One Psychiatric Diagnosis for Each Year

Jacob Sullum | February 15, 2007

It's not clear what role Michael and Carolyn Riley played in the death of their 4-year-old daughter, Rebecca, who overdosed on a combination of psychiatric drugs in December. I don't know whether the criminal charges against them are justified. But surely they bear some culpability for going along with the psychiatrist who confidently diagnosed Rebecca at the age of 2 with "attention deficit disorder" and "bipolar disorder," prescribing the drugs that ultimately killed her: "Seroquel, an antipsychotic drug; Depakote, an equally powerful mood medication; and Clonidine, a blood pressure drug often prescribed to calm children." Let's accept, for the sake of argument, that both attention deficit disorder and bipolar disorder are bona fide brain diseases caused by chemical imbalances that can be corrected with drugs. How can anyone possibly tell, by observing and interviewing a toddler, that she is suffering from these conditions? Because she has a short attention span and goes through mood swings? Tufts-New England Medical Center, where Rebecca was treated, is backing the doctor who made these diagnoses, declaring the care she received "appropriate and within responsible professional standards."

Comments

|2.15.07 @ 6:31PM|#

Ooooh fuck. The Scientologists and the worshipers of Szasz are going to have a field day with this.

|2.15.07 @ 6:36PM|#

Sad, just sad.

|2.15.07 @ 6:50PM|#

Hyperactivity can be diagnosed in very young children -- two's a bit young, but at least by age four. And while I have no doubt there are people that wish to drug their precious little angel to keep them from being too big a hassle, a truly hyperactive toddler is a serious problem.

ADD is seperate from hyperactivity, although the two often go together. (You can be hyperactive without having an attention problem, and vice versa).

I've yet to meet a professional that would diagnosed ADD in someone that young -- you really can't do the standard tests until they're about 6 or 7. I have no idea about bi-polar.

Although I will note this: Showing ADHD is a bona fide chemical imbalance is easy. If I were to take ritalin, I'd get seriously hyper and be unable to focus. It's basically speed, after all. Given to someone with ADHD, they calm down and have much better focusing abilities.

To be honest, the easiest test for ADHD is to dose someone and see how it works. Psychatrists frown on that, so they have a battery of tests for children that measure their ability to concentrate against a known baseline. Those tests tend to require kids to be at least 6 or 7, since younger kids really aren't mentally developed enough to do their end of the test.

Single Issue Voter|2.15.07 @ 7:01PM|#

Hyperactivity can be diagnosed in very young children.............

So are you saying it is a "disease" that can be
"treated" with drugs?

|2.15.07 @ 7:03PM|#

I not only agree with, but fear, that Akira's comment will be prescient.

One of the few times I'll ever agree with Akira, but I look to the Szasz psychiatric denying pigfuckers to inundate this thread with their nonsense. They can all feel free to read this comment and fuck off, but Idoubt that'll happen.

|2.15.07 @ 7:05PM|#

"Although I will note this: Showing ADHD is a bona fide chemical imbalance is easy. If I were to take ritalin, I'd get seriously hyper and be unable to focus. It's basically speed, after all. Given to someone with ADHD, they calm down and have much better focusing abilities."

The preceeding paragraph is complete and unadulterated bullshit. In no way does the above comment comport to any semblance of reality.

Just thought y'all should know.

Single Issue Voter|2.15.07 @ 7:13PM|#

jf,

You seem to have "issues" Perhaps you should double up on your meds.

You don't have to be a Scientology nutcase or a reader of Dr Szasz to realise that giving small children heavy Psych meds is dangerous and abusive. Read the Docs quoted in the NYTs article.

|2.15.07 @ 7:22PM|#

Well, if one person's brain responds to a chemical in one way, and another person's brain responds to the same dose of the same chemical in another way, then I'm gonna go out on a limb and hypothesize that there might be some sort of biological difference between those brains.

