R. L. Cima, Ph.D.

As long as I live, I shall balk at having psychoanalysis swallowed by medicine. - Sigmund Freud

WHO’s Counting

Within the last 70 years, with the assistance of a trillion dollar worldwide pharmaceutical business and their partners in academia – and a willing populace – human beings are being drugged into “balance” to treat fictitious brain diseases in astronomical numbers.  In 2018, the World Health Organization (WHO) estimates 300 million people around the world have depression disorder, 60 million have bipolar disorder, and another 23 million have schizophrenia disorder and other psychoses1 - all of them in need of psychiatric medication.  According to WHO, it’s likely that accurate numbers are significantly higher as poorer countries have no way to record mental illness.  Leading the way – the United States. 

The Journal of the American Medical Association (JAMA) reported in 2017 more than 40 million adults were prescribed one or more psychiatric prescriptions in America (2013).2 Race, you should know, is a factor.  One in five white adults, one in ten black adults, one in twelve Hispanic adults, and one in 20 Asian adults are prescribed psychiatric medications.  By gender, the difference is as significant.  Nearly twice as many women (20.8%) are taking psychotropics than men (11.9%).  Age matters too.  About one in ten 18-39 year-olds are psychiatric patients, nearly one in five 40-59 year-olds, and, out in front by a wide margin, a solid one fourth of adults between the ages of 60-85 are prescribed psychiatric medications.  By the way, why is “mental illness” dependent on race, gender and age?  How does the psychiatric medical model (PMM) scientist explain this? 

Children

There are 75 million children in the United States in 2019.³ Nearly 17 million are diagnosed with a brain disease.  The Center for Disease Control (CDC) reports 6.1 million children have been diagnosed with ADHD disorder, 4.5 million with a behavior disorder, another 4.4 million with anxiety disorder, and 1.9 million with depression disorder.⁴ And why are nearly one in five children being drugged?  The American Academy of Child & Adolescent Psychiatry (AACAP) declares there are eleven psychiatric symptoms and disorders for which psychiatric medication may be prescribed for children.  The list includes bedwetting, anxiety, attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, depression disorder, eating disorder, bi-polar disorder, psychosis, autism spectrum disorders, severe aggression and sleep problems.⁵  

Toddler & Infants Too

From the New York Times, May 2014:

“About 15,000 American toddlers 2 or 3 years old, many on Medicaid, are being medicated for attention deficit hyperactivity disorder, according to data presented Friday by an official at the federal Centers for Disease Control and Prevention.”⁶

From Medical Daily, December 2015:  

“The report shows that psychotropic drug prescriptions among babies nearly doubled in one year, from 13,000 prescriptions in 2013 to 20,000 in 2014, despite the lack of evidence that shows they are effective and safe for young children . . .  psychiatrists often prescribe these drugs . . . for behavioral issues like unusual aggression, temper tantrums, or lethargy.”⁷

What Are We Taking – and Why Are We Taking Them?

From PsychCentral, here of the top 25 psychiatric drugs that were sold in America – and the reasons we take them – in 2016:⁸

Knot in the Mood

More than 338 million prescriptions were written just for anti-depressant medications in 2016, by far the winning diagnosis.  And depression isn’t as simple as you may think.  There are all kinds of depression including atypical depression, bipolar disorder I, bipolar disorder II, catatonic depression, cyclothymia, depressive personality disorder, double depression disorder, dysthymia, melancholic depression, minor depressive disorder, postpartum depression, premenstrual dysphoric disorder, psychotic major depression, recurrent brief depression, and last, but not least, seasonal affective disorder, affectionately known as SAD.  

