After the last post, where I pointed out how Big Pharma has completely corrupted modern psychiatry (particularly in the US) and misled millions of people into believing that their brains are ‘broken’, and that only being permanently on the pills can ‘fix’ them, someone tweeted me the following:
“It’s attitudes like yours that are causing the huge rise in suicides.”
Now, I found this tweet odd for a few reasons: Firstly, I wasn’t quite sure what ‘attitude’ my correspondent was referring to. Presumably, it was the ‘attitude’ that refused to buy into the lie that people are permanently ‘broken’ and irredeemably flawed if they have mental and emotional issues.
My attitude on that subject is that everyone can get past mental health issues, albeit with some huge effort, patience, self-love and prayer, and that the main thin causing emotional problems is a broken heart, not a broken brain. And broken hearts can mend, without drugs, once the person affected knows what’s really caused the problem.
The next thing I found strange about the tweet was the suggestion that saying drugs are bad could cause a huge rise in suicides. I haven’t checked the stats recently, but any rise in suicide rates is undoubtedly being mirrored by a similar rise in the number of people being prescribed anti-depressants.
This is one of the things that psychiatrists and drug companies have gone all out to fudge and obfuscate, but anti-depressants can double the risk of someone committing suicide, especially if they’re an adolescent.
Even just chemically-speaking, studies have shown that many anti-depressants cause people to have much stronger suicidal urges than otherwise, and to encourage them to take that final, drastic step towards turning their suicidal thoughts into suicidal actions.
With more people on anti-depressants than ever, if pills really do cure the problem of people’s depression - as the drug companies and the shrinks are lining up to tell us every 5 minutes - then surely the suicide rate should be going down, and not shooting through the roof?
But another reason my correspondent’s tweet was either extremely ignorant or extremely misleading is because the ‘broken brain’ model being peddled by the psychiatric drug dealers is causing so much suffering to so many people, many of whom are mislead into going on to these ‘wonder pills’ to ‘cure’ their problems, only to find over the medium-long-term that their problems have multiplied and worsened.
At this point, they go back for a different, or an additional pill, or they get their dose ‘upped’ - and this continues either until the side- effects become so unpleasant the patient just can’t hack it any more, or they turn into a drugged-up spiritual zombie who doesn’t feel depressed, because they don’t feel anything any more, including any joie de vivre, connection to others, love, appreciation or hope. I.e., all the things that make us feel glad to be alive.
Often at this stage, the patient is told that their depression has become ‘treatment resistant’ - ie, the drugs aren’t helping, and there is nothing more the shrinks can suggest. Clearly, the drugs aren’t helping because they aren’t addressing the true causes of depression in the first place, namely a broken heart, not a broken brain.
At this stage, the poor patient is stuck with worsening symptoms, an addiction to pills, an inability to cope with their worsening situation, and often a huge number of very unpleasant additional physical and mental health issues, that are politely called ‘side-affects’.
If you continued to buy into the ‘broken brain’ paradigm being peddled by the shrinks, this is the point where you’d fall into utter despair and seriously think about ending it all. Mental health issues like overwhelming anxieties and panic are so unpleasant, a person would do almost anything to put an end to their suffering.
But if you knew right from the beginning that your suffering was rooted in traumatic experiences, and / or growing up in an abusive and / or emotionally-neglectful environment - i.e. your heart was broken by the things you’d experienced, and your brain was fine - then that would change the whole picture.
You’d have some hope that things could change. You’d have some motivation to make that happen. You’d be empowered to dig deep, hang on to God, and to face your inner demons head on. In short, you’d have every reason to keep going, and to live.
Giving people hope that they aren’t permanently broken, and that healing is possible without pills, is not causing anyone to kill themselves, quite the opposite. By contrast, telling people they are defective, ‘broken-brained’ people who are permanently disabled and in need of medication for the rest of their lives is guaranteed to cause many, many people to lose the will to live.
So it’s not my attitude problem that’s causing the huge rise in suicides; it’s all those people who continue to peddle false theories of mental health that tells people they have chemical imbalances, broken brains and no hope of improving by themselves, without medication.
