Wayne Ramsay, J.D.

In the Introduction to his book Rethinking Depression (New World Library 2012, p. 3, italics his) California-licensed family therapist Eric Maisel, Ph.D., says this:

One of the goals of this book is to help you remove the word depression from your vocabulary and, as a result, from your life. If depression were an actual disease, illness, or disorder you wouldn't be able to rid yourself of it just by removing it from your vocabulary. But since it isn't a disease, illness, or disorder, you can dispense with it right this second. What I would love for you to say is "I can't be depressed because there is no disease of depression!

Similarly, in her book A Straight Talking Introduction to Psychiatric Drugs (PCCS Books, Ross-on-Wye 2009, p. 65), Joanna Moncrieff, M.B.B.S., M.Sc., MFRCPsych, M.D., Senior Lecturer in Mental Health Sciences at the University College, London, says this:

...it is important to say here that the term "depression" as currently used is misleading. ... there is no scientific evidence to support the idea that there are particular features of the brain that give rise to the particular feeling of depression.

Unhappiness or "depression" alleged to be the result of biological abnormality is called "biological" or "endogenous" or "clinical" depression. In her book The Broken Brain: The Biological Revolution in Psychiatry, University of Iowa psychiatry professor Nancy Andreasen, M.D., Ph.D., says: "The older term endogenous implies that the depression 'grows from within' or is biologically caused, with the implication that unfortunate and painful events such as losing a job or lover cannot be considered contributing causes." (Harper & Row 1984, p. 203).

Similarly, in 1984 in the Chicago Tribune newspaper columnist Joan Beck alleged: "...depressive disorders are basically biochemical and not caused by events or environmental circumstances or personal relationships" (July 30, 1984, Sec. 1, p. 16). A July 2013 Readers Digest article (pp. 132-133) says "For the past 50 years, the conventional wisdom among many psychiatrists was that depression was caused by a brain-chemical imbalance such as low levels of the feel-good hormone serotonin."

The concept of biological or endogenous depression is important to psychiatry for two reasons. First, it is the most common supposed mental illness. As Victor I. Reus, M.D., wrote in 1988: "The history of the diagnosis and treatment of melancholia could serve as a history of psychiatry itself" (appearing in: H. H. Goldman, editor, Review of General Psychiatry, 2nd Edition, Appleton & Lange 1988, p. 332). Second, all of psychiatry's biological "treatments" for depression—whether it is drugs, electroshock, or psychosurgery—are based on the idea that the unhappiness we call depression can be caused by a biological malfunction in the brain rather than life experience. The erroneous belief in biological causation justifies the otherwise unjustifiable use of biological therapies, primarily "antidepressant" drugs and electroconvulsive "therapy" (see Psychiatry's Electroconvulsive Shock Treatment—A Crime Against Humanity). The biological therapies for this nonexistent "disease" of depression and other so-called mental illnesses also in theory justify the existence of psychiatry as a medical specialty distinguishable from psychology, social work, and counseling.

Many professional and lay people today think depression can be caused by a"chemical imbalance" in the brain even though no chemical imbalance theories of depression have been verified. As psychiatry professor Thomas S. Szasz, M.D., said in 2006, "There is no evidence for a chemical imbalance causing mental illness, but that does not impair the doctrine's scientific standing or popularity" ("Mental Illness as a Brain Disease: A Brief History Lesson"). Psychiatry professor Nancy Andreasen discusses some of the chemical imbalance theories of depression in her book The Broken Brain.

One of the theories she describes is the belief that "depression" (what I think should be called simply unhappiness or severe unhappiness) is the result of neuroendocrine abnormalities indicated by excessive cortisol in the blood. The test for this is called the dexamethasone suppression test or DST. The theory behind this test and the claims of its usefulness were found to be mistaken, however, because, in Dr. Andreasen's words, "so many patients with well defined depressive illness have normal DSTs" (pp. 180 182). An article in the July 1984 Harvard Medical School Health Letter reached a similar conclusion. The article, titled "Diagnosing Depression: How Good is the 'DST'?", reported that "For every three office patients with an abnormal DST, only one is likely to have true depression. ... [And] a large fraction of people who are depressed by other criteria will still have normal results on the DST" (p. 5). Similarly, in an article in the November 1983 Archives of Internal Medicine three physicians concluded that "Data from studies currently available do not support the use of the dexamethasone ST [Suppression Test]" (Martin F. Shapiro, M.D., et al., "Biases in the Laboratory Diagnosis of Depression in Medical Practice", Vol. 143, p. 2085). In her 1993 book If It Runs In Your Family: Depression, Connie S. Chan, Ph.D., acknowledges that "There is still no valid biological test for depression" (Bantam Books, p. 106). Despite its having been discredited, some biologically oriented psychiatrists are (apparently) so eager for biological explanations for people's unhappiness or "depression" that they continue to use the DST anyway. For example, in his book The Good News About Depression, published in 1986, psychiatrist Mark S. Gold, M.D., says he continues to use the DST. In that book Dr. Gold claims the DST is "highly touted as the diagnostic test for biologic depression" (Bantam, p. 155, emphasis in original).