Is there a common denominator for all of these chemicals?  Of course, and it’s easy to see.  All 25 chemicals address the same innate, unavoidable, uncomfortable, and sometimes-hard-to-shake-life-altering-human-experience:  mood.  And yes, that includes ADHD, including the effect ADHD has on the mood of others.  Ok, you may notice, schizophrenia is about consciousness, not mood.  Nonetheless, the PMM provides treatment for schizophrenia and other aspects of consciousness with the same mood medications:  tranquilizers.  Anything else these chemicals have in common?  Yes, of course, and it’s easy to see too.  Twenty-two of them are central nervous system depressants (CNSD), and three of them are central nervous system stimulants (CNSS).  What’s that about and why is it important?

Lost In the Shuffle

Rhône-Poulenc, a French pharmaceutical company, was developing antihistamines for nausea and allergies in the late 1940’s.  Scientists noticed some chemical compounds exhibited exceptional sedative effects.  Dr. Henri Laborit, a French surgeon, called this effect artificial hibernation, and described it as “sedation without narcosis.”  By 1951 Laborit was conducting clinical trials of the newest compound – chlorpromazine (CPZ) –  for use as an anesthetic booster for surgery patients.  He proclaimed CPZ the “best drug to date” in calming and reducing shock during surgery.  Known as "Laborit's drug" among colleagues⁹, by 1953 CPZ was released for use in the operating room.  

Laborit was also a persistent advocate for clinical trials for psychiatric patients using this new wonder chemical.  His persistence was rewarded.  On January 19, 1952, CPZ was administered to a manic patient named Jacque.  Jacque’s improvement was reported to be “dramatic.”  After three weeks – and 855 mg of CPZ – Jacque was released from the hospital.  Word spread quickly about this “breakthrough.”  Dr. Pierre Deniker¹⁰, another French surgeon, ordered CPZ for a clinical trial at the Sainte-Anne Hospital Center in Paris.  His findings were even more dramatic.  Often doubling Laborit’s doses, Deniker found CPZ had much more than sedative effects.  His patients showed “remarkable improvement in thinking and emotional behavior.”  By the end of 1952, Deniker abandoned old, ineffective, and harmful shock methods and began to treat mental illness with CPZ.  

Soon after, Kline & French Pharmaceuticals (today's GlaxoSmithKline) purchased the rights to CPZ from Rhône-Poulenc.  By 1954, Smith-Kline & French received FDA approval to market CPZ as Thorazine to treat schizophrenia.  The world’s first psychiatric medication was created – and marketed.  Advertisements and professionals soon were boasting how “Thorazine helps to keep more patients out of mental hospitals.”  Please remember, hospital beds were required because psychiatric patients needed time to recover from electrocution, the surgeon’s knife, or chemically induced, months'-long comas.  While a chorus of public outcries about the inhumane treatment of psychiatric patients had already begun to empty the beds of these tortuous asylums, psychiatric scientists and drug company marketers attributed this exodus to the “dramatic” success of Thorazine.

Then, in October 1955, Deniker’s Saint-Anne Hospital Center convened the first international Thorazine (CPZ) conference.  Attendees included scientists from Austria, Belgium, Brazil, Canada, Cuba, France, Germany, Great Britain, Holland, Luxembourg, Peru, Portugal, Spain, Sweden, Switzerland, Turkey, United Kingdom, United States and Venezuela.  Soon to follow were thousands of papers from scientists around the world publicizing their own “dramatic” successes with Thorazine for an ever-widening variety of brain disorders, affecting millions of patients.  By 1957, Laborit, Deniker (and Heinz Lehmann) were awarded the prestigious Albert Lasker Award for their contributions to the clinical development and use of Thorazine - dubbed “the world’s first anti-psychotic medication.”¹¹     

During the 1950’s and 1960’s, the pharmaceutical ads for Thorazine were ubiquitous.  Thorazine was prescribed for bursitis pain, cancer pain, emotional stress, anxiety, nausea and vomiting, “management of menopausal patients,” child behavior disorders, acute alcoholism, severe asthma, depression, hiccups, catatonic schizophrenia, schizoaffective conditions, epileptic clouded states, agitation in lobotomized patients, confusional states, senile psychoses, gastrointestinal disorders, psoriasis, and more.¹² By 1964, fifty million people around the world had used Thorazine.¹³

