Psychiatry Gone Astray

Editorial note: We follow up the Guilty post last week with a piece written by Peter Gotzsche that has caused a stir in Denmark and provoked some of the Danish professors he critiques to respond.  

At the Nordic Cochrane Centre, we have researched antidepressants for several years and I have long wondered why leading professors of psychiatry base their practice on a number of erroneous myths. These myths are harmful to patients. Many psychiatrists are well aware that the myths do not hold and have told me so, but they don’t dare deviate from the official positions because of career concerns.

Being a specialist in internal medicince, I don’t risk ruining my career by incurring the professors’ wrath and I shall try here to come to the rescue of the many conscientious but oppressed psychiatrists and patients by listing the worst myths and explain why they are harmful.

 Myth 1: Your disease is caused by a chemical imbalance in the brain

Most patients are told this but it is completely wrong. We have no idea about which interplay of psychosocial conditions, biochemical processes, receptors and neural pathways that lead to mental disorders and the theories that patients with depression lack serotonin and that patients with schizophrenia have too much dopamine have long been refuted. The truth is just the opposite. There is no chemical imbalance to begin with, but when treating mental illness with drugs, we create a chemical imbalance, an artificial condition that the brain tries to counteract.

This means that you get worse when you try to stop the medication. An alcoholic also gets worse when there is no more alcohol but this doesn’t mean that he lacked alcohol in the brain when he started drinking.

The vast majority of doctors harm their patients further by telling them that the withdrawal symptoms mean that they are still sick and still need the mediciation. In this way, the doctors turn people into chronic patients, including those who would have been fine even without any treatment at all. This is one of the main reasons that the number of patients with mental disorders is increasing, and that the number of patients who never come back into the labour market also increases. This is largely due to the drugs and not the disease.

Myth 2: It’s no problem to stop treatment with antidepressants

A Danish professor of psychiatry said this at a recent meeting for psychiatrists, just after I had explained that it was difficult for patients to quit. Fortunately, he was contradicted by two foreign professors also at the meeting. One of them had done a trial with patients suffering from panic disorder and agoraphobia and half of them found it difficult to stop even though they were slowly tapering off. It cannot be because the depression came back, as the patients were not depressed to begin with. The withdrawal symptoms are primarily due to the antidepressants and not the disease.

Myth 3: Psychotropic Drugs for Mental Illness are like Insulin for Diabetes

Most patients with depression or schizophrenia have heard this falsehood over and over again, almost like a mantra, in TV, radio and newspapers. When you give insulin to a patient with diabetes, you give something the patient lacks, namely insulin. Since we’ve never been able to demonstrate that a patient with a mental disorder lacks something that people who are not sick don’t lack, it is wrong to use this analogy.

Patients with depression don’t lack serotonin, and there are actually drugs that work for depression although they lower serotonin. Moreover, in contrast to insulin, which just replaces what the patient is short of, and does nothing else, psychotropic drugs have a very wide range of effects throughout the body, many of which are harmful. So, also for this reason, the insulin analogy is extremely misleading.

Myth 4: Psychotropic drugs reduce the number of chronically ill patients

This is probably the worst myth of them all. US science journalist Robert Whitaker demonstrates convincingly in “Anatomy of an Epidemic” that the increasing use of drugs not only keeps patients stuck in the sick role, but also turns many problems that would have been transient into chronic diseases.

If there had been any truth in the insulin myth, we would have expected to see fewer patients who could not fend for themselves. However, the reverse has happened. The clearest evidence of this is also the most tragic, namely the fate of our children after we started treating them with drugs. In the United States, psychiatrists collect more money from drug makers than doctors in any other specialty and those who take most money tend to prescribe antipsychotics to children most often. This raises a suspicion of corruption of the academic judgement.

The consequences are damning. In 1987, just before the newer antidepressants (SSRIs or happy pills) came on the market, very few children in the United States were mentally disabled. Twenty years later it was over 500,000, which represents a 35-fold increase. The number of disabled mentally ill has exploded in all Western countries. One of the worst consequences is that the treatment with ADHD medications and happy pills has created an entirely new disease in about 10% of those treated – namely bipolar disorder – which we previously called manic depressive illness.

Leading psychiatrist have claimed that it is “very rare” that patients on antidepressants become bipolar. That’s not true. The number of children with bipolar increased 35-fold in the United States, which is a serious development, as we use antipsychotic drugs for this disorder. Antipsychotic drugs are very dangerous and one of the main reasons why patients with schizophrenia live 20 years shorter than others. I have estimated in my book, ‘Deadly Medicine and Organized Crime’, that just one of the many preparations, Zyprexa (olanzapine), has killed 200,000 patients worldwide.

Myth 5: Happy pills do not cause suicide in children and adolescents

Some professors are willing to admit that happy pills increase the incidence of suicidal behavior while denying that this necessarily leads to more suicides, although it is well documented that the two are closely related. Lundbeck’s CEO, Ulf Wiinberg, went even further in a radio programme in 2011 where he claimed that happy pills reduce the rate of suicide in children and adolescents. When the stunned reporter asked him why there then was a warning against this in the package inserts, he replied that he expected the leaflets would be changed by the authorities!

Suicides in healthy people, triggered by happy pills, have also been reported. The companies and the psychiatrists have consistently blamed the disease when patients commit suicide. It is true that depression increases the risk of suicide, but happy pills increase it even more, at least up to about age 40, according to a meta-analysis of 100,000 patients in randomized trials performed by the US Food and Drug Administration.

Myth 6: Happy pills have no side effects

At an international meeting on psychiatry in 2008, I criticized psychiatrists for wanting to screen many healthy people for depression. The recommended screening tests are so poor that one in three healthy people will be wrongly diagnosed as depressed. A professor replied that it didn’t matter that healthy people were treated as happy pills have no side effects!

Happy pills have many side effects. They remove both the top and the bottom of the emotions, which, according to some patients, feels like living under a cheese-dish cover. Patients care less about the consequences of their actions, lose empathy towards others, and can become very aggressive. In school shootings in the United States and elsewhere a striking number of people have been on antidepressants.

The companies tell us that only 5% get sexual problems with happy pills, but that’s not true. In a study designed to look at this problem, sexual disturbances developed in 59% of 1,022 patients who all had a normal sex life before they started an antidepressant. The symptoms include decreased libido, delayed or no orgasm or ejaculation, and erectile dysfunction, all at a high rate, and with a low tolerance among 40% of the patients. Happy pills should therefore not have been marketed for depression where the effect is rather small, but as pills that destroy your sex life.

 Myth 7: Happy pills are not addictive

They surely are and it is no wonder because they are chemically related to and act like amphetamine. Happy pills are a kind of narcotic on prescription. The worst argument I have heard about the pills not causing dependency is that patients do not require higher doses. Shall we then also believe that cigarettes are not addictive? The vast majority of smokers consume the same number of cigarettes for years.

 Myth 8: The prevalence of depression has increased a lot

A professor argued in a TV debate that the large consumption of happy pills wasn’t a problem because the incidence of depression had increased greatly in the last 50 years. I replied it was impossible to say much about this because the criteria for making the diagnosis had been lowered markedly during this period. If you wish to count elephants in Africa, you don’t lower the criteria for what constitutes an elephant and count all the wildebeest, too.

Myth 9: The main problem is not overtreatment, but undertreatment

Again, leading psychiatrists are completely out of touch with reality. In a 2007 survey, 51% of the 108 psychiatrists said that they used too much medicine and only 4 % said they used too little. In 2001–2003, 20% of the US population aged 18–54 years received treatment for emotional problems, and sales of happy pills are so high in Denmark that every one of us could be in treatment for 6 years of our lives. That is sick.

 Myth 10: Antipsychotics prevent brain damage

Some professors say that schizophrenia causes brain damage and that it is therefore important to use antipsychotics. However, antipsychotics lead to shrinkage of the brain, and this effect is directly related to the dose and duration of the treatment. There is other good evidence to suggest that one should use antipsychotics as little as possible, as the patients then fare better in the long term. Indeed, one may completely avoid using antipsychotics in most patients with schizophrenia, which would significantly increase the chances that they will become healthy, and also increase life expectancy, as antipsychotics kill many patients.

How should we use psychotropic drugs?

I am not against using drugs, provided we know what we are doing and only use them in situations where they do more good than harm. Psychiatric drugs can be useful sometimes for some patients, especially in short-term treatment, in acute situations. But my studies in this area lead me to a very uncomfortable conclusion:

Our citizens would be far better off if we removed all the psychotropic drugs from the market, as doctors are unable to handle them. It is inescapable that their availability creates more harm than good. Psychiatrists should therefore do everything they can to treat as little as possible, in as short time as possible, or not at all, with psychotropic drugs.


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You and your meds. Give the real story. Get the real story.

Pharmageddon

Pharmaceutical companies have hijacked healthcare in America, and the results are life-threatening.

 

Dr. David Healy documents a riveting and terrifying story that affects us all.

