healthcare professional and a long time patient. (I have as many alphabet diagnosis as a can of Campbell's(tm) soup.)
People of strong experience, positive or negative, tend to be highly polarized. The challenge of working with human bodies is that they *are* human bodies. There are very few absolutes, in fact, I would posit that the only SURE thing about life is that it ends. With that as a black and white statement, *everything* else is a shade of gray.
It is impossible for *any* single treatment to be appropriate for everyone, whether we're talking about mental health, heart/lung disease, thyroid dysfunction, cataracts, or a broken bone. It's also inappropriate to suggest any given treatment NEVER works for anyone under any condition. Using the BEST option available as appropriate to a given patient is part of the Art of medicine. Trying a treatment and having it fail or simply do nothing is not necessarily 'Bad' medicine, it's trying to find a treatment that works. Effectiveness not only on a single symptom or disorder, but as part of a whole complex biological system is different from person to person, and varies in an individual throughout their life.
We strive for the treatment that will be most effective in a given circumstance, with the lowest risk and fewest side effects. ECT, using John's example, is a completely appropriate treatment for some patients who fail to respond to any other treatment. If the choice is between ECT and suicide (or failed suicide attempt, leaving the patient in far worse condition than the ECT) it is reasonable to consider. Risk versus benefit is analyzed, and presumably an informed decision is made to proceed or not. Yes, I'm aware there are catastrophic potential complications. Many of those complications listed by John can also occur with ski accidents, stroke, near-drowning, organic brain disease... the list goes on. However, for every horror story in a 'Shame' (MH, Med/Surg, OB, Cosmetic Surgery...) website there are dozens to hundreds to thousands of patients who have undergone the same procedure and you rarely hear from them -- because it did what it was supposed to, without complications, and they're back to living their lives. Most people do well, but if you're that one in a hundred or one in a thousand with a serious complication it can suck. A lot. Again, it's not necessarily bed medicine – the variability of a human body is that pesky human body.
In the event the patient is unable to competently consent - for whatever reason; age, unconsciousness, mental processing capacity, one hopes the person/s making the choices are acting in the best interest of the patient as they know it. If the patient is capable of making informed consent (and should be as fully informed as possible) then it should be the patient's choice.
Conditions that respond to biochemical modulation – whether it's toothache pain or schizo-affective disorder are not more or less 'real' or credible than those that respond to therapy, pastoral or compassionate care. A cast is the treatment for a broken leg, not for a heart attack. It's not a matter of better or worse, just different, and there is no 'One Size Fits All' treatment.
I agree that we make our own choices and that no one can tell us what to do but we can accept guidance from Doctors and Psychiatrists. I chose a Dr. that specializes in addiction and mental illness due to his many years of training in that field.
My Dr. absolutely predicted what would happen if I stopped taking my meds, bipolar's stop taking their meds because they feel better, within a month I was back at my doctors office complaining about the symptoms that he had told I would suffer.
Doctors can only prescribe drugs they can't force us to take them. We take them because they are what make us "normal". There is no reduction in my cognitive function in fact the opposite is true.
I apprecate your comments and I believe this is a place for discussion and not a place where you have to surround yourself with yes men. No i'm not talking about your personal choices. I will briefly say a word on withdrawal from meds. When I quit abilify a month later I suffered a bad depression one I haven't suffered in over ten years. I wa on abillify for three years and it was the only drug I ever took. I attribute the depression to its mild antidepressant effect and I stopped abruptly. I waited it out and it went away after a couple of weeks. Who knows what reaction you would get from abruptly stopping those meds of yours. And yes those drugs change the balance of chemical activity in the brain. But psychiatrists now know that the chemical imbalance theory of mental illness was an incorrect theory. That doesn't mean your meds don't control aspects of an illness. They dont know how they do ths but it's not a pure a pure cure as mst brain meds reduce cognitive function, some mild some severe. Nobody can tell you what to do in a free world. You make your choices. I dont think any doctor can with accuracy predict what will happen when you start or stop meds because although they have case studies to go by they dont know what the drugs do to behavior always.