And if these differences happen to be correlated with certain behaviors, behaviors that make healthy and productive function and interaction more difficult, then I'm going to go out on a limb and hypothesize that the differences in question might actually be a disease.

|2.15.07 @ 7:23PM|#

BTW, none of what I just wrote should be construed as support for giving dangerous doses of a medication to a small child. I was addressing the tangent that the thread has already veered onto, not the specific case that started the thread.

|2.15.07 @ 7:26PM|#

SIV,

I do not argue that giving meds to kids under the age of 4 (or, frankly, 9 or 10 for that matter), is an overreach of psychiatry bordering on quackery or malpractice. I'm just agreeing that Akira is correct that the Szasz fanatics who deny any benefit to psychiatry will be showing up en masse once this thread escapes into the blogosphere.

|2.15.07 @ 7:28PM|#

BTW, 500 mgs/day of Depakote combined with 1500 mgs/day of Omega-3 have made me feel the best I have since I was a teenager. I'll admit my stake in disputing the Szaszist/scientologist viewpoint, because it's there.

|2.15.07 @ 7:34PM|#

I'm sure this 4 year old's parents have amazing people skills.

Single Issue Voter|2.15.07 @ 7:36PM|#

jf,

I am showing quite a bit of restraint as you have already called me a "pigfucker" and told me to "fuck off". Have you read Dr Szasz?
He has no problem with voluntary Doctor/Patient
relationships.

As for the original post I would hold the parents just as responsible as if they had taken their child to a faith healer or an exorcist with similar fatal results.

|2.15.07 @ 7:37PM|#

And if these differences happen to be correlated with certain behaviors, behaviors that make healthy and productive function and interaction more difficult, then I'm going to go out on a limb and hypothesize that the differences in question might actually be a disease.
================================
So, since not all brains react the same way to chemicals, the ones that are somewhat outside the norm are diseased?

Wait, what's the norm?

|2.15.07 @ 7:44PM|#

SIV,

I'm sorry, I missed your non-obvious endorsement of (to quote myself) "Szasz psychiatric denying pigfuckers". If you are one of them, perhaps you should walk a mile in the shoes of someone dealing with a psychiatric illness, and tell someone (me, perhaps) that the recovery they have experienced is illusory, just like the actual illness was.

Single Issue Voter|2.15.07 @ 7:47PM|#

jf,

I'm a libertarian-I don't care if you take PCP
and smoke Crack if it makes you feel better.

I quickly googled Depakote- as it is indicated for treatment of epilepsy and migraines it has utility in treating "real" brain diseases.
(not saying whatever you have isn't real)

I take issue with dosing children with dangerous drugs for poorly defined behavioral "illness" that presents no pathology. The child in question was not able to give consent and IMO the parents, at best, abdicated all responsibility.

|2.15.07 @ 7:52PM|#

Allow me to quote from Dr. Szasz himself:

:That the claim that "mental illnesses are diagnosable disorders of the brain" is a lie ought to be evident to anyone who thinks for himself. Here I want to show that the claim that "research in the last decade proves [this]" is also a lie, one more in a very long list in the history of psychiatry. The contention that mental illness is brain disease is as old as psychiatry itself: it is an integral part of the grand lie that psychiatry is a branch of medicine and healing, when in fact it is a branch of the law and social control. Hannah Arendt was right when she observed: "There are no limits to the possibilities of nonsense and capricious notions that can be decked out as the last word in science."

I can give you link upon link of evidence to dispute this, if you desire, from the experiences of both the provider and the client.

|2.15.07 @ 7:54PM|#

SIV,

Don't forget that I completely agree with you that giving mind- and mood-altering drugs to children is reprehensible. I don't think I've given any indication that I believe otherwise.

|2.15.07 @ 8:03PM|#

I am no Szasz fanatic, heck, I'm not even that familiar with him, but jf, would Szasz obect in any way to you ingesting the drugs that you wish to ingest?

Single Issue Voter|2.15.07 @ 8:03PM|#

jf,

You should read Szasz in context-not excerpts.
I'm not going to begin explaining it in a blog comment.
I will point out he rejects the concept of provider/client as a linguistic distortion, prefering the traditional terminology-and relationship- of Doctor/Patient.

karen marie|2.15.07 @ 8:03PM|#

the doctors who prescribed these drugs are as "responsible" as the doctors who prescribed drugs to anna nicole smith. and to elvis presley. have a naming festival.

excuse me while i go swallow some xanax.

|2.15.07 @ 8:14PM|#

She was lying on her side, in a pink diaper, the police said, sprawled across some discarded magazines and a stuffed brown bear.