A little while ago, I bumped into an old friend of mine from the motherland, who used to be one of the most creative, deep, spiritual and loving people I think I’d ever met. Of course, being ‘deep’ like that doesn’t come easy, especially in today’s world, and this person had gone through a lot of depressive periods and other forms of emotional turmoil.
Depression sucks, and is a very hard situation to accept and deal with. BUT - and it is a big but, depression also comes for a reason, a very good reason, and the key to resolving it is to accept what’s actually triggering it off in the first place, and to take steps to properly deal with it.
Depression is triggered by a couple of things:
There’s just one problem: accepting that your mum / dad / sister / husband etc is the one making you feel like you want to just disappear out of the world for good, or like you don’t exist in the world, and that no-one really loves your or cares about you, is not easy.
In fact it’s usually so difficult to accept that your ‘nearest and dearest’ are literally making you emotionally ill and even suicidal with their emotionally neglectful and / or abusive behaviour, that most people prefer flat-out denial and Prozac.
Thankfully, the pharmaceutical companies and corrupt psychiatry have an alternative theory for depression that is much easier for most people to swallow: it’s just a chemical imbalance, silly! Take this little pill, continue to carry on hanging out with your abusive family members, and don’t worry about a thing!
There’s just one problem with this theory (OK, I’m lying. There’s actually loads of problems with this theory, but I don’t want to get ahead of myself…) - it’s completely false. There’s not a single shred of scientific evidence to back up any claim that any emotional difficulty, from the most severe issues like schizophrenia, all the way through to depression, anxiety and ADHD are caused by any ‘chemical imbalances’.
(There’s so much to say about this issue, and I’ve written about it in more detail elsewhere. Try HERE for a good first place to start, and also use the search box on this site to find more articles on this subject.)
But the point of this post is this: When someone takes a pill, even a prescribed pill, to make their emotional pain go away, then they have become a drug addict. Spiritually, there is no difference between a drug addict who’s shooting up heroin, and a drug addict who’s downing a bottle of Johnnie Walker, or smoking their pot, and a drug addict who’s throwing back the Xanax, Zoloft or Prozac.
Let’s remember that PRESCRIBED DRUGS are killing 30,000 people a year in the US alone, with the late popstar Prince being one of the more recent victims of prescription medicine gone mad.
When I saw my old acquaintance, all the light in her eyes had gone. Even in her worst times, her eyes had shone with pain and sadness, but also with feeling, humanity and spiritual depth. That light now was gone. What had happened?
The answer was: Prozac.
After years of fighting off all the ‘helpful’ advice from other people about how to handle her depressions, she’d finally caved in and gone the drug addict route of dealing with the problem. It was just that much easier than acknowledging how dysfunctional her family life and relationships actually were.
Of course, she didn’t say that. All she said is that the anti-depressants were working a treat, and she felt great, really good, the best ever, actually. But the light was gone from her eyes, and I just couldn’t catch hold of my old friend any more in anything more than the most superficial way.
Because the first thing that disappears when you take pscyhotropic drugs - even prescribed drugs - is your connection to God, and your soul.
But that’s not all: whatever we don’t fix in ourselves simply gets passed on down the line, and compounded, for our kids. When people are drug addicts, they emotionally neglect their nearest and dearest. When people are drug addicts, they become emotionally abusive to others, simply because they’ve lost their normal human sensitivity to what is appropriate behaviour.
As well as the spiritual coldness, my old friend had also developed a mocking manner of speaking to others, too. After five minutes of trying to talk to her, I really just wanted to run away as fast as my legs could carry me, because she made me feel really, really uncomfortable.
Ahhh, what a mess our world is. When God is out of the picture, so much suffering and destruction occurs in the void. My old friend feels ‘great’, but she’s now treating other people like dirt, and is completely oblivious to that fact, because the pills she’s taking have dulled her true feelings, including her empathy and compassion.
Anti-depressants are meant to change how the brain works. That’s the whole point. Changing how the brain works is also a classical description of brain damage, and there we have the problem in a nutshell: anti-depressants cause brain damage, and change people’s personalities.
