Antidepressant Smoke & Mirrors
Antidepressant Smoke & Mirrors
by Frederick Ernst, Ph.D.
In a recent edition of the Wall Street Journal, Dr. Peter Kramer writes a defense of antidepressants and does a really nice job of convincing himself that what he is doing, prescribing drugs for people who are not ill, has merit. Unfortunately, he shared his thoughts with the Journal and, even more unfortunately, they published it.
The conclusions he has drawn are simply without merit. A science-informed reader would not have wasted time drifting past the first paragraph of this nonsense unless that reader was curious about the latest marketing-informed propaganda. So first, Dr. Kramer invents a new biochemical imbalance theory, one that not only has no support in science (like the one he’s trying to replace) but also has hardly even been mentioned in the literature of science. Brain resilience? This is a concept you can only find infrequently mentioned in connection with concussion or immune reaction. But according to Dr. Kramer, the “chemical properties of these drugs” (the SSRI’s) are inherently restoring resilience in the brain? (Please ignore here the evidence that these drugs are toxic and actually kill brain cells.)
“Little of the benefit comes from the classical placebo effect.” Says Dr. Kramer. He would be exactly correct if you believe more than 80% to be little. Drs. Joanna Moncrieff and Irving Kirsch should be invited to address this incredible statement! (see for instance http://www.contemporaryclinicaltrials.com/article/S1551-7144(15)30003-3/abstract). Further, Dr. Kramer exclaims, “I read the data with a doctorly eye.” That’s an interesting comment from a doctor identifying with a discipline that continues to wait for science to reveal validation of only one, a first, of its 350 so-called “mental” illnesses after 100 years of trying.
But, rest assured he will not abandon his authoritarian approach to the topic. He turns to a colleague to see if his experiences have been the same. And, of course, they both agree. Depression is getting better in those who are most depressed. Interestingly, and unintentionally, he provides the readers with a perfect example of why depression is not a brain disease that people wake up with one morning. Public health surveys (read, CDC science-based data) “are not fine-grained enough” so he turns to the ultimate science authorities… students and colleagues, and asks them what they see. And then, who does he describe as revealing evidence of this illness? Irma! A lady whose husband and daughter have died and, if things couldn’t get any worse, she now has heart disease. Sounds like an inexplicable endogenous depression to me. Clearly, one of her neurotransmitter systems has come down with something quite coincidentally following these three life events.
The lay public must be informed to understand that doctors are not trained as scientists. Skepticism is not promoted or even encouraged in the training of physicians and probably shouldn’t be. I certainly don’t want the surgeon for my emergency to be thinking about whether or not what he’s doing makes any sense. But of all medical specialties, psychiatry must be taught skeptically or it will never achieve the status of infectious disease medicine or cardiology, the leaders of science-based medicine.
A revolution in medical education is required for psychiatry to achieve the status of its peer disciplines. The foundational pillars of their discipline is marketing, with nearly unlimited underlying financial resources. Remove those dollars and this house of cards collapses under its own weight.
There simply is no science supporting these “treatments.” And, indeed, I will retract this statement in the most humiliating public way if any person on this planet can point to one study revealing that mental illness is an illness with a demonstrable underlying pathophysiology. Just one. Only one. Not much to ask. But as the subtitle of this article suggests, Dr. Peter D. Kramer has seen real benefits from antidepressants. That should be good enough for you.
All my sarcasm aside, the idea that human suffering and distress is a disease has not only long outlived any hoped-for usefulness, it has caused pervasive harm to our population. Mental illness portrayed as physical illness is a flawed idea based on a misconceived extension of metaphor resulting in irreparable harm to the world public. It’s time for a new paradigm and Dr. Kramer’s article is the exclamation point that I would add to the end of this sentence.
Did anyone write to The Wall Street Journal with a response to Kramer's article?
It's not LIKE a religion, it IS a religion. It has Holy Scriptures, High Priests with Holy Vestments, Magical Artifacts with Special Powers (pills), dogmatic adherence to religious doctrine, and even shaming, shunning, and excommunication for those who commit heresy. There is no practical difference - it IS a religion, plain and simple.