Am I the only parent here who finds it odd that a 4yo was diapered? Maybe it is nothing, but the strong meds and lack of potty training make me think lazy parents.

uncle sam|2.15.07 @ 8:34PM|#

Szasz is a psychiatrist after all.

|2.15.07 @ 8:44PM|#

Calling Bill Frist, Calling Bill Frist, long distance medical evaluation needed right away.


Oops, scratch that, the Hit and Run commenters have the situation covered.

|2.15.07 @ 8:46PM|#

This is so sad. That poor, poor little girl.

I also agree with the comments above that the only people to benefit from this nightmare are the Scientologists. My own father is a decent human being largely because of Paxil, which controls his very severe depression. My husband's nephew just started Ritalin, and it's made a truly astonishing difference in his personality. Granted that psych meds, just like any other chemical on Earth, can be misused, the benefits so outweigh the costs. I really hate to think that this will give attention to those who only seek to increase the world's store of misery.

|2.15.07 @ 9:00PM|#

Disclaimers:

1) A 2 year old with emotional problems is normal. Meds aren't a good idea at that age for neurological conditions that don't show physical symptoms.

2) Consenting adults have the right to take whatever mind altering drugs they want.

Thoreau,

"Well, if one person's brain responds to a chemical in one way, and another person's brain responds to the same dose of the same chemical in another way, then I'm gonna go out on a limb and hypothesize that there might be some sort of biological difference between those brains.

And if these differences happen to be correlated with certain behaviors, behaviors that make healthy and productive function and interaction more difficult, then I'm going to go out on a limb and hypothesize that the differences in question might actually be a disease."

This experiment could be informative, but I don't think it is done. I've only read around a dozen academic psychiatry articles, but all of them show a control group of patients already in psychiatric programs who don't get the drug and an experimental group of patients already in psychiatric programs who do get the drug. This makes it impossible to separate underlying biological causes of behaviors from a confirmational bias in interperating the behaviors of psychiatric patients as symptoms. The stereotypes associated with a psych lable also cause some of the symptoms, such as employment difficulties, since some employers go ape when they discover an employee's lable.

If you can show me an experiment where psychiatric patients are given meds and random people off the street are given meds as a control, I would be very interested in reading it. Until then, I remain skeptical.

Still, regardless of how convenced or skeptical I am, each patient should be able to decide for himself.

|2.15.07 @ 9:09PM|#

To quote Jacob Sullum's interview with Szasz (and risk be once again accused of taking him out of context:

Reason: In the 1960s people like R.D. Laing and Michel Foucault agreed with you that psychiatry was a form of social control, a way of stigmatizing and punishing unwanted behavior in the guise of therapy. Both of them identified themselves as men of the left, whereas you allied yourself with classical liberalism. What would you say are the basic differences between their views on psychiatry and yours, and how are those related to political ideology?

Szasz: Although we agreed on the criticism of traditional psychiatry, they somehow never made it clear that bodily diseases--pneumonia, cancer, and so on--are real, but mental diseases are metaphoric diseases, in the sense of a "sick" joke. They are problems, but they are not medical problems in that they do not involve somatic, organic etiologies and are not amenable to a somatic, organic resolution. They are essentially conflicts within oneself and conflicts between oneself and other people. So that would be the first distinction.

Thousands upon thousands of people have been treated, and even cured using "somatic, organic resolution(s)." Szasz is complaining that treating disorders like depression and bipolar disorder pharmacologically is the equivalent of treating blood diseases with leeches.

|2.15.07 @ 9:19PM|#

Doctor, my first trimester fetus doesn't really seem focused on this pregnancy. Anything you can give him?

|2.15.07 @ 9:38PM|#

I agree with miche. There was something wrong here altogether, not just whether or not the child needed or should be prescribed those meds.

