The post follows on from last weeks Zen and Art of Psychopharmacology and links with Potentially Inappropriate Deprescribing PID on RxISK.
Tullio Giraldi and I first e-met in 2009. Introducing himself, he painted an unusual background. He had been a pharmacologist but now his interests lay in Buddhism and psychotherapy. I learnt later that he was an enthusiastic sailor competing at a very high level in big boats.
Tulio was based in Trieste, where Franco Basaglia let the winds of change blow through a mental health system. For millennia before Basaglia, Trieste was famous for the winds blowing down from the mountains. Wind-swept waves from inside the harbor can be seen crashing out over the harbor wall. A place made for sailors and navigators.
We didn’t get to meet in person for a while. Tullio often came to the Isle of Wight where he helped run round the island races for disabled sailors. On one occasion, in the UK on sabbatical he came to a talk I gave. We both thought the message was not something the English would ‘get’.
At the time he was liaising with Mark Williams and others who had imported Mindfulness from the US – Zen and the Art – and were marrying it to Cognitive Behavior Therapy (CBT) to create MBCBT – mindfulness based CBT. This caught Tullio’s attention because of his background in Buddhism.
He wrote Psychotherapy, Mindfulness and Buddhist Meditation. For anyone who doesn’t know much about Buddhism or its migration to the West over a century ago, this is great. Very early on in the West, especially in America, the Freudians attempted to map what the meditators were doing onto their reality – concluding predictably that the meditators were on to something but it fell short of the Freudian insights.
Zen or other Buddhist practitioners then, and maybe even more so today, might dismiss Tullio’s book as saying nothing of any great interest. What need do people dealing with a timeless enlightenment have for a history, which deals with a sequence of events triggered by changes in which way the wind is blowing. If they are snide, Zen advocates might even say we’re still here, where’s Freud?
The publisher approached me to answer questions – would there be a market for a book like this. Absolutely yes, I said, Mindfulness was a huge and growing phenomenon. Anyone involved with it needed a book just like this that laid out the moving parts on both the Zen and the psychotherapy and Western sides. A book that wasn’t attempting to convert anyone to anything.
Retrospectively I can see I didn’t appreciate just how radical Tullio was. It has taken till now to see how much more there was/is to his book than I suggested to the publisher.
Maybe my Zen and the Art article sensed this. I sent an early draft to Tullio and Junko Kitanaka. My reaction now is that the original and even the published version of this article must seem very primitive to Tullio, but he didn’t hint this and both Junko and he helped.
It became easier to see how radical he was when he sent me a draft of a new book Zen Buddhism and the Reality of Suffering, which is heading toward completion.
Zen and Suffering covers similar ground to his earlier book but in addition to telling a history, he stakes out a position – I don’t know anyone else who has put this so clearly although maybe others have.
Island Hopping
A phrase in the new book an archipelago of realities leapt out at me. For me it conjures up the archipelago between Finland and Sweden.
It’s meaning became clear when Tullio said that with psychoanalysis Freud was solving his own problems – as was Jung with his depth psychology, Aaron Beck with CBT, Marsha Linehan with DBT (dialectical behavior therapy) and perhaps both Gerry Klerman and Myrna Weissman with IPT (interpersonal therapy).
This may have struck me partly because none of these options has ever worked for me. CBT clearly worked for Beck etc but telling me to do homework on my thinking style, for instance, is not something that even begins to help me. I can see the sense behind the idea, and others find it helpful, but for me it doesn’t work. Not only does it not work but it makes me feel bad because it doesn’t work – I feel like I’m failing rather than its failing.
Freud’s thinking was immensely logical and coherent, and he took on some great challenges. He is easy to believe in because the thinking is so impressive and seemingly universal. It is also easy to feel a failure if you find it just too challenging to get to grips with. Initiates can’t be helped by being told their resistance, a problem in them, is getting in the way of their understanding the master. If they say something aberrant, they are likely to be told they don’t grasp the finer points. We might call this gaslighting today.
When Tullio said he was now seeing Freud as solving his problems and others as solving theirs – a lightbulb went off.
