Anatomy of an Epidemic (Part Three)

The question was: Why have we seen such a sharp increase in the number of disabled mentally ill in the United States since the “discovery” of psychotropic medications? At the very least, there is one major cause. In large part, this epidemic is iatrogenic in kind.

Now there may be a number of social factors contributing to the epidemic. Our society may be organized in a way today that leads to a great degree of stress and emotional turmoil. For instance, we may lack the close-knit neighborhood that help people stay well. Relationships are the foundation of human happiness, or so It seems, and as Robert Putnam wrote in 2000, we spend too much time “bowling alone”. We also may watch too much television and get too little exercise, a combination that is known to be a prescription for becoming depressed. The food we eat – more processed foods and so on – might be playing a role too. And the common use of illicit drugs – marijuana, cocaine, and hallucinogens – has clearly contributed to the epidemic. Finally, one a person goes on SSI or SSDI, there is a tremendous financial disincentive to return to work.

As a foster mother, Gately was required to follow “medical advice” and give psychiatric medications to the children who arrived on them. Most of the children were on cocktails, and it seemed to her that the drugs were primarily being used to make the children quieter and easier to manage.

She has kept track of a number of the ninety- six children, and as could be expected, many have struggled as adults. “When I look back on the kids that stayed on the drugs and those who got off, it is the ones that are off that are the successes.” She says. “Liz should never have been on the drugs. She got off the drugs and is doing great. She is a full time student in nursing school and almost ready to graduate, and is about to get married. The thing is, if you get off the drugs, you start building these coping mechanisms. You learn internal controls. You start building these strengths. Most of these kids have had very bad stuff happen to them. But they are able to rise above their past once they are off the medications, and then they can move on. The kids who were drugged and continue to be drugged never have the opportunity to build coping skills. And because they never had that opportunity as a teenager, as an adult they don’t know what to do with themselves”. It isn’t a scientific study, but her experience does offer a peek into the toll that the medicating of foster kids is taking. Most of those who stayed on the drugs, she says, ended up “filing for disability”.

Sam Clayborn from New York tells from personal experience what it is like to have been a foster kid in the US. He was born in Harlem and by age six he was living in a residential group home. He says: “They were not so hot on psychiatric diagnoses back then”, he explains. “They were more into beating your ass, restraining you, and just throwing you into an empty room. I’m glad I grew up when it was like that rather than what it is today, because if I grew up now, I’d be drugged up. I’d be doped out and zonked out”.

Starting around 2000, rates of black youth diagnosed with bipolar disorder soared, and based on hospital discharges, they are now said to suffer from bipolar disorder at a greater rate than whites.

Sometimes children with criminal records get to choose – to go to juvenile prison or mental institution, they choose the latter not knowing that they are damaging themselves.

“The Tuskegee syphilis experiments were nothing compared to this. That’s mild shit compared to what they are doing to black kids today. The pharmaceutical companies and the government are cheating in cahoots, and they are doing a wicked dance with a lot of people’s lives. They don’t give a shit about these kids. It’s all about capitalism, and they will sacrifice all the niggers in the hood. We are damaging these kids for life, and the majority of these kids will never rebound. These kids will be destroyed and they are going to make the SSI rolls more overwhelmed”.

“This is happening to a lot of the brothers today, and once they are on the medication, it take them away from themselves. They lose all the willpower to struggle, to change, to make something out of themselves and have success. They succumb to the chemical handcuffs of the mediations. It’s medical bondage is what it is.”

From the book “Anatomy of an Epidemic” by Robert Whitaker.

Anatomy of an Epidemic (Part Two)

Psychiatry has now three classes of medications it uses to treat affective disorders – antidepressants, mood stabilizers and atypical antipsychotics – but for whatever reason, an even greater number of people are showing up at Depression and Bipolar Support Alliance meetings around the country, telling of their persistent and enduring struggles with depression and mania. Patients get diagnosed with manic-depressive illness, informed that they suffer from a chemical imbalance in the brain, and put on Haldol and Lithium. Then comes a cocktail of drugs to counteroffer the side effects of the first two.

All of this physiology – 100 billion neurons, the 150 trillion synapses, the various neurotransmitter pathways, tell of a brain that is almost infinitely complex. Yet the chemical imbalance theory of mental disorders boiled this complexity down to a simple disease mechanism, one easy to grasp.