Not for the first time in my life, I saw how Prozac doesn’t just ‘disappear’ the external signs of depression, it also ‘disappears’ the essence of the person themselves.
But when God is in the picture, it can always come back.
Having a kid tell us that they’re struggling is really hard for a parent to hear. Whether we admit it or not, all of us have a ‘guilt reflex’ that kicks in, and starts blaming us for the problem (and it’s often right - but more on that in a moment).
The trouble is, that then means that we want to shut down the cause of the pain and discomfort and guilt we’re feeling, which often means that subtly or otherwise, we give our kids signals to shut up and go away. That only has to happen a few times, before our kids give up on telling us things that we may find upsetting, or letting us into their inner lives.
When this becomes the ‘norm’ for the parent / child relationship, it can cause so much destruction, loneliness and heartache.
But this happens to even the best of parents, sometimes.
The parental guilt reflex is very strong in most of us, because on some level, we know that we affect our kids’ wellbeing and happiness more than anything or anyone else.
So now, let’s take a deeper look at what’s really going on here, and see if we can come up with some useful guidelines for how to really help our depressed children.
Adults are adept at hiding their true feelings, especially in the west where emotions have been pathologised. That’s why sometimes, God uses our kids to send us messages about where we’re really holding that we often don’t want to look at, accept or consider.
So the first thing to check is: which parent might also be depressed, and why?
Once the parent starts working on their own emotional issues, the issues tend to clear up really fast in their kids, too.
2. Find out why the kid feels depressed
Again, this bit can be SO hard, because of the parental guilt reflex. If you feel you’re going to blow up at your kid, get hyper-defensive, feel anger or crippling guilt, then you may need to enlist someone with more objectivity and perspective to do this part of the process.
But people usually feel depressed because they feel that what they think and feel doesn’t count, or that they’re worthless, or that no-one really cares about them - which are all REALLY hard things for even the most caring parent to hear!
Yet giving the child a chance to express themselves truthfully - and to say even the icky things that no parent wants to hear - without being attacked or ‘punished’ for expressing themselves, is a crucial part of the healing process.
Most of us can’t handle that so well (especially if the guilt reflex is kicking in, and we feel on some level the kid may actually be right.)
But for the child’s own mental health, they need to be able to express themselves truthfully, in a loving, 100% accepting atmosphere. If the parent can’t provide that (and hey, that’s OK to admit) - then find a good counsellor or friend WHO IS NOT GOING TO PUSH YOUR KID DOWN THE ANTI-DEPRESSANT ROUTE.
That last part is crucial.
No chemical imbalance has ever been found to cause depression, or any other mental illness, despite it being such a popular ‘theory’ of psychiatrists (who make most of their income from their exclusive ability to prescribe psychotropic drugs for mental illnesses.)
When kids get pushed onto anti-depressants to ‘make their problems go away’, instead of being encouraged to really speak out what they truly feel, and to re-connect to their families, and to deal with their negative emotions in a productive way, it’s setting them up for a lifetime of worsening mental and physical health issues.
I’m including some research articles, plus one documentary (bottom link) that you may want to check out for yourself:
Negative Effects of Antidepressants | Mad in America
Depression Screening in Children is Not Supported by Research
Antidepressants Often Prescribed to Enforce Heteronormativity
Depression Pills Made Me Unfit To Be A Mother
3. Don’t feel you have to ‘fix’ the problem immediately
Oftentimes, we parents feel as though we have to try and ‘fix’ our kids issues, or even prevent them from having issues in the first place.
While it’s understandable and well-intended, this approach actually does far more damage than good. Life is full of issues, and ups and downs, and negative emotions, and less-than-ideal responses.
When we send our kids a message that they ‘can’t’ be depressed, or that they have huge issues if they feel down, or that their ‘brain is broken’ (i.e. they have a chemical imbalance), we’re piling on guilt, anxiety and worry onto an already crowded platform of negative feelings.
The truth is: we all feel depressed sometimes. That’s part of life.
If the parent is operating from their own guilt reflex, then even without realising it their main focus will be on getting the problem to ‘go away’ ASAP (which is why medication also sometimes looks so darned appealing). But especially with depression, that’s only going to make things worse.