Individual Differences
This notion maps onto what I think and have thought for a long-time about drug dependencies. Getting this idea over to people can sound like I am being more critical than I am. For instance, Mark Horowitz and David Taylor are heroes to many for introducing the idea of hyperbolic tapering.
Saying I think this idea is wrong hasn’t endeared me to any of the very large circle of people around them – John Read, James Davies, Joanna Moncrieff and many others who are also doing great work to draw the problem of increasing antidepressant consumption to wider attention.
My problem is that for ages it has been clear to me there are some people who don’t need to taper at all, whether hyperbolically or not. They can go cold turkey and often seem to do much better precisely because they do – Withdrawal Mysteries.
Others can get off by tapering. They are likely to think the tapering was key when perhaps it wasn’t. Some of those who succeed in tapering off the drug find they are neither back to normal nor well. They can be in a limbo state that lasts years – See The Color of Life. The hyperbolic idea has nothing to say about this.
Hyperbolic Tapering is pharmacologically wrong for someone who is dependent on a drug and thinking about halting it, but it is useful if it encourages people to try. If someone tries and doesn’t seem to be able to make it, the idea that ‘science’ shows it should be possible and not just possible but predictable can become a millstone around her or his neck.
The key group are those who simply cannot get off. The ‘science’ now proves they are shirkers, drug seekers – there is no other explanation for their protests that they cannot stop. This is becoming an increasingly serious and common issue as the RxISK post – Potentially Inappropriate Deprescribing – outlines.
Lots of people are being whipped off drugs, primarily older cheap drugs, on the back of efforts to reduce medication burdens and because the pharmaceutical companies have adopted the Taylor-Horowitz idea and now happily admit there is a withdrawal issue on antidepressants but nothing that a little bit of tapering can’t solve.
Again and again, I’ve had very impressive people come my way who have been on perhaps 4 pills that cause dependence. Without problems they can stop 3 that others find hard to stop but cannot stop the last one. It’s a different last one in each case. This seems to eliminate the idea they are drug seeking, or lack moral fibre idea, stone dead. But their doctors don’t learn from this any more than hyperbolic tapering advocates learn from people who can’t even begin to stop until all of sudden an antidote makes it easy to do so – Side Effexor Withdrawal.
This should come as no surprise given that an SSRI can fail in the immediate goal of treatment which is to emotionally blunt someone, or it can blunt them but they don’t like the effect and it is not useful for them, or it can helpfully blunt them, or it can agitate them so much that suicide is preferable option.
There should be no surprise, but the reactions to saying hyperbolic tapering doesn’t suit all people have been hostility from its advocates. Communication has been severed rather than an interest shown to see what might be built on this. And so things fracture into schools of thought, islands, with charismatic leaders pushing solutions that have worked for them.
A Warm Regard
Some trying to retrieve something from the mess that is psychotherapy research have turned to the notion that a positive warm regard from a therapist is the key to success.
This bland mush conveniently continues to locate the therapist in the role of a zen master, the source of truth, the one who has his or her life sorted out and as a result their positive warm regard is worth so much more than yours or mine. It puts me and you in a passive position. No prizes for guessing this idea doesn’t work for me. It shouldn’t work for you. I’d prefer you to stick to your idea of what works for you and not accept reducing everything down to something bland.
The harm lies in not seeing or listening to me when I tell you your solution doesn’t work for me. A coherent logical structure doesn’t mean something is science. Graphs that look scientific aren’t science. Science happens when people with different views about something they can both observe attempt to come to a consensus.
Consensus cannot happen if there is denial of an issue that stares us all in the face – we are different while at the same time being part of an Us.
It is understandable that religious leaders, zen masters, psychotherapists and doctors reach for universal solutions – science has always sold itself as doing something like this. But real scientific progress lies in distinguishing individual genes and individual stars and individuals. Science aims at the individual level. We are not individual in the sense of totally autonomous. Genes constitute a chromosome. Stars a galaxy. We are part of an Us. My hormone levels are crucially shaped by those around me – they aren’t mine alone.