In his book The Creation of Psychopharmacology (2002)¹⁴, David Healy, the renowned British psychiatrist, professor, scientist, author – and current director of an ECT clinic in Wales – proclaims the discovery of Thorazine as significant to medicine as the discovery of penicillin.  As important, he asserts, Thorazine was also the first profitable psychiatric medication for pharmaceutical companies.  He marks the convergence of these two events – a wonder treatment and profitability – as the genesis of what he termed “biological psychiatry,” and the 1980 publication of DSM-III as bonding psychiatry to the biological cause of mental illness, forever.  Healy also details the prodigious growth of pharmaceutical companies and their promotion strategies, including coordination with academia to find new mental illnesses, and to manufacture the medications to treat them.  

There were huge profits in the making for this burgeoning “take-a-pill-for-it” market, and Big Pharma began to flourish.  By the end of the 1960’s pharmaceutical companies had created dozens of “new and improved” medications for a growing number of new mental illnesses.  By then, Thorazine was regarded as just another, less effective medication, now criticized by its competitors for its notorious side effects.  And what were these “new and improved” medications from Big Pharma?  More tranquilizers.

Was the discovery of Thorazine really as significant as penicillin?  Yes, it was – if you are a proponent of the PMM.  Dr. Healy is, and he has company.  So is 94%¹⁵ of the general public and, presumably, 99+% of professionals.  However, if you are PMM antagonist, then Thorazine was – nothing more and nothing less – the world’s first tranquilizer, and a precursor to the hundreds of tranquilizers to follow.

A Lost Cause

Take a look at this chart of the top ten diagnosed brain disorders, and their causes:

There are a total of 713 medications manufactured by drug companies for the top ten brain disorders, for which there are no known causes.  How is that possible?  By the way, these are just the top ten diagnoses.  You can see the entire list of "Medications for Psychiatric Disorders" at www.drugs.com.¹⁶ Please be warned.  If you are looking for a cause for any of the brain disorders of the PMM, you will be disappointed.  There are none.  

So, do you wonder too?  What in the hell are they treating?  

Jacque to the Future

When Jacque took his first dose of CPZ in 1952, everything changed in psychology and psychiatry.  In just a few decades, psychological diagnoses became medical diagnoses, needing medical oversight, medical solutions, and medical doctors to do so.  Now, a psychiatric medical patient sees a medical doctor for psychiatric medication to address a brain disorder.  Behaviors once considered understandable responses to the challenges of life by psychology became “symptoms” to the doctors of the PMM, and the “symptoms” became evidence of the underlying medical deficiency, derangement, disease, disorder, disability, disturbance, or dysfunction (the 7 D’s of the PMM).

We are approaching 50 million men, women, children, toddlers and infants in the United States who are taking pills for brain disorders.  And business is booming.  Psychiatric medications – the majority tranquilizers, a handful of stimulants, and an occasional analgesic – now number in the thousands, more created every year.  Not a single cure, and not a single cause for any of the ever-growing brain disorders of the PMM.  

Did I mention business is booming?  

Welcome to Zombieland

Psychiatry entered the last half of the 20th Century on an upnote, despite a horrendous track record for the first 50 years.  The PMM scientists created a new, simple, humane, and easily administered treatment solution for mental illness, and by the 1960’s big pharma was making money hand over fist.  Only one thing was missing to unify this marriage.  Healy’s “biological psychiatry” needed a coherent, science-based, peer-reviewed theory to explain how all these miracle drugs worked.    

Well, they found one.  It’s about bad brain parts.  And a Zombie comes with it.