Bradford, good for you for being the first to comment, us psychiatric researchers / truth seekers do see eye to eye, don't we? And I agree, Lawrence Agee, "the level of scientific thought in psychiatry is remarkably low." I'm absolutely amazed at the mind boggling stupidity and lack of ethics within today's psychiatric industry, it literally blew my mind when I learned how dumb, delusional and ungodly unethical today's psychiatric industry truly is. I, too, "have read books by Peter Breggin, MD, and Robert Whittaker and was very impressed by their scientific analysis. But when i read the literature in the journals about drugs like SSRIs, i am often shocked by the lack of science. In the drug ads on tv, it is all about marketing." So true, and I also have read thousands of medical journal articles about the psychiatric drugs, plus thousands of patient comments about those drug classes, as well. But, unfortunately, I do believe you should be "embarrassed to be an MD that i know something fraudulent is going on, that people are being harmed," because I disagree, "there is nothing [you] can do about it." I believe it is your responsibility, as a doctor, to do something to end this medical fraud. Since it should not be only those of us who were declared "irrelevant to reality," "w/o work, content, and talent," eventually a "smart female," "insightful," and ultimately "your entire life is a credible fictional story," by the delusional and paranoid psychiatrists who know less than zero about their patients and the drugs they prescribe; and the ethical scientific journalists, who are left to point out that the ADHD drugs and antidepressants can cause the symptoms of "bipolar." And that over a million children have already had the ADRs of these drug classes misdiagnosed by today's psychiatric industry, according to the DSM-IV-TR. http://www.alternet.org/story/146659/are_prozac_and_other_psychiatric_drugs_causing_the_astonishing_rise_of_mental_illness_in_america And that today's "bipolar" drug cocktail recommendations and "schizophrenia" drugs, specifically the antidepressants and antipsychotics / neuroleptics, can cause both the negative symptoms of "schizophrenia," via NIDS: https://en.wikipedia.org/wiki/Neuroleptic-Induced_Deficit_Syndrome And these drug classes can also cause the positive symptoms of "schizophrenia," via anticholinergic toxidrome poisoning: https://en.wikipedia.org/wiki/Toxidrome As a doctor, you were taught about anticholinergic toxidrome back in med school, I do believe? So all mainstream medical doctors should be well aware of the reality that today's "bipolar" drug cocktail recommendations: http://www.mayoclinic.org/diseases-conditions/bipolar-disorder/basics/treatment/con-20027544 Are actually a recipe for how to make a person "psychotic" with the psychiatric drugs. And I have found ethical doctors who are aware of this, and were embarrassed when I pointed this out. But not dumb and disrespectful enough not to correct my medical records from the prior misdiagnoses. Then, at a subsequent physical, that doctor complimented me by claiming I was a "one in a million" medical researcher, and had me teach his student the importance of respecting the intelligent patients, now that we all live in the information age. Please contact the Mayo, as a doctor, since they do not change their "mad as a hatter" making "bipolar" drug cocktail recommendations, based upon research by non-doctor medical researchers. Even for those of us who are not "irrelevant to reality," "w/o work, content, and talent," but instead are "insightful" and "intelligent females," whose lives are not actually "credible fictional stories," as the delusional psychiatrists believe. Plus, it was confessed to me by an ethical pastor, who was kind enough to read my medical records and research that I'd dealt with "the dirty little secret of the two original educated professions." But now that we all live in the information age, it is time for the psychiatric industry to get out of the business of profiteering off of covering up medical evidence of sexual abuse of small children and easily recognized iatrogenesis for the religions and medical community. All within the "two original educated professions" should be ashamed, truly. But if you are an ethical doctor, Lawrence, you can do something, and you do have a moral responsibility to do so. Isn't it great you are wrong that "there is nothing i can do about it."
I am in total agreement with this article. And i am an MD. My background prior to medical school was in engineering. The level of scientific thought in psychiatry is remarkably low. I have read books by Peter Breggin, MD, and Robert Whittaker and was very impressed by their scientific analysis. But when i read the literature in the journals about drugs like SSRIs, i am often shocked by the lack of science. In the drug ads on tv, it is all about marketing. It often makes me embarrassed to be an MD that i know something fraudulent is going on, that people are being harmed and there is nothing i can do about it.
Appreciate everyone's comments. Yes drugs can be a "racket" and profit motives often get in the way of best medicine. AND the right amount of the right medication for the right person at the right time for the right amount of time can be a Godsend. Yes, situations, trauma, and negative events can cause depressions. So can many other things like being stuck in your life and not having the courage to move forward, food sensitivities, lack of exercise, lack of community, toxins, hormonal disorders, AND organic brain disease. Mental health is a situational, relational, biochemical, psychological, biophysical process. Impacted by all of these things. Not one thing. Not one cause for dysfunction. May this be a year of deeper respect, recognition, and cooperation between all of our fields of study for our unified goal of healing- alleviating suffering as quickly and safely as possible and helping all to achieve our potentials.