From an evolutionary perspective it makes perfect sense to think of us like a team which needs attackers, defenders, goal-keepers etc. Evolution will produce the risk-takers among us – the extraverts now labelled with an ADHD diagnosis – and the risk-managers – the introverts now labelled with an autistic spectrum diagnosis.
We do not want to obliterate these differences – a team of clones is not a team. Even the members of the Western European Archipelago need each other (Ireland, England, Scotland, Wales and Northern Ireland)
But psychotherapists have found it impossible to believe in differences like these. They couldn’t accept that extraverts can conjure up abuse on an alien spaceship that can feel very believable – The Great Silence – but don’t respond to the CBT that works well for introverts.
Psychiatrists have paid no heed to the data that we can predict how much anesthetic is needed to put someone asleep for surgery based on their personality profile – extraverts and introverts differ radically. There is perhaps a slow acceptance within Zen that meditation doesn’t suit extraverts.
A perceptive comment on one of my recent posts asked whether bringing our personalities and constitutions into the frame, as I have just done here, was not once again a way to lay the blame on us – See The Great Silence. It’s not if you look at the bigger picture – none of us is an island – together we are an archipelago.
It’s not the positive warm regard of some expert that helps. It’s a willingness to listen to something that might seem very alien to the ‘expert’. Listening in this sense means accepting the other’s alternate reality. The person telling the story is doing the work and their listening to their own story and feeling the incomprehension of someone not getting it is often the thing that produces change.
I often only know what I want to say in a lecture after I give it. Or giving it helps me move on to something useful to say. A great copy editor can do wonders for the book I thought I’d already written but not if I just meekly accept the suggestions. There are times to accept suggestions and times not, even if for a while at least I end up being the only one on the island.
Bias?
Zen suits Tullio but not me. Or maybe its just the words it is now packed in.
Tullio’s view is that zazen is the way to avoid arguing which is usually more a case of ego’s clashing than something constructive. If zazen is translated as meditation it would mean think – which seems to lead us back toward clashing. In Japanese zazen refers to sitting.
Buddhist groups developed around bodily positions such as the lotus position versus Buddhist position and there are other traditions that squat. These suit Asians rather than Westerners. The migration of Zen to the West has reduced the emphasis on bodily position. When bodily position was a big thing there were ideas about how positions channel energy in particular ways. This sounds to me a touch hyperbolic, or post-hoc rationalization – Freudian in that sense. But there is no doubt that bodily differences play a much bigger part in who we are than is usually sensed.
Look closely at that last word. There are a few different words that could have been used at that point. Each dramatically changes the perspective of this post.
I am indebted to Tullio for a lightbulb moment but his input has taken me in a different direction to him.
To be continued next week in The Creation Narrative.
The Independence of Thought…
Island-Hopping – sail from Island to Island, knowing you will get to your next Island, or, what if a storm blows up, the Ship Staggers, someone Falls Overboard, the Ship knocks over a bridge, and – its not quite so clear-cut
I also ended up in the Isle of Wight, doing my Day-Skipper Course. Three days from Brighton to Calais, we got becalmed on the I of W, for two days – the Skipper with just me and a lad, was probably one of the most soothing people I have ever met. Lean back, no wind, because when the wind comes, you will know all about it.
Maintaining your Zen, whilst trying to stop your antidepressant is tempting, when all seems fatally futile
I used to wonder why there was nowhere to go – if the Heroin Addicts could get Methadone, why wasn’t I offered something?
I tried so much Zen sort of stuff, at my own cost, it must be worth a try.
I found a retired nursing sister who did reflexology in her front room and I ended up in paroxysms of tears before blurting out my SSRI was hurting me.
I found a student who gave me free cranium massage therapy and reflexology as part of his ‘heath therapy degree’ course. I told him about the SSRI, he did not compute.
I found a woman who did Reiki and the ‘laying of hands.’ She had warned me I might have a reaction when the treatment ended. I became almost hysterical and had a waking nightmare that I was inside a womb and couldn’t get out.