NEXT TIME:  Part 4:  The Dope About Dopamine – and Other Ridiculous Notions    

“When the doors to that dorm opened up a strange group of men would exit. They would seem to be in a hurry, but unable to coordinate their movements. Their heads would hang down and half expressions would ripple across their faces. They would run their hands over their heads over and over, and open and close their mouths while sticking their thick tongues out. Their gait was particularly peculiar, with stiff legs dragging their feet along, all the while seeming about to topple. We called this the ‘thorazine shuffle.’” - John Lash - Behind the Thorazine Shuffle, the Criminalization of Mental Illness (2012)¹⁷

Wayne Ramsay, J.D.

The word “schizophrenia” has a scientific sound that seems to give it inherent credibility and a charisma that seems to dazzle people.  In his book Molecules of the Mind–The Brave New Science of Molecular Psychology, University of Maryland journalism professor Jon Franklin calls schizophrenia and depression “the two classic forms of mental illness.”¹ According to the cover article in the July 6, 1992 Time magazine, schizophrenia is the “most devilish of mental illnesses.”² This Time magazine article says “fully a quarter of the nation's hospital beds are occupied by schizophrenia patients.”³ Books and articles like these and the facts to which they refer (such as a quarter of hospital beds being occupied by so-called schizophrenics) delude most people into believing there really is a disease called schizophrenia. Schizophrenia is one of the great myths of our time.

In his book Schizophrenia–The Sacred Symbol of Psychiatry, psychiatry professor Thomas S. Szasz, M.D., says “There is, in short, no such thing as schizophrenia.”⁴In the Epilogue of their book Schizophrenia–Medical Diagnosis or Moral Verdict?, Theodore R. Sarbin, Ph.D., a psychology professor at the University of California at Santa Cruz who spent three years working in mental hospitals, and James C. Mancuso, Ph.D., a psychology professor at the State University of New York at Albany, say:

We have come to the end of our journey. Among other things, we have tried to establish that the schizophrenia model of unwanted conduct lacks credibility. The analysis directs us ineluctably to the conclusion that schizophrenia is a myth.⁵

In his book Against Therapy, published in 1988, Jeffrey Masson, Ph.D., a psychoanalyst, says “There is a heightened awareness of the dangers inherent in labeling somebody with a disease category like schizophrenia, and many people are beginning to realize that there is no such entity.”⁶ Jim van Os, professor and chair of the Department of Psychiatry at Maastricht University Medical Center in the Netherlands, states this conclusion in the February 2, 2016 British Medical Journal: “'Schizophrenia’ does not exist.”⁷

Rather than being a bona-fide disease, so-called schizophrenia is a nonspecific category which includes almost everything a human being can do, think, or feel that is greatly disliked by other people or by the so-called schizophrenics themselves. There are few so-called mental illnesses that have not at one time or another been called schizophrenia. Because schizophrenia is a term that covers just about everything a person can think or do which people greatly dislike, it is hard to define objectively. Typically, definitions of schizophrenia are vague or inconsistent with each other. For example, when I asked a physician who was the Assistant Superintendent of a state mental hospital to define the term schizophrenia for me, he with all seriousness replied “split personality–that’s the most popular definition.” In contrast, a pamphlet published by the National Alliance for the Mentally Ill titled “What Is Schizophrenia?” says “Schizophrenia is not a split personality.” In her book Schizophrenia: Straight Talk for Family and Friends, published in 1985, Maryellen Walsh says this:

Schizophrenia is one of the most misunderstood diseases on the planet. Most people think that it means having a split personality. Most people are wrong. Schizophrenia is not a splitting of the personality into multiple parts.⁸

In the Foreword to the second edition of the American Psychiatric Association’s (APA’s) Diagnostic and Statistical Manual of Mental Disorders (DSM-II), Ernest M. Gruenberg, M.D., D.P.H., Chairman of the American Psychiatric Association's Committee on Nomenclature, said:

Consider, for example, the mental disorder labeled in the Manual as ‘schizophrenia,’... Even if it had tried, the Committee could not establish agreement about what this disorder is.”⁹