Instead, if we encourage our kid (and ourselves), and we do the work to find out what’s really triggering it, and what ‘message’ we’re being given via our negative emotions and depression about what needs to be looked at, changed or improved in our lives, then we’re teaching our children a magnificent lesson in how to stay mentally and emotionally healthy over their lifetime.
People with depression need to be empowered, in some way, to stop feeling like helpless ‘victims’ of circumstance. A key way to do that is to help them figure out WHO or WHAT is causing them to feel that way in the first place, and then to figure out how that scenario can be changed or improved.
4. Make sure the physical side of things is covered
If your child isn’t exercising enough, not sleeping enough, not eating enough of the right sort of food (around their inevitable intake of junk food…) - then that can also seriously contribute to feeling depressed.
Again, the mirroring principle will probably kick in here again, and you may want to consider if the parents are also sleeping enough, eating right and getting enough exercise.
30 minutes of exercise, three times a week, is scientifically proven to be more effective at overcoming depression, permanently, than medications.
Vitamin B12 is also a biggy, for overcoming depression (and a bunch of other mental illnesses…)
Vitamin B12 Deficiency and Brain Health | Blog | Kelly Brogan MD
5. Like yourself
This bit is also really crucial, both because your kid is just your mirror, spiritually-speaking, and also because if you don’t like yourself, your guilt reflex will kick-in big time and will skew your parenting response in a way that’s very unhelpful to both you and your kid.
Tell yourself: “I am doing the best I can!”
Also accept that sometimes, that best really isn’t very good (and that’s true for all parents, even the best ones, because none of us are angels.)
When we parents like ourselves more, and we know that we really aren’t trying to hurt our kids on purpose, or mess them up (even though of course that’s happening a lot…), then we are much gentler and forgiving with ourselves - and also with our kids.
We’re in this process called ‘life’ together. The more we can see that we’re good, the more we’ll also see the good in our kids, which is probably the single biggest ‘key’ to ensuring their mental health and wellbeing.
Dear reader, you’re a great mum or dad!
We’re all down here to work on ourselves and to fix ourselves, and the parents who can admit that they’re flawed, and struggling, and (at least occasionally…) ‘wrong’ are the ones that paradoxically raise the happiest and healthiest kids.
My kids know I am a really rubbish parent in a myriad of ways. They also know that I try my best, and often fail. They also know that I really love them. They also know that I’m (occasionally…) selfish, self-absorbed, mean, lazy, clueless [fill in the blank].
When I can fix this stuff, I do.
When I can’t, I try to apologise, and ask God to help me fill in the bits that are missing (and believe me, there’s a lot).
So it’s crucial to like yourself so that you know that even if your kid needs to say something ‘icky’ to you, in order to clear things up and get back on an even keel, or even if there’s stuff that needs improving or fixing, or even if you yourself have been struggling emotionally, that you are still a great person, and it’s not the end of the world.
That’s the single biggest present you could give yourself, and your children.
TO SUM UP:
Check out my book: Causes and Cures of Depression
It's easy to think that the Diagnostic and Statician's Manual (DSM) (published by the American Psychiatric Association (APA)) has become so refined, polished and researched, that when it comes to defining, diagnosing and treating mental illness, there is simply no other game in town.
But actually, as the DSM has evolved - and created hundreds more new 'disorders' with each iteration - the criticism of the DSM within the mental health community itself has actually reached gigantic proportions.
Below, I’m bringing open letters from:
1. The British Psychiatry Society (BPS) - complaining of the ‘continuous medicalisation of…natural and normal responses to [patients'] experiences.’
2. Thomas Insel, director of the National Institute of Mental Health (NIMH) in the US, who actually states that the NIMH can no longer support the diagnoses and diagnostic criteria being put forward in the DSM-5.
In that far-off time when transparency and honesty was more apparent in the hallowed halls of psychiatry, the APA itself, in the foreword to the Diagnostic and Statistical Manual of Mental Disorders (DSM) III in 1980, stated that the diagnostic system the manual contained was imprecise, and should never be used for forensic or insurance purposes.