In The Broken Brain, Dr. Andreasen also describes what she calls "the most widely accepted theory about the cause of depression...the 'catecholamine hypothesis.'" She emphasizes that "the catecholamine hypothesis is theory rather than fact" (p. 231). She says "This hypothesis suggests that patients suffering from depression have a deficit of norepinephrine in the brain" (p. 183), norepinephrine being one of the "major catecholamine systems" in the brain (pp. 231 232). One way the catecholamine hypothesis is evaluated is by studying one of the breakdown products of norepinephrine, called MHPG, in urine. People with so called depressive illness "tended to have lower MHPG" (p. 234). The problem with this theory, according to Dr. Andreasen, is that "not all patients with depression have low MHPG" (Id). She accordingly concludes that this catecholamine hypothesis "has not yet explained the mechanism causing depression" (p. 184).

Another theory is that severe unhappiness ("depression") is caused by lowered levels or abnormal use of another brain chemical, serotonin. A panel of experts assembled by the U.S. Congress Office of Technology Assessment reported the following in 1992 (The Biology of Mental Disorders, U.S. Gov't Printing Office, pp. 82 & 84):

Prominent hypotheses concerning depression have focused on altered function of the group of neurotransmitters called monoamines (i.e., norepinephrine, epinephrine, serotonin, dopamine), particularly norepinephrine (NE) and serotonin. ... studies of the NE [norepinephrine] autoreceptor in depression have found no specific evidence of an abnormality to date. Currently, no clear evidence links abnormal serotonin receptor activity in the brain to depression. ... the data currently available do not provide consistent evidence either for altered neurotransmitter levels or for disruption of normal receptor activity.

Even if it was shown there is some biological change or abnormality "associated" with depression, the question would remain whether this is a cause or an effect of the "depression". A brain-scan study (using positron emission tomography or PET scans) found that simply asking normal people to imagine or recall a situation that would make them feel very sad resulted in significant changes in blood flow in the brain (José V. Pardo, M.D., Ph.D., et al., "Neural Correlates of Self-Induced Dysphoria", American Journal of Psychiatry, May 1993, p. 713). Other research will probably confirm it is emotions that cause biological changes in the brain rather than biological changes in the brain causing emotions.

IN ALL OF HUMAN HISTORY THERE HAS NEVER BEEN EVEN ONE CASE IN WHICH IT WAS PROVED A PERSON FELT DEPRESSED BECAUSE OF A CHEMICAL IMBALANCE IN HIS OR HER BRAIN

One of the more popular theories of biologically caused depression has been hypoglycemia, which is low blood sugar. In his book Fighting Depression, published in 1976, Harvey M. Ross, M.D., says "In my experience as an orthomolecular psychiatrist, I find that many patients who complain of depression have hypoglycemia (low blood sugar). ...Because depression is so common in those with hypoglycemia, any person who is depressed without a clear cut obvious cause for that depression should be suspected of having low blood sugar" (Larchmont Books, p. 76 & 93). But in their book Do You Have A Depressive Illness?, published in 1988, psychiatrists Donald Klein, M.D., and Paul Wender, M.D., list hypoglycemia in a section titled "Illnesses That Don't Cause Depression" (Plume, p. 61). The idea of hypoglycemia as a cause of depression was also rejected in the front page article of the November 1979 Harvard Medical School Health Letter, titled "Hypoglycemia—Fact or Fiction?"

Another theory of a physical disease causing psychological unhappiness or "depression" is hypothyroidism. In her book Can Psychotherapists Hurt You?, psychologist Judi Striano, Ph.D., includes a chapter titled "Is It Depression—Or An Underactive Thyroid?" (Professional Press 1988). Similarly, three psychiatry professors in 1988 asserted "Frank hypothyroidism has long been known to cause depression" (Alan I. Green, M.D., et al., The New Harvard Guide to Psychiatry, Harvard Univ. Press 1988, p. 135). The theory here is that the thyroid gland, which is located in the neck, normally secretes hormones which reach the brain through the bloodstream necessary for a feeling of psychological well being and that if the thyroid produces too little of these hormones, the affected person can start feeling unhappy even if no problems result from the endocrine (gland) problem other than the unhappiness. The American Medical Association Encyclopedia of Medicine lists many symptoms of hypothyroidism: "muscle weakness, cramps, a slow heart rate, dry and flaky skin, hair loss ... there may be weight gain" (Random House 1989, p. 563). The Encyclopedia does not list unhappiness or "depression" as one of the consequences of hypothyroidism. But suppose you began to experience "muscle weakness, cramps...dry and flaky skin, hair loss ... weight gain"? How would this make you feel emotionally?—depressed, probably. Just as hypothyroidism (hypo = low) is a thyroid gland that produces too little, hyperthyroidism is a thyroid glad that produces too much. Therefore, if hypothyroidism causes depression, then it seems logical to assume hyperthyroidism has the opposite effect, that is, that it makes a person happy. But this is not what happens. As psychiatrist Mark S. Gold, M.D., points out in his book The Good News About Depres-sion: "Depression occurs in hyperthyroidism, too" (p. 150). What are the consequences of hyperthyroidism?: Dr. Gold lists abundant sweating, fatigue, soft moist skin, heart palpitations, frequent bowel movements, muscular weakness, and protruding eyeballs. So both hypo- and hyper- thyroidism cause physical problems in the body. And both cause "depression". This is only logical. It is hard to feel anything but bad emotionally when your body doesn't feel well or work properly. It has never been proved hypothyroidism affects mood other than through its effect on the victim's experience of feeling physically unhealthy.

Some people think chemical imbalance related to hormonal changes must be a possible cause of "depression" because of the supposed biological causes of women's moods at different times of their menstrual cycles. I don't find that argument convincing because I've known so many women whose mood and state of mind was consistently unaffected by her menstrual cycle. Psychology professor David G. Myers, Ph.D., labels premenstrual syndrome (PMS) a myth in his book The Pursuit of Happiness (William Morrow & Co. 1992, pp. 84-85). Of course, some women experience physical discomfort due to menstruation. Feeling lousy physically is enough to put anybody in a bad mood.