The third edition of the APA's Diagnostic and Statistical Manual of Mental Disorders, published in 1980, commonly called DSM-III, was also quite candid about the vagueness of the term. It said: “The limits of the concept of Schizophrenia are unclear”¹⁰ The revision published in 1987, DSM-III-R, contains a similar statement: “It should be noted that no single feature is invariably present or seen only in Schizophrenia.”¹¹  DSM-III-Ralso says this about a related diagnosis, Schizoaffective Disorder:

The term Schizoaffective Disorder has been used in many different ways since it was first introduced as a subtype of Schizophrenia, and represents one of the most confusing and controversial concepts in psychiatric nosology.¹²

In Frances Farmer– Shadowland, a biography of a once well-known actress who became an involuntarily committed mental patient, William Arnold observes that “since the term schizophrenia was coined in 1911 it has had a thousand different meanings to a thousand different psychiatrists.”¹³

Particularly noteworthy in today's prevailing intellectual climate in which mental illness is considered to have biological or chemical causes is what the 1987 edition of the Diagnostic and Statistical Manual of Mental Disorders, DSM-III-R says about such physical causes of this catch-all concept of schizophrenia:  It says a diagnosis of schizophrenia “is made only when it cannot be established that an organic factor initiated and maintained the disturbance.”¹⁴ Underscoring this definition of “schizophrenia” as non-biological is the 1987 edition of The Merck Manual of Diagnosis and Therapy, which says a (so-called) diagnosis of schizophrenia is made only when the behavior in question is “not due to organic mental disorder.”¹⁵

Contrast this with a statement by psychiatrist E. Fuller Torrey, M.D., in his book Surviving Schizophrenia: A Family Manual, published in 1988. He says “Schizophrenia is a brain disease, now definitely known to be such.”¹⁶  If schizophrenia is a brain disease, it is organic. However, the official definition of schizophrenia maintained and published by the American Psychiatric Association in various editions of its Diagnostic and Statistical Manual of Mental Disorders specifically excludes organically caused conditions from the definition of schizophrenia. In Surviving Schizophrenia, Dr. Torrey acknowledges “the prevailing psychoanalytic and family interaction theories of schizophrenia which were prevalent in American psychiatry”¹⁷ that would seem to account for this.

In 1988, in Nature, genetic researcher Eric S. Lander of Harvard University and M.I.T. summarized the situation this way:

The late US Supreme Court Justice Potter Stewart declared in a celebrated obscenity case that, although he could not rigorously define pornography, ‘I know it when I see it.’ Psychiatrists are in much the same position concerning the diagnosis of schizophrenia.  Some 80 years after the term was coined to describe a devastating condition involving a mental split among the functions of thought, emotion and behaviour, there remains no universally accepted definition of schizophrenia.¹⁸

In Surviving Schizophrenia, Dr. Torrey quite candidly concedes the impossibility of defining what “schizophrenia” is.  He says:

The definitions of most diseases of mankind has been accomplished.... In almost all diseases there is something which can be seen or measured, and this can be used to define the disease and separate it from nondisease states. Not so with schizophrenia! To date we have no single thing which can be measured and from which we can then say: Yes, that is schizophrenia. Because of this, the definition of the disease is a source of great confusion and debate.¹⁹

What puzzles me is how to reconcile this statement of Dr. Torrey’s with another he makes in the same book, which I quoted above and which appears more fully as follows:

Schizophrenia is a brain disease, now definitely known to be such. It is a real scientific and biological entity, as clearly as diabetes, multiple sclerosis, and cancer are scientific and biological entities.”²⁰

How can it be known that schizophrenia is a brain disease when we do not know what schizophrenia is?

