Posts Tagged ‘mental disorders’

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Psychiatry’s Flawed Tool: A book full of subjective checklists—the Diagnostic and Statistical Manual of Mental Disorders

Thursday, December 29th, 2011

First Things – December 29, 2011
by Joe Carter

Photo: Garry Mcleod; Origami: Robert Lang

Someday our grandchildren’s grandchildren are going to sitting in college classroom learning about the early 21st century and wonder how a society so seemingly advanced could have such primitive ideas about mental health.They will no doubt be shocked and appalled that our major diagnostic tool for psychiatry is a book full of subjective checklists—the Diagnostic and Statistical Manual of Mental Disorders (DSM versions I-IV).

I became all too familiar with the DSM in my college days, first as a psychology major and then as a behavioral science major (I switched because I believed behavioral science would be more scientifically rigorous. It wasn’t.) I was constantly shocked that such an utterly absurd book could be considered our primary mental health tool. The diagnostic criteria is often so vague that it is virtually impossible to determine if a patient truly has a mental disorder. Yet almost every diagnosis in America is made based on comparing a patient against the DSM’s checklist of “symptoms.”

Part of the reason the DSM is so flawed is because it is highly politicized. For example, homosexuality was classified in DSM as a sexual disorder until the 1970s. And until 1987, “ego-dystonic homosexuality” was still classified as a pathology. These “mental disorders” were later removed, not because of a change in empirical data (since there is none) but because of the protest of gay rights groups. I agree with the gay rights activists on this one: homosexuality should have never been classified as a mental disorder. But this example shows that the judgments made by psychiatrists are often highly subjective and are rooted more in speculative theories than in scientific fact. (Keep in mind that this is the same profession that, for almost a century, believed the Freudian idea that holding your feces in as an infant affected your personality as an adult.)

Such criticisms against the DSM have been made for decades (mostly by cranks like me) but they are gaining a new hearing because of who is now making them: Allen Frances, lead editor of the DSV-IV. As Frances says, “there is no definition of a mental disorder. It’s [BS]. I mean, you just can’t define it.” As Wired magazine notes:

Some of this disputatiousness is the hazard of any professional specialty. But when psychiatrists say, as they have during each of these fights, that the success or failure of their efforts could sink the whole profession, they aren’t just scoring rhetorical points. The authority of any doctor depends on their ability to name a patient’s suffering. For patients to accept a diagnosis, they must believe that doctors know—in the same way that physicists know about gravity or biologists about mitosis—that their disease exists and that they have it. But this kind of certainty has eluded psychiatry, and every fight over nomenclature threatens to undermine the legitimacy of the profession by revealing its dirty secret: that for all their confident pronouncements, psychiatrists can’t rigorously differentiate illness from everyday suffering. This is why, as one psychiatrist wrote after the APA voted homosexuality out of the DSM, “there is a terrible sense of shame among psychiatrists, always wanting to show that our diagnoses are as good as the scientific ones used in real medicine.”

Since 1980, when the DSM-III was published, psychiatrists have tried to solve this problem by using what is called descriptive diagnosis: a checklist approach, whereby illnesses are defined wholly by the symptoms patients present. The main virtue of descriptive psychiatry is that it doesn’t rely on unprovable notions about the nature and causes of mental illness, as the Freudian theories behind all those “neuroses” had done. Two doctors who observe a patient carefully and consult the DSM’s criteria lists usually won’t disagree on the diagnosis—something that was embarrassingly common before 1980. But descriptive psychiatry also has a major problem: Its diagnoses are nothing more than groupings of symptoms. If, during a two-week period, you have five of the nine symptoms of depression listed in the DSM, then you have “major depression,” no matter your circumstances or your own perception of your troubles. “No one should be proud that we have a descriptive system,” Frances tells me. “The fact that we do only reveals our limitations.” Instead of curing the profession’s own malady, descriptive psychiatry has just covered it up.

Read more . . .

http://www.firstthings.com/blogs/firstthoughts/2011/12/29/psychiatrys-flawed-tool/

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Is the American Psychiatric Association in Bed with Big Pharma? Answer: Yes

Tuesday, November 29th, 2011

Note from CCHR Int:  We’re happy to see more and more press running stories containing the facts about psychiatric diagnoses, that mental disorders are not diseases on par with real medical diseases as the psychiatric/pharmaceutical marketing teams would have you believe, but lists of behaviors and emotions repackaged as disease in order to sell billions of dollars worth of pharmaceutical ‘solutions.’   CCHR was the first organization to point out that psychiatric disorders were not medical conditions discovered in labs, but disorders invented in committee by pharmaceutically funded psychiatrists.  We’re very pleased we’re no longer the only ones reporting the facts about psychiatry and its marketing campaigns.  Get the facts here

Do we really need more mental disorder diagnoses creating the need for more drugs in a society that some would say is already over-medicated?

The Fog City Journal – 11/29/2011
by Ralph E. Stone

“The critics — and the public too — have a stake in the proposed DSM-V. More mental disorders may mean just more drugs in our over-medicated society.”

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is published by the American Psychiatric Association. The DSM provides a common language and standard criteria for the classification of mental disorders, which is used in the United States and to some extent internationally, by clinicians, researchers, psychiatric drug regulation agencies, health insurance companies, pharmaceutical companies, and policy makers. The DSM is produced by a panel of psychiatrists, many of whom have financial ties to the pharmaceutical industry. It is considered the “bible” of American psychiatry. The latest edition — DSM-IV — was published in 1994.

In 1952, the DSM was a small, spiral-bound handbook (DSM-I), but the latest edition (DSM-IV), is a 943-page magnum opus. Over time, psychiatric diagnoses have increased in the American population and in turn, drugs that affect mental states are then used to treat them. The theory that psychiatric conditions are caused by a biochemical imbalance is often used as a justification for their widespread use, even though the theory in unproven. Since there are no objective tests for mental illness and what is normal and abnormal is often unclear, psychiatry is a particularly fertile field for creating new diagnoses or broadening old ones.

Medications are widely used to treat the symptoms of mental disorders such as schizophrenia, depression, bipolar disorder, anxiety disorders, and attention deficit-hyperactivity disorder. Sometimes medications are used with other treatments such as psychotherapy.

While I am sure research in mental disorders account for some of this increase, I cannot help but believe that there is a certain amount of disease-peddling going on. That is, instead of promoting drugs to treat diseases, diseases are promoted to fit the drugs. For example, shyness as a psychiatric illness made its debut as “social phobia” in DSM-III in 1980, but was said to be rare. By 1994, when DSM-IV was published, it had become “social anxiety disorder,” now said to be extremely common, thus, boosting sales of antidepressants. Now, social anxiety disorder is “a severe medical condition.” In 1999, the FDA approved a drug for social anxiety disorder. After a successful marketing campaign, the sales of Paxil soared.

