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Are Psychiatric Medications Hurting More Patients Than They Help? (scientificamerican.com)

An anonymous reader quotes Scientific American's Cross-Check blog: Two new posts on this website have me contemplating, once again, the terrible possibility that psychiatry is hurting more people than it helps. Reporter Sarah G. Miller notes in "1 in 6 Americans Takes a Psychiatric Drug" that prescriptions for mental illness keep surging. As of 2013, almost 17 percent of Americans were taking at least one psychiatric drug, up from 10 percent in 2011, according to a new study. "Antidepressants were the most common type of psychiatric drug in the survey, with 12 percent of adults reporting that they filled prescriptions for these drugs..."

This increase in medications must be boosting our mental health, right? Wrong. In "Is Mental Health Declining in the U.S.?," Edmund S. Higgins, professor of psychiatry at the Medical University of South Carolina, acknowledges the "inconvenient truth" that Americans' mental health has, according to some measures, deteriorated...

It's all more evidence of something their blogger wrote in 2012. "American psychiatry, in collusion with the pharmaceutical industry, may be perpetrating the biggest case of iatrogenesis -- harmful medical treatment -- in history."

21 of 432 comments (clear)

  1. Good question by Anonymous Coward · · Score: 3, Funny

    Let's ask APK...

  2. Or people are just under/wrongly medicated. by Alsn · · Score: 4, Insightful

    In happiness charts, Denmark continues to score the highest while they also have the highest prescription rate of antidepressants in the world.

    Not saying Denmark is some shining beacon of mental health but the problem is quite simply harder to diagnose than to correlate psychiatric drug prescriptions and mental health stats. More serious studies are definitely needed.

    1. Re:Or people are just under/wrongly medicated. by bmo · · Score: 4, Insightful

      Maybe it's because in Denmark, you can go to school and get a stipend on top of it. Also, there isn't a race-to-the-bottom with wages. Also, there is a social and medical safety net.

      And bars don't close at 1am like they do here.

      --
      BMO

      "I'd rather have a bottle in front of me than a frontal lobotomy."

    2. Re:Or people are just under/wrongly medicated. by PolygamousRanchKid+ · · Score: 5, Funny

      More serious studies are definitely needed.

      No more studies are necessary. The answer is perfectly clear: Bacon. Those Danes produce lots of it! Even the venerable "The Economist" takes note of that:

      "Denmark is a tiny country, with 5.6m people and wallet-draining labour costs. But it is an agricultural giant, home to 30m pigs and a quiverful of global brands. In 2011 farm products made up 20% of its goods exports. The value of food exports grew from €4 billion ($5.5 billion) in 2001 to €16.1 billion in 2011. The government expects it to rise by a further €6.7 billion by 2020." http://www.economist.com/news/...

      All that happiness-bringing bacon cancels out all those depressing, but brilliant, Lars Von Trier films.

      Not saying Denmark is some shining beacon of mental health

      Not saying Denmark is some shining bacon of mental health

      FTFY

      --
      Schroedinger's Brexit: The UK is both in and out of the EU at the same time!
    3. Re:Or people are just under/wrongly medicated. by Princeofcups · · Score: 4, Insightful

      Maybe it's because in Denmark, you can go to school and get a stipend on top of it. Also, there isn't a race-to-the-bottom with wages. Also, there is a social and medical safety net.

      And bars don't close at 1am like they do here.

      --
      BMO

      "I'd rather have a bottle in front of me than a frontal lobotomy."

      This shows again a COMPLETE lack of understanding mental health. Sure there is a social component. But the drugs are not meant to deal with that. That's what therapy is for. Drugs are used to mitigate a lack of certain neurochemicals in the brain, a PHYSICAL condition. Without a proper balance of serotonin, dopamine, norepinephrine, etc., normal everyday functioning can become impossible. The main issue is when MD's without psychiatric training started prescribing these drugs. "Try this and come back in two weeks" can work with a rash, but not with mental health. Finding the right drugs titrated at the right dosages requires direct interaction between patient and doctor, and probably therapy to understand the social and mental effects of the underlying physical issues.

      --
      The only thing worse than a Democrat is a Republican.
    4. Re:Or people are just under/wrongly medicated. by ColdWetDog · · Score: 5, Interesting

      Sorry to burst your bubble but neurochemistry is really at the 'try this for two weeks and come back to see me'. Even if you are a Board Certified (TM) psychiatrist. We really are at the very beginning of understanding what the brain is doing and how to modify it.