Yes...of course. I will also recommend that they follow your blog. Thanks :)
Oh, don't worry, I'm guilty too - most of us are :) No one is perfect or immune to wanting to champion our own perspective.
Part of me wants to zig at every antipsychiatrist's zag too, but I realize that if I do that, I will be doing nothing else and all the other things, which I consider important and more beneficial, will not get done.
And yes, I do worry about newcomers and their experience of certain influences. I do what I can to try and protect the people who visit my personal blog (things are quite moderated) and, of course, there are rules for commenting at HealthyPlace as well. But I value free speech so even when I really don't like an opinion, I realize the person has every right to express it - even in hateful ways. The internet is wild and wooly like that I'm afraid.
You're welcome for the writings. I'm glad you're finding them helpful.
Of course you can share the writings with your support group but if you could give appropriate credit, that would be appreciated. I consider that "personal use" which is OK with me.
- Natasha Tracy
Yes, it is the case that many people with a mental illness goes through a period of denial and in that denial, they will believe anyone who tells them they don't need medication - whether they do or not. And it's pretty common for the medication to _work_ and for the person to go off of it because "they feel better" and then, of course, without the medication they no longer feel better. I suspect this is because none of us want to take daily medication, understandably.
As for people with illnesses who don't need medication - I tend to think their illness is not as severe, but, of course, each case is different. And I think because we can't pin down biomarkers just yet it's possible that it's not really the same disease at all, but it looks the same because of the symptomology. That's why we're grasping around in the dark in mental illness - we just don't know these things. But we're working on it.
- Natasha Tracy
Thank you for your positive influence. I know that you speak the truth because you are one of us!
I am guilty of engaging because I want to state a positive to all the zealot's opposition. I just keep thinking about my first time to your blog, which wasn't very long ago, I saw the way that you eloquently defended "the cause". If I had seen only the pointless attempts at bashing our illness I may not have stuck around and God forbid if someone fragile enough to hurt themselves found themselves in the middle of all that negativity.
I thank you again for your writings. You have no idea how much having this kind of outlet has help me and I truly appriciate that.
Your humble follower
Oh BTW do you mind if I share your blogs with a new Bipolar support group I am attending?
As you see above I can only speak for myself. I agree everyone is different but I believe everyone with a serious "mental Illness" can be helped by the right meds.
I kind of wonder how serious is a person's mental illness if they don't need meds. It is a biochemical illness - it's real. If you just need talk therapy I think that is something else. Just my opinion.
I agree with you - IGNORE THEM. Better yet, get them out of your life if possible.
After I had my first manic episode I had a boyfriend who studied Behavioral Psych in college. I didn't want to take the meds and was in denial about my Bipolar (Manic-Depression) so I was vunerable and listened to him when he said that I don't need meds. So when I started feeling better I thought that I don't have mental illness and quit my Lithium. Within one month I had an extreme manic episode...
I think that may be why my best friends are on meds too and understand. When I am on the right meds I can be stable, productive, and creative.
I have some experience with psychiatric care and medicine. Have you considered your rapid cycling due to your medication. I wouldn't nor would others have such an issue with psychs if so many were not involuntarily commited. Most of those were not a danger to themselves or others but they are treated as inompetents because they lost their job or looking for one and have nowhere else to go to eat. Many of them are not mentally ill but report life problems and some fabricate illness to eat. Som families commit their adult children over stress of not finding a job in this economy. I'm not talking about excuses but first hand accounts from the institutions I'e been in and yes I did not have an illness. I'm talking to a journalist currntly over my story of psychiatric abuse. Maybe something will happen and shine a light on the overuse of false danger in involuntary commitment.
I understand you feel I'm dismissing of people who have had negative experiences with psychiatry. I don't agree. I don't dismiss them at all. They exist. I would prefer people not have those kinds of experiences. I believe quality care is very important.