Presently, a revised version of the DSM is set for publication in 2013. The proposed revision has proven quite controversial. A group of psychologists with the Society for Humanistic Psychology, for examle, has filed a petition objecting to many of the revisions, arguing that they broaden the definition of mental health disorders, which, in turn, could lead to over treatment with drugs. Some, but not all, of the objections of the Society — along with the British Psychological Society and the American Counseling Association — to the proposed DSM-V include:

- The proposed DSM “fails to explicitly state that deviant behavior and primary conflicts between the individual and society are not mental disorders. Given lack of consensus as to the ‘primary’ causes of mental distress, this proposed change may result in the labeling of sociopolitical deviance as mental disorder.”

- “Several new proposals with little empirical basis also warrant hesitation: For example, ‘Apathy Syndrome,’ ‘Internet Addiction Disorder,’ and ‘Parental Alienation Syndrome’ have virtually no basis in the empirical literature.”

- “…clients and the general public are negatively affected by the continued and continuous medicalization of their natural and normal responses to their experiences; responses which undoubtedly have distressing consequences which demand helping responses, but which do not reflect illnesses so much as normal individual variation.”

Do we really need more mental disorder diagnoses creating the need for more drugs in a society that some would say is already over-medicated? Let’s look at some statistics. According to the Centers for Disease Control and Prevention (CDC) the percentage of Americans who took at least one prescription drug in the past month increased from 44 percent to 48 percent over the past ten years. The use of two or more drugs increased from 25 percent to 31 percent. The use of five or more drugs increased from 6 percent to 11 percent. And in 2007-2008, 1 out of every 5 children and 9 out of 10 older Americans reported using at least one prescription drug in the past month.

And Americans are spending more on drugs. According to the CDC, spending for prescription drugs in the U.S. was $234.1 billion in 2008, which was more than double what was spent in 1999.

And the pharmaceutical industry is profiting. According to Fortune 500 (May 3, 2010 issue date), the profits for the twelve largest pharmaceutical companies was almost $64 billion in 2010. Clearly, Pharma has a financial interest in a DSM with more mental disorders because it will mean a demand for more drugs to treat them.

The critics — and the public too — have a stake in the proposed DSM-V. More mental disorders may mean just more drugs in our over-medicated society.

Supreme Court Justice Oliver Wendell Holmes once quipped, “If all the drugs were thrown in the ocean, everyone would be better-off . . . except for the fish.” While this is a an overstatement, it does contain a grain of truth.

http://www.fogcityjournal.com/wordpress/3217/is-the-american-psychiatric-association-in-bed-with-big-pharma/

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Psychiatry’s Diagnosis Manual Under Fire – will feed culture of overdrugging/overdiagnosing

Saturday, November 26th, 2011

San Francisco Chronicle – 11/26/2011
by Erin Allday

"Another diagnosis, dysphoric mood dysregulation disorder, is basically temper tantrums," Robbins said. "Next thing you know, you could have 2-year-olds on psychotropic medications."

The “bible” of American psychiatry – a manual of mental health used around the world by doctors, consumers and insurance providers – has come under fire from a growing group of psychologists who worry that proposed revisions will feed into a culture of overdiagnosing, and overtreating, otherwise healthy people.

The Diagnostic and Statistical Manual of Mental Disorders, or the DSM, is undergoing its fifth major revision in the more than 60 years since it was first published by the American Psychiatric Association. The last update was in 1994, and the new manual is expected to be released in spring 2013.

Revisions to the DSM are often hotly debated, but after two decades of major, and frequently controversial, shifts in how mental health problems are diagnosed and treated in the United States, this latest update has become especially contentious, many mental health providers say.

Last month a group of psychologists with the Society for Humanistic Psychology posted a petition against many of the suggested DSM revisions, citing what they see as a broadening of the definition of mental health disorders, which, in turn, would lead to overtreatment with drugs.

7,000 signatures

The petition now has more than 7,000 signatures, and last week it won the support of San Francisco’s Saybrook University, with roughly 60 faculty members who emphasize a holistic approach to treating mental illnesses.

“There’s this propensity to push pills instead of looking at what’s really going on with the person,” said Saybrook President Mark Schulman. “When we saw in the DSM-5 that there was going to be a push in the direction of a more medical, less holistic way of doing things, we felt we should take a stand.”

A work in progress

The American Psychiatric Association has posted an online response to the petition, welcoming critiques to and comments on the proposed revisions. Their response notes that the manual is still a work in progress and, as more scientific evidence becomes available, some of the changes may become more palatable to critics.

Since the last diagnostic manual update, research has increasingly pointed to biological causes for a wide variety of mental health conditions and, in response, treatment has turned toward pharmacological answers, some psychologists say. Drugs are being used to solve mental health problems that aren’t problems at all, they add.

In 2010, 1 in 5 American adults was using some type of mental health medication, a 22 percent increase over the past decade, according to a report released last week by Medco Health Solutions, a pharmacy-benefits management company.

Therapy is still popular, but part of the problem is that there simply aren’t enough trained counselors to fill the mental health need. Patients are turning to primary care doctors for medical relief from symptoms for everything from depression and anxiety to attention deficit disorder, many mental health providers say.

Because many primary care doctors rely on the DSM to help them understand and diagnose mental health problems, it’s critical that the manual be as accurate and science-based as possible, say psychologists who have signed the petition.

While trained psychiatrists might be able to distinguish between a mental health disorder that needs medical intervention and a so-called normal human response to a difficult time or situation, primary care doctors may struggle.

Critics’ concerns

Critics of the DSM update say that the task force assigned to make the revisions has suggested broadening the definitions of too many mental health problems, opening the door to even more diagnoses and treatments.

Grief after the death of a loved one, for example, may be included under the diagnosis of major depressive disorder. That means a person’s grief could be labeled a pathological disorder, and not a normal human experience, said psychologist Brent Robbins, a professor at Point Park University in Pittsburgh and an author of the petition.

2-year-olds on meds

“Another diagnosis, dysphoric mood dysregulation disorder, is basically temper tantrums,” Robbins said. “Next thing you know, you could have 2-year-olds on psychotropic medications.”

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How PTSD took over America

Wednesday, November 16th, 2011

Salon Magazine- November 15, 2011 by Alice Karekezi

The diagnosis is now being applied to everything from muggings to childbirth. An expert explains why it’s bad news

We’re not saying that people don’t have difficult emotional experiences and aren’t suffering. What we’re saying is this is not necessarily a disorder that people are experiencing, and if people think like that, it can be very disempowering to them. ( Photo Credit: David Royal Hanson via Shutterstock)

In the past 30 years, post-traumatic stress disorder has gone from exotic rarity to omnipresent. Once chiefly applied to wartime veterans returning from combat, it is now a much more common diagnosis, still linked to traumatic events but now including those occurring outside the battle zone: the death of a loved one on a hospital bed, a car crash on the highway, an assault in the neighborhood park. Many would argue that this is a good thing: greater recognition of psychologically distressing events will lead to more people seeking treatment and a decrease in the preponderance of PTSD – a win-win.