I saw a psychotherapist whose method was for me to sit in her consulting room and for her not to speak to me at all. Sitting in silence for an hour, I broke down in tears and she acted as if that was what I was supposed to do.
I was urged by a friend to visit this ‘transitional place’. I always cried off.
https://www.samyeling.org/
The medical model was to pile on more and more drugs,; the doctors got crosser and crosser.
Plucking a few –
Basaglia would frequently draw comparisons between concentration camps and the asylum system. He felt that psychiatrists were closer to repressive prison guards than humane medics
David and his colleagues were right, people like me (who have difficulties with effexor) can sometimes taper by introducing a different antidepressant.
And so things fracture into schools of thought, islands, with charismatic leaders pushing solutions that have worked for them.
– we are different while at the same time being part of an Us.
The ‘sense’ to me, sounds like the notions in the ‘Archipelago’ are all too ‘Romantic’
The Realities in Throe to the force of the Wind…
We should be alert to the dangers of usually self defined ‘elites’ (Who are they now though)The sycophancy and snobbery which excluded any input from ‘the masses’ stains what might be considered a thoughtful but actually naive dialogue – Freud was adamant he was right and made enemies of such as Jung and others with alternative theories -but all had something in common. Their stern belief in there own theories ..Jung or Adler for example have almost disappeared from the psych literature available to lay people but whose theories many of us find useful. The ones who we do resonate with have often a lasting effect – but try finding a therapy/ist where the client is able to choose which suits them.
These ‘intellectuals’ were so often flawed characters yet believe themselves to the apostles leading ‘the masses’ Jonathan Miller and co actually formed an apostles club in Cambridge
The Einstein-Freud Correspondence (1931-1932)
The letter which Einstein addressed to Freud, concerning the projected organization of
intellectual leaders, was sent in 1931, or possibly 1932, and read as follows:
I greatly admire your passion to ascertain the truth–(Freud could not bear citicism and did much to create conflict to silence real debate or dissent)
brought about by a free (carefully chosen)
association of men whose previous work and achievements offer a guarantee of their
ability and integrity? Such a group of international scope, whose members would have to
keep contact with each other through constant interchange of opinions, might gain a
significant and wholesome moral influence on the solution of
Once such an association of intellectuals–men of real stature–has come into being, it
might then make an energetic effort to en-list religious groups in the fight against war.
The association would give moral power for action to many personalities whose good
intentions are today paralyzed by an attitude of painful resignation. I also believe that
such an association of men, who are highly respected for their personal accomplishments,
would provide important moral support to those elements in the League of Nations who
actively support the great objective for which that institution was created.
I offer these suggestions to you, rather than to anyone else in the world, because your
sense of reality is less clouded by wishful thinking than is the case with other people and
since you combine the qualities of critical judgment, earnestness and responsibility.
The high point in the relationship between Einstein and Freud came in the summer of 1932 when, under the
auspices of the International Institute of Intellectual Co-operation, Einstein initiated a public debate with Freud
For anyone who can’t bear to read Fraud in the flesh ever again a hugely informative and readable book is ‘The Guru, The Bagman and the Sceptic .by Seamus O’Mahony
Just by the way it is interesting to read recently that Archie Cochrane was in ‘psychoanalysis’ for years before giving up on it for the sake of’ evidence based science’ Wondr if he realised what harm as well as some benefit that would lead to .
As far as connectedness is concerned there is a book which has become a bit of a cult recently
Entangled Life’ by the son of Rupert Sheldrake who used to promote the concept ‘morphic resonance’ in an era where there was an interest in the connectedness of all ‘things’ not just between humans but the whole environment.
Merlyn Sheldrake writes wonderfully about the interconectiveness of plant life and the way it encompasses and helps to understand the social life of human beings /all life But he is not dogmatic – share the alternative opinions of others ,perhaps some ‘experts’ have learned the lessons of the past Shame they won’t be applied in the interactions between individuals who consult ‘professionals’.
