There’s substantial truth in this statement, but on the other hand there are many diseases we do not understand fully, but recognize that effective medication exists to manage them and prevent damaging consequences (for instance, atherosclerotic cardiovascular disease).
I haven’t read the paper in Society, but I’m not sure the claims of a doctoral candidate in social work and a neuroanatomy professor are sufficient to overturn the results of many years of research showing that chemical imbalances do play a major role in some mental disorders. That reporters do substandard science reporting is no surprise.
I understand the distinction you’re trying to make, AHunter, but that cite is really, really unconvincing. All it really proves is shitty journalism.
Which is not to say that there may or may not be causal agents to many mental illnesses. Neuropsychology has definitely evolved beyond the ‘‘cold mother’’ hypothesis for schizophrenia, but there have been links to recreational drug use and schizophrenia, to name one potentially causal agent. It’s pretty well established that external conditions and environment impact brain chemistry, and so do cognitive patterns. I don’t believe anyone here (and correct me if I’m wrong) is implying that all mental illnesses absolutely spontaneously generate in the brain. What’s established is that the brain’s functioning or lack thereof impacts behavior and cognition. This is easily demonstrable–if you take a shovel to someone’s head and damage the Wernicke’s area of the cerebral cortex, a person may spout nonsense. If you smash their frontal cortex they might become a sociopath or maybe just really bad at scheduling appointments. The cause—>effect is pretty obvious there – but it seems kind of petty to argue whether the ‘‘cause’’ is the shovel to the front of the skull or the actual damage to the brain. The point is an external affect on the brain as an organ.
Take a man and put him in the midst of a brutal war, and causality gets even more blurry. Obviously his raging case of PTSD wouldn’t exist if it weren’t for the war, but something is keeping him miserable, and the war is over. There are lots of reasonably well-supported theories about what is happening – there is evidence to suggest that traumatic memories are processed in a chemically different way than episodic memory, for example. But one thing is pretty much universally understood: the brain is doing something. What it’s doing, and why it’s doing it, has proved to be really freaking hard to figure out, due to the sheer complexity and malleability of the brain organ. How the brain gets fucked up in the first place – whether it’s a shovel to the front of your skull or surviving an earthquake or just losing the genetic lottery–that’s a much more complex and nuanced issue. Cancer is a good analogy here, due to the vast number of different kinds of cancers. Some have obvious causes, some are still a mystery. Some are relatively easy to cure, others are a death sentence. Should we then cease all cancer treatments until we have found the perfect cure? Why should it be any different with mental illness?
Our understanding of atherosclerosis, if not quite on the same plane as our understanding of diabetes, is still many quantum leaps beyond our understanding of the ailments called ‘mental illnesses’. I’d say we’re on damn firm ground in saying atherosclerosis flat-out IS a disease of the blood vessels, specifically the narrowing thereof, the depositing of rigid inflexible material on the walls thereof… no one is seriously postulating that perhaps having elevated blood pressure or insufficient blood flow to various tissues might be the cause rather than the result of those conditions of the blood vessel, right?
Look, psych drugs are used for the purpose of deliberate zombification of people. NOT by any means to the exclusion of other uses, but the combination of that plus the lack of a clear sense of what the psychiatric maladies consist of plus the lack meds with relatively trouble-free efficacy like one sees in meds for symptom control in atherosclerosis should add up to sufficient reason to :dubious: in response to many of the claims made for these meds.
If you find they work wonders for you, by all means take them, and expect no contradiction from me when you say they work well for you.
If you tout them as something that other people should consider taking, I’m more likely to step in and say “Umm, you should hear the voices of folks whose experiences with those same meds are far less pleasant” and provide some links.
If you seek to define them broadly as effective drugs that successfully treat this or that psychiatric ailment, in any context, expect me to step in and say “Umm, those same medications are demonstrably used to immobilize and control people, and a large portion of people who have had them administered in a psychiatric context claim that is their real or primary purpose there also; they may have effects that some sufferers do indeed find useful or vital to their everyday ability to function, but that doesn’t necessarily mean that they aren’t nevertheless just powerful tranquilizers with no specific characteristics to recommend them for folks in such mental/emotional states”. And provide some links.
