08/27/14

In Pharmakon We Trust

Christina and her husband, Sonny, separated in July of 2013. During a visit on December 18th,—his daughter’s birthday—Sonny strangled his 14 year-old son and then hung himself.  Sonny and Gunnar’s bodies were found in his apartment by Sonny’s girlfriend.  On December 19th Christina kept a previously scheduled appointment with a psychiatrist who she had been seeing for a couple of weeks.

BEFORE her appointment at the University Health Center, Christina’s doctor had placed the University of Vermont police on standby to take her into custody if she refused to admit herself to the psych unit in Fletcher Allen, the UV affiliated medical center. She did decline, so she was detained. A UVM police report showed that there was a delay of several hours before the officers could transport Christina to Fletcher Allen because the mental health staff didn’t have the proper paperwork to legally transport her! Five weeks later, Christina was finally released.

Justina Pelletier suffers with a rare disorder—mitochondrial disease. In February of 2013, at the recommendation of her doctor, she was taken to Boston Children’s Hospital by her mother.  Justina’s gastroenterologist had recently moved there from Tufts. The team at Children’s disputed the mitochondrial disease diagnosis and concluded Justina suffered from somatoform disorder—a psychiatric disorder in which symptoms are real, but have no underlying cause. Some reports indicated this re-diagnosis was first made within a matter of hours or minutes of Justina’s arrival at Children’s and was done without consultation with her treating physicians.

When her parents tried to have her discharged from Boston Children’s, the hospital contacted DCF, who took custody of Justina and accused her parents of medical child abuse. Justina remained a ward of the state until June 18, 2014. Most of that time she spent on a locked psychiatric ward. While in state custody, Justina only saw her family once per week for a supervised hour of visitation and spoke with them once a week on the phone.

In his essay, “Strategies of Psychiatric Coercion,” Jeffrey Schaler commented that treatment providers forcibly “treat” people they consider to be a danger to themselves or others in the name of compassion and care. In effect, psychiatrists and mental health professionals empowered by the state to commit someone involuntarily to a psychiatric hospital argue that the person is a child. Although not literally a child, he is a metaphoric child. “He does not, in their opinion, exercise responsibility for himself because he cannot do so.”

The coercion is supposedly done to protect him from himself. He “needs” to be deprived of his constitutional rights in the name of treating his “mental” illness. And the more a person objects to being coerced into treatment, “the more likely he is to be diagnosed with serious mental illness.”

Los Angeles recently decided to expand a pilot program from 20 to 300 slots that will allow a family member, treatment provider or law enforcement officer to pursue court-ordered outpatient treatment for individuals with serious mental illness. “Those who don’t comply can be taken into custody on a 72-hour psychiatric hold. Patients can’t be forced to take medication under law, but there are other mechanisms for court-ordered medication.”

In his 1963 book, Law, Liberty and Psychiatry, Thomas Szasz predicted the birth of what he called the therapeutic state: “Although we may not know it, we have, in our day, witnessed the birth of the Therapeutic State. This is perhaps the major implication of psychiatry as an institution of social control.” He even went further and coined a new term for this union of psychiatry and the state: pharmacracy.

Inasmuch as we have words to describe medicine as a healing art,  but have none to describe it as a method of social control or political rule, we must first give it a name. I propose that we call it pharmacracy, from the Greek roots pharmakon, for ‘medicine’ or ‘drug,’ and kratein, for ‘to rule’ or ‘to control.’ … As theocracy is rule by God or priests, and democracy is rule by the people or the majority, so pharmacracy is rule by medicine or physicians.

I don’t think we are a therapeutic state … yet. We aren’t a pharmacracy … yet. But I do think we need to be aware of the warnings given by Thomas Szasz. If you need more information before you decide whether the United States is in danger of becoming a therapeutic state, spend some time on the following websites:

PsychRights

Mad in America

ToxicPsychiatry

By the way, a UN report thinks that forced psychiatric treatment is torture:

Deprivation of liberty on grounds of mental illness is unjustified. Under the European Convention on Human Rights, mental disorder must be of a certain severity in order to justify detention. I believe that the severity of the mental illness cannot justify detention nor can it be justified by a motivation to protect the safety of the person or of others. Furthermore, deprivation of liberty that is based on the grounds of a disability and that inflicts severe pain or suffering falls under the scope of the Convention against Torture.

Do you think we are in danger of becoming a therapeutic state?