      The situation is much more complex than TFAs suggest - 'psychiatric health' is a pretty vague and shifting target. Depends on your culture, your role in society, your age, your financial situation, your sex, the sex of the idiot sitting next to you, who is president and much more - including your genetic and epigentic makeup. If you are a creative type, you might want to feel a wider breadth of emotions than if you are flying 747's. This doesn't even begin to approach the questions of what goal does 'psychiatric health' have for the society. The powers that be might want everyone on an emotional zombie program. The hoi polloi not so much.

      G-23 Paxilon Hydrochlorate anyone?

      Any mental health professional will tell you that the meds don't work all that well. But they do work. People who really did need to be institutionalized before the advent of antipsychotics are out in the community. It's not entirely clear that this helps them or the community but the drugs are arguably doing something useful.

      Using broad brush numbers like the amount of antidepressant prescriptions and trying to correlate them with other broad brushed studies using vague and varied methodologies and trying to say anything intelligent is a fool's errand.

      --
      Faster! Faster! Faster would be better!
    5. Re:Or people are just under/wrongly medicated. by bmo · · Score: 5, Insightful

      And how do you propose to fix society so it's not a "shit heap?" Extra points if you can also figure out what we should do with people with mental disorders until you "fix society?" How are you going to make it that nobody is in a bad relationship, loses their job, has a catastrophic medical event that significantly impacts their daily lives, and nobody experiences inconsolable grief over someone close to them dying?

      Oh hay, it's a false dichotomy /and/ a straw-man argument all in one!

      You can improve society so that when things like you posted don't harm people /as much/ as they do today. It's a spectrum, not a binary state.

      Improve availability of education
      Relax or eliminate victimless-crime statutes
      Social safety net - losing a job should not be life or family-threatening.
      Medical safety net - Universal healthcare, like the rest of the developed nations have.
      Decent infrastructure so companies can thrive instead of their trucks being dumped in a river because a bridge collapsed, for example.
      Mandatory vacation time > 1.5 weeks USians
      Enforce labor laws.

      All of these things contribute to societal and mental health. But we can't have that /here/ because that's SOCIALIZUM!#@$!@#$@#$!

      Come back when you get a clue.

      --
      BMO

    6. Re:Or people are just under/wrongly medicated. by gtall · · Score: 4, Interesting

      I have the Harvard Guide to Psychiatry DSM IV (I need to get V). I had to get it for some sort of bearing on peculiar grad students I kept running into. For awhile, I thought I was a strange attractor. Then I came to the conclusion that academia is simply more accommodating to oddness than business world, so it accumulates a wider variety of "clientele".

      Anyhow, it quickly becomes clear that one person with symptoms doesn't have entirely this condition or that condition. Rather, they pick from a smorgasbord of conditions. So each case is different. Add a bit of time for them to water and feed their conditions (and they do), then they get rather full-blown oddness. Some have learned to do bank shots off the reactions they generate in other people. These are difficult cases to handle because they are working you but you still feel sorry for them.

      The best psychiatry can do with drugs is try this or that combination in the hopes of hitting the magic one for the oddball in their office. And then the oddball's physiology is changing over time due to age, diet, or just general physical drift. So what works one year might not work the next. The easiest to deal with are those with an identifiable condition like hyper or hypo thyroid. Few are ever this simple.

  3. What will it take by John+Allsup · · Score: 3, Interesting

    The truth the medical fraternity face is that many have had their lives ruined by the drugs they religiously believe in. The 'evidence' rests on a mire of untested and flawed assumptions (in particular the premises of the statistical methods used to relate data to conclusions: many of which cannot be justified unless the possibility of and influence of complex brain behaviour can be safely ignored). The clinical psychology fraternity, and a number of 'maverick' psychiatrists are, more and more, putting across why mainstream 'medical psychiatry' has much wrong. But this is all too easily swamped by billion dollar marketing machines, lobbying and selective sponsored trials which have a habit, like 'proven by science' infomercials, of showing the sponsoring company's products as better than others.