[humor]No no no, they help the brain, not cause one to hunger for them.[/humor]
Before this discussion continues, you are talking about anti-psychotic medications and not all psycho-pharmaceuticals right? This is an important distinction. If you’re talking about anti-psychotics, I think your stance holds more merit. I’m not sure how much merit, but more.
Excellent, an ideal example and a good post thanks.
Yes, our PTSD victim is experiencing real misery and needs help (assuming he wants help and accepts it volitionally under conditions of fully informed consent, etc), and even while we say “It is the war that did this to him” we can’t fix the war; it is, as you said, already over. Even if we somehow transformed society in such a way that never again in the experience of our species would the lands be blotted by warfare, and then told him so, I accept that that might not drag his mind out of the neuro-biochemical-memory-driven rut it’s in. And even if our psych drugs aren’t ‘magic bullets’ they are what we have, and maybe some of them would help.
I hope many of us are on the same proverbial page on this up to this point.
The problem lies in part with the zillions of unpleasant human circumstances that are less easily recognized than a well-publicized war but which affect those involved in ways not terribly dissimilar to PTSD: the sufferers may be briefly acknowledged as hypothetical sufferers of unknown events or circumstances but the attention quickly shifts to the sufferer’s brain, and because it does so the locus of the problem becomes the sufferer. Something gets lost there: it has been known to be empowering and liberating for such a victim to fully ‘get’, to fully realize, what atrocities have been practiced upon them to result in their state of mind; to get mad about it, to internally grasp that this is not happening to them because they deserve it but because something wicked did this to them. To say “you feel this way because you have a chemical imbalance in your brain, end of story, take this pill”, if it doesn’t completely bar that type of realization, does place barriers in the way of it, while telling the rest of the world “This person has a brain malfunction, that is the cause of intense and unpleasant-to-be-around emotional states that this person may be in, and/or ideas and notions this person may entertain that are different from what most of us believe. You can reasonably discredit whatever this person says, especially if this person is not taking the recommended feeling-deadening, abstract-thought-occluding medications prescribed”.
The problem also lies, in part, with, well, lies. The claim is made, on behalf of these medications, that they are the pinnacle of a highly developed medical science, that, much like insulin or even digoxin, they work in a very effective way to directly intervene where physiological intervention is medically necessary, with a focused action, to address a known and well-understood condition. That is a lie. OK, if taken out of this politicized context, we could say “an exaggeration” or “a rather optimistic way of putting it that glosses over a lot of problems with that model” or whatever.
But the problem, finally, does lie with the context. These are drugs that are administered on an involuntary basis to people, including not only those diagnosed mentally ill but others who are simply, for the moment, a real or potential behavior problem, for the express purpose of wiping out their ability to cause a problem for those who are managing them. Stick that on one end of a continuum, drag your imaginary slider bar through a middle-zone of inpatient psychiatric settings where it us used for behavioral control but at least in some cases on people who consider themselves ‘out of control’ when not so medicated and who, at least in some circumstances, take the meds voluntarily, then drag your slider on towards the other end where administration of such meds is given only in hopes of making the lives of sufferers better and enabling them to live their lives. The latter end of the spectrum does not invalidate the rest, but rather more the opposite: GIVEN that lies and distortions exist as justifications for deliberate brain-immobilization, and GIVEN that such lies, once in existence, will be printed, touted, and believed both by sincerely prescribers thereof and hopeful swallowers thereof, it is not the occasions of involuntary administration for pernicious purposes that should be called into question, but the shiny clean airbrushed face of modern pharmacopoeia presented on the other end.
I would in fairly recent history have restricted it to the antipsychotics, yes. Certainly it is those which most inform my phrasings etc… but in the last 5 years I have taken an increasingly jaundiced view of the much more mainstream-marketed antidepressant category. They may not be used to deliberately zombify people, but they have often been rushed to market, their unknown risks insufficiently tested for and their known & demonstrated dangerous effects swept under the carpet, in ways that both pro-medical-model pro-psychiatry advocates like the National Alliance for the Mentally Ill and folks like us in the Mad Pride / Mental Pts Liberation mvmt find appalling.