Stephen Joseph disagrees. In his new book, “What Doesn’t Kill Us,” the professor of psychology, health and social care at the University of Nottingham (in the U.K.) warns that our culture’s acceptance of PTSD has become excessive and has led to an over-medicalization of experiences that should be considered part of ordinary, normal, human experience. This has kept us from proactively working through our grief and anxiety: We’ve become too quick to go to the shrink expecting him to fix us, rather than allowing ourselves the opportunity to grow and find new meaning in our lives as a result of painful, but common, events. Joseph advocates for a push toward post-traumatic growth as therapy to treat the stress of trauma, which he distinguishes as being different from the hokey, blue skies and rainbows, pop psychology that he claims has exploded in our culture in the past decade.

Joseph spoke to Salon over the phone to discuss our misunderstanding of the disorders, the meaning and usefulness of suffering, and if some cultures are more prone to PTSD than others.

How would you define a traumatic event? Is it subjective or are there some basic requirements that must be met?

I see trauma as a psychological rupturing. It’s when something happens to us that ruptures our psychological skin. Or, something which shatters our assumptions about ourselves in the world. That’s what I think of as traumatic, and in a way that can be many things. So, that can include a wider range of experience, and I can understand trauma in that broader way. There are lots of different experiences, such as being in a road traffic collision, or experiencing an illness – those sorts of things can be traumatic to people. It can be experienced as psychologically traumatic. But whether it’s necessary to create a psychiatric diagnostic category to capture those experiences is perhaps not necessary.

Do you believe that PTSD is over-diagnosed?

Well, that’s a really, really tricky question to answer because in a way it’s diagnosed pretty much exactly as it’s described in the Diagnostic and Statistical Manual (DSM). So whether the definition of PTSD is too broad is a different question, if you see what I mean. When PTSD was first introduced in 1980, it was defined much more tightly. The gatekeeper criterion to the diagnosis was: Have you experienced a traumatic event? In 1980, it was defined in such a way that only people who had experienced an event that was really outside the range of usual human experience, [like] Vietnam or the Holocaust, had experienced the sorts of experiences that were thought to elicit PTSD. So if you experienced something like a car accident or a traumatic birth, then you couldn’t get a diagnosis of PTSD, because, by definition, you hadn’t experienced a traumatic event.

In 1994, the definition changed in such a way as to include other, broader experiences. Equally persistent was the person’s subjective experiences of what they thought was traumatic. When that happened, people who had experienced car accidents, traumatic births, what we would have otherwise thought of as more ordinary life events, insofar as they are not statistically unusual, could then be diagnosed as a having PTSD. So now we are in a position where lots of people are able to receive the diagnosis of PTSD. So it’s not that it’s being over-diagnosed in that sense. The difficulty or problem, if there is one, is whether, generally speaking – PTSD would be part of this – the DSM over-medicalizes human experience. Things which are relatively common, relatively normal, are turned into psychiatric disorders.

Can you describe some of the typical symptoms of PTSD?

When people experience trauma, when their assumptions about themselves and the world come crashing down, there’s often a period of avoidance. People just try to block out what happened. Switch off. Turn their attention to other things. That’s quite understandable. Then, over time, that gives rise to memories and emotions that come flooding in as the person sort of begins to try to make sense of what happened, and that can become so powerful and distressing that they have to push that away again and go back into a period of avoidance. So sometimes people go through that, periods of avoidance and intrusion. That seems to me as a healthy and adaptive way of working through something painful, emotionally painful, that has happened to us. So those are the experiences. PTSD is when those experiences become so overwhelming that the person can’t function anymore – at work, or school, or in their social life. It takes over so much. But otherwise the symptoms of PTSD are fairly normal, natural ways of dealing with adaptation.

It’s important to see those experiences as quite normal and natural. They are not symptoms of a disorder by themselves. They’re just the way that people deal with an upsetting event in order to be able to make sense of things and to move on. It’s only when they become so overwhelmingly intense that they might be considered a disorder. I think that’s where we get into the problem with what PTSD is: when people are going through that normal experience, but they see it as having a disorder rather than a normal process of adaptation.

That will diminish over time?

Exactly.

Is the emotional pain overblown in such cases?

The suffering is very real. We’re not saying that people don’t have difficult emotional experiences and aren’t suffering. What we’re saying is this is not necessarily a disorder that people are experiencing, and if people think like that, it can be very disempowering to them.

What is the detrimental effect of over-medicalizing these more common human experiences of grief and pain?

When we think of ourselves as suffering from a disorder in a medical sense, well we go to the doctor and we expect the doctor to prescribe whatever the medical treatment is. We’re not in the driver’s seat. We go along – we tell them [our] symptoms, they listen to us, they diagnose what the problem is, and then they work out what the appropriate treatment is. That’s the mind-set when we’re working within a medical framework and we think of ourselves as suffering from a disorder. We sit down in front of the therapist and we expect the therapist to be like a doctor – to be looking out for what the symptoms are so that they can make the correct diagnosis and prescribe us the right treatment. The language of PTSD invokes those ideas, and I think it’s those ideas that can be quite unhelpful at times. For what we’re talking about here, if it’s a normal, natural process, what’s really important is for the person to be in the driver’s seat for themselves – to make their own choices, their own decisions, because we’re dealing not with a disorder, but a battle within the person to find new meanings and new ways of understanding the world. That’s what they have to do. Nobody else can do that for them.

What is “post-traumatic growth”?

Post-traumatic growth is when people come out of trauma having learned new things about themselves and about the world and about their relationship with the world. People develop new philosophies of life. They develop new priorities in life. People learn an awful lot about themselves: their strengths; what they’re good at; having new respect for themselves. They sort of see their lives as divided into two halves: before the event happened and after the event happened. There is a clear demarcation. And they recognize that something happened to them that sliced their world in half in that way, and things for them are now completely different. How they lead their lives has been transformed – their priorities about life, their relationships.

I think one of the things that captures that the most [starts with] the idea that, sometimes, people lead their lives in a way that is dictated by external forces of status and wealth, which are very much big drivers in our capitalist society. We often, in our everyday lives, forget about the small things that are quite important – our relationships: remembering to nurture them, to look after the people around us, to be giving, to be compassionate. When traumatic events happen, people are often shaken back to reality, and remember what really matters to them. Often it is those other things – remembering somebody’s birthday; nurturing our friendships; looking after our parents, the people around us; really embracing our relationships; and letting go of a more materialistic outlook. People often describe it as getting back to who they really are, or feeling more true to themselves, or being more genuine or more authentic. Somehow the idea of the false self that people create around them is shattered, like Humpty Dumpty falling off a wall. The essence of who they are emerges.

