NYC Therapist Talks: Psychiatric Drugs- Worth the Risk?
After finishing the book “Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America”, by Robert Whitaker (2010), and doing my own follow-up research, I feel even more strongly about marketing and over-diagnosing (and subsequent over-prescribing) of psychoactive drugs in this country. Folks, we have been sold a lie, and it goes like this: insane asylums were busting at the seams until the advent of psychiatric meds, at which point mental illness was all but cured. Psychiatry saved the day. Research seems to suggest, however, the number of people who are diagnosed as mentally ill is exponentially higher now, we have more and more diagnoses with each publication of the psychiatric “Bible”, the DSM, and more and more pills prescribed to more and more people at a younger and younger age than ever before.
Whitaker’s analysis of the research also illustrates how in most cases, regardless of the class of drug, there might be subtle improvement in the very short-term, but in the long-term psych drugs tend to cause more harm than good-regardless of the type/class of drug.
Depression- A Chemical Imbalance?
Back in the day, depression was treated only with talk therapy, and even if left untreated, was not debilitating, and would lift, with a majority of of patients recovering spontaneously within a year. Now, however, patients are given anti-depressants, and will likely see their symptoms subside in the first few weeks. (Research also shows a placebo- a sugar pill- works just as well.) But the pills stop working. The dosage is increased, and the side effects start to kick in, because the brain is trying to compensate for the “chemical imbalance” that was just induced by the introduction of those pills to begin with. Now, if you the client stops the medication, there is a high rate of relapse and something that would probably have abated on its own will now turn into something chronic and debilitating- not because that’s what depression does, but that’s what being on anti-depressants does. Oh, and have you ever seen that cartoon commercial for Zoloft that says “Only your doctor can diagnose depression”? Marketing at it’s finest! Any licensed mental health provider can diagnose depression, because we are all pretty much forced to use the psychiatrist’s manual, the DSM!
How about this one?
Anxiety traces its roots to neurasthenia, hysteria and Freud’s “anxiety neurosis”- in women (Whitaker, 2010)- the word “neurosis” being key. Historically, this again was not something debilitating requiring hospitalization. Enter benzodiazepines- great for the first few weeks, then terribly addictive and then the brain becomes impaired. Withdrawing from benzos seems to be worse than the initial anxiety!
Prescribing Drugs to Children
Whitaker describes the rise of prescriptions to children for diagnoses ranging from ADD/ADHD to something that doctors began to sell right along with that diagnosis as “comorbid”- juvenile bipolar disorder, and I have seen clients as young as 13 in my own practice who had been prescribed anti-psychotics and mood stabilizers like lithium. Whitaker’s analysis shows “Twenty years ago, our society began prescribing psychiatric drugs to children and adolescents, and now one out of fifteen Americans enters adulthood with a ‘serious mental illness’” (p. 246).
According to the data, in the late 1950′s, most schizophrenic patients that were hospitalized were discharged within one year, and siz years after hospitalization, 70% of them were living on their own- living “successfully in the community” (p.92). The outcome is the same in countries and cultures that do not have a history of pathologizing the human experience- when people are not medicated, but are supported throughout the course of their psychotic episodes, they get better. When they are given psych drugs- they appear to get worse.
Whitaker’s argument comes down to this- there are psychological phenomena that human beings experience that have been turned into a commodity by the pharmaceutical industry, by psychiatrists and the APA, and by “stakeholders” like the growing membership of NAMI (National Alliance on Mental Illness). These groups have acted in tandem to package and sell the idea that mental illness is the result of chemical imbalances and broken brains, and the best course of action is to take a pill. That pill’s efficacy is been proven in studies- studies by the pharmaceutical companies that show short-term results and ignore the long-term side-effects.
All in all, it’s a really interesting and eye-opening read. For a sneak peek- check out a presentation done by Whitaker himself. Oh yeah- he’s not a Scientologist, and it’s not just those Scientologists who are looking at the psychiatric drug movement with a critical eye.
In my practice, we are more interested in client’s own report of how they are doing in their lives, and how they are doing in therapy. And we can do it without resorting to labeling them with mental illnesses that add to their sense of being disabled. In every session we do, the client rates various areas of their lives, and we structure our session around the areas that the client is telling us they need help with. At the end of every session, the client rates how well that session went for them. The result is that we have data that can show the course of a client’s work with us. In the intake, we do a full assessment and are tracking which clients are on what medication for what diagnosis, and we are able to track a client’s own sense of whether or not what we’re doing in therapy is helping them or not. And withdrawing from therapy? That’s actually the goal, not a fear- and not something that involves even MORE medication and pain. There is no quick fix. We all have issues sometimes, and we all need people to talk to and to get support in whatever way we need to express whatever psychological situation we are in. There are absolutely therapists who will enable you and keep you dependent and despondent. But there are also those of us who want to work on getting you depending on yourself and back out living your life.