I know people who have been diagnosed as bipolar who are on meds and some off. Same with kids I grew up with who were called ADD, with results running the gamut. So my opinion is based on that and the little more medical reading I've done - medical treatment for behavior is a very individual thing and not simple, so I really hate to see a case like this be a reason to go either way on whether or not to medicate.

Single Issue Voter|2.15.07 @ 9:45PM|#

jf,

Well at least you found the "mental illness as metaphor" part.

So would you consider Rebecca Riley now "cured"?

That "chemical imbalance" or "bi-polar" will not be measurable in her blood or spinal fluid- the pathologist won't find it in the autopsy.
The "disease" has no pathology.

|2.15.07 @ 9:50PM|#

The baby's doctor was Asian. I bet the diagnostic criteria was that she wasn't playing violin yet.

Morat20 writes: "Psychatrists frown on that, so they have a battery of tests for children that measure their ability to concentrate against a known baseline."

Including the world's most boring computer game!

jf writes: "Szasz is complaining that treating disorders like depression and bipolar disorder pharmacologically is the equivalent of treating blood diseases with leeches."

He's like a man born a few decades pre-penicillin who becomes a doctor and spends the rest of his life decrying how medicine is a sham with no effective treatments for simple infections.

|2.15.07 @ 9:57PM|#

jtuf writes: "If you can show me an experiment where psychiatric patients are given meds and random people off the street are given meds as a control, I would be very interested in reading it. Until then, I remain skeptical."

One of the diagnostics for ADHD is, as I mention above, the world's most boring computer game, which measures your reaction time and your false positive/false negative errors. It periodically flashes a rectangle on the screen, with a small rectangle inside it; if the small rectangle is in the top of the larger rectangle, you push a button; if it is in the bottom, you don't push the button.

It then does some statistical calculations and compares your numbers against a scale presumably derived from putting lots of normal and add people through the program.

One thing that the physician can do is to have the patient come back and retake the test on meds, and compare the numbers. The 'game' is so simple and random there probably isn't any learning involved.

Nowadays, though, there are less blunt research tools, such as PET scans, which have shown small but real physical, structural differences between the brains of people with ADD and 'norms'.

|2.15.07 @ 10:01PM|#

"So would you consider Rebecca Riley now "cured"?"

Nice, basing a point on a clear case of malpractice.

How about a real case of bipolar?

|2.15.07 @ 10:03PM|#

"I will point out he rejects the concept of provider/client as a linguistic distortion, prefering the traditional terminology-and relationship- of Doctor/Patient."

So give him a cookie. Who cares?

|2.15.07 @ 10:17PM|#

Dr. Szasz missed his true calling: He should put his quaint time-capsule views of neurology in tightly-packed prose printed on the side of bottles of soap.

Single Issue Voter|2.15.07 @ 10:18PM|#

Jon H,

Malpractice?
There is no "malpractice" here- No less an authority than Tufts University has determined
that young Rebecca Riley's care was
"appropriate and within responsible professional standards."

The semantic difference between Provider/client
and Doctor/Patient is indicative of the power in the relationship. The former is paternalistic and authoritarian the latter is between equals engaged in a contractual relationship. Keep your fucking cookie.

PET scans can no more diagnose ADD then a phrenology examination. They still use you computer game despite such "scientific" breakthroughs.

So did you hit the jackpot and score the dexedrine 'script or are you stuck with that crappy Adderall? With the stricter controls on peudoephedrine, Adult ADD/HD diagnosis should skyrocket.

Single Issue Voter|2.15.07 @ 10:24PM|#

Psychiatry is NOT neurology.
Neurologists don't run around defensively proclaiiming strokes and tumors are "real diseases" like any other disease- they don't have to. Neurologists need not disavow the medicine of their profession in the "bad old days".

|2.15.07 @ 10:26PM|#

matt writes: "So, since not all brains react the same way to chemicals, the ones that are somewhat outside the norm are diseased? "

If it causes problems for the person.

I mean, hell, if a diabetic doesn't *mind* having his feet rot off, he doesn't have to worry about taking care of them. Is gangrene a disease if you can't feel it and you don't need the affected limbs?