Yes, becoming truer to oneself captures the idea very well. Realizing that life is short and sometimes there isn’t as much time left as we thought to put up facades.

This kind of makes trauma sound like a blessing (you even mention people describing it as a “gift”). Is finding meaning the same thing as condoning the traumatic event? And doesn’t this talk of growth all sound very “kumbaya-ish” and unrealistic?

One of the reasons, sometimes, that post-traumatic growth can be seen unfavorably is that it seems like saying that trauma can lead to greater happiness; that for people who have been through trauma, it’s a good for them – they’re happier. That’s just so not the message. It’s not saying that trauma leads to happiness, in terms of smiling and feeling good and laughing and joy – not that type of happiness. What we’re talking about is how trauma can lead to a deeper, more existentially meaningful and fulfilling life, and that in turn may lead to greater happiness further down the road. But, post-traumatic growth is not about happiness in the sort of yellow, smiley face sense.

In essence, post-traumatic growth is a very simple idea, but it has been overshadowed by this mass of psychiatric literature over the past 30 or 40 years about the overwhelming destructive side of trauma, and about how these lead to medical problems. It’s a very simple idea, but [post-traumatic growth] sits, on the one hand, very uncomfortably within mainstream culture of the world of psychology and psychiatry, and on the other hand it seems to sit very comfortably with some other parts of Western culture, such as positive thinking, but it also clashes with some of that literature which is quite superficial, and not grounded in scientific research, and makes unsupported claims.

So, no, post-traumatic growth] doesn’t mean that [people] value or cherish the bad thing that has happened to them. They just accept that it has happened to them. People will often say they wish it hadn’t happened, or they wish they could go back, but there is a realism that they know they can’t. So it’s accepting that they can’t go back; they can’t change things. The only way forward is to go forward. It’s when people can’t accept that something has happened, and they [try] to go back to how they were before, is when they struggle. Acceptance is just being realistic – not seeing it as a good thing.

And someone not experiencing growth — or experiencing PTSD — is that person always trying to go back?

I think that often that’s what gets people stuck – trying to go back, trying to rebuild their lives exactly as it was before. That can lead people to get very stuck because it just isn’t possible when traumatic events happen and we’re presented with new information about the world, or with losses. It just isn’t possible to go back and make things as they were. We have to somehow accept what has happened to us and move on.

Is post-traumatic growth something completely in opposition to PTSD or post-traumatic stress? Either you have one or the other?

They can sit together. The way I see it, post-traumatic growth mostly arises out of post-traumatic stress. So it’s how people deal with the post-traumatic stress; how they manage to deal with the intrusive thoughts that are plaguing them; and the new sense they make of their experiences. So it’s through the post-traumatic stress, through the struggle of post-traumatic stress that post-traumatic growth arises. So often there’s a period of time in which people will begin to talk about post-traumatic growth but they will still be suffering from post-traumatic stress. They’re not in opposition. In a way, they are opposite sides of a coin.

You make a claim that true happiness is something that in and of itself cannot be pursued, and one is doomed to fail if one tries. How is that?

Well, that’s an idea that some philosophers have put forward. Some of the research seems to suggest that what’s really important to finding happiness is meaning and purpose in life. If we think our road to happiness is through seeking hedonistic pleasures night after night, then that’s not likely to lead to a deep, fulfilling level of happiness. But, if we find ways of finding meaning and purpose, wherever that might be, then we’re not setting out directly aiming for happiness but that’s what we’re going to get. We’re going to find a more fulfilling life. Happiness is a byproduct, but in a sense it’s more guaranteed.

When we think of psychological therapies, and the helping professions in general, they often have been about helping people feel better. [For] people with various problems of depression, anxiety or post-traumatic stress, therapy is about getting the person to have a more positive emotional state. That’s been, really, what the therapy world has been about for 50 years, and yet that’s only half the picture. The other half is about the meaning we put on things, our purpose in life, our sense of ourselves, our sense of autonomy, our relationships. Psychology can also be about those things. I’m not saying that therapists have ignored them altogether; for sure, they haven’t, but those more existential ideas have been overshadowed by trying to feel good. This is the idea between what psychologists call subjective well-being, which is about feeling good, and psychological well-being, which is what you could call “meaning-good,” and it’s just about getting the balance between those two things right.

Are there some cultures that are more prone to post-traumatic growth?

That’s a really good question. I don’t think the research has really documented that yet as to whether it may be more common. What the research has shown, however, is that post-traumatic growth is something observed in pretty much all cultures that have been investigated, though differently defined in slight ways. “Post-traumatic growth” sounds like a very Western idea, but [it’s one that] gets back into history and into all sorts of cultures. It’s an idea that’s very resonant with Buddhist and some Chinese philosophy ideas, as well as ideas in Western religion.

http://www.salon.com/2011/11/15/how_ptsd_took_over_america/singleton/

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If I have mental illness, I want doctors to prove it

Wednesday, October 12th, 2011

The Irish Times, October 11, 2011
by John McCarthy

Click on image to read the Mental Health Declaration of Human Rights

I AM MAD, a proud member of the mad community. Of course, madness exists – it’s normal, it’s as old as mankind, and it’s in every family. But if I have a disease in my brain called “mental illness”, I want the doctors to prove it. The brain is the most complicated organ in the body, yet doctors diagnose mental illness just by looking at you, and then you are labelled for life.

I’ve been diagnosed with unipolar depression, bipolar or manic depression, dysphoric elation – whatever that’s supposed to be – and paranoia. I’ve been told that I have a chemical imbalance in my brain that shows I have a mental illness. Yet not one of these fellows even took my pulse. They did it by sitting looking at me and talking to me.

I had a breakdown as a consequence of my dysfunctional childhood and because my business was collapsing – the banks were hounding me and I owed thousands. I was locked up for a year. I attempted suicide when I was on my heaviest dose of medication – a mixture of 10 different drugs a day.

There’s no such thing as a sudden breakdown: the madness was like the San Andreas Fault within me, lying dormant and buried. It was like an emotional stroke, a stroke of the spirit rather than the brain. But stroke victims can recover and they aren’t permanently labelled as disabled.

Our mental health laws allow two psychiatrists to sign a piece of paper and lock you up for the rest of your life because you’ve been diagnosed with a mental health problem. It’s based on nothing more than opinion, and that’s part of the cruelty of the mental health system in this country. You can be incarcerated and force treated against your will.

Why try to define madness? We should stop defining. We are all individuals with individual lives, and people react differently to different life situations. But the pharmaceutical industry, working with psychiatrists, tries to mass treat the individual, putting everyone in the same box.