 

University of California Press (2012)

 

Available on Amazon.com

 

Comments

  1. Thanks so much for posting this. A clear, concise refutation of the myths associated with psychiatric drugs which is easily understood by lay people is immensely valuable. I will be circulating it throughout my networks and particularly to the families I work with who are so often given antidepressants to deal with the grief they experience as a result of losing a loved one to suicide.

    • I will copy it for our GP who prescribed an SSRI for my daughter. Her grasp of the myths exactly matches those in Dr Healy’s post. My daughter’s suicide at 20 was “caused by depression not the medication”

  2. Waiting for Godot?

    Waiting for Godot is a play which “has achieved a theoretical impossibility—a play in which nothing happens, that yet keeps audiences glued to their seats. What’s more, since the second act is a subtly different reprise of the first, he has written a play in which nothing happens, twice.” (Irish Times)

  3. Doctor Healy: I would very much like to know how I might gain your authorization to cross-post a link to this BLOG entry to DxSummit.org, the Global Summit for Diagnostic Alternatives, sponsored by the Society for Humanistic Psychology. It seems to me that your piece is one of the more cogent arguments I have seen, against the mythologies routinely spouted by proponents for the medicalization of daily life.

    I am also very interested to learn of your views concerning other bits of gross malpractice that have found their way into the Diagnostic and Statistical Manual. High on that list in my view would be psychosomatic medicine as a field, with its assertion of the self-evident nonsense that emotional distress can be “converted” into otherwise unexplainable medical symptoms.

    I have talked with hundreds of medical patients who have been substantively harmed by such assertions, by being denied appropriate medical investigation and care after being labeled as having “somatoform” mental health disorders. There is also evidence that just by applying a label of “psychogenic pain”, a doctor will more than double the risk of suicide in patients whose medical symptoms have not otherwise been diagnosed and treated.

    Sincerely,
    Richard A. Lawhern, Ph.D.
    Resident Research Analyst

  4. Marnie Woodcock says:

    A refreshing stance to see more psychiatrists willing to speak out about abuse and corruption which has hampered the psychiatric industry for a very long time and left millions of victims in its wake.

    Question is- when will any government take the bull by the horns on this and many other abuses and make this public knowledge. My experience in the UK is that being labelled with a psychiatric condition, has become an alternative route to dis-crediting and silencing people, especially when they’ve blown the whistle regarding severe abuse and failings across several sectors.

  5. Anne O'Beirne says:

    Our citizens would be far better off if we removed all the psychotropic drugs from the market, as doctors are unable to handle them. It is inescapable that their availability creates more harm than good. Psychiatrists should therefore do everything they can to treat as little as possible, in as short time as possible, or not at all, with psychotropic drugs” ~ Wow! Fairly profound coming from a Psychiatrist.

    There have been times when I found major tranquilizers that I can tolerate or minor tranquilizers useful. But I never needed them long term and no one explained that to me in 2008! As a result I ended up heavily drugged for 3 yrs which was completely unnecessary. Not forgetting that my major issues started while on an SSRI (Citalopram). It led to extremes of “highs” and “lows” and a diagnosis of “Bipolar Affective Disorder”. I had to figure it out for myself. Now I spend time trying to create awareness for others even though I meet resistance. And it is great to have your work to refer to.

    I am now at the stage of no drug use and do Yoga almost every day. I also listen to relaxation CDs, try to do mindfulness and sometimes do meditation. This requires daily work. I have also given up alcohol and try to watch my diet. As well as walking. Bibliotherapy is also something I find useful. And the idea of WRAP (Wellness Recovery Action Plan). The 5 key concepts of RECOVERY are: Hope, Personal Responsibility, Self-advocacy and Support. And also having good, honest doctors to refer to. Thank you.

    My symptoms are slowly subsiding and going away. Officially losing the label may be that bit trickier. But that is the plan. The last thing left to come back is a full night’s sleep. Working on that.

    • Anne O'Beirne says:

      Correction ~ The 5 key concepts of RECOVERY are: Hope, Personal Responsibility, Education, Self-advocacy and Support.

      • Jake Eagleshield says:

        Psychiatry has no business in the treatment of alcoholism. It hangs mentally ill labels on people they do not deserve,then proceeds to treat the perceived mental illness,(which is a CAUSE of the mental problem,not a symptom) and forget about getting the alcoholic to stop drinking,which in most cases will cause the mental disorder to go away. I have yet to meet a shrink who told a patient,”you are fine,you do not need my help” They MUST find something wrong with everyone,to justify their existence,and all those little letters behind their names.

  6. Dr Healy I applaud you for this article.
    Thankyou.
    Millions worldwide including myself have been totally hoodwinked by so called academic giants (ie doctors) calling black white.

  7. A great, direct summary of important themes. I think that the withdrawal point made under the “chemical imbalance” myth cannot be overemphasized. Dr. Gotzsche writes that “The vast majority of doctors harm their patients further by telling them that the withdrawal symptoms mean that they are still sick”. That is true, but the situation is even worse than that.
    Symptoms that appear when psychoactive drugs are taken are interpreted as having “unmasked” inherent conditions, rather than being counted as the side effects they clearly are. The press enthusiastically blames acts of violence, that look a lot like withdrawal from SSRIs or other drugs when one reads the facts, on the failure of the perpetrator to take his meds.
    This tendency to blame people for drug effects may be the single factor most responsible for perpetuating all the myths. Everyone sees the same situation, but psychiatrists too often add to the harm they have done by offering misleading, corrupt interpretations, which the public and the press accept.
    Excellent blog, I would like SSRIstories to reference it.

  8. As a parent of a 23 year old with schizoaffective disorder, we are very conflicted re. antipsychotics. We believe his disorder was triggered by heavy cannabis use.

    After the first break, risperidone was tapered to zero after 10 weeks. We read Whittaker’s book at this time. Things settled, but after a “little” cannabis six months later, there was another break. Because of side effects, quetiapine was used. Things leveled out and after 6 months use, a very gradual (many months) taper was done.

    The third break occurred 2 months later. Because the hospitalizations were so inhumane, we tried letting things run their course. The levels of psychosis varied from mild to moderate over a 10 month period. Eventually he was forcibly taken to the hospital from his university (not by our choice). He is now on olanzapine.

    My point here is simple… if a person goes psychotic, there are no effective or accessible services to help families, even if you can afford to self-pay. There is no alternative for supportive professionals working in the home, this aint Finland! Second, the antipsychotics, for whatever reason, do eventually moderate the most overt symptoms. Lastly, mental health hospitals are little more than lock-down facilities that provide little more than medication in deplorable conditions.

    While everyone involved recognizes the risks of long term antipsychotic use, there simply is not a well-developed body of literature or practitioners to guide families and patients through difficult times. After the first break, his doctor was Peter Breggin, the dean of anti-medication and he disowned our son as a patient when he came to the office in a psychotic state. What is a family to do?

    Answers please, not a statement of problems and myths, Dr. Healy.

    • Dear GS – Trying to find humane & effective help can be a tough slog especially in the USA! I don’t think either David Healy or Peter Gotzsche would say never touch antipsychotics – just use the smallest dose for the shortest time possible.

      I’m encouraged that your son was even allowed to taper off – most “shrinks” round my way insist the drugs have to be lifelong. He and you might enjoy a look at this online hub: http://www.madinamerica.com

      Lots of good people searching for answers like yourself. MindFreedom also has some good resources. There’s also a network of “voice hearers” groups that seek to understand & live with their symptoms (some use meds, many don’t): http://www.hearingvoicesusa.org

  9. Dr. Healy, thanks for going against the prevailing attitude in the medical profession and posting this. I went through a period of pretty severe depression several years ago at the same time I was being diagnosed with and going through a terrible period of Crohn’s Disease. I was prescribed antidepressants and filled the prescription but never could bring myself to take them. I read that there appeared to be a connection between Crohn’s and depression, and thought that maybe if my Crohn’s symptoms diminished that perhaps the depression would as well. I was concerned about messing around with my brain chemistry and wondering how I would ever get off antidepressants once I started them, particularly if they impaired my judgment. Thankfully, over 12-18 months my Crohn’s gradually went into remission and I came out of the depression. I have remained in remission on the Crohn’s and have had no episodes of depression in the several years since.

    I suspect you could write largely the same article about statins which are overprescribed based on the successful lobbying efforts of the pharmaceutical industry to repeatedly lower the levels of cholesterol at which they’re prescribed. My father took these for years and became very weak with muscle fatigue in his 60’s. I suspect the statins played a role in that.

    After much reading on these type of topics and understanding the incentives of the pharmaceutical industry and the medical community, my default position is to refuse a drug or medical screening unless there is an extremely compelling argument for it when considering the risks and potential benefits under both scenarios. And while I will consider the physician’s advice, I will also do my own research.

  10. Thanks for sharing this Dr. Healy,

  11. My son suffered from fairly severe school-related anxiety when he was very young. Every doctor insisted that I start him on Paxil or Prozac or Zoloft. I politely declined.

