Critical psychiatry: discussing some of the conflictions within the medical profession
Updated: Jan 28
I am feeling pretty shattered this week because writing about psychiatric medications has coincided with my recurring problems and complications with them: principally, the battle to withdraw from the antipsychotic quetiapine.
I wouldn’t mind taking these drugs if they actually relived my symptoms, but the fact is - they don’t. The reality of the situation (in my case anyway) is that they give me terrible side effects, new symptoms, and are a nightmare to withdraw from.
It’s taken me two decades to finally come to this conclusion because I trusted the medical professionals and thought they knew better than me. However, now that I have my own (extensive) lived experience, combined with the research, experience, and opinions of others, I feel compelled to speak out for the sake of future patients!
I know that I’m not alone in my thinly veiled hatred of psychiatric medications, but I do respect those whose opinions differ – I really don’t want any fall-out – these are my thoughts and opinions, and I am not forcing them on anyone, I’m just sharing the truth of what happened in my individual experience.
My intention is not to scare patients either, it’s merely to educate them through my own lived experience so that they can be better informed and (hopefully) avoid some of the carnage that these brain altering drugs have created in me!
No unified approach
Over the course of my illness, I’ve seen countless psychiatrists and done so much of my own research that I’ve virtually qualified as one as well!
The standout observation that I’ve both noticed and been subjected to, is the fact that not one psychiatrist agrees when it comes to the treatments and medications.
I know this because throughout the two-decade span of my illness every psychiatrist has taken a different approach, the result being that my brain has had to withstand a barrage of medical mistakes and failures on top of the illness itself!
‘First do no harm!’
The countless errors and disasters that my poor brain has had to withstand don't sit well beside the Hippocratic Oath that doctors swear on qualifying to ‘First do no harm!’:
“In the oath, the physician pledges to prescribe only beneficial treatments, according to his abilities and judgment; to refrain from causing harm or hurt; and to live an exemplary personal and professional life.”
Although I have great admiration for anyone who has battled their way through medical school, the principles of the Hippocratic Oath haven’t necessarily been prioritised in my experience! If they had been, then myself and others would never have been allowed to suffer to the extremes that we have!
It seems to me that psychiatry today is all about trial and error with the emphasis on the error when it comes to the medications and treatments!
I understand that we only progress our knowledge through trying different approaches but when it’s your own life that’s being destroyed in the process, then that’s a big deal and not a whole load of fun. The Hippocratic Oath also states that:
“Patients are to be treated not as cases or experimental subjects, but as human beings worthy of respect and compassion.”
Hmmm. Do my fellow patients feel that they are being treated like this? I would say that’s debatable!
Again, I don't want to be attacked for my opinions - I'd like things to be better for others and I'm a voice for many patients out here who all feel the same!
Criticisms of the pharmacological approach
There are many psychiatrists who are now evaluating the role, efficacy, and side effects of the medications more critically, and today I’m going to share a few of their thoughts and opinions.
“Many psychiatrists simply do not want to face up to the harms their treatments can produce.” Joanna Moncrieff
Perhaps the most prominent of professionals to speak out about the potential problems of psychiatric medicines is critical psychiatrist, researcher, and author Professor Joanna Moncrieff.
I was first alerted to her work by a friend who sent me a YouTube clip of her criticism of antipsychotic medications last year. The following extract is taken from a paper Professor Moncrieff wrote in 2017.
Side effects of psychiatric medications
In my book The Bitterest Pills, I wrote of how many psychiatrists simply do not want to face up to the harms their treatments can produce. This is illustrated by the way the psychiatric establishment tried to avoid the implications of tardive dyskinesia, by suggesting it was a symptom of ‘schizophrenia,’ and ignoring the evidence that tardive dyskinesia involves cognitive impairment.
“Similarly, when it became obvious that some of the second generation antipsychotics caused massive weight gain and metabolic disturbance, mainstream psychiatric journals published articles suggesting that diabetes was linked with schizophrenia as well.”
Long term use of antipsychotics
Coupled with, and possibly linked to this evidence of harm, doubts have started to mount that the benefits of long-term treatment with antipsychotics have not been as firmly established as is generally believed.
The inadequacies of randomised trials of maintenance treatment have been highlighted, as has the fact that there is little data on the overall impact of drug treatment when it is taken over the long periods of time that many patients are prescribed it for.
“Some evidence points towards the possibility that some people may do better if they stop or reduce their antipsychotic treatment, rather than continue on it long-term.”
These points have been raised by several mainstream psychiatrists, as well as the usual suspects, including me.
Reminder to psychiatrists
“Psychiatrists need to be fully aware of the detrimental effects of antipsychotics on the brain and body.”
They also need to acknowledge the way these drugs make life so miserable for many people, even for some who might have been even more distressed were they to be without them, something that is well described in Miriam Larssen-Barr’s recent blog on the Mad in America website.
“Psychiatrists need to support people to evaluate the pros and cons of antipsychotic treatment for themselves and to keep doing this as they progress through different stages of their problems. To do this, psychiatrists need to be able to acknowledge the real nature of these drugs, and not sweep inconvenient truths under the carpet!”
The full article can be found here.
Professor David Cohen
Professor Cohen has discussed all sorts of issues in psychiatry including (among many others) informed consent and the corruption of the pharmaceutical companies. The following is an abstract from one of his research papers:
For the past 50 years, physicians in the West have been prescribing psychotropic drugs systematically to hundreds of millions of people to alter undesirable and disruptive emotions and behaviour.
In the 1980s, with the advent of Prozac (fluoxetine), biological psychiatry was finally consecrated as the reigning school of thought in mental health. Anyone could now confidently attribute mental illness to an imbalance in neurotransmitters. Since then, members of all helping professions, leaders of science, opinion and politics, the media, the educational and the justice systems, and the military have sanctioned the use of prescribed mind- and mood-altering drugs as the first resort when people face any crisis or distress. For the treatment of every single psychological affliction, in men and women, in all ethnic groups, from the toddler to the aged, taking psychotropic drugs is now the cornerstone remedy, all other efforts secondary.
“Despite the reliance on psychopharmaceuticals, however, not even modest improvements in the incidence, prevalence, relapse rate, duration, or long-term outcome of any condition routinely treated today with psychotropics, such as depression and schizophrenia, can be discerned. On the contrary, despair, distress, and dysfunction are regularly announced to be increasing in the affluent West and throughout the world (WHO Mental Health Survey Consortium, 2004).”
Dr Kelly Brogan
There are also some psychiatrists who disagree with the use of medications altogether like Dr Kelly Brogan who I first discovered when trawling YouTube earlier this year.
Dr Brogan was a conventional psychiatrist for many years and spent much of her career prescribing medications to help treat her patients’ conditions however, she is now a pioneer in the field of holistic psychiatry and is one of the few known psychiatrists who takes a non-pharmaceutical approach to mental illness.
In the following video Dr Kelly explains all the problems in psychiatry which I spend hours discussing and writing about! I have added this one before but it’s so brilliantly succinct and addresses so many of the problems that I’ve decided to add it again!
I am now absolutely shattered, having spent so long on the blog this week discussing these very difficult, contentious (and frankly upsetting) issues and conflictions!
I will be taking a break for a few days to rest and recover (and continue my quest to rid myself of quetiapine!) but will be back on Tuesday with more educational insights and comments from #dyingtostayalive!
Thanks for reading,
Speak to you soon,