    --
    John_Chalisque
  4. The evidence cited seems pretty thin. by hey! · · Score: 4, Interesting

    (1) Suicide rates -- In the US I think the increase in suicide rate is likely attributable to increased firearm ownership. There is no evidence that I know of that indicates that the increased level of gun ownership presents an increased risk to others -- in fact the rate of firearm homicide has gone down (along with most other violent crimes). But suicidal impulses -- which are very common -- plus a handgun in your pocket... that is a very dangerous combination.

    (2) Rate of DoD PTSD rising -- likely to have to do with the influx of veterans from three wars (Gulf 1 & 2 + Afghanistan), plus a higher survival rate from severe physical trauma.

    (3) Rise of opiate abuse -- coincides with the appearance of new prescription drugs and more aggressive prescribing of pain medication.

    (4) Rise in disability awards -- conflated with a drive to recognize mental disabilities as on a par with physical ones.

    At my age I've lived through many a moral panic, and this feels like the beginnings of one. Which is not to say mental illness doesn't cause real suffering, or that we shouldn't make it more of a priority. But what we need are more evidence-based approaches. Unfortunately we seem to be headed in the opposite direction.

    --
    Post may contain irony: discontinue use if experiencing mood swings, nausea or elevated blood pressure.
    1. Re:The evidence cited seems pretty thin. by Solandri · · Score: 5, Informative

      (1) Suicide rates -- In the US I think the increase in suicide rate is likely attributable to increased firearm ownership.

      Suicide rates are up in many OECD countries over the last 10 years, many of whom have strict restrictions on firearm ownership. Several countries which ban or restrict guns have higher suicide rates than the U.S.. Also, it's predominantly males in the U.S. who opt for suicide by gun; females usually try to overdose or slit their wrists. Yet the ratio of male to female suicide rate is practically the same for the U.S. (3.73), UK (3.77), Germany (3.54), France (3.22), Spain (3.73), and Italy (4.0). Suggesting that guns are merely a tool of choice among male U.S. suicides, not an enabler of higher suicide success rates.

      The U.S. is more diligent about collecting this sort of data and making it available to the public. So global trends tend to show up sooner in U.S. data sets. Not because the U.S. is special or atypical. Most of the OECD suicide stats I was able to find still date from 2011. It took quite a bit of searching to find that chart of suicide rates in non-U.S. countries up to 2013.

  5. I think the medication rate is constant by Anonymous Coward · · Score: 3, Interesting

    Whereas once upon a time it was quite normal in society for everybody to drink alcohol regularly, nowadays it is unfashionable to be an alcoholic so psychiatric medications have taken over.

    A hundred years ago, if I had anxiety I would just drink booze to get over it. Now I take Paxil. Not only am I spending a lot less money (because a single pill costs less than a bottle of wine or 6-pack of beer), but I can safely drive a car, and I'm not an asshole to my family.

    You may also notice that it seems every other kid is on some medication for ADD/ADHD. Why? My guess is that it's because we can't beat them anymore. Now that it's no longer socially acceptable to hit children who act out we have to medicate them instead.

    dom

  6. Don't be fooled by the words "Scientific American" by bluegutang · · Score: 5, Insightful

    This piece is written by a kook who frequently writes on various "spiritual" and pseudoscientific topics. Among his recent posts:

    Seeing the Miracle of Existence in the Darkest of Times
    Does Evolution Have a "Higher Purpose"?
    Astrophysicist Says Experiments Might Soon Reveal Dark Matter's "True Nature"
    What Would a Machine as Smart as God Want?
    My Doubts about Deepak Chopra and the Monetization of Meditation
    World's Smartest Physicist Thinks Science Can't Crack Consciousness
    The Mind–Body Problem, Scientific Regress and "Woo"
    Dear "Skeptics," Bash Homeopathy and Bigfoot Less, Mammograms and War More

    True to form, this article's point is a passive-agressive claim based on absence of evidence:
    "Like most psychiatrists, Higgins does not consider the possibility that medications might be contributing to the decline of mental health."

    Actually, I'm sure most psychiatrists HAVE considered this possibility, and they follow the peer-reviewed evidence which concludes the opposite.

    If anyone wants to argue with this scientific consensus, they are welcome to do their own peer-reviewed studies. But this article and its sources haven't.

  7. Pimping drugs for profit by geekmux · · Score: 4, Insightful

    "Antidepressants were the most common type of psychiatric drug in the survey..."