    But it got to a point that I couldn’t get a doctor in our area to see him for treatable issues that he had. (He had extraordinarily MILD cerebral palsy–or something that mimicked very, very mild C.P.) I was labeled as non-compliant–and I guess I was “non-compliant.” I didn’t trust the medication; I thought it was a bad idea for my kid.

    Meanwhile, I was very tired, I was gaining weight, easily fatigued, pale, out-of-breath during exercise, spent lots of time sitting and laying on our couch. So, every doctor I saw diagnosed me with depression and wrote me a prescription for Prozac, Paxil, or Zoloft. But I knew I wasn’t depressed. I didn’t TEND TOWARD depression–I was a generally happy person. Sorta born that way, I think. So I never filled the prescriptions for myself, either.

    One day, I decided I would compromise. I decided I would get one of my prescriptions filled and see what effect the medication had on me.

    I was given, supposedly a “baby dose,” and only took half of one one day.

    I woke up the next morning with the worst sense of impending doom than I can describe. It was like a dark drapery was pulled down on my entire life. For the very first time in my life I felt deep, inexplicable sadness–I experienced utter despair. Out of nowhere!

    This was 24 hours after having taken one half of one pill!

    It terrified me that this medication was given to children and adolescents who may not make the connection between THAT pill and THAT feeling.

    I became a member of 23andme and begged them to start asking their members if they had had any similar experiences. 23andme is currently studying this. Perhaps it is a medication that certain genetic profiles respond well to, and others do not.

    (Sort of like statin meds, @DP–same experience with my dad and my husband following statin medication. Same medication–same symptoms. Symptoms that never relented.)

    Anyway, I have met people who feel they have received a benefit from anti-depression medications–but they tend to be people who always tended toward depression.

    But I think anti-depressant medication can be downright dangerous (particularly to children and adolescents) who do not tend toward depression; indeed I think it can trigger depression!

    By the way–my fatigue, lack of energy, etc.,–I was severely, severely anemic, as it turns out. I wasn’t “depressed.”

    I appreciate parents who are at the ends of their rope, and I am not saying that all such medication is bad for all children. But my child’s anxiety cleared up without medication. I was fortunate enough to be able to home school him until he seemed ready to overcome the anxiety for the payoff of spending time with peers. (About 5th-6th grade.) He’s a great kid, and a great student–4th year pre-med at UCLA. (Neuroscience major, ironically.) To this day–he’s never been medicated with a psychotropic medication.

    I am just so relieved to see this issue discussed. And I am so relieved that I was an adult when I tried my one-half of a “baby dose” of Prozac.

    • Deirdre Oliver says:

      You are very lucky. On a friend’s suggestion I was given Prozac when I was extremely stressed with 4 major life changing projects maturing at the same time. I remember almost nothing of the next 20 months. Apparently, overnight, I had a gross suicidal reaction. I was admitted to a private clinic and given ECT the next day. For the next 20 months, after being diagnosed with bipolar which astonished everyone I knew, I had one drug after another and almost continuous ECT (66), mostly against my will. I lost the memories of my children growing up, my skills as a sculptor, I couldn’t recognise some of my own work, the ability to write (my third book was about a third finished), a planned movie series and a sitcom (optioned), all had to be abandoned. Frequently people would and still do, come up to me claiming friendship but I had no idea who they were. One was a gallery owner looking for more work. It was 3 years before I began to discover that huge sections of my memory was wiped out. Despite what David Healy says there is an enormous body of evidence that shows ECT severely affects memory & cognition. “It’s [memory loss] a nonissue. The idea that your memory is wiped out is a fiction.” British psychiatrist David Healy, MD, FRC.
      Tests have shown significant deficits, particularly in my non verbal cognitive functions, similar to those found after any severe brain trauma. For 13 years I was trapped in the psychiatric system. Last February, (2013) I walked away after my doctor said all she could offer me was Closapine and/or ECT. I have had NO signs of ANY `mental illness’ whatsoever. I have even got my tennis game back. I knew that doctor for 10 years. I have tapered off the drugs and am now an advocate and activist against the excesses of psychiatry. Good luck for the future and congratulations for being a great Mum.

  12. C. S. Herrman says:

    Apart from what most of us know — that the psychiatric profession has been unforthcoming as to necessary facts or accountability, that the pharmaceutical companies exert entirely too much influence, and that too many doctors are more or less incompetent — the issue remains that you, too, Dr. Healy, are in at least one regard just as incompetent as those you imply to be. To be specific:

    The impression you leave, and doubtless intend to leave (presuming you have an IQ worth mentioning), is that your morals and competence veer between the Scylla of Peter Duesberg of HIV denialist fame, and Thomas Szasz of pharmocological denialism fame. I suspect the latter is but a bipolar humbug in no mood to allow an empirical rational for his moods and exaggerations and embellishments. Fortunately they are more irritating than harmful. The former, however, is easily a medium for hundreds if not thousands of HIV deaths. And the reason you are keeping their delightful company is this — you suppose that because we do not have the Mack-truck-in-your-face evidence, you can feel free to idiotically assert that mental illness is mainly iatrogenic in the way Duesberg claims HIV is owing to drugs, recreational and therapeutic.

    Now allow me to set you aright, Sir. When anti-retrovirals came to be statistically (at p < .001) associated with lowered viral loads and the latter, by the same significance with decreased symptomatology, it doesn't require anyone but a full-blown bipolar with an agenda to pronounce the antithesis to what is rational to all normals. Dr. Healy, you are expected as a professional to know these things very well, and yet you deliberately exaggerate, embellish and employ hyperbole to light tinder rather than educate minds.

    How else to account for so ribald a denial of scientific orthodoxy? While you allow drugs in acute cases, the vast majority of mental illness that causes unemployment, poverty, vagrancy, belligerency, family destruction, and etc., are the result of chronic, not acute symptomatology, which you would have the reader believe are collectively, and in all likelihood, not requiring of treatment. Reread the thoughtful comment of GS. That person know what they were talking about.

    You can't have it both ways, doctor. Get a grip and rewrite that article before reposting elsewhere.

    • To CS Herrmann.
      I would like to add to the list:
      – All psychotropic drugs (including antidepressants) have a chemical structure and an influence on neurotransmitter pathways similar to illegal drugs. It’s a myth that they are different. Consequently, addiction and side effect reported on psychotropic drugs are similar to illicit drug users.
      – Pharmaceutical clinical trials include only small population and usually ‘trouble’ cases are excluded by participant selection criteria. That’s why only post-marketing surveillance can reveal all adverse effects. However the post-marketing results are very rare reach doctors.
      – It is only a THEORY that depression is the consequence of neurotransmitters imbalance. We only know that SSRIs block the reuptake of the neurotransmitter serotonin in the brain. The result is an increased availability of serotonin in the synaptic space, which cause the decrease of specific transporters . Is this imbalance helps to ‘balance’ the brain function? In another words we only hypothesize that it helps to control depression. In my opinion, it’s brain cells that ‘adapt’ to long prescription of SSRI s and rebalance itself to norm. Changing the balance of serotonin SEEMS TO help brain cells send and receive chemical messages ( no clear evidence provided by research).
      – What is norm and what is not in brain biochemistry? We all react differently to drugs. It is a known fact, however, data produced by pharmacogenetics, for example, are openly denied by majority of medical practitioners. In opposite, facts based on ‘SEEMS TO’ theory is embraced.
      Dr Gotzsche is not denying requirement to treatment , he is raising awareness of adverse drug reaction on SSRIs and drug overuse. Ignoring the fact that any drug (including SSRI) can cause side effect is also leads to life-threatening situations for thousands of patients (deterioration of HIV patients is just quicker). You are obviously moved by losses because of HIV denial and Dr Gotzsche is also concerned about the health and well-being of mental patients due to the denial of drug safety knowledge.
      Thanks for this brave post!

      • Thank you.

        • Deirdre Oliver says:

          ANDREA – You are an inspiration to us all. Your strength and wisdom belies your age. The world is a better place because of people like you. There is a development in the UK, via Dr Lucy Johnstone, a style of `therapy’ called `psychological formulation’. There is an interview with her on Facebook. An idea. Thank you. Deirdre.

      • C. S. Herrman says:

        I appreciate your points, Iskander. But I also represent the commonsense understanding that science and experience together create and support, namely, that psychotropic drugs WORK on the vast array of mental illness.

        As I said in my post at the very top, I am aware of the deficiencies of medical and psychiatric practice. It goes without saying that mistakes are rife, dangerous and indeed culpable of misery, debility and death.

        But two points remain relevant by way of perspective. First, practically nobody who has any experience with mental illness or the health professions is unaware of all the issues surrounding SSRIs. It’s old hat. Period. What is at risk is that constant harping on the obvious risks losing track of the relevant fact that the drugs WORK. Second, people being people, those with agendas take advantage of others’ desire to place trust in experts. This means that readers are necessarily in adverse reliance, and must hope, without recourse to knowledge, that the experts will not abuse their trust. The two folks responsible for this cavalcade of overblown hyperbole are playing on natural instincts to question all of authority when only parts of it are problematic. Overstressing these errors, while independently necessary (but already done sufficiently) serves only to cause normals and patients alike to question exactly what is most dangerous to question — the efficacy of these drugs to greatly reduce infirmity. I am thousands of others are the proof of that.

