Welcome to From Insults to Respect.

Last week, I presented a post titled, “Mental Illness as Distress, Abnormality, and Dysfunction.” There, I explained that it is actually normal in our society to have periods during which we become concerned that we are too distressed, or too dissatisfied with our level of functioning. The pharmaceutical companies, I noted, promote that these concerns are mental disorders and can be safely addressed by going to a psychiatrist.

Psychiatrists, using the Diagnostic and Statistical Manual of Mental Disorders-5th Edition (DSM-5), label expressed concerns as mental disorders, and then write prescriptions for drugs they call medications. This is financially rewarding for psychiatrists and makes billions for the drug companies. Unfortunately, this model is promoted as a sound science supported enterprise, although science paints a dramatically more complicated picture.

The question of whether psychiatry is even properly viewed as a science was taken up in an article titled, “Is Psychiatry Scientific? A Letter to a 21st Century Psychiatry Resident.” Published in 2013 by the National Library of Medicine, its conclusion section states in part, “The DSM-5 is a dead end, and even the NIMH scientists acknowledge that DSM-5 does not describe valid entities supported by valid scientific research.” Nevertheless, on the basis of this approach, the average psychiatrist makes $220,000 per year.

Here’s a narrative illustrating what they do to earn this.

Good afternoon, Mrs. Doe. I hope your trip here went smoothly.

Yes. I’ve come for an appointment, Dr. Smith, because I’ve been very depressed. I’ve been seeing on TV commercials that there are some pills that can help.

Yes, Mrs. Doe, there are. But first, please tell me how long these depressed feelings have been going on.

Well, my husband and I have begun the process of having a divorce, and, well even before that, we were having marital problems, and, well, maybe for a few months now its been pretty bad.

Has it been affecting your sleep?

Oh, yes. I often have trouble falling to sleep for hours.

How about eating?

Sometimes I end up drinking too much, and I have a bad stomach reaction….

After this type of conversation goes on for about an hour, the doctor prescribes a pill, informing the patient of what kinds of side effects to watch out for.

Psychiatrists, like other medical doctors, seek to validate their treatment with studies that are carried out using acceptable scientific methodologies. Let’s take a critical look at the outcomes of these studies.

The Science

Short term studies indicate the use of “antidepressants” can cause irritability, anxiety and panic, emotional flattening, involuntary muscle movements, sexual impairment, suicidality, weight gain and aggression. Additionally, serious withdrawal effects are well-documented and can last for months, and can be mistaken for a return of depressive symptoms. 

In these short term studies, some subjects taking these drugs do report some improvement after a few weeks, but so too do those who take a placebo, or begin a physical exercise program, or begin seeing a counselor or psychotherapist, or begin to meditate. The difference between the  improvement experienced between the active drug and placebo groups tends to be slight.

Even this slight improvement has been questioned because of serious flaws in the research design. These flaws have to do with the drug studies being funded by pharmaceutical companies and because most of the subjects in the studies were taking a different “antidepressant” prior to the study.

Why would taking a different “antidepressant” prior to taking the new drug in these studies lead to making the new drug look more effective than a placebo? To qualify to be in the study, those who had been taking a different “antidepressant” had to agree to stop taking it for a couple of weeks prior to taking the new “antidepressant.” It often takes more than two weeks to wean off of these types of drugs. Therefore, many of these subjects in the placebo group were experiencing withdrawal reactions from no longer taking any “antidepressant.” This then creates the illusion that the new drug is more effective than a placebo because those taking the placebo mistake their withdrawal reaction that is continuing after they begin to take the placebo to a worsening of depression. Meanwhile, those in these studies who were taking the actual new drug are less likely to experience withdrawal reactions because new “antidepressants” are similar to the older ones. 

As for the long term effects of these drugs, there are some studies that looked at this and found that those who took “antidepressants” had worse outcomes than those who did not receive the drug despite having the same symptoms.

I focus above on the science regarding depression because it is the most common reason people go to a psychiatrist, but all of the drugs psychiatrists tend to prescribe are unhealthy. The so called “antianxiety” drugs, colloquially called “benzos,” are addictive, and side effects include drowsiness, dizziness, and decreased alertness and concentration. Lack of coordination may result in falls and injuries. Another result is impairment of driving skills and increased likelihood of traffic accidents. Decreased libido and erection problems are also common side effects. Depression and disinhibition may emerge.

The so called “antipsychotic” drugs are even more dangerous. Here’s a list of them, and I provided a link for each one so people can learn more about what they are.

• antimuscarinic effects
• bed-wetting
• blood disorders
• body temperature problems
• emotional effects
• eye problems
• heart problems
• liver disorders
• metabolic syndrome
• neuroleptic malignant syndrome (NMS)
• neuromuscular side effects
• sedation (sleepiness)
• seizures (fits)
• sexual and hormonal problems
• skin problems
• suicidal feelings and behaviour
• tardive dyskinesia (TD)
• tardive psychosis
• weight gain

Some estimates suggest the “antipsychotics” shorten a person’s life by around 10 to 20 years. That’s a lot of damage to cause.

My Conclusions

Dr. Jeff Rubin

For several years, I moderated a series of debates on this topic. The panel members included several leading psychiatrists who supported what they did in their practice. I came away fairly convinced that they genuinely believed they were providing an enormously helpful set of treatments. They also struck me as intelligent, caring individuals, and I respected them for their willingness to debate the issues.

Their efforts at rationalizing what they do consists of describing their experience with their patients in glowing terms, minimizing the negative side effects while exaggerating the benefits of the drugs they prescribe, and admitting that much of the scientific support for their treatments are indeed flawed but set this quickly aside with comments like, “Hey, all research studies have flaws.” Even in the face of other debate panel members that included one psychiatrist, a noted scientist, and patients who disagreed with them, they steadfastly remained convinced that their approach was consistent with the best science available.

These debates also included patients who fervently believed the psychiatric/mental disorder way of looking at their concerns has been enormously helpful. Their two chief arguments were,

1. Mental illnesses are real illnesses, and therefore, this eliminates blame for what they were going through,

2. The psychiatric drugs have “saved their lives,” or significantly improved their lives.

To this, I want to make it clear that neither I, nor most of the people I know, blame patients/clients for experiencing psychological concerns regardless of their views on this issue. At the same time, I have met people who do blame people for any and all behaviors they don’t like about them regardless of their views on mental illness. Since the notion of mental illness as real illness has been the dominant position by psychiatrists, stigma has not been eliminated. Moreover, I know smart, intelligent people who choose to take psychiatric drugs that I genially like and respect. With those words of clarification, I nevertheless have, after hearing both sides of these issues, concluded psychiatry causes far more harm than good, while being a heck of a financially rewarding business model.

It’s hard to come to this conclusion because making a good living is a fine thing to be doing. I don’t want to be seeming to be putting down the value of this, and I fear that people might think I have unkind feelings toward psychiatrists in general. I recognize and accept good people see these issues so very differently than do I.

Well, enough for now on this so very challenging topic. Let’s depart with a shift to something more pleasant.

Spring has arrived, along with its beautiful, colorful flowers fluttering in fragrant breezes. And so, may we all find some time to get outside, breath deeply, and find within us a wonderful appreciation of the many fine aspects of being alive.

My Best,
Jeff

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Some people will enjoy reading this blog by beginning with the first post and then moving forward to the next more recent one; then to the next one; and so on. This permits readers to catch up on some ideas that were presented earlier and to move through all of the ideas in a systematic fashion to develop their emotional intelligence. To begin at the very first post you can click HERE.

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