The truth is that the word schizophrenia, like the words “pornography” and “mental illness”, indicate disapproval of that to which the word is applied and nothing more. Like “mental illness” or “pornography”, “schizophrenia” does not exist in the sense that cancer and heart disease exist but exists only in the sense that good and bad exist. As with all other so-called mental illnesses, a diagnosis of “schizophrenia” is a reflection of the speaker’s or “diagnostician’s” values or ideas about how a person “should” be, often coupled with the false (or at least unproven) assumption that the disapproved thinking, emotions, or behavior results from a biological abnormality. Considering the many ways it has been used, it’s clear “schizophrenia” has no particular meaning other than “I dislike it.” Because of this, I lose respect for mental health professionals when I hear them use the word schizophrenia in a way that indicates they think it is a real disease. I do this for the same reason I would lose respect for a person’s perceptiveness or intellectual integrity after hearing him or her admire the emperor’s new clothes. While the layman definition of schizophrenia, internally inconsistent, may make sense in some situations, using the term “schizophrenia” in a way that indicates the speaker thinks it is a real disease is tantamount to admitting he doesn’t know what he is talking about.

Many mental health “professionals” and other “scientific” researchers do however persist in believing “schizophrenia” is a real disease. They are like the crowds of people observing the emperor’s new clothes in Hans Christian Andersen’s short story. They are unable or unwilling to see the truth because so many others before them have said it is real. A glance through the articles listed under “Schizophrenia” in Index Medicus, an index of medical periodicals, or an Internet search, reveals how widespread the schizophrenia myth has become. Because these “scientists” believe “schizophrenia” is a real disease, they try to find physical causes for it. As psychiatrist William Glasser, M.D., said in 1976: “Schizophrenia sounds so much like a disease that prominent scientists delude themselves into searching for its cure.”²¹ This is a silly endeavor, because these supposedly prominent scientists can’t define “schizophrenia” and accordingly don't know what they are looking for.

According to three Stanford University psychiatry professors, “two hypotheses have dominated the search for a biological substrate of schizophrenia.” They say these two theories are the transmethylation hypothesis of schizophreniaand the dopamine hypothesis of schizophrenia.²² The transmethylation hypothesis was based on the idea that “schizophrenia” might be caused by “aberrant formation of methylated amines” similar to the hallucinogenic pleasure drug mescaline in the metabolism of so-called schizophrenics. After reviewing various attempts to verify this theory, they conclude: “More than two decades after the introduction of the transmethylation hypothesis, no conclusions can be drawn about its relevance to or involvement in schizophrenia.”²³

Columbia University psychiatry professor Jerrold S. Maxmen, M.D., describes the second major biological theory of so-called schizophrenia, the dopamine hypothesis,in his book The New Psychiatry, published in 1985: “...many psychiatrists believe that schizophrenia involves excessive activity in the dopamine-receptor system...the schizophrenic's symptoms result partially from receptors being overwhelmed by dopamine.”²⁴ But in the article by three Stanford University psychiatry professors I referred to above they say “direct confirmation that dopamine is involved in schizophrenia continues to elude investigators”²⁵ In 1987 in his book Molecules of the MindProfessor Jon Franklin said “The dopamine hypothesis, in short, was wrong.”²⁶

In that same book, Professor Franklin aptly describes efforts to find other biological causes of so-called schizophrenia:

As always, schizophrenia was the index disease. During the 1940s and 1950s, hundreds of scientists occupied themselves at one time and another with testing samples of schizophrenics’ bodily reactions and fluids. They tested skin conductivity, cultured skin cells, analyzed blood, saliva, and sweat, and stared reflectively into test tubes of schizophrenic urine. The result of all this was a continuing series of announcements that this or that difference had been found. One early researcher, for instance, claimed to have isolated a substance from the urine of schizophrenics that made spiders weave cockeyed webs. Another group thought that the blood of schizophrenics contained a faulty metabolite of adrenaline that caused hallucinations.  Still another proposed that the disease was caused by a vitamin deficiency. Such developments made great newspaper stories, which generally hinted, or predicted outright, that the enigma of schizophrenia had finally been solved. Unfortunately, in light of close scrutiny none of the discoveries held water.²⁷