Some people believe women experience undesirable mood changes for biological reasons because of menopause. However, a study by psychologists at University of Pittsburgh reported in 1990 that "Menopause usually doesn't trigger stress or depression in healthy women, and it even improves mental health for some". According to Rena Wing, one of the psychologists who did the study, "Everyone expects menopause to be a stressful event, but we didn't find any support for this myth" ("Menopausal stress may be a myth", USA Today, July 16, 1990, p. 1D).

It is also widely believed that women go through a period of depression for biological reasons after giving birth to a child. It's called postpartum depression. In his book The Making of a Psychiatrist, Dr. David Viscott quotes Dr. George Maslow, a physician doing an obstetrical residency, making the following remark: "Come on, Viscott, do you really believe in postpartum depression? I've seen maybe two in the last three years. I think it's a lot of shit you guys [you psychiatrists] imagined to drum up business" (Pocket Books, 1972, p. 88). A woman who had given birth to eight (8) children, which in my opinion qualifies her as an expert on the subject of postpartum depression, told me what she called "postpartum blues" are real, but she attributed postpartum blues to psychological rather than physiological causes. "I don't know about the physiological causes", she said, but "so much of it is psychological." She said "You feel awful about your looks", because in our society a woman is "supposed" to be thin, and for at least a short time after giving birth a woman usually isn't. She also said after childbirth a woman feels considerable "physical exhaustion". Childbirth also is the beginning of new or increased parental obligations, which if we are honest we must admit are quite burdensome. The arrival of new or additional parental obligations and the realization of the negative ways new or additional parenthood obligations will affect a woman's (or man's) life is an obvious non-biological explanation for postpartum depression. It may not be until the actual birth of the child that parents realize how parenthood changes their lives for the worse, but a letter from a female friend of mine who at the time was only three months pregnant with her first child illustrates that depression associated with childbirth may come long before the postpartum period: She said she was frequently breaking down in tears because she thought with a child her life would never the same and that she would be a "prisoner" and wouldn't have time to do what she wanted in life. A reason these psychological causes are often not candidly acknowledged and postpartum (or pre-partum) blues instead attributed to unproven biological causes is our reluctance to admit the downside of parenthood.

Another theory of biologically caused depression is based on stroke damage in the left front region of the brain. What makes it seem possible this might be neurologically caused rather than being a reaction to the situation a person finds himself in because of having had a stroke is stroke damage in the right front of the brain allegedly causing "undue cheerfulness." However, a careful reading of books and articles about neurology for the most part doesn't support the allegation of undue cheerfulness from right front brain damage. Instead, what most neurological literature indicates sometimes results from right front stroke-related brain damage is anosognosia, usually described as lack of concern or inability to know their own problems, not happiness or cheerfulness (e.g., neurology professor Oliver Sacks in The Man Who Mistook His Wife for a Hat and Other Clinical Tales, Harper & Row 1985, p. 5).

Perhaps the most often heard argument is that antidepressant drugs wouldn't work if the cause of depression was not biological. But antidepressant drugs don't work. As psychiatrist Peter Breggin, M.D., says in his book Talking Back to Prozac (St. Martin's Press 1994, p. 200), "there's no evidence that antidepressants are especially effective". Or as British psychiatrist Joanna Moncrieff writes in her book The Myth of the Chemical Cure—A Critique of Psychiatric Drug Treatment (Revised Edition, Palgrave Macmillan 2009, pp. 144 & 152):

...contrary to current opinion, antidepressants are not superior to placebo even in the most severe forms of depression. ... The idea that antidepressants have a specific action on a biological process is still cited as the main justification for the idea that depression is caused by a biochemical abnormality. ... However, the evidence reviewed above suggests that antidepressant drugs do not exert a specific effect in depression.

Psychologist Irving Kirsch, Ph.D., wrote an entire book bebunking the assertion that so-called antidepressants have antidepressant effects: The Emperor's New Drugs—Exploding the Antidepressant Myth (Basic Books 2010). In The Antidepressant Fact Book (Perseus 2001, p. 14) psychiatrist Peter Breggin, M.D., says "The term 'antidepressant' should always be thought of with quotation marks around it because there is little or no reason to believe that these drugs target depression or depressed feelings." There is even evidence that so-called antidepressants make people feel more depressed: According to Dr. Moncrieff, "Evidence suggests that for people without mental health problems, antidepressant drugs are unpleasant to take and make them feel worse. The evidence reviewed in the previous chapter suggests that we have no reason to believe that they elevate mood in patients either" (The Myth of the Chemical Cure, p. 171). Antidepressants are, in other words, a health care scam. Their only possible beneficial effect is placebo effect. This has not prevented drug companies from making billions of dollars selling supposedly antidepressant "medications," however. As California-licensed family therapist Eric Maisel, Ph.D., asks in his book Rethinking Depression (p. 240), "Has the 'mental disorder of depression' been fabricated by the mental health industry to turn human unhappiness and the consequences of human unhappiness into a cash cow? ... You will have to decide if all this mental health labeling is a marvel of medical progress or a variation on the age-old penchant for selling snake oil." Even if so-called antidepressants did help (aside from placebo effect), that wouldn't prove a biological cause of "depression" any more than would feeling better from using marijuana or cocaine or drinking liquor.