    Last two times I've visited my general practitioner I was given a "new" form to fill out that essentially tried to convince me I was depressed; I was visiting for a cough and my yearly physical, neither of which had fuck-all to do with depression, but they sure as shit were trying like hell to get me on medication for it.

    We have the same industry to thank for the opiate/heroin epidemic as well. How fucking ironic the drug pimps addicting America are marketed to "help" us. Perhaps it's time we actually start putting health over profits.

  8. Don't forget about the War on Drugs. by Shane_Optima · · Score: 5, Interesting

    The single biggest influence on the state of psychiatry today is moral conservativism and other assorted panderings to popular culture and the law. Their desire to stay profitable and respectable in mainstream society long ago destroyed any real credibility they had as a serious hard science.

    Pretty much every highly effective anti-depressant ever made (including but certainly not limited to opioids and dopaminergics) is a scheduled substance and almost never prescribed for depression, because apparently every single human being alive is just a helpless addict just waiting for the chance to swallow twenty pills at a time chasing a high. SSRIs have abysmal efficacies, but that didn't stop them from pushing the placebo revolutionary drug Prozac to being one of the most prescribed drugs in the country. A lot of people are still under this weird impression that antidepressants work by re-establishing some natural balance of neurotransmitters present in "normal" people, when there's every indication that this is not the case. (FDA is partially at fault here allowed pharma companies to put out some ads that strongly implied this was how SSRIs worked.)

    And it's not as if modern antidepressants aren't addictive; like many psychotropic drugs, SSRIs and SNRIs induce physical dependency with potentially severe withdrawal symptoms if abruptly terminated.

    No, the actual difference between modern antidepressants and "addictive" drugs that actually make you feel good is... the latter actually work. Consistently and compellingly. And it's for that very reason that they are deemed dangerous. Drugs that are highly effective in enabling human happiness work better at higher dosages (which is how dosage increase works among most drugs that are actually effective, if you think about)... which of course leads to massive problems among the subpopulations of people who have poor impulse control or are overly euphoria-craving.

    And all of this plays directly into the hands of religious and social conservatives who have for millenia made careers out of claiming that anything that people like too much must be bad. You'd think that more people would be suspicious of a profession claiming to be a science that was, just a couple generations ago, trying to chemically castrate people against their will to cure them of their homosexuality... ah well.

  9. Series of tubes by sjukfan · · Score: 5, Insightful

    You know when a non techie talk about the Internet as a series of tubes? This is one of those times but about psychiatric meds.

    First off, of course it's wrong if you take meds so you can handle the stress of two full time jobs or assume you can just take a couple of pills and your depression will be gone.

    But for most people out there with a psychiatric condition meds and therapy (and some more therapy) is a life saver. The meds will remove some of the symptoms so you can live an almost normal life while therapy helps with the cause for them. A depression is nothing like feeling a bit under the weather, a panic disorder does not go away with a gluten free diet, and grave OCD is as easy to just hold in as Ipecac

  10. Re:Of course not. by Bite+The+Pillow · · Score: 5, Insightful

    Oh, good, pseudo intellectual cynicism has dismissed the whole topic. No need to discuss this, ilsaloving has seen through all of the smoke bombs and has clearly articulated the fundamental explanation.

    Enjoy the karma boost you get from people who only want to reward opinions matching their own.

  11. Re: Duh. by BarbaraHudson · · Score: 4, Insightful

    But the drugs just takes care of the symptoms to some extent. Not the cause. We need to dig deeper.

    Kind of hard to dig deeper if the person is overwhelmed by the symptoms. If someone wants to kill themselves today, you don't want to risk taking 3 months of therapy to try to get to the bottom of their problems. Also, finding the cause doesn't necessarily fix everything. The brain is plastic. Every time a person goes through a bout of depression, it increases the odds of another bout irrespective of the cause.

    --
    "Transparent" is a shit show that trades on every stereotype going. A man in drag is NOT a transsexual.
  12. Re:One giant leap... by Billly+Gates · · Score: 5, Insightful

    I have numerous issues created by just 3 months on Celexia. I am changed, asexual, and developed drinking and financial problems that were not present before medication. Also I have been off the meds for 4 months I may add and will never know if I will return to my normal self again.