I, personally, believe that when you have a mental illness that is out of control (that being determined by the person experiencing it) you need help. Now, you might choose to get that help through many ways, some of them are drug-free, like therapy, and that is your right. I don't deny any of that. There are exceptions to that rule if you're a danger to yourself or others, but by and large, people are masters of their own destiny.
There is a difference between a person who has had a positive experience med-free and those that rile against psychiatry. Sure, feel free to talk about whatever you like. That's your call. For example, I think NAC has been beneficial for me (it's a supplement) and I have written about it. But the difference is I don't feel like strong-arming people into trying it and I readily admit it might or might not work for any given person. The seriously antipsychiatry people I meet _demand_ that everyone _do_what_they_do_ and _believe_what_they_believe_ and I feel no such thing is reasonable.
I don't reduce anything to a bumper stick. That's just it. Things are more complicated than people who are antipsychiatry are willing to admit.
- Natasha Tracy
Good for you. I hope that helps.
- Natasha Tracy
THe problem there is, Natasha, that you are very dismissive of people who were harmed by psychiatry, with "but doctors mean good". And there is a top post about how you HAVE TO, absolutelly have to get treatment even if it sucks, comparing it to cancer treatment... the thing is... if you get treatment for cancer, you don't expect to develep carcinoma in other part of body as RESULT of cancer... what good is treatment for mood disorders, when it whacks up your MOODS?
what bothers me about psychiatry... it dismisses all existential and spiritual aspects of one's troubles. Gawd, if I talked about my experiences, I'd be given the schizotypal label (because that's what they call shy weirdos these days). For many people the mainstream is just not the answer. Does it mean we have to shut up?
THere are people who do well without meds.... so why shouldn't we talk about it? I get mad when somebody who had horrible experience with many meds is told "just keep trying until one works" and is not told and allowed to try med free route... who knows, maybe it would work for many of them. But you not gonna hear this in the mainstream psychiatry.
Or should the people who have been harmed by psychiatry just shut up? Do you think your position is completely void of emotion?
It's psychiatry that creates a lot of the anti-psychiatry movement by pushing them out if they don!t comply. For many people then... it's all or nothing. Be doped senseless (in the community I am member of people tell stories how they doctors laughed off their complains about meds, or throw cutesy statments and "would you rather be fat and happy or thin and unhappy" and "eating kills you as well") or do it on their own. Many therapists will not deal with me since I am not on meds... so I am forced to do it on my own.
It's not that simple. Please, try to think more closely about why people think certain way... you cannot reduce it to bumper sticker statement.
Thanks for this post Natasha. Stay strong! I love your site but the unthinking zealots make me angry. Lately my email has been clogged up by their comments. I have followed your advice... not to engage!
What would you consider "most" disorders. Types of therapy have been proven to work for depression, bipolar, borderline personality disorder, post-traumatic stress disorder, generalized anxiety disorder, obsessive compulsive disorder and schizophrenia, off the top of my head.
Therapy has not proven to be effective for most disorders. I never understood how talking to someone could unlock the keys to depression etc. A friend is just as good if you need clarity for some reason.
Yes, I think walking away can be best for everyone's sanity. Some people just really get off on the adversity. I don't and I'm not sure it's healthy in general. I see how angry people get at me and I just think all that energy could be used in a more positive way.
Thanks for your comment.
Thanks for your excellent blog Natasha. I am one who has chosen the psychiatry, medication and therapy route to treat my bipolar 2. I do encounter many people who disagree with my choices, but I choose the route you have suggested. I do believe they have the right to their opinions, although most of them have never experienced bipolar first-hand. I don't believe they have the right to try to force their opinions on me. I don't try to force my opinions on them. I choose not to engage in long discussions about treatment options and why they think I've made the wrong choice. I am doing well. It's my body, my disorder & my decision. If I have to get up and walk away, I do. I do it politely and not in anger. I just let the person know that this is a subject I don't wish to discuss any further.