        So, again, while we require to know the whole truth, we must understand that overplaying our hand can do its own kind of damage. Think how many are refusing treatment for serious mental illness because they have taken literally all of these warnings of the two who sponsor this column and others. Were it not for the constant barrage of fear-mongering parading as innocent warnings there would be far less reason to worry over the continuing specter of mass killings. See my article Alice in a Mass Killer’s Wonderland either at OpEdNews or on ResearchGATE.

        • David_Healy says:

          We disagree on this point. First the data show rating scale changes rather than real benefits. Second RCTs are necessarily focussed on a primary outcome – one effect – and close to hypnotize doctors from noticing the 99 other things a drug does. On a numerical basis there are more people being injured than harmed. The drugs are risky. The risks may be worth taking if the condition warrants it – but most people being given SSRIs do not warrant such risks and are ill-informed as to the risks. Most of the Antidepressants currently being consumed in Western settings are being administered chronically – close to 10% of the population – and this likely reflects dependence.

          DH

        • C.S. Hermann says: “First, practically nobody who has any experience with mental illness or the health professions is unaware of all the issues surrounding SSRIs.”

          I challenge that assumption. I wonder what your evidence might be.

          Here are more than 1,000 current case reports demonstrating clear patterns of clinician error in misdiagnosing common adverse reactions, overprescribing, not knowing the basics of tapering, and not recognizing withdrawal symptoms http://tinyurl.com/3o4k3j5

          It’s very, very obvious that many doctors all over the world, including psychiatrists, are completely unaware of the risks of antidepressants.

          • C. S. Herrman says:

            Oh, I hear you loud and clear. But recall what I actually said, that which you excerpted. I referenced those outside of the profession, not within. And I also, I say now for the third time in these comments, that the professions has been horrifically bad in many regards, and you are mentioning one of them, to which i can hardly offer complaint for being in full agreement.

            But now note the larger perspective here. Patients MUST learn to be their own advocates when they cannot find others. And nmy advocates I DO NOT mean those whose counsel implies a denial of the basics: 1) mental illness is a reaction to stress and is due to the organism’s over-reactions that become generic and hard-wired, whence requiring more than talk therapy; 2) the drugs work. Not universally, but nearly enough so as to be a well taken fact of existence that is only foolish and worse to deny or ignore.

            Ergo, when it comes to anti-depressants and SSRI in particular, ptirnets have to question openly thier doctors’ choices and explanatipons. They need to bring in copies of scholarly articles increasingly available for free on the internet (Elsevier especially good) — and I do NOT include in that category the off-hand half-truths of the two authors of this post series.

            Admittedly, this is hardly an ideal solution. But there are no other better ones until we manage to reform medical education, especially the residency programs in psychiatry. We should also seriously consider giving better training to clinical psychologists and have them enabled to work hand-in-hand with physicians. More can be done. But again, it is NOT good policy to spread so much venom through half-truths that people are led away from the essentials. That is my undying belief and I will never waver in it, for my own experience and that of everyone I have counseled supports it.

          • I can assure you through personal experience as well as 1,000 case reports that it is very, very difficult for patients to educate doctors by offering them scholarly articles, no matter how well chosen.

            Physicians are fairly impervious to information, no matter how well documented, coming from a patient. They would rather function on the basis of their own belief systems, something they learned from a drug company, or word-of-mouth from a friend at a conference.

            You say: “1) mental illness is a reaction to stress and is due to the organism’s over-reactions that become generic and hard-wired, whence requiring more than talk therapy; 2) the drugs work. Not universally, but nearly enough so as to be a well taken fact of existence that is only foolish and worse to deny or ignore.”

            Both of those assertions are debatable. The first, out of biological psychiatry, is strongly contested by the psychotherapy community as well as psychiatry reformers. The foundations for the second — that the drugs undeniably work — have been shown to be riddled with all kinds of error: jiggered clinical trial results, conflict of interest, observer bias, etc. You may recall the huge uproar over Irving Kirsch’s findings? Plus, you have the testimony of patients — but who wants to hear from them?

            Given the huge 30% dropout rates from clinical trials, mostly due to intolerable side effects, clinical trials reveal that about a third find antidepressants intolerable, a third get no beneficial effect, and a third supposedly benefit. This is what you’d expect from drugs that are no more effective than placebo.

            I agree patients need to be their own advocates. In fact, I call this defensive medicine — you defend yourself against your doctors. The facts about antidepressants have been so thoroughly distorted, the general public needs strong corrective messages for its own good.

            With the excessive overprescription of antidepressants in the developed world (example: the US http://www.cdc.gov/nchs/data/databriefs/db76.htm), it’s hard to believe the truth should be suppressed lest potential customers get scared off: Given the risks, antidepressants should be used only as a last resort in extreme cases.

            Clearly, overprescription to millions is a public health issue that needs to be addressed. Waving the bloody shirt of dire consequences such as suicide serves no one but the psychiatry industry. Obviously, 11% of the US population doesn’t need to be taking antidepressants to reduce the .01% suicide rate.

          • Miss Diagnosed says:

            Well said. The what I have come to learn is (both from experience and my own extensive research into patient testimonials) is the worsening of both mental and physical health issues, that go dismissed by Doctors for being adverse reactions/side effects because not listed by Pharma.
            The symptoms and ADRs instead believed as other ailments and thus also drugged to treat, these range from physical problems (bowel/skin/headaches/eye strain etc) to that of believed more aggressive mental health issues (Bipolar/Unipolar/Manic Depression)

            Take a look at the Effexor petition itself, there are no less than 30.000 signatures asking Wyeth to list the full list and extremities of the ADRs and symptomatic reactions.

            Are 30.000 people really that wrong? Is it not actual scientific evidence that 30.000 people are suffering as opposed to benefittng?

            I truly believe common sense speaks for itself – A business needs customers, repeat customers to ever be successful – Pharma is indeed a business (one of the most powerful and successful businesses on the planet.

            A patient cured is a customer lost – Nuff said.

            Furthermore – Only now, years on I have come to learn terminology needs inspecting on every scientific study – Please note even the leaflets accompanying the antidepressant states how the drug is `believed` to work. there is no definitive actuality of how it works.

            My further research has led to other studies claiming drugs and methods as `suggested` , `assumed`, inclined to, `indicating`, Nothing is proven as solid fact.

            The people advocating these drugs based on pharma` marketing is scary – I do not wish ill on the anyone but, in this case, experience outweighs text book knowledge and I invite any advocate to have a taste of their own medicine (pun intended)

        • Sorry but I must say you’re wrong, wrong and wrong.

          First of all many of these drugs do not work (I suggest looking in Pubmed for meta-analysis studies on the original clinical trials submitted to FDA). Most if not all of the apparent “my patient got better so the drug works” can be attributed to the placebo effect. And even when one claims that the drugs “work” one has to wonder what is exactly the definition of “working” in case of psych drugs. This seems to be very often different for patients and doctors especially in involuntary cases. Walking around feeling like a zombie is not exactly what most people desire. Plus there is clear evidence that antipsychotics make people worse in the long-term and likely prevent spontaneous recovery.

          Secondly, I’ve seen and talked to many so-called “professionals” and I can’t recall a single one of them who had any idea about the drugs they were so eager to prescribe for anything, including off-label uses. I had more knowledge about them after reading the leaflet for 5 minutes but everything I said was dismissed as nonsense. I’ve seen “good professionals” denying that benzos can cause anterograde amnesia despite the fact that they are used exactly for that effect in other areas of medicine. So I don’t believe for a second that “practically nobody who has any experience with mental illness or the health professions is unaware of all the issues surrounding SSRIs”.

          Thirdly, it is not the folks who are questioning authority who are the problem. The problem is that the authority has lost it’s credibility to the point that many people who lack necessary education to understand the complexities of various problems don’t know what to believe anymore so they stop believing anything at all. Putting on a smiley face and pretending that everything’s OK and don’t panic does not work anymore nor should it work. The only thing to do is to fix the problem and apologise.

  13. Thank you Dr. Gotzsche for this breath of fresh air! If I had a dollar for every time I’ve been handed the “insulin story”, I could retire rich. One of the story’s selling points (especially among those who know it’s not good science) is the promise that it will reduce stigma attached to mental illness. Yet there’s considerable evidence that people who see psych diagnoses as caused by a “broken brain” are actually less likely to accept those diagnosed as neighbors, and more likely to fear them.

    There’s also real evidence that this narrative of a “lifelong brain illness” especially when given to young people experiencing a first mental or emotional crisis, produces demoralizing hopelessness and helplessness. And it’s often reinforced by mental health professionals who tell them to relinquish their goals and accept a future built around their meds and their chronic illness.