And "causes problems" can mean "preventing the person from achieving his or her own self-directed goals and ambitions" not just "fitting into a socially imposed behavioral norm at school and work".

If you can't learn at school, and you can't perform at work, you probably won't be any good at your hobbies, either. Pretty much any worthwhile goal requires lots of practice, and practice requires extended application of attention even when the task gets boring.

No amount of utopian happy talk about letting people be themselves is going to change that.

Single Issue Voter|2.15.07 @ 10:32PM|#

John H,

You must have got the dexedrine....SCORE!!!

|2.15.07 @ 10:44PM|#

SIV writes: "PET scans can no more diagnose ADD then a phrenology examination. They still use you computer game despite such "scientific" breakthroughs."

They still use the computer game because it's effective and cheap. Far cheaper than a PET scan.

And no, PET scans aren't much use for diagnosis, but they are useful for establishing that there is a physiological difference in people with ADHD, instead of relying on external studies of behavior and task performance.

"Neurologists need not disavow the medicine of their profession in
the "bad old days".

You mean like surgeons? And they were often better than the elite 'doctors' who refused to get their hands dirty and worked from theory alone, empirical evidence be damned.

Psychiatry is no different from any other medical discipline - they get better as new tools and knowledge are discovered and adopted. The brain was simply a tougher problem than, say, blood flow, or vaccination, because until recent you only had the patient's behavior and testimony to go on, and very often that isn't reliable evidence.

ADHD was first noted in people with head injuries. Then it was noted in kids who behaved like people with head injuries.

The line between modern psychiatry and neurology is somewhat blurred in some areas. Many 'psychiatric' things become 'neurological' because of high-tech research.

A man walks into a doctor and says he can't see anything on his left. But his right hand can write the names of things he says he doesn't see. Insane? That depends on what year it is when he walked into the doctor.

|2.15.07 @ 10:57PM|#

The real reason why kids are being fed Ritalin etc. is performance enhancement. Steroids for the brain, if you will. But that isn't a socially acceptable reason to take drugs (much less give them to kids), so people make up lies about treating a disease.

|2.15.07 @ 11:13PM|#

"The real reason why kids are being fed Ritalin etc. is performance enhancement. Steroids for the brain, if you will. But that isn't a socially acceptable reason to take drugs (much less give them to kids), so people make up lies about treating a disease."

Glasses are also about performance enhancement. Nobody cares if astigmatism is called a "disease" or a "disorder" or "non-normal".

|2.15.07 @ 11:15PM|#

miche,

There are a number of reasons for why a 4 year-old was still in diapers. Including, but not limited to:

- parents were fuck ups
- child was too overmedicated to potty train
- child was potty trained and was wearing pull ups due to occasional lapses and the reporter didn't know the difference
- child was of the large minority of children who train at age 4 or later
- child was developmentally delayed
- child was severely emotionally disturbed
- child was sexually abused
- child actually was bipolar and ADD and it impaired her ability to learn in spite of the medication

|2.15.07 @ 11:20PM|#

Max,

Give a kid without an attention deficit Ritalin or Adderall and you'll see just how not performance enhancing they are. Parents who manage to coax a Ritalin or Adderall prescription for a kid who doesn't need it learn to regret it. As stated above, it creates an attention deficit problem in people who don't have one. It's speed, not caffeine. There is nothing subtle about it.

|2.15.07 @ 11:23PM|#

"You must have got the dexedrine....SCORE!!!"

Actually, I'm med-less. A couple weeks ago I called to ask for a new month's ritalin prescription. My doctor called back later and said she would be fired if she wrote any more prescriptions, and I'd have to see a specialist for that from now on. Well, fine, except she referred me to a specialist last summer and that person never even got back to me. So I'm looking for a new doctor in a new system. (I also found out that my doctor got her degree from a med school in Dominica.)