Well, some people rile against bad doctors (well, most people, understandably) and some people rile against _all_ doctors. There's a big difference. I hate bad doctors. I think most people do.
As for Freud, well, I'm not a Freudian and I don't snort cocaine so he's not really my guy (see, I do know something about Freud, moreover, he doesn't really make your case about psychologists, but that's OK).
I consider psychologists (those qualified to do psychotherapy, generally) and psychiatrists both important parts of a healthcare team. I recommend therapy to people pretty much daily.
As for efficacy, I know of no study that suggests therapy is _more_ effective than psychiatry; however, there are studies that say that medication and therapy work better together than either one alone.
And you may not know this but there are rather prominent groups of antipsychiatrists who lump psychologists with psychiatrists, as in, they hate psychologists and don't think they should exist.
I'm glad you (generally) like the blog. Thanks for your comment.
- Natasha Tracy
I note there is no mention of doctors who make mistakes,prescribe the wrong medicine or the wrong treatment.Those are the same type of people that your so-called anti-physciatrists are railing against the bad ones.Have you ever researched Freud i sincerely doubt it or you would know he treated about eight patiants and at least one died as a result of his treatment.The brain/mind is more complicated than the human body yet Psychiatrist get one year of training in their specialist field
I wish people like yourselves who are very influential(deservedly so) would separate therapy into Psychiatrists on the one side and physiotherapists separately. Mental health nurses are far better and use far more modern techniques than old outdated dis proven methods like clinical psychiatrists use.
I am not just speaking from my own personal experience but of others i talked to. I saw a psychiatrist for a whole wasted year and suffered having to work at the same time then six months later i had a relapse and ended up of work again.I had CBT with a MHN for six weeks and was problem free for eight years and only when i trusted the wrong person who stole from me and then evicted me so i was homeless then getting taken in by another friend and working 80 hours a week for a company that was bieng investigated for fraud on an international scale did i relapse.ECT never works and is barbaric pills work with depression to get you to a place where therapy can help but are never an answer.
My uncle is bi-polar was for 20 years now he is drug free all due to a special diet(the wonders of having lots of talent and turning that into cash)
Natasha you always give very clear explanations of the science of medications but on the therapy side i think you are blinded just as some of the "zealots" on the otherside of the argument. Psychologists have much better success rates than psychiatrists
However please keep up the good work i actually enjoy reading your blog and do think its very informative,also you take the time to reply to people which is helpful.
I agree with you, people who have negative feelings of psychiatry do so for all sorts of reasons and may think any number of things about science, and of course, they aren't all the same. You are an example of someone who wants to focus on one aspects of psychiatric rights, and you are certainly welcome to do so. You aren't really the kind of person this post is talking about.
Yes, some people recover without medication. Of this there is no doubt. Mental illness and treatments come in many flavours and different things work for different people - which I say all the time because I believe in people doing what works for them.
I do not advise people to go off of medication for medical reasons but I have written articles on when people should consider it and how to do it if they want to (not on HealthyPlace). That's precisely because I _do_ respect people's right to choose their own paths.
I respect your choices and have no interest in choosing your treatment for you.
- Natasha Tracy
This post isn't about you. I didn't address it to you and I deal with many people on a daily basis, you are but one.
I, personally, am not offended although you seem to have misunderstood my remark. I said that you couldn't understand aspect of mental illness until you had been there (or it seems for many people) but I never said that I, personally, tried to take my life in front of my parents, I didn't.
You can talk about anything you like. If I didn't think so, I would simply delete your comments but I haven't done that because I respect your right to express yourself.
That said, there *are* persons with mental illness who for personal reasons choose to cope without medications - and for whom it works.
There are many who find the effects of neuroleptics - the personal, subjective experience of it - unbearable.
Their (read: my) reality in this is just as valuable and just as true as anyone who does engage in treatment via more traditional approaches.