    MindFreedom USA conducted a survey of “Hope in Mental Health” interviewing 390 people, most of whom rated themselves as either fully or substantially recovered. Yet almost two-thirds reported being told their illness was lifelong and that symptom management was the best they could expect. Three-fourths were told at some point that they would be on medication for the rest of their life, and 49% were urged to give up a cherished life goal such as a career, a family or a home of their own.

    http://www.madinamerica.com/2012/12/messages-of-hopelessness/

    The story archive itself is a real treat – and they’re still accepting new stories:

    http://igotbetter.org/stories

    • Deirdre Oliver says:

      Try this one for `mis-information +++Re ECT:
      “It is one of the most effective treatments in all of medicine—not just psychiatry.” and…If a patient’s depression is one that requires lifetime treatment with ECT, then ECT would be used for life.”
      Edward Coffey, MD, professor of psychiatry and of neurology at the Henry Ford Health System in Detroit, Michigan, and a member of the American Psychiatric Association’s (APA) task force on ECT.
      …“the least accepted among the psychiatric treatments.” The authors attributed that perception to “outdated myths about the procedures and side effects,” as well as its portrayal in the media as “an inhumane or even sadistic form of treatment.” A survey published in the April 15, 2005 journal Psychiatry Research.
      The media gets its info from the users. Not “Myths”, just experience.

  14. was given these ssri drugs for panic attacks.I was given all the drivel of chemical imbalance etc etc, I took them for 8 years after being told I would need to take them for life, because I need them like a diabetic needs insulin.I became emotionally numb , gained a lot of weight and my love life disappeared.
    So I stopped taking them, tapering over 3 months as instructed by my Gp, the withdrawl was horrendous I had the most horrid depression, suicidal thoughts, head shocks, head pains, stomach & bowel problems, balance problems, tinnitus, head pressure, lost over 2 stone below my normal weight, had anxiety, akathesia, and much more, These symptoms lingered for years and after 8 years off some still remain. I started with Panic attacks and ended up with a cocktail of awful symptoms I never had prior to these drugs!

  15. Great article, and I can shake hands with former poster Ruth.
    I was prescribed Paxil/Seroxat in 2002 for anxiety relates issues. While it worked pretty well in suppressing my anxiety, I also did some strange and dangerous things while under the influence of the drug. I wanted to get off after 2 years but I was addicted already and got so sick from the withdrawals I saw no other choice than restarting to keep my job.
    No single explanation from my GP who ony told me that “some people needed it for life” without giving any explanation about the difference between relapse and withdrawal.
    I remained a prisoner of Seroxat for three more years with severeal horrific withdrawal attempts, cold turkey, cutting the dose in two or alternating the dose. All method only led to acute and unbearable disease.
    I finally quit in 2007, still not knowing about tapering and hoping for the best. It has become the most hellish ride of my life and almost my death.
    Now 6 years later, having lost my job due to WD a long time ago, having lost tens of thousands of bugs I am still recovering from the withdrawal of this so-called “non addictive wonder drug”.

    I reported my horrific and slmost fatal experience with Paxil/Seroxat to all involved watchdog offices in the Netherlands, only to get a 10-line answer in which I was “thanked for reporting”.
    Also I wrote a letter to manufacturer GlaxoSmithKline to confront them with my experience and with the fact that all this was already reported since 2002 and asked director Van Olden how GSK was going to conpensate me and the many other victims of this “wonder drug” and how it was possible that is was marketed as non addictive.
    In the reaction of this “doctor” Van Olden, he only stated that my files were closed “because of my anger”… Without answering any of my questions!

    These murderous malpractices really need to stop and this article is one step in the right direction. Also finally tapering strips for Paroxetine are availiable now here in the Netherlands, way too late for me but even some psychiatrists seem to slowly see the light.
    But unfortunately, we have to accept that many years of our lives have been destroyed by criminal companies pushing crinimal drugs and we just have to live with that…

    Dr. Healy thanks for your bravey and good work. Your work helps me to accept what has happend to me and many others and find the force to build a new life on the smoking ruins of my old life which was destroyed by Seroxat.

  16. daisy swadesh says:

    Thank you for this article. It’s short and very to the point–good for passing on to others. And thank you for your courage in speaking up.

    As a teenager I found I got so sleepy drinking at parties I stopped trying to drink. I was totally uninterested in street drugs. When I was given antipsychotics the adverse side-effects were immediate and severe (one affected my fine motor coordination to the point that I couldn’t dress myself). Of course I have chosen to go as drug-free as possible.

    If more doctors listened to their patients they would have discovered these and many other things long ago.

  17. Great article. I wish you would mention the benefits of psychotherapy as a treatment modality for many mental disorders; it is safe, effective, and creates lasting change. As more and more people begin to see through the claims of the pharmaceutical industry, safe alternatives to drugs need to be promoted.

  18. Dr Healey,
    If you don’t believe that mental illness is not caused by a chemical imbalance ; do you have an explanation for the pathogenesis of melancholic depression and schizophrenia ?
    Don’t you believe in mental illness?
    How do you think that these illnesses should be treated if you don’t believe in psychotropic medications ?
    Your post is very confusing;I would recommend you to talk about the ideal ways of treating rather than wasting time on myths.
    I agree that many psychological conditions can be contained by psychotherapy rather than medications and in such conditions medications cause no good than harm but tell us how genuine psychiatric illness can be treated because it not only is beneficial to the patient but also beneficial to the society as risks are minimised .

    • David_Healy says:

      Lucky

      The post was written by Peter Gotzsche. I believe mental illness is real and physical treatments can help. The chemical imbalance ideas is just marketing copy – inspired marketing copy that has led millions of people to give themselves some very real chemical imbalances that have been far worse than anything that might have been wrong in the first instance. DH

      • DH – you have never addressed my question of a month ago — how should a family deal with an overtly psychotic family member, if not with antipsychotics?

        Our son’s third break occurred in August 2012. because his two prior hospitalizations were so dreadfully bad, we promised him that WE would not take him to the hospital. In April 2013 he was hospitalized for a month — taken there by police.

        The antipsychotics brought him back to some measure or nomalcy, to the point where he could resume his university studies.

        We, as parents, are completely dissatisfied with the provision of psychiatric care. But the column’s contentions, while many are true, are not fully supported in fact or practice.

        • David_Healy says:

          Greg

          I can’t find an original email from you on my system or a note from you on the blog so I am slightly at a disadvantage here. I also don’t know if you’re referring to Peter G’s post or to something from me.

          Re use of antipychotics – I have never advocated not using them. But they do need to be used with care in that they are generic tranquilizers rather than specifically helpful for psychosis, and they come with risks of suicide, aggravation of psychosis, sudden cardiac death, a range of metabolic problems and dependence.

          Any one using them should try to ensure the person being given them is on the right drug for them – some antipsychotics may be more dysphoric for me than others – and in the right dose – the best doses are usually much lower than ordinarily given – and only continued for as long as needed.

          Is there something in this last statement you disagree with?

          David

          • DH – I was referring to Peter G’s post, in particular in the last paragraph: “Our citizens would be far better off if we removed all the psychotropic drugs from the market”. My original post was January 22 as “GS”.

            I agree that all psychotropics are over used. I agree that they can be harmful and have all sorts of nasty side effects and result in premature death or suicide. They should be prescribed far less than they are, at lower doses and for shorter durations when possible.

            Our experience is a son with schizoaffective disorder, 3 psychotic breaks and a total of 78 days in “metal health units”. We lived with our son in the house in varying degrees of psychosis from Summer 2012 until Spring 2013. In our experience psychosis is not self-limiting, even if a person is getting psychotherapy. The antipsychotics are what brought him back to to some measure of reality.

            I agree that some drugs are “less bad” than others (all “bad” to some extent). He had terrible side effects from some including EPS, akasthesia and dystonia. Others simply didn’t do anything. Some give him a measure of normalcy.

            In the US provision of psychiatric care is terrible — even if you can afford to self pay, there simply are not the providers with either the time or experience to provide adequate guidance — psychotherapy and thoughtful and thorough psychopharmacology.

            Blanket statements like “Our citizens would be far better off if we removed all the psychotropic drugs from the market” are just as bad as forced treatment model advocated by E. Fuller Torrey.