Once again this is a story of neurotransmitter pathways that have been transformed by the medications. After several weeks, their feedback loops are partially disabled, the presynaptic neurons are releasing less dopamine than normal, the drug is thwarting dopamine’s effects by blocking D2 receptors, and the postsynaptic neurons have an abnormally high density of these receptors. The drugs do not normalize brain chemistry, but disturb it, sometimes to a degree that could be considered “pathological”. That is how “create perturbations in neurotransmitter functions”. Knock down a “target symptom”.

The drugs ameliorate anxiety for a short period of time and thus they can provide a depressed person much needed relief. However they work by perturbing a neurotransmitter system, and in response, the brain undergoes a compensatory adaptations, and as a result of this change, the person becomes vulnerable to relapse upon drug withdrawal. That difficulty in turn may lead some to take the drugs indefinitely, and these patients are likely to become more anxious, more depressed, and cognitively impaired.

There is a story that psychiatry doesn’t tell, which shows that our societal delusion about the benefits of psychiatric drugs isn’t entirely an innocent one. It had to grossly exaggerate the value of its new drugs, silence critics, and keep the story of poor long-term outcomes hidden. This is a willful conscious process, and the very fact that psychiatry has had to employ such storytelling methods reveals a great deal about the merits of this paradigm of care, much more than a single study ever could.

Writer suggests full disclosure.

The real question is “When and how psychiatric medications should be used?” The drugs may alleviate symptoms over the short term, and there are some people who may stabilize well over the long term on them, and so clearly there is a place for the drugs in psychiatry’s toolbox. However, a “best” use paradigm of care would require psychiatry, NAMI, and the rest of the psychiatric establishment to think about the medications in a scientifically honest way and to speak honestly about them to the public. Psychiatry would have to acknowledge that the biological causes of mental disorders remain unknown. It would have to admit that the drugs, rather than fix chemical imbalances in the brain, perturb the normal functioning of neurotransmitter pathways. It would have to stop hiding the results of long-term studies that reveal that the medications are worsening long-term outcomes.

How can we insist that our society’s mental health system be driven by honest science rather than by a partnership that is constantly seeking to expand the market for psychiatric drugs?

From the book “Anatomy of an Epidemic” by Robert Whitaker.

Anatomy of an Epidemic (Part One)

Melancholy, of course, visits nearly everyone now and then. “I’m a man, and that is reason enough to be miserable.” wrote the Greek poet Menander in the fourth venture B.C., a sentiment that has been echoed by writers and philosophers ever since. In the 17th century tome Anatomy of Melancholy, English physician Robert Burton advised that everyone “feel the smart of it…. It is most absurd and ridiculous for any mortal man to look for a perpetual tenure of happiness in this life”. It was only when such gloomy states became a “habit”, Burton said, that they became a “disease”.

To cure black bile (depression) Hippocrates recommended the administration of mandrake and hellebore, changes in diet and the use of cathartic and emetic herbs.

During the Middle Ages, the deeply melancholic person was seen as possessed by demons. Priests and exorcists would be called upon to drive out the devils. Then with arrival of the Renaissance in the 15th century, the teachings of the Greeks were rediscovered, and physician once again offered medical explanations for persisted melancholy.

Psychiatry’s modern conception of depression has its roots in Emil Kraepelin’s work, which had two major categories, and later three: depressive episode only, manic episode only and episodes of both kinds. In the short span of 40 years, depression had been utterly transformed. Prior to the arrival of the drugs, it had been a fairly rare disorder, and outcomes generally were good. Patients and their families could be reassured that it was unlikely that the emotional problems would turn chronic. It just took time – 6 to 12 months or so – for the patient to recover. Today, the NIMH informs that public that depressive disorders afflict one in 10 Americans every year, that depression is “appearing earlier in life” than it did in the past, and that the long-term outlook for those it strikes is glum.

There was an intellectual challenge to this theory’s legitimacy, an attack launched in 1961 by Thomas Szasz, a psychiatrist at the State University of New York in Syracuse. In the book The Myth of Mental Illness, he argued that psychiatric disorders were not medical in kind, but rather labels applied to people who struggled with “problems in living” or simply behaved in socially deviant ways. Psychiatrists had more in common with ministers and police than they did with physicians. His book helped launch an “antipsychiatry” movement by various academics in the United States and Europe. All questioned the “medical model” of mental disorders and suggested that madness could be a “sane” reaction to the oppressive society. Mental hospitals might better be described as facilities for social control, rather than for healing, a viewpoint popularized in “One Flew Over the Cuckoos’ Nest”, which swept the Oscars in 1975. Jack Nicolson’s character got lobotomized (part of his brain surgically removed) for failing to stay in line.