Antidepressants have been clinically proven to have no significant difference from placebos in the treatment of depression, according a study published in the British Medical Journal. The summary of the study concluded:
A lot of people also swear by headache aids that are applied directly to the forehead. That does not mean they are proven to work.
If you read the comments to that article, you’ll find that while it raises some important points, Kiersch and Moncrieff’s main claim doesn’t hold up under scrutiny.
I have bipolar I disorder. Like stretch’s spouse, my manic episodes are “mixed,” meaning that I don’t have the euphoric, “fun” mania - I just get irritable, agitated, have about a 90-second attention span for everything and have this tendency to fly into inappropriate rages. I’ve lost two jobs that way, actually - having screaming fits at my boss then dissolving into hysterical crying. This was years before I actually got a correct diagnosis.
I respect AHunter3’s views, but I don’t agree with them. I understand that he had bad experiences with the “mental health system” and psychoactive medications, and that sucks. In my case, I fully believe that the medicines I take for my bipolar have given me my life back. I can hold a good job, I can keep friends, and (most important) I don’t hurt my poor longsuffering husband’s feelings all the time anymore.
For what it’s worth, while I have Bipolar I, my sister has Major Depression with OCD (very. very severe) and Dad is a depressive who self-medicates with alcohol. While I agree that it hasn’t been proven exactly what causes mental-illness, to say that family connections like mine (and many other families’) don’t point to some inheritable brain anomaly/abnormality is protesting a bit too much.
Do the geniuses and doctors of the SDMB really equate asthma and diabetes with the myriad of partially described conditions that drugs like Paxil is prescribed for? Interesting…
You know what? I’m going to stop taking my Lamictal! That way, the REAL ME, the one that blacks out and bites right through the side of my tongue, only to wake up later with no memory of the last twelve hours. How does that sound?
Before I started taking Paxil and getting therapy, I was a mess. I suffer from obsessive-compulsive disorder. When I was ten, for example, I caught one bitch of a stomach bug, and spent the whole day throwing up. (Nine times, IIRC). After that, for about six months, whenever I had the slightest cramp, whenever I even heard about someone getting sick, I’d stay up all night panicking. I’d drink glass after glass of water, or ginger ale, if we had it, convinced that if I could just let out a few monster belches, I’d be okay. I was also only able to sleep after 4:30 am, because that’s what time I got sick originally that time.*
Does this make sense? Of course not! I KNEW it was insane-but I couldn’t stop it.
Or when I was twelve-I was convinced I would go to Hell. I don’t remember all the details, just that I was again, not sleeping night after night.
The worst was when I turned 18, and started college. For some assinine reason, I was convinced I was going to suddenly turn gay.** It was stupid, there was no reason to, but there it was. I was having constant panic attacks, all I did was sleep. It had nothing to do with feeling unworthy, or unloved, or whatever. I knew I was loved, and I knew I wasn’t an unworthy, horrible person (well, no more than USUAL ). It was just these constant fears of completely irrational things happening, that I couldn’t control.***
It came to a head (heh) one night when I was in the car with my mom and Baby Sis, and I just started screaming uncontrollably, lying in the back of the car, my sister crying, my mother trying to keep me calm until we got home. Long story short, I ended up in therapy. I was prescribed Paxil, yes. BUT, I also did CBT. But one didn’t work without the other.
Today, I still have some OCD-like quirks-I have to have things arranged a certain way, or checking little things constantly. But I’m no longer obsessing about irrational completely stupid, no way will happen crap.
I’ll probably be on Paxil until I die. Oh well. The side effects have pretty much gone away-I don’t notice them. I notice more effects from the Lamictal, and THAT’S even more of a necessity.
In short? If you have a problem with me taking said drug, well, too bad. If that isn’t “the real me”, oh fucking well. Kiss my crazy ass.
MY personal favorite comment? “It’s all in your head!” Guess what? Of course it’s all in your head! So’s a brain tumor! Does that make it imaginary?
(I appologize for the length. This is something I feel VERY passionately about, and it usually makes me see red when I read comments from people like ianzin.)