Of course, madness has a downside. I hated it, but my hate was for myself really. I lost the ability to receive love. I was a complete pain in the arse, but my wife and family never stopped loving me. Yet you can learn from being mad. In fact, it was one of the most constructive learning experiences of my life.

I learned how to receive love with confidence. I have learned how to be at peace with who I am.

How do you learn to receive love? Well, if someone says you look well today, you say thank you. That’s the first step, but when I was in my negative side, that felt as hard as climbing Everest.

The Murphy and Ryan reports quite clearly showed that when you give power and authority to one section of the community over another abuse is bound to follow.

Mad Pride Ireland brings out the stories of people who have been abused under this system.

Society has bought into this idea that the mad community is dangerous and to be feared. The nuns got away with the same kind of thing for years with “loose women”; they took the problem part of the community away and buried them.

But we need to be free to ask awkward questions, to challenge the ethos of power and control. There is an aura of fear around psychiatric units. If you’re hopeless and helpless, you’ll be embraced and looked after. If you start asking questions, if you speak out with strength, they don’t want to know. When I started questioning things, I was offered more medication and told I was developing paranoia.

With every Mad Pride event we open up a public playground; there are no protests, no speeches. We scan everyone for normality – clowns use rubber chicken “normality detectors” to check people for signs of normality – and no-one has passed that test yet. We had 17,000 people at our event in Cork, all rocking to the music on a beautiful summer’s day.

It’s all about showing that madness is an everyday occurrence that affects everyone, and it can be dealt with in an open, loving way, with no fear. Now key people are beginning to listen to us. It shows what you can do with no money but a bit of goodwill.

Today I am lying here with motor neurone disease. I prefer the old name for it – creeping paralysis. You lose the use of your limbs, the ability to swallow, you end up incontinent. It’s a relentless disease. But there’s an honesty about the way neurology approaches it. Neurologists admit they don’t know the cause or cure for it.

They have done every test under the sun, I’ve undergone the deepest brain scan imaging in the country. But they admit they don’t know where it comes from and there is no fix, no treatment. Yet a psychiatrist can diagnose you just by looking at you.

I am happy for the psychiatric diagnoses I have had to be scientifically tested. I have a suggestion: I will put myself forward for psychiatrists to carry out any test they wish to do, in public, and I will publish the results. I’m dying, so I have nothing to lose.

click image to read more

But no-one is ever going to get a diagnosis of mental illness out of science: you will only ever get a diagnosis based on an assessment of behaviour. There is no science behind this disease, yet we have given the power of law to this guesswork. How are they getting away with this?

http://www.irishtimes.com/newspaper/health/2011/1011/1224305573629.html

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Mental illness redefined

Wednesday, October 12th, 2011

The Chicago Tribune

By Julie Deardorff, Tribune Newspapers

 October 12, 2011

When psychiatrists diagnose mental illness, they turn to an unwieldy book called the Diagnostic and Statistical Manual of Mental Disorders, or DSM for short.

First published in 1952, the tome also is used as a standard by researchers, the health insurance industry and pharmaceutical companies.

But the American Psychiatry Association is now in the middle of a historic and controversial revision of its bible. The fifth and highly anticipated edition, DSM-5, has sparked dissension among psychiatrists and generated more than 8,000 public comments on topics ranging from sexual- and gender-identity issues and anxiety disorders to mind-body problems.

The proposed revisions are “based on the most rigorous and up-to-date scientific findings available,” said Dr. Darrel Regier, the DSM-5 task force vice chairman. Inclusion, meanwhile, “means that a mental illness is more likely to be a target of research, which ultimately will improve our understanding how best to diagnose and treat psychiatric disorders,” he said.

Critics say some of the new entries broadly extend some definitions of mental illness and lower thresholds for some existing disorders, which will result in higher rates of diagnoses. That, they argue, “could result in massive overtreatment with medications that are unnecessary, expensive and often quite harmful,” Dr. Allen Frances, chairman of the DSM,-IV task force, wrote in the Psychiatric Times.
Read the rest of the article here OR get the facts about psychiatric disorders here  

No Science No Cures

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Depression? Don’t believe it —Big Pharma has gained an ever greater hold over our mental & emotional lives

Friday, September 9th, 2011

The Brisbane Times, Australia – Spetember 9, 2011
by Lisa Appignanesi

"Over the last 40 years the Diagnostic and Statistical Manual of Mental Disorders - the bible of the psychiatric professions - has spawned more and more diagnostic categories, "inventing" disorders along the way and radically reducing the range of what can be construed as normal or sane. Meanwhile Big Pharma, feeding its appetite for profits and ours for drugs, has gained an ever greater hold over our mental and emotional lives, medicalising normality."

In 2000 the World Health Organisation named depression as the fourth leading contributor to the global burden of disease and predicted that by 2020 it would rise to second place. I suppose WHO didn’t mean it to sound like a target to be aimed for, but we seem to be rising to the challenge in any case.

A new survey from the European College of Psychopharmacology, a meta-analysis of a mass of research, reports that a staggering 164.8 million Europeans – 38.2 per cent of the population – suffer from a mental disorder in any year.

As well as depression, this includes neural disorders such as dementia and Parkinson’s; childhood problems from ADHD to “conduct disorder”; and the leading anxiety disorders – everything from panic attacks to obsessive-compulsive disorder to shyness. The latest figures for Australia, from 2007, indicate that more than one in five people – 3.2 million – had suffered from anxiety, a mood disorder or substance abuse in the preceding 12 months; 2-3 per cent more were estimated to have been affected by other mental illnesses.

Depression and anxiety, they tell us, are disproportionately women’s ailments. Men, it seems, become alcoholics (another illness category) rather than depressives, particularly in eastern Europe.

Such reports are worrying. They may draw attention to a rising toll of human suffering, but they pinpoint the imperialising tendency of the mental health sector. Our ills and unhappiness are squeezed into a package labelled “disorder” and an ever-proliferating assortment of supposedly objective diagnostic categories. A cure is somehow promised, though it rarely seems to come, certainly not for everyone or for ever. In talking to the press or drafting press releases, researchers often extrapolate from their material in order to create good copy.

The notion that women are somehow more prone to mental illness often emerges. According to Hans-Ulrich Wittchen, one of the report’s authors, the reason women suffer nearly twice as much depression and anxiety disorders as men lies in the changing social pattern in which women take on work on top of marriage and children.

So stay home, ladies, and you’ll be as happy as apple pie; though in the 50s when we stayed home to bake it, the doctors gave us Miltown and Valium to help us take pain-free care of hubby and the young ones.

On the subject of women’s greater susceptibility, it’s just as well to remember that women go to doctors far more than men, for all kinds of ills: indeed, women’s greater incidence of mental ills just about equals their greater number of visits to the doctors. If men went to doctors as often as they go to the pub, it’s a fair guess that their unhappiness would be represented as depression or anxiety as well.