"ANTIDEPRESSANTS" ARE A HEALTH CARE SCAM

A careful reading of the books and articles by psychiatrists and psychologists alleging biological causes of the severe unhappiness we call depression usually reveals purely psychological causes that explain it adequately, even when the author believes he has given a good example of biologically caused depression. For example, in Holiday of Darkness: A Psychologist's Personal Journey Out of His Depression (John Wiley & Sons 1982), an autobiographical book by York University psychology professor Norman S. Endler, Ph.D., he alleges his unhappiness or so-called depression "was biochemically induced" (p. xiv). He says "my affective disorder was primarily biochemical and physiological" (p. 162). But from his own words it's obvious his depression was due primarily to unreturned love when a woman he got emotionally involved with, Ann, decided to "wind down" her relationship with him (pp. 2-5) and when he suffered a career setback (loss of a research grant) at about the same time (p. 23). Despite his claims of biochemical causation, nowhere does he cite any medical or biological tests showing he had any kind of biological, bio¬chemical, or neurological abnormalities. He can't, because no valid biological test exists that tests for the presence of any so-called mental illness, including allegedly biologically caused unhappiness (or "depression").

Similarly, in The Broken Brain, psychiatry professor Nancy Andreasen gives the example of Bill, a pediatrician, whose recurrent depression she thinks illustrates that "People who suffer from mental illness suffer from a sick or broken brain [emphasis Andreasen's], not from weak will, laziness, bad character, or bad upbringing" (p. 8). But she seems to overlook the fact that Bill's allegedly biologically caused recurrent depressions occurred when his father died, when he was not permitted to graduate from medical school on schedule, when his first wife was diagnosed with cancer and died, when his second wife was unfaithful to him, when he was arrested for public intoxication during an argument with her and this was reported in the local newspaper, and when his license to practice medicine was suspended because of stigma from psychiatric "treatment" he received (pp. 2-7).

One of the reasons for theorizing about biological causes of severe unhappiness or "depression" is sometimes people are unhappy for reasons that aren't apparent, even to them. The reason this happens is what psychoanalysts call the unconscious:

Freud's investigations shocked the Western world ... Comparing the mind to an iceberg, largely submerged and invisible, he told us that the greater part of the mind is irrational and unconscious, with only the tip of the preconscious and conscious showing above the surface. He main¬tained that the larger, unconscious part—much of it sexual—is more important in guiding our lives than the rational part, even though we deceive ourselves into believing it is the other way around. [Ladas, et al., The G Spot And Other Recent Discoveries About Human Sexuality, Holt, Rinehart & Winston 1982, pp. 6 7]

In An Elementary Textbook of Psychoanalysis, Charles Brenner, M.D., says "the majority of mental functioning goes on without consciousness... We believe today that...mental operations which are decisive in determining the behavior of the individual...even complex and decisive ones—may be quite unconscious" (Int'l Univ. Press 1955, p. 24). A news magazine article in 1990 reported that "Scientists studying normal rather than impaired subjects are also finding evidence that the mind is composed of specialized processors that operate below the conscious level. ...Freud appears to have been correct about the existence of a vast unconscious realm" (U.S. News & World Report, Octo¬ber 22, 1990, pp. 60-63). An article in the June 2011 Psychology Today magazine tells us "Neuroscience has also confirmed another fundamental tenet of psychoanalytic theory—the idea that our motivations are largely unconscious ... 'Neuroscience tells us unambiguously that consciousness really is just the tip of the iceberg'" (Molly Knight Raskin, "The Idea That Wouldn't Die", p. 75 at 83). People's unhappiness or so-called depression being caused by life experience is not always obvious, because the relevant mental processes and memories are often hidden in the unconscious parts of their minds.

DEPRESSED? IT'S NOT YOUR BRAIN. IT'S YOUR LIFE

This critical aspect of human psychology was missed or overlooked in an otherwise excellent book, The Loss of Sadness—How Psychiatry Transformed Normal Sorrow Into Depressive Disorder (Oxford University Press 2007) by Allan V. Horwitz, Ph.D., Professor of Sociology and Dean of Social and Behavioral Sciences at Rutgers University, and Jerome C. Wakefield, Ph.D., D.S.W., Professor of Social Work at New York University. Drs. Horwitz and Wakefield effectively debunk the American Psychiatric Association's concept of depression as a disorder except when there is no obvious cause in terms of life experience. They erroneously assume experiences in life and the thinking that cause sadness will always be obvious and easy to identify and that when no such cause can be readily identified, deeply felt or prolonged sorrow may indeed be a true biological or psychological "disorder" even though they, like all who support the idea of endogenous or biological depression, are unable to identify the supposed non-experiential, biological causes and simply assume such causes must exist.

I believe unhappiness or so-called depression is always the result of life experience. There is no convincing evidence unhappiness or "depression" is ever biologically caused. The brain is part of our biology, but there is no evidence severe unhappiness or "depression" is sometimes biologically caused any more than bad TV programs are sometimes electronically caused. "[T]he question is not how to get cured, but how to live" (Joseph Conrad, quoted by Thomas Szasz, The Myth of Psychotherapy, Syracuse Univ. Press 1988, title page). "When mental health professionals point to spurious genetic and biochemical causes," of depression and recommend drugs rather than learning better ways of living, "they encourage psychological helplessness and discourage personal and social growth" of the sort needed to really avoid unhappiness or "depression" and live a meaningful and happy life (Peter Breggin, M.D., "Talking Back to Prozac" Psychology Today magazine, July/Aug 1994, p. 72).