And finally internal issues: during the 1970s, there was a deep philosophical split between the Freudians and those who embraced a “medical model” of psychiatric disorders. In addition there was a third faction in the field, composed of “social psychiatrists”. This group thought that psychosis and emotional distress often arose from an individual’s conflict with his or her environment. If that was so, altering that environment or creating a supportive new one (ex. Soteria Project) would be a good way to help a person heal. The field had “identity crisis”.

But then they got an idea.

The purpose of DART, the NIMH explained in 1988 was to change public attitudes so that there is greater acceptance of depression as a disorder rather than a weakness. It regularly goes undiagnosed and undertreated. And that it could be a fatal disease if left untreated”. Welcome to the epidemic!

From the book “Anatomy of an Epidemic” by Robert Whitaker.

Blog Transition

Dear Friends,

I’m finally transitioning all the content of this blog to its domain

Please, read new posts at new location! Last weekend I summarized all feedback on the happiness formula from independent testers and already scheduled its publishing. Check it out!

Have a happy version of reality!

Marina 🙂

Shared Wisdom and Resources

I’ve been looking for websites about happiness and self-improvement. Those who seek shall find. While I was sitting at Peet’s Coffee&Tea  in Santa Monica I noticed a man next to me creating an elaborated chart, looking like a fishbone in Corel which reminded me  a cause – effect tool from my consulting life. I asked him what it was. Charles told me that he is working  on the website Keys to self-motivation. He just started this website and the fishbone is one of his ideas to be posted soon. As Charles explained he has 20 years of experience in construction and he saw many men floating through life like lost boats, living day by day without having concrete goals not only career-wise but in other aspects of their life. So the fishbone is to create more structure and direct people where they want to go. Charles’ wife also has a website Detox Vortex, it is about living healthy.

We had a very interesting discussion and shared our knowledge on the topic. One of the websites Charles suggested is Self-growth. The site has numerous resources for those who have the time and interest to learn different techniques. We both appreciate Steve Pavlina blog, which has thousands of great posts (it’s been around since 2004).

I told Charles about his potential competitor My life list and about Daily feats, a site that suggests good deeds for you and gives you points for completing them.

A friend recommended to me a site about how to get over difficult time in one’s life Out of stress. Through I’m happy project I connected with Rachel, who has a website Undercurrent coaching. I mentioned before Ricky’s site Life long happiness. Subscribe to blogs you like, find inspiring quotes about life, love and helping others. Visit Quote Garden.

If you are very depressed and want help, try Depression Support Help and Psychology Info. I recently found National Empowerment Center (NEC) website. There are many depression and suicide prevention organizations… Just type the words “depression help”… and there will be a list to choose from.

What I recommend the most is…  go and volunteer… You will learn everything in comparison: your pain, their pain, the world’s pain. You’ll see how making other people happy will make you feel. Don’t expect to get anything in return for your help to others. Just do it. Ad you will see the difference soon… “One must really have suffered oneself to help others” ~Mother Teresa.

If you want to start your own project and need fundraising or want to invest into somebody’s project, check out Crowdrise, Kiva, Profounder, Kickstarter and Donorchoose.

There are lots of interesting meet-ups about how to become happy. One of them is run by Dr. Amy Coget in San Francisco. I never met Amy but her positive attitude is contagious. She runs The San Francisco Happiness Club.

This year on the International happiness day, July 10, she created Smile Mob Event: “We will be giving away free smiles and free hugs too!  If you wanted more happiness in your life and to celebrate your own and others happiness then join us at the SF Happiness Club.  After participating in a smile mob this past week, I guarantee you will gain a great happiness boost!”

And finally, there will be another group testing of the happiness formula in Cambridge, MA on Aug 10 at 7 PM in Algiers Café in Harvard Square. All participants will be able to try the latest version of the tool,  create their own happiness formula, help others to increase their happiness and provide feedback. Everyone is welcome to attend!