One of the many things that became clear to me as I was working on my book on the rise and rise of the mind-doctoring professions over the last 200 years, is that classifications of mental disorder are hardly absolutes. They are far more often constructs that mirror their time’s aspirations and ways of understanding. They may reflect subjective experience, but only insofar as we can prod and organise our inchoate inner lives to fit pre-existing psychiatric tick lists.

Useful tools for statisticians, the classifications are also useful to public health administrators, insurance companies, lobbying bodies, or pharmaceutical companies who need “homogeneous populations” on whom to carry out drug trials. But I remain to be convinced that these proliferating classifications help individuals find relief – except, of course, that momentary relief from giving an expert name to what may feel like an intractable set of problems.

Over the last 40 years the Diagnostic and Statistical Manual of Mental Disorders – the bible of the psychiatric professions – has spawned more and more diagnostic categories, “inventing” disorders along the way and radically reducing the range of what can be construed as normal or sane. Meanwhile Big Pharma, feeding its appetite for profits and ours for drugs, has gained an ever greater hold over our mental and emotional lives, medicalising normality.

The more studies that come along to tell us about the rise in mental illness, the more we fit our problems and unhappiness into a category of mental disorder, developing symptoms to take to the doctor in search of a cure. Humans are suggestible creatures. And doctors like to help: they provide the pills Big Pharma recommends, though many must now know that research has shown placebos can work just as well and with fewer side effects.

If doctors – rather than politicians or teachers or priests or friends and family – are to be the guardians of our wellbeing, then doctors really should be provided with new kinds of “treatments”. Psycho- and group therapy could, of course, be rolled out, and not just of the 10-week variety: anything that builds up the individual’s inner resources and allows emotions to be reflected on can’t be bad.

But doctors could recommend group running for depression, proved to have far better effects than SSRIs. Reading groups, too, offer a definite lift. As for women, more free childcare, after-school clubs and husbands who take days off to go to the doctor with the kids (or sort out that drinking problem) would lift a depressed mood wonderfully. Then there’s poverty, terrible schools … could health systems take those on as well?

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Are you shy? Then you have a mental disorder

Thursday, September 8th, 2011

The mad claim that 165 million Europeans suffer from ‘mental illness’ confirms that normal emotional states are now seen as diseases.

Spiked – September 8, 2011

by Tim Black

‘Mental health disorders are Europe’s largest healthcare challenge in the twenty-first century’, announced Hans-Ulrich Wittchen this week.

A professor of psychology and psychotherapy at the University of Dresden, Wittchen wasn’t saying anything we haven’t heard before. The World Health Organisation has also gleefully predicted that by 2020, ‘depression will be the second leading contributor to the burden of disease’. Still, the magnitude of Wittchen’s Europe-wide diagnosis is more than a little shocking: 38 per cent of Europeans, he said, are suffering from a mental disorder. That’s about 165million people.

Wittchen arrived at these shocking results, published in Neuropsychopharmacology, after a three-year-long review of data from previous studies involving over 500 million people in 30 European countries. Therein he discovered that nearly 40 per cent of those 500million were suffering from one of nearly a hundred mental or neurological problems, the most common of which were anxiety disorders, insomnia, depression, alcohol and drug dependence, and dementia.

‘Although the figure [of 165million] seems shockingly high, this is the most rigorous study done in Europe’, saidGraham Thornicroft, a professor of community psychiatry at the Institute of Psychiatry at King’s College London.

There is a great deal of scepticism towards Wittchen’s results and what they mean. And no wonder. Even in these overly medicalised times, where feeling well is increasingly confused with awaiting diagnosis, the idea that well over a third of Europe is suffering from a mental disorder just doesn’t tally with our actual lived experience. After all, does it not seem absurd to think that one in every three Europeans is mentally ill?

In fact, what Wittchen’s findings really indicate is the expansion of the diagnostic categories of mental illness, not the expansion of mental illness itself. Writing in the Guardian on Wednesday, Lisa Appignanesi rightly drew attention to the ever-expanding girth of the so-called bible of the psychiatric profession, the Diagnostic and Statistical Manual of Mental Disorders (DSM).

When it was first published in 1952 it contained a then unprecedented 60 diagnostic categories for mental illness. And subsequent editions have expanded its diagnostic reach even into everyday, mundane behaviour. By 1994, the fourth (and current edition) recognised a total of 384 mental ailments (plus 28 ‘floating diagnoses’). And if the preliminary revisions are any indication, the fifth edition, due in 2013, looks set to supply psychiatric practitioners with yet more labels for disorders and illnesses we didn’t even know we had.

As many have observed before, absurdity abounds in the psychiatric worldview. The most banal of everyday behaviours, emotional states that I’d wager almost everyone has encountered at some point in their lives, have been given technical, medical-sounding names. So shyness becomes ‘avoidant personality disorder’; anger becomes ‘intermittent explosive disorder’; and if the experts get their way, not throwing stuff away will become ‘hoarding disorder’. In an incredible bit of insightless prose, we are told by DSM’s recent consultation document that, ‘The symptoms [of hoarding disorder] result in the accumulation of a large number of possessions that fill up and clutter active living areas of the home or workplace to the extent that their intended use is no longer possible’.

While it is easy to make fun of the silliness of the psychiatric industry for giving our most banal behaviours a jargonised sheen, there is a serious point here, too. When everyday subjective states, such as shyness or distractedness, are turned into clinical objects, they become ripe for external, clinical intervention. We cease to be capable of overcoming a bout of anxiety, perhaps brought about by job worries; instead we are encouraged to see ourselves as in need of professional, expert help. And any practical problems at the root of, say, ‘depression’ or ‘anxiety’ – like unemployment or marital problems, for instance – are transformed into mental problems in need of psychiatric solutions. Wittchen’s assertion that the ‘immense treatment gap… for mental disorders has to be closed’ is therefore charged with ominous Brave New World intent. Europe is a continent of therapeutic supplicants in the making.

Read the rest of the article here:  http://www.spiked-online.com/index.php/site/article/11060/

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America conned: Psycho pharma drug pushing empire under fire

Tuesday, July 26th, 2011

NaturalNews – July 26, 2011

by Monica G. Young

"psychopharma is looking like an idea whose time has passed."

Is America truly stricken with widespread mental illness? Do tens of millions need mind-altering drugs? A recent flurry of media articles lead readers to a realization that Big Pharma and the “mental health” industry have deceived Americans on a grand scale.

The “New York Review of Books” two-part article by Dr. Marcia Angell, Senior Lecturer at Harvard Medical School and former Editor in Chief of The New England Journal of Medicine, summarizes it extremely well. She analyzes three books by authors Irving Kirsch, Robert Whitaker, and Daniel Carlat. Each deconstructs the apparent mental illness epidemic and theory that mental disorders stem from brain chemical  imbalances which can be corrected by drugs.