Wayne Ramsay, J.D.

All diagnoses and treatment in psychiatry assumes the validity of the concept of mental illness or mental disorder.  Coverage for psychiatric and other mental health treatment in health insurance policies is based on the same assumption.  However, many mental health professionals have questioned the validity of the concepts of mental illness and mental disorder.

The best known of these is psychiatry professor Thomas Szasz, M.D., whose book The Myth of Mental Illness was published in 1961.¹

However, even before this, in 1958, Philadelphia psychiatrist Philip Q. Roche, M.D., who was winner of the American Psychiatric Association's Isaac Ray Award for outstanding contributions to forensic psychiatry and the psychiatric aspects of jurisprudence, in his book The Criminal Mind, said:

[I]n the natural world there is no such thing as mental disease or defect, but rather certain patterns of behavior to which, in a given social context, we apply certain names which enable us to talk about and to effect certain changes in the social relationships of those who exhibit them and to effect changes in the individuals themselves. At best, we are left to the imposition of purely arbitrary criteria in selecting such persons.²

In his testimony before the Mental Health Committee of the New York State Assembly (state legislature) on May 18, 2001, neurologist John Friedberg, M.D., said, “I do not believe in mental illness....Psychiatric drugs and electroshock inflict real injury in the name of treating fictive maladies.”³

In 2012, neurologist Fred A. Baughman, M.D., said “there is no such thing whatsoever as a psychiatric or psychological disease.”⁴

In 2018, Chuck Ruby, Ph.D., a psychologist and Executive Director of the International Society for Ethical Psychology and Psychiatry (ISEPP), said “The conventional mental health industry goes to great lengths in an attempt to perpetuate the myth of mental illness ... ISEPP's goal is to dispel the myth of mental illness....The problems we've dubbed mental illnesses are about inter- and intra-personal, spiritual, existential, economic, and political matters, not real disease."5

In 2013, in their book Mad Science, Stuart A. Kirk, D.S.W., Tomi Gomory, Ph.D., and David Cohen, Ph.D., said:

…we have argued, the existence of a disease of mental illness has never been established...together we've amassed over seventy five years of teaching mental health courses in graduate schools of social work to thousands of students and practitioners...after more than ten decades of determined research and the expenditure of untold sums, no one can verify that madness is a medical disease....There is, of course, the unpredictable but remote possibility that the psychiatric system produces it's ‘Gorbachev,’ a widely acknowledged leader and spokesperson who says plainly and loudly that the emperor has no clothes, that while many people could use help for their distress or have their disturbance contained to preserve our peace of mind, there is no mental illness.⁶

In a lecture in 2015, psychologist Paula J. Caplan, Ph.D., said, “Nobody should be diagnosed with mental illness.”  After her lecture I asked Dr. Caplan if she really meant nobody.  She said yes and that is the reason the concept of mental illness itself is not valid.⁷

In 2015, in his book Deadly Psychiatry and Organized Denial, Dr. Peter C. Gøtzsche, a physician specializing in internal medicine, and professor of Clinical Research Design and Analysis at the University of Copenhagen, said:

Quite often, psychiatrists prefer to talk about a mental disorder, rather than a mental illness or disease, which is because psychiatric diagnoses are social constructs....psychiatrists have blown life into a social construct that is nothing but a variation of normal behavior and have given this construct a name, as if it existed in nature and could attack people.”⁸

The Merriam-Webster Dictionary defines “social construct” as “an idea that has been created and accepted by the people in a society”.⁹  Physical realities are not social constructs. For example, cancer is not a social construct.  Cancer is not a social construct because it exists whether we believe in it or not.  On the other hand, “crime” is a social construct: There is nothing in nature that defines hurting or killing a person or an animal as wrong.  Crime exists only because we define certain actions as crimes or our common agreement that certain things are crimes.

My argument here is that “mental illness” is only a social construct, not a real disease.  Mental illness exists only in the way crime exists and does not exist in the way cancer does.  There is no evidence for mental illness or disorder as a biological fact rather than as a social construct:

In 1974, in his book The Death of Psychiatry, psychiatrist E. Fuller Torrey, M.D., wrote, “None of the conditions that we now call mental ‘diseases’ have any known structural or functional changes in the brain which have been verified as causal.”¹⁰

In 1988, Seymour S. Kety, M.D., Professor Emeritus of Neuroscience in Psychiatry, and Steven Matthysse, Ph.D., Associate Professor of Psychobiology, both of Harvard Medical School, said “an impartial reading of the recent literature does not provide the hoped for clarification of the catecholamine hypotheses, nor does compelling evidence emerge for other biological differences that may characterize the brains of patients with mental disease.”¹¹

In 1992, a panel of experts assembled by the U.S. Congress Office of Technology Assessment concluded: “Many questions remain about the biology of mental disorders.  In fact, research has yet to identify specific biological causes for any of these disorders....Mental disorders are classified on the basis of symptoms because there are as yet no biological markers or laboratory tests for them.”¹²

In 1996, psychiatrist David Kaiser, M.D., said “modern psychiatry has yet to convincingly prove the genetic/biologic cause of any single mental illness.”¹³

In 1998 in his book Blaming the Brain: The Truth About Drugs and Mental Health, Elliot S. Valenstein, Ph.D., Professor Emeritus of Psychology and Neuroscience at the University of Michigan, said: “Contrary to what is often claimed, no biochemical, anatomical, or functional signs have been found that reliably distinguish the brains of mental patients.”¹⁴