Other efforts to prove a biological basis for so-called schizophrenia have involved brain-scans of pairs of identical twins when only one is a supposed schizophrenic. They do indeed show the so-called schizophrenic has brain damage his identical twin lacks. The flaw in these studies is the so-called schizophrenic has inevitably been given brain-damaging drugs called neuroleptics as a so-called treatment for his so-called schizophrenia. It is these brain-damaging drugs, not so-called schizophrenia, that have caused the brain damage. Anyone “treated” with these drugs will have such brain damage. Damaging the brains of people eccentric, obnoxious, imaginative, or mentally disabled enough to be called schizophrenic with drugs (erroneously) believed to have antischizophrenic properties is one of the saddest and most indefensible consequences of today’s widespread belief in the myth of schizophrenia.

Belief in biological causes of so-called mental illness, including schizophrenia, comes not from science but from wishful thinking or from desire to avoid coming to terms with the experiential and environmental causes of people’s misbehavior or distress. The American Psychiatric Association’s definition of “schizophrenia” as non-organic, and the repeated failure of efforts to find biological causes of so-called schizophrenia suggest “schizophrenia” belongs only in the category of socially or culturally unacceptable thinking or behavior rather than in the category of biology or “disease” where many people place it.

¹John Franklin, Molecules of the Mind – The Brave New Science of Molecular Psychology (Dell Publishing Co., 1987, p. 119

²July 6, 1992 Timemagazine, p. 53

³Id., p. 55

⁴Thomas S. Szasz, M.D., Schizophrenia–The Sacred Symbol of Psychiatry  (Syracuse University Press, 1988), p. 191

⁵Theodore R. Sarbin, Ph.D., and James C. Mancuso, Ph.D., Schizophrenia–Medical Diagnosis or Moral Verdict?(Pergamon Press, 1980), p. 221

⁶Jeffrey Masson, Ph.D.,Against Therapy(Atheneum 1988), p. 2

⁷Jim van Os, British Medical Journal, February 2, 2016, “`Schizophrenia’ does not exist” https://www.bmj.com/content/ 352/bmj.i375

⁸Maryellen Walsh, Schiz-o-phre-nia: Straight Talk for Family and Friends(Warner Books 1985), p. 41

⁹Ernest M. Gruenberg, M.D., D.P.H., Diagnostic and Statistical Manual of Mental Disorders (DSM-II) American Psychiatric Association 1968), p. ix

¹⁰American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (DSM-III, 1980), p. 181.

¹¹American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R), p. 188

¹²Id., p. 208

¹³William Arnold, Frances Farmer– Shadowland(Berkley Books 1982), p. 125

¹⁴DSM-III-R, p. 187

¹⁵Merck Manual of Diagnosis and Therapy, 1987, p. 1532

¹⁶E. Fuller Torrey, M.D.,Schizophrenia: A Family Manual(Harper & Row 1988), p. 5

¹⁷Id., p. 149

¹⁸Eric S. Lander, Nature, November 10, 1988, p. 105

¹⁹E. Fuller Torrey, M.D., Surviving Schizophrenia – A Family Manual (Harper & Row 1988), p. 73

²⁰Id., p. 5

²¹William Glasser, M.D., Positive Addiction(Harper & Row 1976) p. 18.

²²Jack D. Barchas, M.D., et al., “Biogenic Amine Hypothesis of Schizophrenia”, appearing inPsychopharmacology: From Theory to Practice, Oxford University Press, 1977, p. 100

²³Id., p. 107

²⁴Jerrold S. Maxmen, M.D., The New Psychiatry(Mentor 1985), pp. 142 & 154

²⁵Barchas, et al. (note 22), p. 112

²⁶Franklin (note 1), p. 114

²⁷Id., p. 172

THE AUTHOR, Wayne Ramsay, is a lawyer whose practice has included representing psychiatric “patients”.

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.

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

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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..."