Another leading voice in the field of psychiatry, Bessel Van Der Kolk, had this to say about the DSM 5:
“With DSM 5, psychiatry firmly regressed to early nineteenth century medical practice. Despite the fact that we know the origin of many of the problems it identifies, it’s ‘diagnoses’ describe surface phenomena that completely ignore the underlying causes.”
The main problem is that psychiatry, as defined by the DSM 5, has thrown all of its weight behind the canard that ‘chemical imbalances’ are causing mental illnesses, despite the fact that no scientific evidence proving this has ever been put forward, despite 30 years’ of research.
It remains an unproven theory of mental illness, and one that the pharmaceutical companies have been exploiting ruthlessly, because if you can pretend that a mental illness is caused by a ‘chemical imbalance’, then you can also pretend that you can manufacture a pill to ‘cure’ the problem.
The real issue causing mental illnesses is trauma, and particularly, the trauma children experiences when they are abused, neglected, ignored, or otherwise not cared for by their parents or other main caregivers.
But there are two big obstacles preventing this information about what's really causing mental illness from being widely accepted, and properly dealt with, namely:
MONEY - the APA is estimated to have made $100 million from sales of the DSM, which is currently retailing for a whopping $144 over on Amazon.
But that's just the tip of the iceberg: The disorders put forward in the DSM for the most part rely very heavily on the unproven notions of 'chemical imbalances' causing the issues, and drugs being the solution to the problem.
Psychiatrists are the only people in the mental health field who can prescribe psychotropic medications for patients, hence, if the 'drug-solution' model was abandoned, most people would have absolutely no reason to visit an expensive psychiatrist, and would probably prefer a cheaper (and probably much friendlier and more effective...) therapist.
PARENTS DON'T WANT TO ACCEPT HOW MUCH RESPONSIBILITY THEY REALLY HAVE FOR THEIR CHILDREN'S WELFARE AND HAPPINESS
It's much easier for all of us to pretend that hitting and yelling at our kids, or preferring Facebook and online pursuits to spending quality time with our children, really doesn't impact them as much as it does.
It's much easier for all of us to pretend that mental illnesses and depressed, unhappy children are caused by faulty genes or bad wiring in the brain, and nothing to do with how badly they're often treated by us, their parents, and the other people in their lives.
But while believing that lie is definitely MUCH easier for the grown-ups, it makes things so much harder for the kids themselves. Why? Because instead of taking the onus off them for why they're so messed up and acting out, it labels them as 'defective' people with broken brains, and lets the people who actually really caused the problem - normally the parents - completely off the hook.
And if that's not guaranteed to make a person crazy and depressed, then I don't know what is.
As always, there's more to say on this topic, but for now, here's the text of the two open letters criticising the DSM-5:
OPEN LETTER FROM BPS criticizing the DSM 5: (emphasis mine)
“The Society is concerned that clients and the general public are negatively affected by the continued and continuous medicalisation of their natural and normal responses to their experiences; responses which undoubtedly have distressing consequences which demand helping responses, but which do not reflect illnesses so much as normal individual variation.
We therefore do welcome the proposal to include a profile of rating the severity of different symptoms over the preceding month. This is attractive, not only because it focuses on specific problems (see below), but because it introduces the concept of variability more fully into the system.
That said, we have more concerns than plaudits. The putative diagnoses presented in DSM-V are clearly based largely on social norms, with 'symptoms' that all rely on subjective judgements, with little confirmatory physical 'signs' or evidence of biological causation. The criteria are not value-free, but rather reflect current normative social expectations.
Many researchers have pointed out that psychiatric diagnoses are plagued by problems of reliability, validity, prognostic value, and co-morbidity. Diagnostic categories do not predict response to medication or other interventions whereas more specific formulations or symptom clusters might (Moncrieff, 2007).
Finally, disorders categorised as ‘not otherwise specified’ are huge (running at 30% of all personality disorder diagnoses for example). Personality disorder and psychoses are particularly troublesome as they are not adequately normed on the general population, where community surveys regularly report much higher prevalence and incidence than would be expected.