So, I'm med-less until I can find a new doctor, associated with a different hospital system, because this is a giant pain in the ass I've not experience since shortly after diagnosis in 1993, when an ancient Philly doctor treated me like a tweaker because I didn't have the name, location, and phone number of my prior physician (total visits: maybe 6, tops) memorized. (I was in college and my prior doctor was in the same building as my summer co-op job, but was not convenient later when I was in the city for and carless, my car having been totaled by a hit-and-run truck driver at 3am. So I tried to find a doctor in the city and got a crabby nonagenarian. Maybe it was Dr. Szasz.).

In the meantime, i can't concentrate for shit at work. So fuck off.

Nat|2.15.07 @ 11:27PM|#

jf: BTW, 500 mgs/day of Depakote combined with 1500 mgs/day of Omega-3 have made me feel the best I have since I was a teenager.

I take 1250mg Depakote (on top of 200mg Wellbutrin and, um, some other self-medication) and it is no picnic. It's nice not losing emotional control several times a day, and I'm less easily distracted, and the panic attacks are gone, but I also have occasional nausea, it's fucking up my eyesight, I have to sleep more, and I lost the feeling of awesome mental energy I sometimes get. This is inconsequential compared to the most common side effects of Depakote, which I luckily avoided. It fucks with the liver, so I have to get a blood test occasionally to make sure my liver hasn't died; I can't even touch alcohol (I'd already quit, so that wasn't a problem). On the balance, I think it's an improvement; my symptoms are relatively very mild, but I was screwing up my job and missing or ruining opportunities to improve my life, and after feeling worse and worse for five years I didn't see any improvement ahead.

Still - I don't know how much that little girl was on, but any amount in my opinion is too much. The type of mood disorder it treats isn't something you can tell just from looking at someone (especially someone whose facial expressions are probably still developing). I often feel like I'm 10 IQ points lower than normal; that's a lousy thing to do to a child. Seroquel is nasty, nasty stuff; it's used to control paranoid delusions and hallucinations. I'm perplexed at what standard is used to diagnose a child with those symptoms.

Single Issue Voter: The "disease" has no pathology.

I am as fascinated as anyone about the physiological roots (if any) of mental disorders - I'm a biologist, so it's my job to solve puzzles like that. However, at the risk of provoking the mental-illness-is-a-social-construction crowd, I would say that an inability to function in everyday life in the modern world qualifies. That doesn't mean "playing by your own rules" or shocking popular mores, or even avoiding friends because of depression and fear of social interaction (although that can be bad too); more like screaming at your coworkers for no apparent reason, or breaking off a 5-year friendship because of a sudden and overwhelming attack of paranoia.

Jon H: In the meantime, i can't concentrate for shit at work. So fuck off.

What he said, double.

|2.15.07 @ 11:28PM|#

Hopefully before I get nailed to the blog wall here, I'd like to make it clear that I have a great deal of difficulty believing that a 2 year-old could exhibit enough behavioral problems to warrant a bipolar and ADD diagnosis worthy of depakote, seroquel, and clonidine and not warrant inpatient status.

On the other hand, I can easily imagine that a 2 year-old could exhibit enough behavioral problems that parents could be relieved to have some diagnosis that gave them some hope for their child's happiness and their own peace of mind, even if that diagnosis called for radical treatment.

|2.15.07 @ 11:40PM|#

I hate to beat the somatization/endometriosis thing (which I seem to do on every thread involving Dr Szaz), but I think that is a classical case where a real illness is horribly mistreated by psychiatrists due to the fact their models of "psychiatric" illnesses are empirical stabs-in-the-dark.

Somatization is a "mental illness" where people complain of mysterious abdominal pains, painfuls sexual intercourse and general weakness. It strikes mostly women in their early child-bearing years. My old medical reference books (my ancestors on boths sides of my family collect textbooks) have these scary treatments to "train" women suffering from this illness to submit to their husbands and get over this weird sexual hangup.

Guess what? It's not a brain illness after all (alhtough it may still be found in the DSM IV)! The symptoms of somatism are idnetical to a reproductive disorder called endometriosis which causes severe abdominal pains, makes sexual intercourse painful, soemtimes causes sterility, and saps its victims' strength. Essentially, the condition occurs when, for reasons that are not understood, menstrual tissues start growing outside the uterus. Everytime a woman suffering from this condition gets her period, she starts bleeding internally, and there is a good chance that the blood will clot and trigger the generation of scar tissue which welds organs together in uncomfortable arrangements.