Live Group Testing of the Happiness Tool in Santa Monica, CA

There were seven of us in Urth Cafe in Santa Monica at 7PM on Wednesday. Due to traffic I was a little stressed, but “Peace of mind” tea cured it all. I was pleasantly surprised with overall attendance: 6 people showed up from 10 RSVPs which is pretty high.

We gathered in the courtyard, where it is more quiet, plenty of shade and more space in comparison to the main room. After quick introduction, participants scattered around the courtyard and completed the forms with 20 questions.

While I was entering numbers from the first set of forms into the Excel file and calculating participants’ happiness ratios, they wrote questions about their obstacles of happiness.  We rotated the second set of  forms among participants, so that each of them had a chance to answer other people’s questions. The questions were about romantic life, work life balance, connecting to people better, etc.

At the end everyone received two forms back: one with their happiness ratio and the other with answers to their questions. We had a discussion and the feedback was most valuable. Kim enjoyed giving answers, while writing her own questions was hard.

Warren said that he tried to answer questions as best as he could because he knew how important it was for the other person and that person’s happiness depended on it. He also mentioned that it would be nice to do this test every morning, because it is a good check for someone’s life. Warren was surprised at the complexity of the test. Even though there were just twenty questions, they do cover all sources of happiness and the happiness ratio is correct.

I was asked “What does the ratio mean?” and the answer is “of everything you want for your happiness how much do you think you have right now”. I was curious if the exercise helped to focus on what participants have or what they don’t have. Kim said that for her it was about understanding how many good things she has in her life and about being grateful for them.

I explained that this assessment could work both ways: it could either direct you to lower your expectations or help achieve what you need the most in your life (being more proactive).

As we drove back my friend, who also participated in the event, said that she wrote a question and the answer was not new to her but it was reassuring to hear it from a stranger, which just reconfirmed that she really needs to do it and really focus on it. Imagine that 100 people read your question and gave you 100 great answers. Even  if you don’t act upon their recommendation, it is possible that  you will be happier simply because so many people care about you and your happiness.

It turned out that one of the participants Ricky has a great website Lifelong happiness, he gave us special bracelets, which are part of the 30 day challenge. I checked his website out after the event and was very impressed. All the content on the website is to help people to achieve happiness in life. One of the quotes is “Let no one ever come to you without leaving better and happier. ~Mother Teresa”

As for the testing of the tool in San Francisco that was planned for June 30, only one person showed up who happens to be my friend 🙂 We waited for the rest of the folks in Epicenter Cafe for about 40 minutes and then went to Udupi Palace for an Indian dinner. I didn’t get upset that others didn’t show up because I realized that on Thursday before the 4th of July many people may decide to travel or run last minute errands, so I was totally fine with having a dinner with my friend instead. But that same day he introduced me to a guy who was really interested in the tool and I promised to send it to him. If I can help one person learn something that will help him find his happiness I’m happy.

Live Group Testing of the Happiness Tool in Boston

In spite of rain, four people showed up for the testing last Wednesday: two men and two women. I only knew one person out of four, the rest were from I’m Happy Project Meet-up group.

We met in the courtyard of the Boston Public Library, which has a beautiful fountain. I briefly gave an overview of the project. It is interesting that one of the attendees was a Sociology professor who is going to write a book about happiness. After I distributed the forms to the attendees and explained the rules, we moved to one of the rooms in the library and the participants took seats at different tables. The point was to simulate isolated environment and be anonymous as if we were home completing forms online, not next to other humans present.  

After participants completed the forms anonymously they dropped them in the bag and I rated the forms via the tool I have in Excel and wrote their ratios of happiness on the forms. While I was rating, participants formulated two questions about their obstacles to happiness and wrote them down (also anonymously) on the second form. We rotated the question forms between 4 tables, and everyone had a chance to answer other people’s questions and got answers to their own questions. They also recorded their high and low points… of the day (or of their life as of today). The whole exercise took about one hour.

At the end we briefly discussed the session. Participants felt that their ratios were about right. And it turned out that everyone enjoyed writing answers for others even more than receiving answers to their own questions… And one person mentioned “I felt closer to you than before, even though we are strangers… As if we are close friends, we shared very important things with each others.”

There will be two more live sessions in San Fran and LA over next two weeks, I will also summarize feedback from individual testers in other posts. Thank you to all testers!



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