Dr. Angell’s review has sparked a host of other journalists to applaud her and fuel the fire. An article in Forbes even concludes, “psychopharma is looking like an idea whose time has passed.”

As an overview:

Ten percent of Americans over age six take antidepressants. Antipsychotic drugs, once reserved for schizophrenics, have become the top-selling class of drugs in the US, with over $14 billion in sales in 2009. ADHD, bipolar and autism diagnoses have exploded in the past two decades with at least 5 million US kids now on psychiatric drugs.  Ten percent of boys take drugs for ADHD. Half a million kids take antipsychotics, including preschoolers.

The chemical imbalance theory rose to fame when Prozac hit the market in 1987, accompanied by massive hype that it corrected a chemical deficiency in the brain. In the years that followed, the number of people prescribed drugs for mental illness skyrocketed. Today, “treatment” for mental disorders is synonymous with psychoactive (mind-altering) drugs.

Tracing the origin of this theory shows it wasn’t that chemical imbalances were discovered in the mentally ill and then drugs were devised to correct the imbalance. Instead, drugs created for other purposes were incidentally found to also affect brain chemicals and blunt mental symptoms. Drug companies, hungry for new markets, and   psychiatry, eager to build stature in the medical arena, leapt on this. They conducted a vast campaign to popularize chemical imbalances as the cause of mental disturbance and push drugs as the answer.

As Dr. Angell writes, “instead of developing a drug to treat an abnormality, an abnormality was postulated to fit a drug.” “Or similarly,” she says, “one could argue that fevers are caused by too little aspirin.”

Many scientific studies disprove the chemical imbalance theory. After fifteen years of research, Irving Kirsch – psychologist and author of “The Emperor’s New Drugs” – concludes, “It now seems beyond question that the traditional account of depression as a chemical imbalance in the brain is simply wrong.” Research studies show psychoactive medications actually disrupt brain chemistry and causes the brain to function abnormally. This year prominent neuroscientist, Dr. Nancy Andreason, announced proof that antipsychotics shrink the brain.

Studies also demonstrate that long-term recovery rates are higher for nonmedicated patients. For instance, the World Health Organization conducted an investigation in fifteen cities around the world and out of 740 depressed individuals studied, those that weren’t on psychiatric drugs had the best long term outcomes.

In the pre-medication era, it was known that with time, people usually recovered from depression. If kids had tantrums, were unruly or shy, they were apt to outgrow it. Today, individuals branded with disorders are likely to receive long-lasting diagnoses, endless prescriptions and the poorer ones tend to remain on disability for life.

Big Pharma manipulation

Dr. Marcia Angell says the author of each of the three books agrees on “the disturbing extent to which the companies that sell psychoactive drugs – through various forms of marketing, both legal and illegal, and what many people would describe as bribery – have come to determine what constitutes a mental illness and how the disorders should be diagnosed and treated.”

According to IMS Health, an information and consulting company, pharmaceutical companies spent $6.1 billion in 2010 in marketing to US doctors. Another $4 billion was spent on direct-to-patient advertising.

Drug trials, used to bring a drug to market, are funded by drug companies, heavily biased and misleading. Companies may sponsor as many trials as they like until they have just two positive ones to submit to the FDA. Great care is taken to hide negative trials. The highly positive results of placebo trials are downplayed: a high percentage of patients recover on a fake drug (like a sugar pill) – proving that the more a person believes he will benefit from a treatment, the more likely he will experience a benefit.

In regards the Diagnostic and Statistical Manual – the psychiatric bible of mental disorders, used in prescribing drugs – Dr. Angell points out “in all of its editions, it has simply reflected the opinions of its writers.” The majority of the psychiatrists involved in creating the current edition had financial ties to drug companies.

Author Daniel Carlat points out that “psychiatrists consistently lead the pack of specialties when it comes to taking money from drug companies.”

Crime against humanity

And where has the “mental health” industry and “drug therapy” brought our nation?

As Americans line up at their local pharmacy, documented side effects are legion: weight gain, deadened emotions, diabetes, heart problems, liver damage, stunted growth in kids, shortened life spans and on and on. Those prescribed one psychoactive drug are commonly prescribed another to address side-effects, with many on daily cocktails of meds.

An estimated 2.2 million Americans are hospitalized each year for adverse drug reactions. Over 100,000 die from them.

Instead of decreasing, the number of adults on disability pay for mental illness has soared 250% since 1987 and for kids it’s a 35X increase.

The greatest  crime to humanity is the mass drugging of children. Yet it’s perpetrated within schools, doctors offices, foster homes and juvenile facilities daily.

There is good news. In the past few years, drug companies have faced a rise of multi-billion dollar class action suits. The key popularizer of childhood bipolar and antipsychotics for kids, Dr. Joseph Biederman, was publicly sanctioned by Harvard Medical School for failing to report $1.6 million he pocketed from drug companies. Some drugmakers are steering away from pursuing new psychoactive drugs.

Nazi chief propagandist Joseph Goebbels once said, “If you tell a lie big enough and keep repeating it, people will eventually come to believe it.”

This chemical-imbalance/drug therapy lie has been told big enough and repeated enough, that much of America believes it. Isn’t it time we all put a stop to it?

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Mass psychosis in the US—How Big Pharma got Americans hooked on anti-psychotic drugs

Tuesday, July 12th, 2011

ALJAZEERA – July 12, 2011

by James Ridgeway

Drug companies like Pfizer are accused of pressuring doctors into over-prescribing medications to patients in order to increase profits - GALLO/GETTY

Has America become a nation of psychotics? You would certainly think so, based on the explosion in the use of antipsychotic medications. In 2008, with over $14 billion in sales, antipsychotics became the single top-selling therapeutic class of prescription drugs in the United States, surpassing drugs used to treat high cholesterol and acid reflux.

Once upon a time, antipsychotics were reserved for a relatively small number of patients with hard-core psychiatric diagnoses – primarily schizophrenia and bipolar disorder – to treat such symptoms as delusions, hallucinations, or formal thought disorder. Today, it seems, everyone is taking antipsychotics. Parents are told that their unruly kids are in fact bipolar, and in need of anti-psychotics, while old people with dementia are dosed, in large numbers, with drugs once reserved largely for schizophrenics. Americans with symptoms ranging from chronic depression to anxiety to insomnia are now being prescribed anti-psychotics at rates that seem to indicate a national mass psychosis.

It is anything but a coincidence that the explosion in antipsychotic use coincides with the pharmaceutical industry’s development of a new class of medications known as “atypical antipsychotics.” Beginning with Zyprexa, Risperdal, and Seroquel in the 1990s, followed by Abilify in the early 2000s, these drugs were touted as being more effective than older antipsychotics like Haldol and Thorazine. More importantly, they lacked the most noxious side effects of the older drugs – in particular, the tremors and other motor control problems.