Guess how effective all those treatments to teach the victim to put out for her husband were in treating the pain?

My take on Dr Szaz's beef with psychiatry is that it's very much like alchemy. There are all these cockamamy theories (Jungianism, Freudianism and the like), these treatments wherein the mechanism is unknown, and an inability to define the disease.

To me, he's criticising astrology, and people are snapping back that he is arguing that planets don't exist! A good astrologer coudl tell you where MArs was goign to appear in the sky on a certain date. But it wasn't because he had a good theory concerning the motions of Mars and the Earth around the Sun.

True, psychiatrists do do alot of good. While they may not have adequate scientific theories, and thier treatments are hit-or-miss affairs more reminiscent of middle-ages medical arts, in the end they have stumbled on some treatments that work and help a lot of people to live lives with a semblance of dignity. However they still make ghastly mistakes like telling a woman balled up in pain from the web of scar tissue twisting her uterus into a spiral that she should get over her sexual hangups.

|2.16.07 @ 12:02AM|#

"My take on Dr Szaz's beef with psychiatry is that it's very much like alchemy. There are all these cockamamy theories (Jungianism, Freudianism and the like), these treatments wherein the mechanism is unknown, and an inability to define the disease."

The thing is though - that's more a description of modern *psychologists* and *therapists*, not *psychiatrists*. If I'm not mistaken, psychiatrists have to have general medical training, which the others do not. That's why psychiatrists can prescribe meds, and psychologists and therapists cannot.

I could entirely believe a male psychologist, having no clue about endometriosis, could come up with some weird faux-psychological ailment.

And therapists, well, they include the kind of people who think it's a good idea to smother kids as part of "rebirthing therapy" or to blame all the patient's problems on satanic ritual abuse.

I've moved around the country a lot since I was diagnosed with ADHD, so I've been to quite a few shrinks for evaluation or ritalin rx maintenance. I've only had a single shrink who was the classic voodoo analytical type with the standard Freudian couch. He was old, and that was 1993. He suggested I had an anxiety problem. I didn't go back.

I frankly don't think the med schools are putting out many old-fashioned Freudian/analytical/voodoo psychiatrists these days, and probably haven't for twenty years.

Any loons who would have gravitated to that field 50 years ago probably become therapists now. The pre-reqs are far lower.

Dan Brown|2.16.07 @ 12:18AM|#

jf, as I understand it, Szasz's position is as follows: There are brain disorders -- which are real illnesses -- and there are behavior problems, which may or may not be caused by brain disorders; the term "mental illness" confuses the two. Psychiatric medication has helped me immeasurably, and I accept this point completely.

Nat|2.16.07 @ 12:25AM|#

Jon H: That's why psychiatrists can prescribe meds, and psychologists and therapists cannot.

In fairness, though, my psychiatrist told me when he first started me on antidepressants that I needed to see a therapist as well, and that meds were only a partial solution and more of a prophylactic one. Or as the pharmacist told me, "these aren't happy pills." I'm terrible at rationally analyzing my own behavior, and I imagine that there are ways I could change life for the better that I'm just missing because of my set attitudes and patterns. Some therapists are indeed frauds, but I can see why it would be worthwhile to have someone else pick apart your problems dispassionately. And someone who provides therapy for a lot of "head cases" would probably become an expert at understanding their mental processes.

On the other hand, I could see therapy being much less useful for ADD. Ritalin was a scary drug though; wonderful at the peak, not so hot once it wears off (especially the next day). I wasn't on it for very long because it sent my blood pressure soaring and made my temper worse, but I still miss it, which scares me even more. It can be a huge help to some people but I can't believe we're feeding it to kids on a large scale.

*|2.16.07 @ 12:37AM|#

My take on Dr Szaz's beef with psychiatry is that it's very much like alchemy. There are all these cockamamy theories (Jungianism, Freudianism and the like), these treatments wherein the mechanism is unknown, and an inability to define the disease.