          • Deirdre Oliver says:

            I worked with a group of about 30 young people, 16-24, in a `schizophrenic rehab’ unit in the 70s. (We cynically called it the institutionalisation unit). All had been diagnosed with at least 2 psychotic episodes. The charge nurse of the unit was a musician and felt it would be a good idea to devise some kind of musical production. He called me in as he knew I’d had a career in the theatre before I became a psych nurse. We rehearsed and performed/toured this production for 6 months. Nobody had any kind of psychotic break, nobody missed a single rehearsal or performance. As time went by the kids, many of whom were almost paralysed with drugs, sparked up. We had a kind of professional theatre attitude going even though chlorpromazine etc had them by the throat). We found several really talented kids who blossomed, some who were discharged came back to keep going with the show. Parents & friends got involved in lending vans, (to carry sets & equipment), making costumes, (we had almost no money), a doctor’s wife, an artist, helped with painting sets. It was a wonderful time, for me as much as for them. One young woman with a terrible history, paranoid father, childhood schizophrenia, who had passed her final law exam during an acute psychotic episode, who never spoke (drugs) asked to be in the show I almost cried. I think she, (R), was one of the most inspiring people I ever met in my life. It ended after 6 months partly because I was a student and had to be moved on. Within 3 months my 2 most talented kids killed themselves. The wisdom then was, `you will not get better, you can only control…blah, blah. It wasn’t enough. I went on to become a nurse clinician (psychotherapy) and never returned to that unit. R was lost to the system, but one of the outpatients, a brilliant artist who also got depressed at the future being laid out in front of him, DID get better. He stopped his meds, (I knew that and I think quite a few of the others did too, but said nothing) and later became president of a mental health organisation. He retired a few years ago. I’m telling this story because it was a clear path that could have been followed but never was. Purpose, involvement, expectations for self & other, the arts but not necessarily. The history of psychiatry is a brutal one & still is. But the Quakers had it right. Give someone a safe place, reasonable lodgings, good food (well fair food but plenty of it), EXPECTATIONS , respect and a gentle caring attitude you are inviting them back to a world worth living in. The psychiatry I see today is still brutal, the return of psycho `butchery’ we called it in the 1970s, the continued use of electroshock, the forced drugs, physical violence including restraints, shackles and seclusion, and aggressive bullying by staff, are saying we know best, you are a worthless loony, so you will do what I say whether you like it or not. I am now a sometime advocate, ex-patient myself, (at 57), badly damaged by ECT and drugs that were used to treat an SSRI suicidal reaction and ECT induced PTSD which was treated with ECT. My experience of working in an acute `crisis intervention’ unit (unlocked) with limited use of drugs & NO ECT showed me that there was nearly always a reason for the `crisis’ and I and my team worked hard with the patient, and family/support people, and I think they left with hope. I hope so. So rock on `Open Dialogue’! We should be looking for `healing’ not treating. We should not be saying `they’, `you’, we should be saying `us’ and `we’. I took my uniform off way back then and I happily told everyone that `I’m not better than you’, `I don’t know better than you what you need’, `I don’t know how you feel unless you tell me’, `I’ll believe what you tell me’, `your reality is just as valid as mine.’ Well I don’t know if the aliens are coming, do I, do you? Can we please do better? THE PATIENT is just another person and you are not immune.

  19. I’d like to see some comments on this blog post critiquing Dr. Gotzsche’s article above http://real-psychiatry.blogspot.com/2014/02/an-obvious-response-to-psychiatry-gone.html

  20. Miss Diagnosed says:

    I have told my story so many times – In short I had no mental illness until put on SNRI Venlafaxine

    Initially diagnosed in 2001 for `Mild Depression` which was basically my being unhappy and stressed as a young single mum being bullied by an ex – I steadily became worse and diagnosed with manic depression and suicidal tendancies.

    My research into these drugs has led me to despair that they are still on the market despite the actual evidence of both patient and medical professional testimonials alongside the death rate.

    Pharma still lies and promotes these drugs as wonder treatments and even cures. Billions in profit overriding peoples lives.

    How can these myths still be believed? Pharma`s marketing is disturbingly clever, How it has not been brought to book for false advertising and fabricated evidence God only kows

  21. daisy swadesh says:

    I won’t argue here about the existence or non-existence of mental illness. What is certain is that a vast number of people are MISdiagnosed–and that the diagnosis is never corrected. Before the inclusion of PTSD in the DSM-III (1980) many thousands of Vietnam veterans were routinely diagnosed with schizophrenia despite over half a century of awareness of “battle fatigue” and “shell shock” etc., and that PTSD had been first accurately described in 1942 (38 years before) by Dr. A. Kardiner who described the physiological aspects of an altered stress response and called it a “physio-neurosis” (see Traumatic Stress (1996?) B. van der Kolk, et al, editors).
    This is also true for survivors of severe child abuse and molestation who have endured daily interrelational trauma–but the negative effects and stress
    of long-term unhealthy relationships are ascribed to an inborn defect such as a personality disorder.
    And few PCPs take a careful history before diagnosing depression and prescribing SSRIs, and even fewer respond to problems of side-effects.

    If they would fully correct these errors–and similar ones–it would go a long way to addressing the existing problems.

  22. I applaud this article.
    I’m dealing with anxiety and emetophobia for over 4 years. I have never been prescribed medication and only did therapy for it. Even though my phobia didn’t get any better and my anxiety is at it’s tops, I would never take any medication. I’m tired, I can’t leave the house, but I wouldn’t take anything for it. Most of the people around me tried to convince me that drugs would make it easier, that I could have a normal life. Lucky me, my therapist told me: “I can give you Xanax, you will be like a vegetable and you would come to therapy twice a week for many many years. I would make a fortune out of you as you would need me and medication more and more. I can’t put anyone on Xanax. I’m human.” I was indeed lucky.
    I have friends on Xanax and they are doing worse than me with the same anxiety problems to start with. After 4 years of therapy, reading articles and meditation I still believe that anxiety and phobias are emotional imbalances. In my world you cannot treat emotional imbalances with medication. You can’t fix them like that. In best case you only avoid the symptoms and pretend you are fine when deep inside of you, the roots are still there. In therapy I’m trying to find the roots of my anxiety and phobia and heal those from the roots.
    Leaving side effects and painful withdrawals apart, does anyone think that emotional pain can be cured with medicine? Isn’t it, in fact, something very personal that has left you a scarr? How could you ever cure something emotional with meds?
    Will meds take away unfortunate experiences or memories that hurt? Will they ever take away the fact that you were abused on any level? Will they make you more confident, more aware or happier?
    I am still lucky to have the force to try. I’m still trying my best. I’m trying to go out even though my confort zone is reduced to my 4 walls and when I go out I feel sick. I’m trying to go to therapy even though I hate it and love it at the same time – it just hurts. I’m trying to do exposure, I’m obsessing with images from therapy but I’m still going forward. I’m 24, I want a family and a life. I still do.
    If I will ever go back to normal? I don’t know… But for the rest of my days I want to go to bed every night knowing that I did my best that day without any drugs.
    After 4 years I can say that anxiety thought me how to more open minded, how not to judge people, how to understand everyone better than I did before, how to care, how to love more, how to appreciate everything I have, how to love the sunshine every morning regardless of my fears. I would never give that up and I would most certanly loose them by going on drugs.
    Thank you for this article. Helped more than a lot!
    For everyone else, stay strong whever you are! All my best wishes to everyone!

  23. I’m glad you knew better and did not go down that path. I think that saying you had depression linked to Crohn’s disease is in itself kind of bs. Depression was supposed to be a disease, when a person has a long period of bad mood for no reason, or say pathologically. But now any reaction to a bad life situation be it disease, family problems, money issues etc. is a depression. There is nothing abnormal about being sad and feeling overwhelmed and hopeless when in any of these circumstances and labelling it as a separate disease that is somehow a medical problem in its own right is total and utter nonsense.

  24. I don’t think anyone is advocating banning these drugs although the argument for a severe restriction could be made. Antipsychotics are not anti-psychotic, they’re just major tranquilizers and it should be up to the person who’s taking them to decide if they prefer this effect over whatever psychotic experiences they have. What does your son think about it? I know it can be difficult for people in your situation but letting the practice of just drugging people by default and keeping them like that is ensuring that the system will never be improved. Psychotherapy is not likely to help too much, the Open Dialogue-like approaches are different from psychotherapy, the fat that some talking is done does not mean they’re the same. Moreover, on the drugs – it seems like although they suppress the symptoms in the short term over the long-term they make people much worse. I could write more but I’ll just recommend a good article:
    https://www.madinamerica.com/2014/03/fat-lady-sung/
    It quotes a lot of studies on the subject but does not exhaust the list.
    I don’t have a good answer about what to do in your situation. I know from experience that the hospitals are horrific places of torture and drugs often are not better, the torture is just in your head. Unfortunately, until we build a better system there is no way out…

  25. Dr Healy thinks electroshock (ECT) is great!
    He wrote a book about it.

    See these websites for more info on ECT:

    ectresources.org, endofshock.com, breggin.com,
    mindfreedom.org, ectjustice.com, ect.org

    • Deirdre Oliver says:

