As I work with clients/patients with mental health issues, I wanted to share some information regarding psychiatry, psychiatric drugs and the pharmaceutical industry, because not all is as you are lead to believe.
This is not to say that it is all bad, there are some excellent psychiatrists doing some excellent work, I think it is just fair to make more people aware of some of the significant points that are misleading for many.
The majority of people assume that psychiatry is just like any other branch of medicine, with objective tests for diagnoses and drug treatments that cure real diseases. In reality however, psychiatric diagnoses and treatments differ enormously from diagnoses and treatments for diseases like cancer or diabetes, since, for mental disorders, there are no known biological ‘diseases’ for psychiatric drugs to ‘treat’.
Below are several Unrecognised Facts about modern psychiatry which every patient, practitioner and policymaker needs to be aware of.
- No Known Biological Causes: There are no known biological causes for any of the psychiatric disorders apart from dementia and some rare chromosomal disorders. Consequently, there are no biological tests such as blood tests or brain scans that can be used to provide independent objective data in support of any psychiatric diagnosis
- Myth of the Chemical Imbalance: Psychiatric drugs have often been prescribed to patients on the basis that they cure ‘a chemical imbalance’. However, no chemical imbalances have been proven to exist in relation to any mental health disorder. There is also no method available to test for the presence or absence of these chemical imbalances
- Diagnostic System Lacks Validity: Psychiatric diagnostic manuals such as the DSM and ICD (chapter 5) are not works of objective science, but rather works of culture since they have largely been developed through clinical consensus and voting. Their validity and clinical utility is therefore highly questionable, yet their influence has contributed to an expansive medicalisation of human experience
- Psychiatric Drugs Cause Altered Mental States: Just like other substances that affect brain chemistry (such as illicit drugs), psychiatric drugs produce altered mental states. They do not ‘cure’ diseases, and in many cases their mechanism of action is not properly understood
- Antidepressants Have No Benefit Over Placebo: Studies have have found that antidepressants have no clinically significant benefit over placebo pills (inert pills) in the treatment of mild to moderate depression, while they provide some benefit for severe depression, at least in the short term. Recent research also suggests that antidepressants may be associated with with a risk of increased mortality, at least among the elderly
- Worse Long-Term Outcomes: There has been little research on the long-term outcomes of people taking psychiatric drugs. The available studies suggest that all the major classes of psychiatric drugs add little additional long-term benefit, and for some patients they may lead to significantly worse long-term outcomes
- Long-Lasting Negative Effects: Psychiatric drugs can have long-lasting negative effects on the brain and central nervous systems, particularly when taken long-term, which can lead to physical, emotional and cognitive difficulties
- Negative Effects Are Often Misdiagnosed: Psychiatric drugs can have effects that include mental disturbance, including suicide, violence and withdrawal symptoms. These can be misdiagnosed as new new psychiatric presentations, for which additional drugs may be prescribed, sometimes leading to long-term use of multiple different psychiatric drugs in the same person
- Psychiatric Drug Withdrawal Can Be Disabling: Withdrawal from psychiatric drugs can be disabling and can cause a range of severe physical and psychological effects which often last for months and sometimes years. In some cases, withdrawal charities, report it may lead to suicide
- More Medicating of Children: Use of psychiatric drugs in children and adolescents has been rapidly expanding across the developed world. The potential long-term damage these drugs can have on developing brains has not been properly assessed. Furthermore, there is now some evidence that increased use of medication within this age group is leading to worse long-term outcomes
- Regulator Funded By Industry: The UK regulator of psychiatric drugs (the MHRA) is entirely funded by the pharmaceutical industry, and employs ex-industry professionals in key leadership positions. Such conflicts of interest could lead to lenient regulation that places commercial interest above patient protection
- Conflicts of Interest: Ties between doctors and the pharmaceutical industry are are particularly widespread in psychiatry. In the UK psychiatrists do not have to report to any agency or authority how much industry income they receive each year
- Manipulation and Burying of Drug Trial Data: The majority of psychiatric drug trials are conducted and commissioned by the pharmaceutical industry or those who have extensive ties with them. This industry has a long history of burying negative results, and of manipulating research to highlight positive outcomes