This problem – as well as threatening the validity of the approach – has significant implications. If community samples show high levels of ‘prevalence’, social factors are minimised, and the continuum with normality is ignored. Then many of the people who describe normal forms of distress like feeling bereaved after three months, or traumatised by military conflict for more than a month, will meet diagnostic criteria.
In this context, we have significant concerns over consideration of inclusion of both “at-risk mental state” (prodrome) and “attenuated psychosis syndrome”. We recognise that the first proposal has now been dropped – and we welcome this. But the concept of “attenuated psychosis system” appears very worrying; it could be seen as an opportunity to stigmatize eccentric people, and to lower the threshold for achieving a diagnosis of psychosis.
Diagnostic systems such as these therefore fall short of the criteria for legitimate medical diagnoses.
They certainly identify troubling or troubled people, but do not meet the criteria for categorisation demanded for a field of science or medicine (with a very few exceptions such as dementia.)
We are also concerned that systems such as this are based on identifying problems as located within individuals. This misses the relational context of problems and the undeniable social causation of many such problems. For psychologists, our wellbeing and mental health stem from our frameworks of understanding of the world, frameworks which are themselves the product of the experiences and learning through our lives.
DSM-5 2011 British Psychological Society response, June 2011 Page 3 of 26:The Society recommends a revision of the way mental distress is thought about, starting with recognition of the overwhelming evidence that it is on a spectrum with 'normal' experience, and that psychosocial factors such as poverty, unemployment and trauma are the most strongly-evidenced causal factors.
Rather than applying preordained diagnostic categories to clinical populations, we believe that any classification system should begin from the bottom up – starting with specific experiences, problems or ‘symptoms’ or ‘complaints’. Statistical analyses of problems from community samples show that they do not map onto past or current categories (Mirowsky, 1990, Mirowsky & Ross, 2003).
We would like to see the base unit of measurement as specific problems (e.g. hearing voices, feelings of anxiety etc)? These would be more helpful too in terms of epidemiology. While some people find a name or a diagnostic label helpful, our contention is that this helpfulness results from a knowledge that their problems are recognised (in both senses of the word) understood, validated, explained (and explicable) and have some relief. Clients often, unfortunately, find that diagnosis offers only a spurious promise of such benefits.
Since – for example – two people with a diagnosis of ‘schizophrenia’ or ‘personality disorder’ may possess no two symptoms in common, it is difficult to see what communicative benefit is served by using these diagnoses.
We believe that a description of a person’s real problems would suffice. Moncrieff and others have shown that diagnostic labels are less useful than a description of a person’s problems for predicting treatment response, so again diagnoses seem positively unhelpful compared to the alternatives.
There is ample evidence from psychological therapies that case formulations (whether from a single theoretical perspective or more integrative) are entirely possible to communicate to staff or clients.
We therefore believe that alternatives to diagnostic frameworks exist, should be preferred, and should be developed with as much investment of resource and effort as has been expended on revising DSM-IV. The Society would be happy to help in such an exercise.”
Director’s Blog: Transforming Diagnosis
By Thomas Insel on April 29, 2013
In a few weeks, the American Psychiatric Association will release its new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This volume will tweak several current diagnostic categories, from autism spectrum disorders to mood disorders. While many of these changes have been contentious, the final product involves mostly modest alterations of the previous edition, based on new insights emerging from research since 1990 when DSM-IV was published. Sometimes this research recommended new categories (e.g., mood dysregulation disorder) or that previous categories could be dropped (e.g., Asperger’s syndrome).1
The goal of this new manual, as with all previous editions, is to provide a common language for describing psychopathology. While DSM has been described as a “Bible” for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has
been “reliability” – each edition has ensured that clinicians use the same terms in the same ways.
The weakness is its lack of validity.
Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever. Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment.