      You bet, Sue. I did send a missive about this but I’m not sure where it went. I’ll send a few facts again. A black panther is a leopard, you just have look harder to see the spots.
      1….”the move away from using ECT as a first-line treatment of depression in the 1940s and 1950s…is a medical calamity: ” A treatment of proven safety and reliability.” Yeah, and the world began 6000 years ago??? “It is as though penicillin had entered a fallow period because of opposition from Christian Science.” (I think they mean Scientology)
      2. Re memory loss, “It’s a non-issue. The idea that your memory is wiped out is a fiction.”
      3. Co-author, Edward Shorter, “…the feeling…unilateral is really a waste of time. Empirically (?) we know there is less memory disturbance in unilateral, but what is widely overlooked is that the memory loss with bilateral is not that big a deal. It’s vastly overstated…”
      4. Co-author Max Fink “ECT is one of God’s gift to mankind.” But it’s women who get 70% of ECT.”…”“Persistent memory loss is a very rare phenomenon. You won’t find much in the literature except from individuals who complain, patients who get together and chatter and say all their troubles are due to ECT.” (NASTY EH? They’re keeping Maxy away from the public these days. Typically, hide anything close to telling the truth.) Let’s check some FACTS:
      1. Healy: “ECT is effective and prevents suicide.”
      FACT: NO. It does nothing for depression. It merely superimposes a traumatic brain injury/organic brain syndrome whose symptoms are interpreted as `improvement’.
      NO evidence whatsoever that ECT protects against suicide, may CAUSE it. Telling people this is irresponsible as they may stop being vigilant.
      2. Healy: “New techniques make ECT safe.”
      FACT: NO. The power & strength of the shock to the brain is hugely increased from earlier times. Old = under 100volts for 0.1 second; new = 450 volts for 8 seconds.
      3. Healy: “There has to be a suitable convulsion to be therapeutic.”
      FACT: NO. The convulsion is a side effect. It’s the power that does the job. Brief pulse (1940s) ECT was ditched because the lower power didn’t cause an injury severe enough to `change’ behaviour.
      How does Dr Healy feel about the `need’ to top up ECT’s miserable results with an anti-depressant? But then he can always give people a head injury every week, or month for years to `maintain improvement’?
      Why won’t Healy et al allow access to patients and set up a placebo study; or let us do a simple non-invasive study using EEG supervision before, during and after ECT to check out your claim of `no physical’ injury to the brain; or use neuropsychological testing at regular intervals over a long term; or Sabin’s 1951 Autobiographical Memory Test or something similar before and after ECT to see if your claims of NO Memory loss?
      Why do you tell us that those against ECT, including your own colleagues who don’t like ECT, are liars, manipulators and `whining’ insightless idiots?
      Who is the REAL David Healy?

      • David_Healy says:

        For anyone interested to chase this further, there is extensive prior correspondence on healyprozac.com under the academic stalking section and the shock therapy controversy section of this.

        David Healy

  26. Deirdre Oliver says:

    Dear David, I really mean it. Who IS the real David Healy? Your stance on the drugs is great. But those comments about ECT that I quoted, are what you said. Have you changed your attitudes or don’t you go there any more? I can understand that the drug issue would take an enormous amount of time and I realise that no one can do everything.
    Having worked at a large mental hospital I actually saw the impact of the phenothiazines. Suddenly you only needed 4 staff members in 45 bed wards, but sometimes the guys would get stroppy, spit their meds into the pig bin slops (most placid pigs in the country, didn’t need ECT either). That’s when the ECT machine was brought out. Whap!!! `turn up the power for this bastard, he won’t do that again.’ (he’s senior `fellow’ now). There were wards there where no one spoke, they sat staring at the walls. `Burnt out schizophrenics’ Burnt out was right – Insulin, ECT & lobotomy, people with near dead brains, no life, not even unhappy, just nothing. Hundreds of them, a massive tragedy. And they’re bringing those brutal, procedures back?! I think this is a sign that the docs are afraid. They really DON’T have much to offer and they’re beginning to see that. What are they going to do? Closapine & ECT? Then add `psychosurgery! The extremists, zealots and money guys are shouting the loudest. A lot of docs have been happy with the status quo, they haven’t kept up, but now they’re being confronted by patients who know more than they do and they’re not coping. Too many haven’t really learnt any `talk’ therapies, CBT might work for some, but not with amateurs. The message is coming in loud and clear from some of your colleagues, the `New Psychiatry’, Pat Bracken’s group; the Critical Psychiatry movement is growing too. This is where your lot should be looking. Not behaving like trapped rats fighting to the death to keep something that’s not keepable. There is no disgrace being wrong – sh’t happens. Where it really goes bad is when you know it’s wrong but refuse to fix it. Of course there will be financial consequences if ECT is dismantled, but is that really the most important thing? It could be a really exciting ride to test out new things. Instead of bits of silly science struggling around the fringes of the dying bio theories, that are, in fact proving the ECT `damage case’, the emphasis should be on finding, identifying and implementing some of the newer ideas on psychosocial, psychotherapy developments. There can be enough controversy in that to make it fun. Instead of the standoff between disciplines, embrace and iron out your differences for the sake of the PBP (poor bloody patient). I actually I don’t have an issue with the use of some of the available drugs for acute situations in the short term, Open Dialogue actually use the benzodiazepines which in the very short term could tackle the incredible anxiety that someone can feel at the beginning of a psychotic episode. It’s very frightening to hear voices saying horrible things.
    I read your stoush with Linda Andre and you came across as defensive. A lot of people trust you so I think we all need to know where you stand across the board.

  27. “It’s [memory loss] a nonissue. The idea that your memory is wiped out is a fiction.”
    No wonder they say that about ECT. I was given benzos and suffered almost complete antergorade amnesia (you don’t lose memories that are already there but you can’t form any new ones) and when I complained later about it to the doctors they told me it was impossible. Interestingly so, because there are numerous papers on pubmed when people use benzos for exactly this purpose – to induce amnesia before invasive medical procedures to reduce trauma. Psychiatrists lie about side effects. Lie or are totally misinformed but honestly I don’t care which one is it. It’s criminal.

  28. I have five sons, when my husband and 2nd son died within 10 months of each other. My third son had an emotional breakdown. The psychiatrist here has given every anti-psychotic imaginable some causing him agony pain in his head that was unbearable for him. He wants to get off the medications completely but the doctor threatens me that it is impossible to get him off the meds that he would go into a trance or something permanent uncommnicable while other doctors dsagree. He has given him so many and he changes them all the time. He works for one of the drug companies doing speeches and recommending the drugs. The current one he is on is LATUDA and Seroquel and my son has had terrible side effects that are really bad. Can he go off the meds without going into a trance or whatever the psychatrist has threatened me will happen. I am so heartbroken, this boy earned a Doctorate of Divinity and his mind sounds gone from all the years of these meds. Please help me, I will sell my house to come to you if you think you can save him. He has suffered so much. The doctor even told us when my husband was alive that he gave the boy now a man two drugs that caused him to hear voices (Effexor and Wellbutrin) there are so many Geodon, Abilify, Lithium, Injections, Zoloft, Paxil everyone you could imagine and my son would scream from the pain in his head. Please help me Help him. He was so well edcated and his thinking now is like he forgets simple things. It is lke they gave him a CHEMICAL LOBOTOMY! How do these pychiatrist know what levels of chemistry are in the brain. They don’t, it is a guessing game and they have destroyed my wonderful son who was so well educated. They took his soul. Please give me some ray of hope. You sound like an innovator and could save these poor souls victimized by pyshchiatrist who so easily give out these lethal drugs that cause terrible agony. They don’t know what they are dealing with. My son has lost his youth and any possible happiness plus it is heartbreaking to my family what is left of them. Please advise, you sould like someone who cares about the individual. God bless you if you expose this horrible practice of frying people’s brains! Thank you.

  29. The follow is shared from The Wellbeing Foundation Article on the words of the late Dr Michael Corry…who spoke out about the evils of Psychiatry and ECT…

    ECT must be outlawed — now
    If you arrived at A&E with the same symptoms as ECT produces, you’d be rushed to Intensive Care. Why does this barbaric practice, masquerading as ‘treatment’, continue in use? Michael Corry says it should be outlawed

    Mary, a 66-year-old woman, was one of 859 patients who in 2003 received Electroconvulsive therapy (ECT) in this country. Two years later, she has trouble remembering how many shock treatments she received, can’t remember what time of year she was in hospital, or how many weeks she spent there. “It’s all a blur”. One thing Mary is certain of is that her memory is greatly diminished: “I feel as if I’m suffering from dementia. I can’t remember things, and I keep losing the thread of conversations and I’m always forgetting where I left things. I have to look at old photographs to remind myself of the life I had”.
    Mary is a retired school teacher whose husband was killed in a road traffic accident in 2002. Her grief was overwhelming, and her adult children were so worried about her living alone that they advised her to sell her home in the country and move to an apartment in Dublin where she could be close to two of them. It did not work out. ” I felt enclosed and trapped, I missed the open spaces, my garden and the familiar surroundings. It was like living in a coffin with the lid off”. She became anxious and fearful and disliked going to the shops. She dreaded answering the phone. Everything now seemed pointless. Her admission to a private psychiatric hospital with depression was a speedy one.
    After three months of hospitalisation and eight sessions of electroconvulsive therapy, she was discharged on three different kinds of medication; an antidepressant, an anti-psychotic and lithium, all of which she still takes. Mary now wants to come off this medication. “I feel numb, and my emotions are frozen. I can no longer feel joy or sadness, instead I feel nothing. If I stop the pills and can start feeling again, maybe it will compensate for my confusion and memory loss.” Mary’s story is not unusual for many survivors of ECT.
    But what exactly is ECT? In many respects, it resembles a surgical procedure. An electrical current of between 70 and 400 volts is passed through the brain of the patient with the intention of producing a grand mal or major epileptic seizure. The voltage is typically as great as that found in the wall sockets in your home. If the current were not limited to the head, it could kill patients by inducing a cardiac arrest, the cause of death in electrocution.