There was another set of self proclaimed ‘intellectual elites ‘ around the same time as Freud. Literary dilettantes who thought about things seriously, such as Aldous Huxley but again there were so many reprehensible characters amongst them Many were just so up themselves that although they became admired by groups very divorced from the real life of most of us they like Fraud and present day psychoanalysts they could still weild a harmful influence on us even years after their deaths. Aldous Huxley’s interest in psychedelics has been corrupted by so called therapists promoting it as a ‘treatment’
Too long? Sorry Yawn yawn
My wise and greatly missed Australian mother gave me three pieces of unforgettable advice:
‘You’ve got to roll with the punches’.
‘Stay away from trick cyclists, darl’, they don’t know their arse from their elbow.’
‘This above all: to thine own self be true, And it must follow, as the night the day, Thou canst not then be false to any man.’
Obviolusly, she grabbed wisdom wherever she found it.
‘It’s a willingness to listen to something that might seem very alien to the ‘expert’. Listening in this sense means accepting the other’s alternate reality. The person telling the story is doing the work and their listening to their own story and feeling the incomprehension of someone not getting it is often the thing that produces change.’
So astute. It’s that moment when your listener looks at their most perplexed when you hit psychological paydirt. Their confusion signals your own – your emotional block, the uncomfortable hole in your introspective narrative, the personal conflict, the void.
When I was unhappy (emotional control freak never showing extreme distress in public) about the avoidable ill health of someone I love – a cousin said, ‘I don’t know how you can STAND IT – Maybe you should go and talk to someone’.
SOMEONE – why would I want to talk to SOMEONE? SOMEONE who has probably been educated to keep a professional emotional distance? ‘A bland mush’ (lol) – non merci.
Like you, perhaps, I will not be squished into someone else’s theoretical framework. Professionally delivered empathy gives me a fit of the giggles – a head slightly and kindly tilted induces hysteria, such that I have to repair to the bathroom to rest my forehead on cool tiles to recover composure.
It’s tough for largely self-aware, self-disciplined extraverts. In my experience the choice is either – an unedited download to someone with whom you share love – and wait for that telling moment of perplexity on their faces. Or talk to the dog – who is less perplexed than you might think – especially if it’s German Shepherd. That’s what I do, with my mother’s voice echoing in my mind.
Individual Differences
Long before the rise of influential figures in the field of antidepressant safety, individuals grappling with the challenges of their medication congregated online to exchange insights and strategies for managing side effects. Among these platforms was Paxil Progress, a valuable forum that abruptly disappeared not long after the resolution of Paxil withdrawal lawsuits.
The forum comprised individuals with firsthand experience of the diverse range of withdrawal symptoms associated with Paxil. Neither prescribing physicians nor patients possessed all-encompassing solutions or definitive guidance.
Advancing to the latter part of the 2000s, prominent medical figures increasingly assumed roles as advocates for the thousands confronting withdrawal issues.
Today, we witness the availability of tapering strips and assurances of safe and efficient withdrawal protocols, albeit often at a considerable cost.
Presently, social media platforms in written and visual formats facilitate the dissemination of information. Previously, forums provided support, with many shared tips and tricks being freely accessible.
Personally, I’ve harbored reservations about the concept of tapering strips and the claims of individuals guaranteeing to alleviate withdrawal symptoms, particularly when financial transactions are involved.
Newer advocates, garnering media attention due to their status, appear to overlook the era of patient-driven interaction. Some individuals have even attempted to steer others away from me, falsely linking me to Scientology.
This shift is peculiar. It seems that the tactic employed by pharmaceutical companies is now adopted by those seeking to distance themselves from established advocates.
Many are unaware that the issue of withdrawal has persisted for decades and was initially championed by patients in forums, alongside a select few professionals who made significant sacrifices (notably Healy & Medawar).
Contemporary professionals find it easier to acknowledge antidepressant-induced withdrawal, knowing they will likely face minimal or no repercussions.
Where were these voices years ago?
Post-SSRI Sexual Dysfunction (PSSD)
Presently, numerous PSSD sufferers utilize social media platforms in ways that were previously unimaginable to me when I first began raising awareness about withdrawal issues.