Patients with mental disorders deserve better. NIMH has launched the Research Domain Criteria (RDoC) project to transform diagnosis by incorporating genetics, imaging, cognitive science, and other levels of information to lay the foundation for a new classification system. Through a series of workshops over the past 18 months, we have tried to define several major categories for a new nosology (see below). This approach began with several assumptions:
· A diagnostic approach based on the biology as well as the symptoms must not be constrained by the current DSM categories,
· Mental disorders are biological disorders involving brain circuits that implicate specific domains of cognition, emotion, or behavior,
· Each level of analysis needs to be understood across a dimension of function,
· Mapping the cognitive, circuit, and genetic aspects of mental disorders will yield new and better targets for treatment.
It became immediately clear that we cannot design a system based on biomarkers or cognitive performance because we lack the data.
In this sense, RDoC is a framework for collecting the data needed for a new nosology.
But it is critical to realize that we cannot succeed if we use DSM categories as the “gold standard.”2 The diagnostic system has to be based on the emerging research data, not on the current symptom-based categories. Imagine deciding that EKGs were not useful because many patients with chest pain did not have EKG changes.
That is what we have been doing for decades when we reject a biomarker because it does not detect a DSM category. We need to begin collecting the genetic, imaging, physiologic, and cognitive data to see how all the data – not just the symptoms – cluster and how these clusters relate to treatment response.
That is why NIMH will be re-orienting its research away from DSM categories.
Going forward, we will be supporting research projects that look across current categories – or sub-divide current categories – to begin to develop a better system. What does this mean for applicants? Clinical trials might study all patients in a mood clinic rather than those meeting strict major depressive disorder criteria.
Studies of biomarkers for “depression” might begin by looking across many disorders with anhedonia or emotional appraisal bias or psychomotor retardation to understand the circuitry underlying these symptoms. What does this mean for patients? We are committed to new and better treatments, but we feel this will only happen by developing a more precise diagnostic system. The best reason to develop RDoC is to seek better outcomes.
RDoC, for now, is a research framework, not a clinical tool. This is a decade-long project that is just beginning. Many NIMH researchers, already stressed by budget cuts and tough competition for research funding, will not welcome this change. Some will see RDoC as an academic exercise divorced from clinical practice. But patients and families should welcome this change as a first step towards "precision medicine,” the movement that has transformed cancer diagnosis and treatment.
RDoC is nothing less than a plan to transform clinical practice by bringing a new generation of research to inform how we diagnose and treat mental disorders. As two eminent psychiatric geneticists recently concluded, “At the end of the 19th century, it was logical to use a simple diagnostic approach that offered reasonable prognostic validity. At the beginning of the 21st century, we must set our sights higher.
It's amazing how many people's lives are being ruined by the indiscriminate prescription of addictive medications. The story you're about to read is straight from the horse's mouth, and was written by a brave individual who hopes to save others the heartache and suffering she and her family endured, when her husband was prescribed benzos without any warning or advice from the doctors about how addictive and 'bad' they could be, long-term.
This is the story of how my husband went from being an extremely healthy, happy person (the sort who drinks spinach / flaxseed shakes for breakfast, who never even takes Tylenol, who is an athlete, extroverted and outgoing), to a different person, anxious and addicted to prescription pills.
One day, he got a phone call: “Due to "corporate restructuring", your department is being eliminated. We’re so sorry, but we'll send the details re. compensation, etc." It was as if the floor had suddenly vanished, leaving my husband lying flat on his back, wondering what had just happened.
Over the next few months, my husband and I went through six different stages, in dealing with the fall-out:
Stage 1: Disbelief.
"What do you mean, fired? You're upper management! You've been there 15 years!".
It felt like a game show or Candid Camera prank ... this couldn't be real.
Stage 2: Shock, insomnia. Not knowing what to do. Sitting on the couch, staring at nothing.
Instead of regrouping, thinking about updating the resume and networking, he could not process what happened. People were calling, stopping by, reaching out to help, but he would look at them, dazed, as if seeing them for the first time. He developed a tremor in his hand, and was unable to sleep more than 3 hours a night.
Stage 3: Anxiety, depression.
Lack of sleep began to have severe effects. We went to our family doctor for sleeping pills, trying a few before finding one that helped.
Even with better sleep, however, he was not the same. He felt so lost. I spent time online, and discovered that sudden job loss ranked as one of the top four life stresses (after death, divorce and serious illness).