The atypical anti-psychotics were the bright new stars in the pharmaceutical industry’s roster of psychotropic drugs – costly, patented medications that made people feel and behave better without any shaking or drooling. Sales grew steadily, until by 2009 Seroquel and Abilify numbered fifth and sixth in annual drug sales, and prescriptions written for the top three atypical antipsychotics totaled more than 20 million.  Suddenly, antipsychotics weren’t just for psychotics any more.

Not just for psychotics anymore

By now, just about everyone knows how the drug industry works to influence the minds of American doctors, plying them with gifts, junkets, ego-tripping awards, and research funding in exchange for endorsing or prescribing the latest and most lucrative drugs. “Psychiatrists are particularly targeted by Big Pharma because psychiatric diagnoses are very subjective,” says Dr. Adriane Fugh-Berman, whose PharmedOut project tracks the industry’s influence on American medicine, and who last month hosted a conference on the subject at Georgetown. A shrink can’t give you a blood test or an MRI to figure out precisely what’s wrong with you. So it’s often a case of diagnosis by prescription. (If you feel better after you take an anti-depressant, it’s assumed that you were depressed.) As the researchers in one study of the drug industry’s influence put it, “the lack of biological tests for mental disorders renders psychiatry especially vulnerable to industry influence.” For this reason, they argue, it’s particularly important that the guidelines for diagnosing and treating mental illness be compiled “on the basis of an objective review of the scientific evidence” – and not on whether the doctors writing them got a big grant from Merck or own stock in AstraZeneca.

Marcia Angell, former editor of the New England Journal of Medicine and a leading critic of the Big Pharma, puts it more bluntly: “Psychiatrists are in the pocket of industry.” Angell has pointed out that most of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the bible of mental health clinicians, have ties to the drug industry. Likewise, a 2009 study showed that 18 out of 20 of the shrinks who wrote the American Psychiatric Association’s most recent clinical guidelines for treating depression, bipolar disorders, and schizophrenia had financial ties to drug companies.

In a recent article in The New York Review of Books, Angell deconstructs what she calls an apparent “raging epidemic of mental illness” among Americans. The use of psychoactive drugs—including both antidepressants and antipsychotics—has exploded, and if the new drugs are so effective, Angell points out, we should “expect the prevalence of mental illness to be declining, not rising.” Instead, “the tally of those who are so disabled by mental disorders that they qualify for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) increased nearly two and a half times between 1987 and 2007 – from one in 184 Americans to one in seventy-six. For children, the rise is even more startling – a thirty-five-fold increase in the same two decades. Mental illness is now the leading cause of disability in children.” Under the tutelage of Big Pharma, we are “simply expanding the criteria for mental illness so that nearly everyone has one.” Fugh-Berman agrees: In the age of aggressive drug marketing, she says, “Psychiatric diagnoses have expanded to include many perfectly normal people.”

Cost benefit analysis

What’s especially troubling about the over-prescription of the new antipsychotics is its prevalence among the very young and the very old – vulnerable groups who often do not make their own choices when it comes to what medications they take. Investigations into antipsychotic use suggests that their purpose, in these cases, may be to subdue and tranquilize rather than to treat any genuine psychosis.

Carl Elliott reports in Mother Jones magazine: “Once bipolar disorder could be treated with atypicals, rates of diagnoses rose dramatically, especially in children. According to a recent Columbia University study, the number of children and adolescents treated for bipolar disorder rose 40-fold between 1994 and 2003.” And according to another study, “one in five children who visited a psychiatrist came away with a prescription for an antipsychotic drug.”

A remarkable series published in the Palm Beach Post in May true revealed that the state of  Florida’s juvenile justice department has literally been pouring these drugs into juvenile facilities, “routinely” doling them out “for reasons that never were approved by federal regulators.” The numbers are staggering: “In 2007, for example, the Department of Juvenile Justice bought more than twice as much Seroquel as ibuprofen. Overall, in 24 months, the department bought 326,081 tablets of Seroquel, Abilify, Risperdal and other antipsychotic drugs for use in state-operated jails and homes for children…That’s enough to hand out 446 pills a day, seven days a week, for two years in a row, to kids in jails and programs that can hold no more than 2,300 boys and girls on a given day.” Further, the paper discovered that “One in three of the psychiatrists who have contracted with the state Department of Juvenile Justice in the past five years has taken speaker fees or gifts from companies that make antipsychotic medications.”

In addition to expanding the diagnoses of serious mental illness, drug companies have encouraged doctors to prescribe atypical anti-psychotics for a host of off-label uses. In one particularly notorious episode, the drugmaker Eli Lilly pushed Zyprexa on the caregivers of old people with Alzheimer’s and other forms of dementia, as well as agitation, anxiety, and insomnia. In selling to nursing home doctors, sales reps reportedly used the slogan “five at five”—meaning that five milligrams of Zyprexa at 5 pm would sedate their more difficult charges. The practice persisted even after FDA had warned Lilly that the drug was not approved for such uses, and that it could lead to obesity and even diabetes in elderly patients.

In a video interview conducted in 2006, Sharham Ahari, who sold Zyprexa for two years at the beginning of the decade, described to me how the sales people would wangle the doctors into prescribing it. At the time, he recalled, his doctor clients were giving him a lot of grief over patients who were “flipping out” over the weight gain associated with the drug, along with the diabetes. “We were instructed to downplay side effects and focus on the efficacy of drug…to recommend the patient drink a glass a water before taking a pill before the  meal and then after the meal in hopes the stomach would expand” and provide an easy way out of this obstacle to increased sales. When docs complained, he recalled, “I told them, ‘Our drug is state of the art. What’s more important? You want them to get better or do you want them to stay the same–a thin psychotic patient or a fat stable patient.’”

For the drug companies, Shahrman says, the decision to continue pushing the drug despite side effects is matter of cost benefit analysis: Whether you will make more money by continuing to market the drug for off-label use, and perhaps defending against lawsuits, than you would otherwise. In the case of Zyprexa, in January 2009, Lilly settled a lawsuit brought by with the US Justice Department, agreeing to pay $1.4 billion, including “a criminal fine of $515 million, the largest ever in a health care case, and the largest criminal fine for an individual corporation ever imposed in a United States criminal prosecution of any kind,”the Department of Justice said in announcing the settlement.” But Lilly’s sale of Zyprexa in that year alone were over $1.8 billion.

Turning people into zombies

As it turns out, the atypical antipsychotics may not even be the best choice for people with genuine, undisputed psychosis.

Read the rest of the article here: http://english.aljazeera.net/indepth/opinion/2011/07/20117313948379987.html

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