People are not just bundles of chemicals. People become depressed because of negative events in their lives. Psychiatry just wants to treat people like robots and drug them. People need kindness to heal their problems, not drugs. These drugs are only used to zombify people into passivity, not to help them.
I have been reading about disorders of the corpus callosum, or DCC. that can be diagnosed with an MRI (NOT an fMRI). Subtle effects of the disorder are so incredibly similar to behavioral symptoms used for psychiatric diagnoses. And if the effects are very subtle, symptoms may not manifest until adolescence or young adulthood, precisely the time when people have psychotic breaks. From the National Organization of Disorders of the Corpus Callosum, “In many cases, they are attributed incorrectly to one or more of the following: personality traits, poor parenting, ADHD, autism spectrum disorders, Nonverbal Learning Disability, specific learning disabilities, or psychiatric disorders. It is critical to note that these alternative conditions are diagnosed through behavioral observation. In contrast, DCC is a definite structural abnormality of the brain diagnosed by an MRI. These alternative behavioral diagnoses may, in some cases, represent a reasonable description of the behavior of a person with DCC.” So wouldn’t it be a good thing if MRIs were used to determine if a structural abnormality is causing behavioral symptoms for so many thousands of people? Isn’t giving people drugs for behaviors that are caused by a structural abnormality of the brain the equivalent of giving drugs to a person born without legs and insisting the drugs will help them walk?
A new paradigm is definitely needed. I’ve developed a concept called Self-Acceptance Psychology that explains the real, root causes of supposed “mental disorders” and reframes these as normal, natural behaviors resulting from low self-worth, fear, shame, self-criticism and a desperate need for love and belonging. These can be easily and effectively addressed without medications by learning to generate self-acceptance. Yet the psychiatry profession continues to medicalize “mental disorders” and push pills, rather than advocate for safe, effective psychotherapy and self-help. As I learned myself, the solution to self-doubt and self-recrimination is finding compassionate self-acceptance, so that internal judgments and the high need for approval decrease.
"It's time for a new paradigm..." Absolutely agree. I am humbly venturing forth with my offering in that regard: Self-Acceptance Psychology. This concept explains the real, root causes of supposed “mental disorders” and reframes these as normal, natural behaviors resulting from low self-worth, fear, shame, self-criticism and a desperate need for love and belonging. These can be easily and effectively addressed without medications by learning to generate self-acceptance. Yet the psychiatry profession continues to medicalize “mental disorders” and push pills, rather than advocate for safe, effective psychotherapy and self-help. As I learned myself, the solution to self-doubt and self-recrimination is finding compassionate self-acceptance, so that internal judgments and the high need for approval decrease. A PDF of these concepts is instantly available online for $5. Would love some input! www.SelfAcceptancePsychology.com
I'm both glad and sad to be the first commenter here. I first read Dr. Breggin's "Toxic Psychiatry" in the early 1990's, and I'm a regular reader and commenter at >madinamerica.com<, so that gives you and idea where I'm coming from. I'm also a psychiatric survivor, with lived experience of over 40 years now. Dr. Ernst is far too kind here, to both psychs, and the WSJ. The pseudoscience LIES of the DRUG RACKET known as "biopsychiatry" are once again on full marketing mode display in the WSJ. The WSJ is all about big banking, high finance, and Wall St. Money, money, money. THAT is why this article ran in the first place. Have you ever heard of an effort by gov't, or anybody, to make so-called "anti-depressants" *FREE*? Of course not! Drugs are big business! Drugs make lots of money for (some) people. There are literally families of PhRMA, who have made $Billions$ off opioids. PurduePharma&Oxycontin is only one of many examples But to get back strictly to so-called "SSRI's", and so-called "depression" - there's NO objective scientific evidence that so-called "depression" is anything more than a normal variation in normal human experience. It's the inevitable result of persons having some difficulties in life. There's no "there" there, in terms of an actual disease process. And, the available scientific evidence shows that placebo is just as effective as ANY SSRI, with NONE of the unintended effects. Psychiatry - and it's minions & apologists - need to be called out for the frauds and hucksters which they are. Psychiatry is a pseudoscience, and a drug racket, and a means of social control. Anybody who believes anything the psychs say, has never studied the history of psychiatry in the former Soviet Union. That sordid tale would not, and could not, exist, if psychiatry was anything other than a pseudoscience, a drug racket, and a means of social control.