Most people in this situation begin to recover from the shock after a few weeks of it "sinking in," but that did not happen. Instead, he began to slide into a depressed state. In over 20 years of marriage, I think the last time I can recall my husband crying was on 9/11. Now, it was becoming a near-daily occurrence.
Stage 4: ‘Professional’ help.
Our doctor recommended a psychiatrist. For the first visit, I went along, as my husband felt too anxious to drive. Out of desperation he agreed to begin taking pills for anxiety and depression. We toyed around with dosage, until finding what seemed to help.
Stage 5: Side effects.
We were completely unaware at the time of the addictive nature of the drugs (benzodiazepenes) that had been prescribed for my husband. We assumed the doctor would only prescribe what was safe.
However, my husband was on the meds for a few months, not short term. We were uninformed about how addictive it would be, and the side effects. He began getting terrible headaches every day, which he described as a clamp being squeezed around the front of his head. He was jittery and forgetful. He felt his heart beating very rapidly at times.
After four months of this, he decided he wanted off. The crying spells had greatly lessened, but the strong feeling of pressure in his head all day long was driving him crazy. He was at this point going on job interviews, yet feeling unable to concentrate or focus.
Stage 6: Talking to God
I suggested to my husband that he should maybe try talking to God. He is a logical, rational sort, so the idea of "talking to G-d" as one would speak openly with a dear friend, did not appeal to him at all
Still, I would read to him every day from a book called ‘The Garden of Emuna’, about how everything that happens to us, happens for a reason. Even when is seems to make no sense. Even if it causes suffering. Not only that, but it is all for our ultimate benefit. God knows what’s best for us, and we should not only accept it, but thank Him for it, since it is ultimately for our benefit.
That got my husband's attention:
"Are you suggesting that I actually thank God for being fired?" he asked, incredulous.
When I nodded, he continued. ..
"Okay. I'll try that. Thank you, God, for giving me this long unemployment. Thanks for taking away the job I loved, our main source of income. Thanks for giving me a psych doctor that is so expensive, we have to pay for it out of our savings. Thank you for the pills. Thanks for turning my life upside-down and causing me to feel the absolute worst I have ever felt. Thank you for the feeling that my skull is bring crushed by a giant clamp. Thank you for making me a total, good for nothing, pathetic loser who can't support his family. There. How's that? Did I get everything?"
Eventually, it occurred to my husband that he had nothing to lose by talking to God, so he started doing it every day, and even wrote out his own little script.
Aside from personal prayer, we realized that he must get off of the medications, whose side effects were becoming debilitating.
What I most want to convey to others who might be in this situation, is that certain meds are highly addictive, and the withdrawal symptoms can be brutal.
The horrible headaches my husband suffered for months when lowering doses to withdraw, were overwhelming. He’s an experienced marathon runner, and very in tune with his body. To feel like his brain was not under his control was disturbing. He has a high tolerance for pain and discomfort, but the crushing pressure in his head was unlike anything he'd ever felt.
I hope anyone who is prescribed a benzodiazapene drug will do their research, and be aware of the side effects. Know that they are highly addictive, and withdrawal can be very difficult.
Even though my husband was on a low dose, and followed a slow-tapered withdrawal, he had a hellish time. In retrospect, I wish we had taken a non-addictive sleeping pill, and known about the dangers of the drugs he was prescribed.
I cannot speak for everyone who is on these benzodiazepine drugs. Every situation is different. I will only will say, we would NEVER have gone that route, if we had known beforehand about the strong the side effects, and how terrible the withdrawal experience would be. I can understand why many people get stuck taking these pills for the rest of their lives, now that I see firsthand how hard it is to successfully stop taking them.
In the end, thank G-d, he was able to wean off of the medication, and return to his regular self. I should say a newer, improved version of himself - one with a heightened sense of gratitude for good health, and family. He has kept talking to God as part of his life. Has found a new job that, in hindsight, he likes better than the old one.
Though it was an extremely difficult journey that stretched the better part of a year, I am grateful to say he is out of the tunnel now, out of the darkness, and standing once again in the daylight. Looking back, we realize that God had a plan. We only needed to trust Him.