According to neurologist Fred Baughman, M.D., in 1999, “there is no scientific data to confirm any mental illness.”¹⁵

In 1999, in their textbook Neurobiology of Mental Illness, three psychiatry professors at Yale University School of Medicine (Dennis S. Charney, M.D. et al.) said “We have so far failed to identify bona fide psychiatric disease genes or to delineate the precise etiological and pathophysiological basis of mental disorders.”¹⁶

In 2000, in his book Prozac Backlash, Joseph Glenmullen, M.D., clinical instructor in psychiatry at Harvard Medical School, said “In medicine, strict criteria exist for calling a condition a disease.  In addition to a predictable cluster of symptoms, the cause of the symptoms or some understanding of their physiology must be established....Psychiatry is unique among medical specialties in that...We do not yet have proof either of the cause or the physiology for any psychiatric diagnosis.”¹⁷

In 2001, in his book Commonsense Rebellion: Debunking Psychiatry, Confronting Society, psychologist Bruce E. Levine, Ph.D., said “no biochemical, neurological, or genetic markers have been found for attention deficit disorder, oppositional defiant disorder, depression, schizophrenia, anxiety, compulsive alcohol and drug abuse, overeating, gambling, or any other so called mental illness, disease, or disorder.”¹⁸

In 2009, Allen Frances, M.D., chairperson of the Task Force that created two editions of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, DSM IV (1994) and DSM IV TR (2000), criticizing the proposed Fifth Edition of this book published in May 2013, noted that “not even 1 biological test is ready for inclusion in the criteria sets for DSM V.”¹⁹  In 2013, in his book Saving Normal: An Insider's Revolt Against Out of Control Psychiatric Diagnosis, DSM 5, Big Pharma, and the Medicalization of Ordinary Life, Dr. Frances said “The powerful new tools of molecular biology, genetics, and imaging have not yet led to laboratory tests for dementia or depression or schizophrenia or bipolar or obsessive compulsive disorder or for any other mental disorders...We still do not have a single laboratory test in psychiatry....thousands of studies on hundreds of putative biological markers [for mental illness] have so far come up empty.”²⁰

In a lecture at the University of New England in 2013, British psychiatrist Joanna Moncrieff, Senior Lecturer in Mental Health Sciences at University College London, said “There is just absolutely no evidence that anyone with any mental disorder has a chemical imbalance of any sort...absolutely none.”²¹

In 1991, in his book Toxic Psychiatry, psychiatrist Peter Breggin, M.D., said “there is no evidence that any of the common psychological or psychiatric disorders have a genetic or biological component.”²² Twenty-four years later, on the Coast to Coast AM radio show on February 9, 2015, Dr. Breggin said “There is no known physical connection to any psychiatric disorder. There is no genetically determined cause. It's all drug company propaganda, because the pharmaceutical industry with its billions of [advertising] dollars, and the medical industry, thinks you're more likely to take drugs if you think you have a genetic or biological disease.”

In 2015, in his book Deadly Psychiatry and Organized Denial, Dr. Peter C. Gøtzsche, a physician specializing in internal medicine, and professor of Clinical Research Design and Analysis at the University of Copenhagen, said “it hasn't been possible to demonstrate that people suffering from common mental disorders have brains that are different from healthy people's brains.”²³

So, if mental illnesses, mental diseases, or mental disorders or syndromes must have a biological etiology or cause to qualify as illness, disease, disorder, or syndrome, none have been proved to exist.

Mental illness being a social construct and not a real illness, disease, syndrome, or disorder is illustrated by the fact that homosexuality was once considered mental illness or disorder but is not now in 2019.  Homosexuality was officially defined as a mental disease or disorder on page 44 of the American Psychiatric Association's standard reference book, DSM II: Diagnostic and Statistical Manual of Mental Disorders (the 2nd Edition), published in 1968.  In 1973, the American Psychiatric Association voted to remove homosexuality from its official diagnostic categories of mental illness.²⁴  So when the third edition of this book was published in 1980 it said “homosexuality itself is not considered a mental disorder.”²⁵  The 1987 edition of The Merck Manual of Diagnosis and Therapy states: “The American Psychiatric Association no longer considers homosexuality a psychiatric disease.”²⁶  If mental illness were really an illness in the same sense that physical illnesses are, the idea of deleting homosexuality or anything else from the concept of illness by having a vote would be as absurd as a group of physicians voting to delete cancer or measles from the concept of disease.  But mental illness isn't “an illness like any other illness.”  Unlike physical disease where there are physical facts to deal with, mental “illness” is entirely a question of values, of right and wrong, of appropriate versus inappropriate.  After homosexuals successfully demanded acceptance of their sexual orientation, it no longer seemed appropriate to call homosexuality a “disorder.”

If anyone should be able to define what is and is not a mental disorder, it is Allen Frances, M.D., chairperson of the Task Force that created the 1994 and 2000 editions of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM).  According to Dr. Frances, “there is no definition of a mental disorder.  It's bullshit.  I mean, you just can't define it.”²⁷

Actually, you can: The defining characteristic of a mental illness or disorder is simply disapproval: Anything in a person's mentality that most people greatly disapprove of qualifies. This is true whether it is homosexuality or unusual political or religious beliefs, or anything else.  For example, when the “New Hampshire Hospital was established, in 1842...in the first year, more than a quarter of admitted patients suffered from an ‘overindulgence in religious thoughts,’ with several claiming to be prophets”.²⁸  Political dissidents have been committed to mental hospitals in the Soviet Union and China²⁹ — and the USA: When I observed commitment hearings in Washington, D.C., many were “White House cases,” people who went to the White House to protest something and were involuntarily “hospitalized.”