*[sub]Ironically, what finally broke the obsession, was getting the stomach flu a SECOND time around, and not panicking, and just letting it ride. Yeah, weird, I know.[/sub]
**[sub]No offense to gay people. I have no bias against homosexuality, as those who know me, well, know. Nor did I then. Again, it’s just irrational, like most obsessions tend to be.[/sub]
***[sub]The suckiest thing about OCD is the KNOWING your fears are completely irrational-but not being able to stop them. And trying to reason your way out of it only feeds into the cycle and makes it worse.[/sub]
Actually, I stand by my statement. You didn’t quote the part of my post where I specified that I didn’t have any stressors that my depression was a reaction to. I mean, I have stress (I work, have a husband and family, need to clean up my dogs’ poop everyday, etc.), but nothing unusual happened. I just woke up depressed one day. And then I reached the end goal level of my medication, and woke up not depressed that day.
This may not be a peer reviewed medical study, but I also don’t need a peer reviewed study to know that the rumbling in my stomach means that I’m hungry. If that makes me unscientific, so be it.
By the way, my actual diagnosis is Bipolar NOS with anxiety disorder. My father was bipolar with anxiety disorder, my mother is bipolar and schizophrenic, my aunt on that side is schizophrenic, my grandfather on that side was an alcoholic, my brother doesn’t believe in medication but gets panic attacks, my aunt on my father’s side is the same, and my grandfather on my father’s side was bipolar with anxiety attacks. A clearer picture of genetically based psychiatric disorders you’ll never have.
You might want to look up sarcasm, or possibly joke. It seemed obvious to me that the posts regarding asthma and diabetes were equating ianzin’s quoted comments from the other thread implying that treating “psychological” conditions with proper use of medication as “hiding the real person” with similar use of medication to treat “physical” conditions as also “hiding the real person”.
The first time I read this thread I saw this and just nodded my head to myself, but I have to speak. I’m glad you posted this. I’ll bet you you would be surprised at how many people have no clue you take meds. And to be sure, you must be exactly what the doctors and researchers hoped for when they were searching for them. As I have seen your picture, I have always figured you just to be a little shy, for personal reasons. I’ll bet your few friends and relatives admire you.
I don’t really like talking about my problems because they were so mild and are mostly gone. But I spent the first 21 years of my life with very very subdued emotions. There was no reason for it - there was just a chemical problem. Paxil took care of it quickly and easily, and also helped with my previously unknown social anxiety. Could therapy have helped me? Maybe. Was I being force-fed drugs? No. Was I being zombified? Hell no - I was a zombie before and Paxil fixed it.
Sure the drug industry is out to make money. And yes, the health industry isn’t perfect. But in the long run, doctors want to help people.
I find the comments unpersuasive, especially the criticism regarding active placebo. The comment is actually arguing that SSRI’s are no better than atropine, which I find to be not much of an indictment. Atropine as an active placebo is better at maintaining the double-blind security, because atropine causes some of the superficial side effects of SSRI’s, such as dry mouth. If anything, the use of active placebos enhances the placebo effect, because both patient and researcher are more likely to believe the drug is the real thing, so both demonstrate the same efficacy against depression.
The placebo is not supposed to have any active ingredients in it. If it does, it no longer fits the definition of placebo. It is its inability to affect brain chemistry that serves as a control.
Why are you more willing to believe the study that goes against what hundreds of other studies show?
And greetings to my friend, AHunter3! I hope things are well for you. Do you know of any SSRIs that are used to sedate and control people? Surely they could find something stronger than “my beloved prozac.”
Although AHunter3 and I disagree often about psychiatry and medicines, he is understandably cautious and very fair-minded.
You are mistaken. Many pharmaceutical companies are now using active placebos precisely because inert placebos frequently allow both patient and researcher to penetrate the double-blind security. And that is why I find all of the other research suspect, because if a patient concludes they got a placebo because they feel no side effects at all, the outcome of the study is compromised and the conclusions about efficacy are meaningless.
). It was just these constant fears of completely irrational things happening, that I couldn’t control.***