    Electrodes are placed over both temples. The electric shock is administered for as little as a fraction of a second to as long as several seconds. The electricity in ECT is so powerful it would burn the skin on the head where the electrodes are placed unless conductive electrode jelly was used. Because a shock-induced seizure is typically far more severe than those suffered during spontaneous epilepsy, in earlier times, unless the patient’s body was paralysed by pharmacological agents, it would undergo muscle spasms sufficiently violent at times to crack vertebrae, break limb bones, and damage teeth. To avoid this, current practice involves sedation with a short-acting intravenous barbiturate, followed by muscle paralysis with a curare derivative, and artificial respiration with oxygen to compensate for the paralysis of the patient’s breathing musculature.
    The shocks create an electrical storm that obliterates the normal electrical patterns in the brain. They are administered in a series over a few weeks, in an average of six to ten sessions, to ensure the procedure ‘takes’, that is, alters the electrical activity of the brain in such a way that the individual will not remember, at least for several months, the depression that they were experiencing before the shocks. I have seen a number of patients who have been administered over100 ECT sessions, and are no better as a result.

    In essence, ECT is an electrical brain injury, typically producing a global mental dysfunction. Following it the individual is dazed, confused, and disoriented, and cannot remember or appreciate current problems. The changes one sees are consistent with any acute brain injury — a concussion, such as from a blow to the head from a hammer.

    If a woman like Mary came to a hospital emergency room displaying the same symptoms as those produced by ECT, perhaps from an electrical accident in her kitchen, she would be treated as an acute medical emergency and might be placed on anticonvulsants. If she developed a headache, stiff neck, and nausea — a triad of symptoms typical of post-ECT patients — she would probably be admitted for observation to the intensive care unit.
    The greater the brain damage, the more likely that certain memories and intellectual abilities will never return. Memory deficits, retrograde and anterograde (before and after the event), are among the most common early signs of traumatic brain damage, and are seen in virtually all cases of ECT. Events which follow an ECT session are forgotten completely, such as visitors calling, phone calls received, speaking with their psychiatrist, etc. Memories are foggy about details of personal history such as family weddings, graduations, and jobs. Since the mind is the place the memory calls home, such deficits are extremely anxiety-provoking and disorienting since one’s very identity has been altered. Autopsy studies of animals and some of humans show that ECT causes severe cellular damage, including cell death.
    Arguments put forward as to the benefits of ECT have to be examined with extreme caution, for several reasons.
    It is fundamentally traumatic in nature.
    Many of the patients are vulnerable and unable to speak up for themselves.
    It is administered to many involuntarily due to their having being committed to hospital against their will.
    Most controlled studies of efficacy in depression indicate that the treatment is no better than placebo.
    It perpetuates the illusion that depression is the result of a disease of the brain rather than an emotional response, as in Mary’s case, to life events.
    Why has there not been medical questioning of ECT as a procedure? There can only be one of two answers. Either the psychiatrists using it are misguided enough to believe still that the dubious benefits outweigh the well-established risks to their patients, or a cover-up is occurring in case, if brain damage to patients is acknowledged, law suits will follow.
    ECT should be abandoned immediately, as it is no longer medically sustainable and is dehumanising for all concerned. The eminent American psychiatrist Thomas Szasz wrote:

    Electricity as a form of treatment is based on force and fraud and justified by ‘medical necessity’. The cost of this fictionalisation runs high. It requires the sacrifice of the patient as a person, and of the psychiatrist as a clinical thinker and moral agent.

    The words and writings of the late Dr Michael Corry who valued “the patient” as a person and as a human being….God Bless Him…may he rest in peace…

    • David_Healy says:

      If we ban all poisons we effectively get rid of medicine which is the art of giving a poison to produce good. The problem doesn’t lie in ECT which is no more brain damaging than the medications we use in vast quantities or in the drugs, the problem lies in the doctors.

      We need doctors whom we can trust to take the risks that are involving in using ECT and drugs. If you don’t have a doctor like that you need to change doctor

      DH

      • Problem with the Drs is, if you know the drugs are harming you and one Dr states, (as many do) you are wrong to even suggest such a wild claim, you are spoken to as if a child or worse, as if a `problem patient`…..

        Getting another GP to treat you let alone agree with you is what furthers the despair and confusion – Why and How are the supposed intelligent and most trustworthy individuals in society so clueless? or are they?

        I am not saying all Drs are evil or stupid, however, 1 in 12 (over a period of 11 years) – not including the 2 Psychiatrists and a Psychologist, took it upon himself to actually check my notes and see the pattern of destruction – I never had a mental illness prior to an initial mild depression diagnosis in 2001 (I was alone and being bullied by an ex), and of course he noted the worsening on switching medication and dose upping/downing (all so obvious when you say it like that, however as the drugged neurotic manic depressive I could not think let alone work it out myself).

        Drs need education as do patients…. if Pharma was innocent and truly a health care specialist well, educating the masses would be first on a list.

        These drugs are to fool everyone, as is all brain `treatment` and mental disorder propaganda, Not only does pharma thrive on a patient cured is a customer lost, it thrives on inventing an illness to treat.

        Emotional trauma is not a mental illness, nor is stress, nor is an excitable child or a subdued child. There are reasons as to why people are struggling emotionally, calling life`s struggles an illness is insulting as much as it is ludicrous.
        Getting to the root of why is the only way forward and science (medicinal) has`nt worked this out? I mean come on.
        So sad only some of us have come to learn this the hard way. The only comfort I get from all my past suffering is, I know of 3 people who have been offered antidepressants and declined due to having witnessed first hand what they did to me.

  30. I am 32 days off this poison! Now I have horrible depression and was treated for anxiety without depression 26 years ago. Withdrawal? How long can this last!?

    • David_Healy says:

      Months

    • Jay it depends on how long you were on the medication and at what dosage?

      The longer you were medicated and the higher the dose was, will determine an estimate amount of time alone, the rest depends on what your tolerance levels are?

      You say you are off the poison, are you going cold turkey? Please dont, take into account the dose and time period, a rough guide…..

      I was medicated in 2001, (initially 75mg) the dose upped/switched/upped and switched back again up until 2009 (my highest dose being 300mg)

      It took me from December 2009 until Feb 2012 to wean myself off via liquid doses. by the later days I was pushing hard at reducing 1ml per month/six weeks…. sheer determination is what keeps you going (and the knowledge that you know what you are going through… try not to say, `I am depressed`, tell yourself you are in withdrawal)

      No one, only you can determine the pace you can tolerate, just ensure you read and research what you are going through because the medical profession is still ignorant, especially the prescibers and pharmacists.

      I was even disturbingly advised to take one 75mg pill every other day for a week or two, as a means to taper the years of abuse to my brain and body…. if i had not have known better (thanks To reading David Healy/ Peter Breggin/ Moncrief and more) I very much doubt I would be sat here today… in fact I know I would not be (just words on a screen but, sincere!)

      Good Luck,

      • Deirdre Oliver says:

        I appreciate that what you are going through is hell. A cautionary tale. A woman, friend of a friend, took anti-depressants for several years, appreciating that `you shouldn’t just stop, because the depression might return’. She then suggested to her doctor that she stop. He was reluctant, but she went ahead, tapering her dose in what she believed to be a sensible way. (He did not help). She became extremely distressed, he said, `I told you so’, and admitted her to hospital, diagnosed her as bipolar and treated her with anti-psychotic drugs and Electroshock. When the first round of this didn’t `work’ he shocked her again and raised the doses of the drugs. From an `extroverted, fun’ person, she is now housebound and withdrawn, `a changed person’, her friend told me. This treatment is for the withdrawal symptoms. This is ABUSE! Beware. You may have to go back on the drug in order to survive the withdrawal effects but don’t do it with your previous doctor. As Sarah said, it can take months, even years to get off them and you will need a pharmacist as well to make doses in small enough increments. After all, the `balance of your brain’ has been severely disrupted, as it is with cocaine, heroin etc. It will take time. But it will happen. All the best.

  31. 5 years ago I was given a 3 year course of SSRI’s, for the last two years I have been hoping I would recover from what I know now to be permanent Akathisia, Tinitus and a terrible memory. The withdrawals were shocking but to live on with permanent damage is not pleasing, my psychiatrist actually denied that headzaps were related to venlafaxine withdrawal.
    My mind is certainly not what it was 5 years ago. I have no job , no friends and no life thanks to the effects of these medicines.
    In hindsight I broke up with my girlfriend and as a result the medical profession saw fit to damage my brain.
    I applaud you for writing this.

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