Those affected by PSSD often exhibit heightened assertiveness, understandably so given their plight.
Some may argue that my approach was aggressive when using my blog as a communication tool. However, that was my sole means of advocacy back then, as Twitter, Facebook, and similar platforms were in their infancy. Those challenging drug companies and regulators were often labeled as mavericks, Scientologists, or conspiracy theorists.
While there is now some resistance towards newer advocates, it primarily emanates from Twitter psychiatrists seemingly driven by ego. Rather than engaging in constructive debates, I observe individuals grasping onto narratives as if their lives depended on it.
Forums, when managed effectively, served as invaluable resources because they prioritized assistance over assigning blame to specific entities. These virtual gatherings were akin to cyber-cafes, attracting like-minded individuals, albeit occasionally disrupted by dissenting voices.
Twitter operates differently. Privacy is nonexistent. Well-intentioned tweets detailing how “Method A” facilitated safe withdrawal are often met with criticism from both psychiatric professionals questioning the poster’s medical background and safety advocates asserting the superiority of “Method B, C, or D.”
Returning to the essence of your post: “Individual Differences.”
This encapsulates the essence of tapering. There is no one-size-fits-all approach.
I’ve encountered individuals who abruptly ceased antidepressants without experiencing withdrawal, as well as those who painstakingly tapered but struggled to overcome withdrawal symptoms.
These contrasting scenarios are often pitted against each other, neither proving beneficial for individuals contemplating discontinuation of antidepressants; indeed, both may be detrimental.
Anyway…
Deprescribing antidepressants….sometimes trying to solve the unsolvable?
We have had 36 years of swallowing SSRI drugs, (fluoxetine was introduced in the US in 1988 and in the UK in 1989). A significant number of people, (perhaps millions), have consumed these drugs for lengthy periods. Many long term consumers continue to live ‘differently balanced lives’ in what is a reasonable but incredibly compromised way. For some the irony of shouting out their ‘need’ for their antidepressant usually hides a multitude of failed attempts to withdraw from their medication. Many people resign themselves to an ignorant but understandable acceptance these drugs ‘keep them sane’, ‘have cured their anxiety’ and they ‘cannot live without them’. Paradoxically they probably can’t live without them but it is due to their physiological dependence.
What is needed is the acceptance many of the millions who take antidepressants are physiologically and irrevocably changed. No deprescribing hypothesis might ever explain the complexity of changes these drugs have made. No self-proclaimed deprescribing expert (however much they are paid for sometimes their opportunistic services), will be able to guarantee reducing medication will not leave us (whatever our length of exposure to the drugs) in a worse place with chronic and enduring problems. As Dr Stuart Shipko says, “If I thought that it was possible, I would have opened a string of clinics all over the country to help people off of antidepressants. Unfortunately, the problems that often occur when people try to stop an SSRI antidepressant are much more severe and long-lasting than the medical profession acknowledges, and there is no antidote to these problems”.
Notwithstanding the progress being made by some well-intentioned individuals, patients dependent on antidepressants can be vulnerable to the exploitation of those marketing themselves as ‘restorers of health’. Often making what seem exploitative, spurious, and unprincipled claims that they have the powers to successfully withdraw people from psychiatric medication. This emerging, fast growing industry of professionals and services are profiting financially from a mass market of desperate patients harmed by prescribed medication.
I question the somewhat authoritarian manner in which we are told to get off antidepressants. Deprescribing is a personal, individual experience and requires a harm reduction approach without goals and prescriptive guidelines. For those dependent, attempting withdrawal might become no different to being part of the experiment they unwittingly participated in when they swallowed their first pill. There is no doubt being dependent on drugs leaves us vulnerable and there are numerous factors affecting dependence which lead to remaining as balanced as possible precarious. For those dependent but unaware, one bad generic, skipping doses, drug shortages, inability to afford medication, one piece of bad advice, can mean the difference between normality and akathisia.