    There is a whole site called survingantideppressents.com

  13. Re:Of course not. by AthanasiusKircher · · Score: 5, Interesting

    I see a lot of in-recent-decades cultural shifts that can easily explain a rise in depression.

    I wouldn't exactly dispute the gist of your claims, but I think the relevant psychological factor has little to do with your trends.

    People in the past may not have divorced as much, but how much has infidelity actually risen? How much has "kids being raised in broken homes" risen compared to, say, rate of child abuse if you go back more than a couple generations? People used to whip their kids. You had pre-adolescents working in coal mines. Everybody (including kids) used to be basically slightly inebriated most of the time, back when water was frequently unsafe and the carrier of disease... so drunken beatings were pretty much normal.

    Family situations were undeniably a lot worse back in the "good ole days." Even in the 1950s or whatever "golden age" of the American middle class family you might imagine from Leave it to Beaver, a significant number of people were taking some sort of crap for a "pick me up" that we'd conflate with drug use today.

    Main difference: we didn't TALK about this stuff as much, outside of town gossip. We lamented the stories of the folks "on the other side of the tracks," and those people lamented the stories of the REALLY poor folks they knew. Today, we all lament our own situations.

    Or, you talk about leaders as if corruption in politics were new. 'Twas always thus, but perhaps we didn't TALK about it as much.

    Or, you talk about the decline of middle class numbers. Yeah, it's a bad trend. But, if we're going to talk about history, even most "poor" people in a place like the U.S. today are living with conditions leagues ahead of the "middle class" a couple centuries back.

    I'd bet if you took a bunch of middle-class American folk and took them back to the 17th century and let them even lead a reasonably "upper-class" life then, a significant number would just commit suicide within a year... whereas the 17th-century folks were perfectly happy with what they had.

    Why would anyone expect depression rates to go down in an environment like this?

    I wouldn't exactly expect depression rates to go down, but I do think they're rather unpredictable based on objective living conditions of a population. There have been quite a few studies looking at "happiness" in more "primitive" cultures around the world and realizing that satisfaction and happiness have relatively little to do with anything objective, and a lot to do with your own perception of your life and the world around you.

    Your post is a good example of the way narratives of cynicism and outright pessimism have taken over the way many people perceive themselves and their lives today. They turn on the news and they don't hear "Murder rate continues 1000+-year trend downward!" or even that murder rates or child abduction rates or whatever have fallen a lot in the past couple generations. Instead, they hear about bad stuff happening today or this week or this year. CONSTANTLY.

    I am NOT arguing that we just bury our heads in the sand and ignore the news, but there is a lot of truth in the statement "Ignorance is Bliss."

    If you thought about your examples a little more, you'd realize this is even encoded in your own "data." Why do people get divorced so often today, for example? Generally, it's because they claim to be "unhappy," and they think doing something else will make things better. Except the data shows they are MOSTLY WRONG. Divorce rates for second marriages are something like 66%; divorce rates for third marriages are close to 75%.

    If people actually knew what "made them happy" and were capable of seeking it out rationally, the divorce rate should go down with more experience in marriages. Instead it goes up.

    The issue is that people are not objective about their own experiences. They are mostly incapable of making objective assessments of how their sit

  14. Psychiatric medications are awesome by scourfish · · Score: 4, Insightful

    I suffer from anxiety and depression that runs in my family. I used to be afraid to enter a building if there were other people in it, this invisible wall kept me from doing things I enjoyed, and I would often feel worthless, despite having a decent lifestyle with what could only be described as first world problems. Anxiety attacks that felt like either a heart attack or this sense of impending death occured almost every day. These do not occur due to some sort of emotional trigger. I tried exercise, eating healthy, and relaxing. There was some benefit, but nothing that stopped the anxiety attacks. Sertraline has been life changing for me. I'm able to go outside, I'm less nervous in large groups or around strangers, and I'm more accepting of both my gifts and my shortcoming. I haven't had an anxiety attack for years. I don't miss having one. The only major side effect is that I have to pee a lot, and I get nauseous if I miss a dose, but I'm willing to make that trade off. I wish I could go back in time and reclaim 10 more years prior to starting zoloft. I recommend that critics of psychiatric medication watch Stephen Fry's "The Secret Life of a Manic Depressive" or listen to the experiences of people who rely on those medications before making blanket statements of "useless" or some conspiratorial claim.