It is possible, for instance, to believe the right to refuse treatment is a human right, whatever someone's position on the science might be. It is quite possible to hold this belief while having no or few objections to the mainstream scientific consensus.
As a person who has experienced treatment over my express objections and against my will, I value choice above all else - even science.
I'm not interested in arguing the science - it's outside my area of specialization. All I care about is whether my wishes for what happens to my own body and my own mind to be respected - whether it's treatment or not - whether it's supported by double-blind placebo-controlled studies or not - whether the statistical evidence says I'm being unwise in my choices or not.
I sometimes feel that people who have experienced the system in oppressive ways end up attacking the whole thing.
I do know the precise mechanisms behind mental illness are not well understood. History has shown many hypotheses, and more are made often. However, scientific ignorance of the specifics does not, to my mind, mean there is no mechanism.
I believe my symptoms are produced by my biological brain.
But, people who have rational choices to not accept medication are often lumped in with those who act unreasonably or are unscientific.
I find myself a skeptic (i.e. James Randi, Richard Dawkins, Penn Teller) and a human rights crusader. I find it odd that my emphasis on the freedom to choose to be untreated puts me at odds with the scientific community in this when I'm the first to criticize unscientific, magical, or illogical thinking in other situations.
I, in fact, have considerable empathy for people who do feel neuroleptics are something they need. Given how terrible they were for me, I can only respond to the statement "I've lost everything one too many times to stop my medication" with profound respect. My hatred of neuroleptics, from my own experience, gives me a greater appreciation of just what that choice means for some people.
But I will fight to the ends of the earth in support of someone else who says "I want to try to cope without these terrible drugs," because there was no one to fight for me when I said that.
I wish the "Psychiatric Survivor" movement would focus on experiences of oppression and force - very genuine and extant issues - as opposed to fighting science.
My movement is a civil rights movement. It contends that free choice is paramount. It holds that basic human rights and basic human dignity belong to all - even those who have thought process problems.
I am a psychiatric survivor, not because I don't believe in science, but because of what I have survived in the name of science.
I just had to learn to separate my hatred of force and wiser-than-thou paternalism from my feelings on science.
I don't have any intention of telling you how to handle your illness, as long as you afford me the same. I respect your choices - including treatment - but I expect the same respect for mine.
Not all psychiatric survivors are antiscience, but all humans have the right to focus on what works for them.
I'm just another voice for people to sort. You're educated. You know about he high risk of ect. I talk to anybody who thinks about doing this. Read the ect hall of shame online that exposes the deceptive practices of those who direct funding and operate the machinery. To have your mom slowly come to from ect and not recognize you is an abomination of doctors. I think I would rather be locked up for an unmanageable depression than to lose not just memories but the ability to read or remember an extensive vocabulary, which has happened. You seem to not want to hear about questions surrounding treatment. Eventually all these treatments other than compassionate ones such as talking will beabandoned when genuine understanding of people's issues or complaints are possibly correlated to a medical treatment. Some illnesses may be a disorder that arises from biological dysfunction or may be the result of a cascade of experiences and thoughts that produce a negative feeling for the person. This question is still open because the brain is still an open frontier of research with many questions. I'm not saying that psychiatrists have not cleaned up their act when they discovered the chemical imbalance theory of mental illness was discovered to be wrong. Some drugs do affect psychosis to an extent they appear normal and act normal. But many recover on their own without meds. Look. I don't know why you object to my talking about ect, foster children overwhelmingly on powerful brain meds, or 2 year olds being reated with meds for bipolar. Yes I called you spoiled because you still talk about that day you attempted suicide before your parents an take no responsibility for that or your reaction to what you call a mental illness. But if it's not that what. Saying that I rant is a bit absurd compared with your dictionary of a blog almost solely devoted to glorifying psychiatry to an almost religious unquestioning. I hope this hasn't offended you because I only wish to talk about what I've seen and to read about other people's stories and for all to know that what I am interested is an honest and transparant health professional.