Today's almost universal belief in mental illness can be compared with another, at one time, almost universal belief that was also only a social construct: witchcraft.  Belief in witchcraft resulted in the infamous Salem witchcraft trials and the conviction and execution of supposed witches.  A witch was defined as a person who was in league with the Devil and had supernatural powers.  There actually were no such persons.  Just as it was impossible to be a witch, it is impossible to be “mentally ill” in a genuinely biological, medical, or scientific sense. Scientific determination that a person is mentally ill is as impossible as scientific determination that someone is a jerk.  Calling someone mentally ill or disordered reveals an attitude rather than stating a fact.

What if we did find a biological cause of a supposed mental illness or disorder?  Were that to happen, psychiatry professor Thomas Szasz once said, the finding of a physical cause would make the problem a physical illness, and whatever mental changes occurred as a result would be symptoms of bodily disease.³⁰  For example, brain cancer, stroke, and bacterial or viral infection of the brain are not usually considered causes of mental illness even when they cause abnormalities in thinking or behavior.  Since nothing can be an “illness” (or disease or syndrome or disorder) without a biological abnormality, and the finding of a biological abnormality makes the problem a physical illness rather than a mental illness, “mental illness” is actually an oxymoron or nonsensical term.

People can and do experience debilitating depression, anxiety, obsessions, compulsions, phobias, panic attacks, hallucinations, and delusions, and they may be violent or suicidal, but there is no evidence the reason is usually or typically biological abnormalities or, in other words, illnesses.

Because “mental illness” is an invalid concept, all laws predicated on “mental illness” should be repealed or invalidated by courts.  Nothing should ever happen because of diagnosis of fictitious disease.

References

(1) Thomas S. Szasz, The Myth of Mental Illness (Harper & Row 1961). 

(2)  Philip Q. Roche, The Criminal Mind (Farrar, Straus and Cudahy 1958), p. 253. 

(3) John M. Friedberg, M.D., “Neurologist John M. Friedberg on ECT”, May 18, 2001, http://ectjustice.com/neurologist-john-m-friedberg-on-ect/, accessed January 5, 2019.

(4) Fred A. Baughman, M.D., in his lecture at the Empathic Therapy Conference 2012, “The ADHD Stimulant Epidemic”, at 33 minute, 2 seconds point, available on DVD at EmpathicTherapy.org. 

(5)  Chuck Ruby, Ph.D., April 2018 Bulletin of the International Society for Ethical Psychology & Psychiatry, https://psychintegrity.org/wp-content/uploads/2018/11/Apr-2018.pdf, accessed January 5, 2019

(6)  Stuart A. Kirk, D.S.W., Tomi Gomory, Ph.D., & David Cohen, Ph.D., Mad Science (Transaction Publishers 2013), pp. 195, 301, 302, 328, italics in original, underline added. 

(7)  Paula J. Caplan, Ph.D., “Diagnosisgate”, conference of National Association for Rights Protection and Advocacy (narpa.org), Washington, D.C., August 23, 2015. 

(8) Dr. Peter C. Gøtzsche, Deadly Psychiatry and Organized Denial (People's Press 2015), pp. 26 & 145. 

(9) “Social construct”, Merriam-Webster Dictionary, https://www.merriam-webster.com/dictionary/social%20construct?utm_campaign=sd&utm_medium=serp&utm_source=jsonld, accessed January 5, 2019.

(10)  E. Fuller Torrey, M.D., The Death of Psychiatry (Penguin Books 1974), pp. 38-39. 

(11)  Seymour S. Kety, M.D. & Steven Matthysse, Ph.D. in Armand M. Nicholi, Jr. (ed.), The New Harvard Guide to Psychiatry (Harvard University Press 1988), p. 148.

(12)  The Biology of Mental Disorders (U.S. Gov't Printing Office 1992), pp. 13, 14, 46, 47. 

(13)  David Kaiser, M.D., “Commentary: Against Biologic Psychiatry”, Psychiatric Times, December 1996, http://www.psychiatrictimes.com/bipolar-disorder/commentary-against-biologic-psychiatry, accessed January 5, 2019.

(14)  Elliot S. Valenstein, Ph.D., Blaming the Brain: The Truth About Drugs and Mental Health (Free Press 1998), p. 125.

(15)  Fred Baughman, Insight magazine, June 28, 1999, p. 13.

(16) Dennis S. Charney, M.D. et al., Neurobiology of Mental Illness (Oxford Univ. Press 1999), p. vii.  

(17)  Joseph Glenmullen, M.D.,, Prozac Backlash (Simon & Schuster 2000), pp. 192, 193. 

(18) Bruce Levine, Ph.D., Commonsense Rebellion (Continuum 2001), p. 277.  

(19) Allen Frances, M.D., “A Warning Sign on the Road to DSM V”, Psychiatric Times, June 26, 2009, http://www.psychiatrictimes.com/diagnostic-and-statistical-manual-mental-disorders/warning-sign-road-dsm-v-beware-its-unintended-consequences, accessed January 5, 2019.

(20)  Allen Frances, M.D., Saving Normal (Harper¬Collins 2013), pp. 10, 11, 244.  