07/30/14

Getting Off the Antidepressant Merry-Go-Round

I told Allison to concentrate on my voice and imitate how I was breathing. My coworker held her head in her lap. Together we kept Allison focused until the paramedics came. Determined to stop all drug use after she came into outpatient drug and alcohol treatment, she decided to stop taking her Paxil … cold turkey. The result was a severe panic attack and ER visit.

The Center for Disease Control and Prevention (CDC) estimated that eleven percent of Americans 12 and over use antidepressants. More than 60% of those taking an antidepressant medication have taken it for 2 years or longer; 14% have taken the medication for 10 years or more. Like Allison, women between the ages of 40 and 59 are those most likely to be taking an antidepressant (22.8%). Antidepressants were the most commonly used medication by persons aged 18-44; they were the third most commonly used prescription drug by all Americans in 2005-2008.

Okay, you’re thinking you want to try to withdraw from antidepressants; but you don’t want to duplicate Allison’s experience. What should you do?

First, do some research on the growing evidence of problems with antidepressants.

Look at some of the material available on the websites “ToxicPsychiatry” by Peter Breggin and PsychRights by Jim Gottstein. Here are a few recommendations.

Start with Patient Online Report of Selective Serotonin Reuptake Inhibitor-Induced Persistent Postwithdrawal Anxiety and Mood Disorders, by Carlotta Belaise,  Alessia Gatti, Virginie-Anne Chouinard, and Guy Chouinard,on Psychrights. It is a short, easy to read study of online self-reports of withdrawal symptoms and postwithdrawal symptoms that they attributed to the discontinuation of SSRI antidepressants.

Then read “Do Antidepressants Cure or Create Abnormal Brain States?” by Joanna Moncrieff, found on ToxicPsychiatry. If you want further information, try her book, The Myth of the Chemical Cure. Dr. Moncrieff effectively challenges the received wisdom of the chemical imbalance theories underlying the use medications for depression, psychosis and bipolar disorder.

If you have used antidepressants for a number of years, also read: “Now Antidepressant-induced Chronic Depression Has a Name: Tardive Dysphoria,” by Robert Whitaker. Try out his website as well, Mad in America.

You can also read two articles that I’ve written and made available here on Faith Seeking Understanding: “Antidepressant Withdrawal or Discontinuation Syndrome?” and “Antidepressants Their Ineffectiveness and Risks.

Second, become familiar with the potential postwithdrawal side effects of antidepressant withdrawal.

There is a website of free resources at RxISK. You can research reported side effects by drug name; and you can report a drug’s side effects. But be sure to look at the “Symptoms-on-Stopping Zone.” Read about the concept of medication spellbinding coined by Peter Breggin on his ToxicPsychiatry site. Try his article, “Intoxication Anosognosia: The Spellbinding Effect of Psychiatric Drugs” or his book, Medication Madness for a more detailed discussion.

Mario Fava has developed a scale to assess withdrawal/discontinuation symptoms during an antidepressant taper. You can see a copy of his DESS Scale here; and read about antidepressant discontinuation here. You can download the original Fava article here after registering with psychiatrist.com.

Finally, don’t try this at home alone.

Read this blog post on Mad in America by Monica Cassani. Locate psychiatric support groups and websites like Beyond Meds by Monica Cassani. RxISK has published a detailed “Guide to Stopping Antidepressants.” Also read Your Drug May Be Your Problem: How and Why to Stop Taking Psychiatric Medications or Psychiatric Drug Withdrawal, both by Peter Breggin.

Make sure you have medical support and monitoring from a doctor or psychiatrist who is supportive of your attempt to taper. Someone who is president of the local chapter of NAMI and believes in the chemical imbalance theory of depression is not a good choice to supervise your drug taper. Postwithdrawal symptoms will be seen as the re-emergence of your underlying psychiatric disorder and proof you need to be on medications for life.

Tell family and friends of your decision and enlist them (those who are receptive to your decision to taper) as members of an accountability or support group. Have them read this material.

In closing, remember this warning by Dr. Peter Breggin on his website:

Most psychiatric drugs can cause withdrawal reactions, sometimes including life-threatening emotional and physical withdrawal problems. In short, it is not only dangerous to start taking psychiatric drugs, it can also be dangerous to stop them. Withdrawal from psychiatric drugs should be done carefully under experienced clinical supervision.

Do you think someone should remain on antidepressant medications indefinitely?