In 2011 Marcia Angell, “a member of the faculty of Global Health and Social Medicine at Harvard Medical School and former Editor in Chief of The New England Journal of Medicine” wrote an article titled “The Epidemic of Mental Illness: Why?

I wonder: Why indeed? Though in my case, for somewhat different reasons.

In her article Angell reviews and synthesizes the information from three books:

  1. The Emperor’s New Drugs: Exploding the Antidepressant Myth by Irving Kirsch
  2. Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America by Robert Whitaker
  3. Unhinged: The Trouble With Psychiatry—A Doctor’s Revelations About a Profession in Crisis by Daniel Carlat

The results, massively controversial at the time and fortunately a little more accepted now, was that most antidepressants didn’t do much more than placebos, and statistically had the exact same efficacy as many illegal drugs and stimulants in lessening the symptoms of depression. Think about that for a second.

Angell also talks about something all of us on the receiving end of mental health treatment start to wonder about after our first major “life-fixing-drug-program” courtesy of John Doe psychiatrist:

When it was found that psychoactive drugs affect neurotransmitter levels in the brain, as evidenced mainly by the levels of their breakdown products in the spinal fluid, the theory arose that the cause of mental illness is an abnormality in the brain’s concentration of these chemicals that is specifically countered by the appropriate drug. For example, because Thorazine was found to lower dopamine levels in the brain, it was postulated that psychoses like schizophrenia are caused by too much dopamine. Or later, because certain antidepressants increase levels of the neurotransmitter serotonin in the brain, it was postulated that depression is caused by too little serotonin. (These antidepressants, like Prozac or Celexa, are called selective serotonin reuptake inhibitors (SSRIs) because they prevent the reabsorption of serotonin by the neurons that release it, so that more remains in the synapses to activate other neurons.) Thus, instead of developing a drug to treat an abnormality, an abnormality was postulated to fit a drug.

“Thus, instead of developing a drug to treat an abnormality, an abnormality was postulated to fit a drug.”

Again: Think about that for a second. The implications herein are absolutely disgusting. But consider the meta-disgust deserved by the implicit modus operandi of the psychopharmacological drug companies and the pathetic “professionals” – many with medical degrees – who either knowingly propagated this habit or couldn’t be bothered to take the time to look into negative drug trials or non-results in testing. These are human beings we’re talking about, many of them children. And yes, it’s easy to ride a white horse on behalf of your own ingroup, but had I no mental health diagnosis, this information would still infuriate me.

Typical psychiatrist hard at work circa 2011.
Typical psychiatrist hard at work circa 2011.

I’ll here throw in a quote Angell took directly from Whitaker:

Prior to treatment, patients diagnosed with schizophrenia, depression, and other psychiatric disorders do not suffer from any known “chemical imbalance.” However, once a person is put on a psychiatric medication, which, in one manner or another, throws a wrench into the usual mechanics of a neuronal pathway, his or her brain begins to function…abnormally.

This gentleman used the suicides-I-mean-illnesses of teenagers to buy his wife a Lexus.
This gentleman used the suicides-I-mean-illnesses of teenagers to buy his wife a Lexus.

The point here is the that the only thing abnormal about mental illness is the effect of the drugs you’re prescribed to “fix” it. Eat your heart out, Kay Jamison.

For obvious reasons, drug companies make very sure that their positive studies are published in medical journals and doctors know about them, while the negative ones often languish unseen within the FDA, which regards them as proprietary and therefore confidential. This practice greatly biases the medical literature, medical education, and treatment decisions.

What the back office of a psychiatrist's office looks like.
What the back office of a psychiatrist’s office looks like.

But amidst all this horseshit is an idea even more implicitly buried, and wondering as to the reasons why is – with a caveat for the sake of your own well-being, if you have a soul – so ineffably gross and repugnant and self-serving that it might be the one thing that actually warrants a reactionary homicidal rampage (don’t do this). You ready bro?

You don’t have an “illness” at all.

At CBTN we are advocates of diagnosis over illness  eight days a week, thirteen months a year, eleven years a decade – I wrote about the key differences between diagnosis, disease and disposition here if you’re up for a more thorough discussion – but in otherwise skipping the fine print, know – know – that there is nothing “wrong” with you if you have a mental health diagnosis.

And in tying in the preceding material, strong evidence exists in the fact that these profiteering “doctors” and drug companies are the same ones influencing your diagnosis.

The tally of those who are so disabled by mental disorders that they qualify for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) increased nearly two and a half times between 1987 and 2007—from one in 184 Americans to one in seventy-six. For children, the rise is even more startling—a thirty-five-fold increase in the same two decades…

A large survey of randomly selected adults, sponsored by the National Institute of Mental Health (NIMH) and conducted between 2001 and 2003, found that an astonishing 46 percent met criteria established by the American Psychiatric Association (APA) for having had at least one mental illness within four broad categories at some time in their lives.

Translation: if the APA had its way, half of the entire United States (or world, if they really had their druthers) would be considered “mentally ill.”

Does that sound reasonable to you?

That’s a rhetorical question, and you fucking know it homie.

There is a 50% chance your shrink is crazier than you are.
According to their own critera, there is a 50% chance your shrink is crazier than you are.

By their own reasoning, half of the APA has a mental illness; it’s a coin toss whether or not your psychiatrist ought to be seeing you for therapy…

That, my friends and mental health family, is not a fucking “illness.”

It’s a phenotype – and a cool one at that.

Some fifty thousand odd years ago – The Great Leap Forward, for evolutionary scientists – human beings, despite remaining physically the same (as they have for an estimated two hundred thousand years – read about Anatomically Modern Humans here) there was an almost overnight explosion of art, culture, tool use, and other complex behavior. In other words, our bodies stayed the same but our minds went ape shit. We became behaviorally modern.

Would you say it was for the better?

If psychoactive drugs are useless, as Kirsch believes about antidepressants, or worse than useless, as Whitaker believes, why are they so widely prescribed by psychiatrists and regarded by the public and the profession as something akin to wonder drugs? Why is the current against which Kirsch and Whitaker and, as we will see, Carlat are swimming so powerful?

Your “illness” is better explained by the theory of evolution than it is by a half-baked theory claiming half of us are insane. Trust your brain – it sounds ridiculous because it is. Instead what is happening is behavioral evolution – and, as once self-awareness made people seem nuts, so to does a self-awareness of our self-awareness at times drive us bat shit crazy.

The good news is, you can control this. You’re in charge of your own mind. No one including me is saying it’s easy – just that it’s possible.

Give it a shot.

POST SCRIPT – This is not carte blanche to go off your meds – if you don’t have Buddha level 9000 self-control and a vice-like grip with statistical data and models for understanding your cycles, start there instead of being that asshat that just jumps off the high dive into shark-infested waters. KEEP TAKING YOUR MEDS – just pay attention.

Feel free to post any thoughts, criticisms, comments or concerns here or in the CBTN Forum.

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