(21)  “Joanna Moncrieff—The Myth of the Chemical Cure; The Politics of Psychiatric Drug Treatment”, https://www.youtube.com/watch?v=IV1S5zw096U, at 53 minutes, 52 seconds point, accessed January 5, 2019.

(22)  Peter Breggin, M.D., Toxic Psychiatry (St. Martin's Press 1991), p. 291.

(23)  Dr. Peter Gøtzsche, Deadly Psychiatry and Organized Denial (People's Press 2015), p. 26. 

(24)  “An Instant Cure”, Time magazine, April 1, 1974, p. 45. 

(25)   American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 3rd ed. (DSM-III - 1980), p. 282. 

(26)  Merck Manual of Diagnosis and Therapy, 15th edition, 1987, p. 1495.

(27)  Allen Frances, M.D., quoted  by Gary Greenberg, “Inside the Battle to Define Mental Illness”, Wired Magazine, December 27, 2010, https://www.wired.com/2010/12/ff_dsmv/ , accessed January 5, 2019.

(28)  Rachel  Aviv, “God Knows Where I Am”, in M. Kaku (ed.), Best American Science Writing 2012 (HarperCollins 2012), p. 246-247. 

(29)  Richard J. Bonnie, LL.B.,“Political Abuse of Psychiatry in the Soviet Union and in China”,  J.Am.Acad.Psych.Law 30:136-44 (2002), http://jaapl.org/content/jaapl/30/1/136.full.pdf, accessed January 5, 2019

(30)  Thomas S. Szasz, Lexicon of Lunacy (Routledge 1993), p. 33.

Recommended Video

“There is no such thing as mental illness”, Stefan Molyneux, YouTube.com (2011)

THE AUTHOR, Wayne Ramsay, is a lawyer with the Law Project for Psychiatric Rights (PsychRights.org).

Joanne Cacciatore's Care Farm

Take a look at the Yahoo Lifestyle article showcasing Joanne Cacciatore's Care Farm in Sedona, Arizona. Joanne's brainchild is a unique application of this model to helping people who are in the throes of bereavement. She helps people reconnect to the earth, animals, nature, and themselves while allowing the painful process of mourning to happen as it naturally does. This stands in stark contrast to the conventional and absurd method of trying to make the pain go away. Congrats Joanne!

Watch ISEPP's David Walker speak about how the mental health industry has privileged "white" America and disenfranchised the native people who preceded the European invasion.

ISEPP's Hank McGovern has come out with a book on suicide prevention. Check it out at Amazon. Hank speaks from personal and professional experience. Take a look at his recent interview below with Michele Paiva, ISEPP's marketing guru.

The book has received 5 stars out of 47 reviews so far. From one review: "The author artfully uses the dramatic frame of a suicide note and a tumultuous, well-drawn childhood to take readers through his quest for meaning, peace, and balance...His encapsulations of various therapies, particularly rational emotive behavior therapy, are soulful and illuminating, and emphasize the power of practical, positive action and  behavior...Overall, this is an evocative, intriguing, self-exploration...sometimes overwhelming, yet compelling..."

ISEPP was joined by allied sister agencies in demanding ethical guidance from five leading professional mental health member organizations regarding serious problems with the Diagnostic and Statistical Manual for Mental Disorders (DSM). Ever since its publication in 2013, mental health experts and international organizations have decried the DSM's lack of validity. Applying an invalid diagnostic system to people is unethical and harmful. Still, it continues to reign as the official diagnostic system and there has been no attempt to rectify this problem.

In an Open Letter sent Tuesday, August 15, 2017, ISEPP spelled out how this places mental health practitioners in an ethical double bind. They must knowingly use an invalid and potentially harmful manual to help people in need, as health insurance companies require a DSM diagnosis for services to be reimbursed. But if they abide by their ethical standards and refuse to use the invalid manual, people in need will not be able use insurance benefits to afford services and they will go without help. Either choice will place the practitioner squarely in conflict with their prime ethical mandate of "do no harm."

The following agencies joined with ISEPP in this Open Letter:

International Society for Psychological and Social Approaches to Psychosis, United States Chapter

Center for Loss and Trauma

National Coalition for Mental Health Recovery

MindFreedom International

Hearing Voices Network USA

MISS Foundation

Volunteers in Psychotherapy

Warfighter Advance

ISEPP's Joanne Cacciatore is helping to pave the way for a new model of care for those traumatized by loss. See her recent review of the literature on carefarming and traumatic grief. 

In a dramatically different approach to traumatic grief than traditional Western treatment (which often focus on diagnosing and medicating people who are deeply grieving) the carefarm approach is simple, safe and focuses on three restorative areas of support:

1. Carefarming which will include offerings such as gardening and therapeutic horticulture, animal therapy, rescue animal caregiving, green recreation, landscape maintenance, and ecotherapy;
2. Contemplative practices which include meditation/centering prayer, mindfulness based support groups, bibliotherapy, grounding, and ritual;
3. Physical well-being which includes yoga and other exercise, massage, physical activity, acupuncture, and psychoeducation around sleep hygiene, healthy eating, stress resilience, and traumatic grief counseling.
4. Carefarming, as a whole and in its individual components, has been shown to help many vulnerable population groups. Many countries in Europe utilize care farming as a humanistic approach to human suffering in vulnerable groups with powerful psychological and social outcomes that reduce harm and help people improve their coping abilities. And, carefarming costs a fraction of treatment as usual. The average day at a carefarm costs between $60-$150. The cost of treatment as usual in an inpatient setting is about $1000- $1100 a day. 

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