The hyperbolic tapering idea can become a problem for some. Communicated sometimes as a ‘fait accompli’ it can lead to a false belief that the answer has been found, the problem solved and everyone needs to get on board. It encourages people to try stopping as it gives the impression that we have worked out how to get off antidepressants and all we have to do is apply this approach. I would encourage everyone to live a life antidepressant free but for millions it is too late and damage limitation the best option.
Above all we need responsible prescribing. Less prescribing of these drugs means less harm and dependence and ultimately less demand for withdrawal and support services. While governments, medicine and psychiatry continue to deny patients best possible care and the answers they deserve, are we often sending those dependent on and harmed by psychiatric medication down experimental rabbit holes full of empty, lack of evidence-based promises. Are we sometimes trying to solve the unsolvable?
Whoever conjured up the term ‘antidepressant’ was on to a goldmine.
Most people take things at face value.
Even twenty years ago, we were seduced.
The timing was great for the four Panorama programmes, just after so many of us sustained severe injuries and injurious behaviour. Panorama would not have made four programmes if the injuries were negligible.
Quite why GlaxoSmithKline decided to get in on this billion-dollar market is a matter for them; copy-cat versions are extremely dangerous. Prozac was extremely dangerous.
The best books describing this catastrophic state of affairs is Children of the Cure by David Healy and Prescription for Sorrow by Patrick D. Hahn.
Is the problem unsolvable?
I don’t think so.
The mega-hype in the 90s and 2000s grabbed this huge market and hailed ‘antidepressants’ as the go-to drug for anxiety and depression and a host of other ailments. Off-label took off.
Massive advertising campaigns from pharmaceutical companies induced doctors to prescribe and prescribe. Psychiatric and General Practitioner Societies got behind this and before you knew it, ‘antidepressants’ became a norm.
FDA, MHRA, NICE, Medical Journals, the Professions, did nothing to halt these drugs and so the massive marketing was something not easy to come back from.
The massive fines to pharmaceutical companies are largely irrelevant; a relatively small cost compared with their marketing budgets.
The message of Ghostwriting hasn’t made a dent.
The message of nobody ever seeing the Data; hasn’t made a dent.
The most curious thing is almost everyone getting on the bandwagon.
It is now proven to be from the huge numbers prescribed ‘antidepressants’ that the goldmine has taken off and taken over.
We have been caught out loudly and clearly.
Today on BBC Radio4, Sir Professor Simon Wessely, who is always conjured up on matters ‘psychiatric’, was asked about the huge rise in autism and ADHD, and admitted that it was a societal problem and most probably most would not want medication. Pity he didn’t apply this to his deep belief that ‘antidepressants’ are not overly prescribed.
Having been tapering hyperbolically and been on a site which advocates this and having seen the massive number of threads go silent often after cries of increasing desperation and having seen those who have cold turkeyed and do not recover and those who have tapered hyperbolically and do not recover, I have to agree on balance with David Healy’s assessment. There is a generalised denial that many are unable to stop their drugs and that those who manage to stop in many cases are physiologically and permanently changed for the worse.
These tapering sites were a refuge because the medical profession at large would not help patients who were dependent on these drugs and refashioned their symptoms as relapse. However I have read stories of people recovering fully having cold turkeyed their drugs after having been on them for years and years and but relatively few stories of those who recover fully having tapered hyperbolically..
It is a pity that people are not able to be open to all the evidence because that is the only way that the damage done by these drugs to how many and to what remedies have worked or have not worked can be quantified. The hyperbolic taper method is ultimately a hypothesis or theory until it can be proved and to date it hasn’t been.
Tapering site remain a valuable resourse because it is very often the only place where people damaged by these drugs can be heard.
My own view is that perhaps the only way out for many who are chronically disabled by these drugs is more drugs i.e. the psychedelics or if they can tolerate it a low dose mood stabiliser.
M
Thanks for this. I gave 6 people with protracted withdrawal or PSSD ketamine – which is psychedelic although maybe not the same as mushrooms. To my surprise it made things worse. This is odd. As the Zen and Psychopharmacology article says the SSRIs are almost the opposite to the the psychedelics – they close minds down where psychedelics open up. We weren’t brave enough to repeat the experiment
D