Umm...yeah, get back to us when you figure out the difference between psychiatry and psychology. Here's a hint: psychiatrists base diagnoses on the DSM-IV. No Freud or Jung in there, I assure you.

The MOA of many diseases is unknown. Just as one example among many, the pathogenesis of HELLP syndrome in pregnant women is not well understood, but there are obvious clinical signs which make for a diagnosis. Likewise with many psychiatric diagnoses: although the MOA may not be completely understood, an overall clinical picture can make for a diagnosis which is completely valid from a medical perspective.

As we learn more about the brain (the regulation of neurotransmitters, normal function of the dopaminergic system, neuron paring, executive function, etc) we are starting to understand the organic basis of many psychiatric disorders. Some of you would do well to acquaint yourselves with that literature before spouting off about how un-scientific the discipline is.

|2.16.07 @ 12:41AM|#

"As stated above, it creates an attention deficit problem in people who don't have one. It's speed, not caffeine. There is nothing subtle about it."

Where does this BS come from? If you give a normal person speed, it certainly does not cause an "attention deficit". On the contrary, people on speed are extremely productive.

|2.16.07 @ 12:49AM|#

My problem with psychiatry-deniers is simple: Despite what little lies we like to tell ourselves, there is no "soul" and no there is difference between "mind" and "body." Everything you think, everything you know, everything you feel emotionally is nothing more than a complex bio-chemical program that's being run in that fleshy computer that resides in your skull. Yes, the programing can be changed as you get more information, and routines can be suppressed in response to situations, but the fact of the matter is that we are meat robots running software written by natural selection over the course of millions of years.

To deny that flaws in this bio-chemical program can not be corrected with bio-chemical means (i.e. drugs) is like saying that insulin doesn't help a diabetic. Having more than my share of personal experience with the mentally ill, to deny that there is nothing really wrong with them is not just a denial of scientific reality, but just plain sick. Rather than find the right treatment for the mentally ill, would we leave them to suffer because

I view Szasz the same way I view Michael "Astrology Is A Science" Behe: an "expert" who is willing to fudge science to fit their pre-conceived notion of the world. Behe dreams up "Intelligent Design" so he can deny evolution so he can craft biology to fit his theistic view of the world. Meanwhile, Szasz claims schizophrenics are just faking insanity so he can cling to his archaic notions of "free will." In both cases, science is done a horrible mis-service, and in the case of Szasz that mis-service can have dire consequences for the mentally ill and the people who live near and around them.

Yes, somebody fucked up here. Whether it was greed or just plain stupidity, I can't say. But doctors in numerous fields from oncology to podiatry make bad calls from time to time. Parents can make bad calls too. Do we now proclaim medicine to be "junk science" and go back to thinking disease is caused by daemons and bad humours? No? Then why should we toss out over a centuries worth of data that has yielded fantastic treatments like Prozac, Paxil, Lithium, Ritalin, that have helped improve the lives of thousands, if not millions, of people on the advice a politically motivated quack or a celebrity UFO cult/pyramid scheme devised by a bad sci-fi author turned con-artist?

|2.16.07 @ 12:51AM|#

EDIT: Rather than find the right treatment for the mentally ill, would we leave them to suffer because we want to hold on to the illusions that we have total control over ourselves?

|2.16.07 @ 12:54AM|#

EDIT: Behe dreams up "Intelligent Design" so he can deny evolution and craft biology to fit his theistic view of the world.

*|2.16.07 @ 12:55AM|#

The thing is though - that's more a description of modern *psychologists* and *therapists*, not *psychiatrists*. If I'm not mistaken, psychiatrists have to have general medical training, which the others do not. That's why psychiatrists can prescribe meds, and psychologists and therapists cannot.

I somewhat cross-posted with Jon H. Jon, you are not mistaken. Psychiatrists are MDs who complete a residency in psychiatry. Further, they are acutely aware of the gap that exists between our clinical understanding of psychiatric disorders and a complete scientific understanding of the cause. Many work diligently outside their clinical practice doing research to close that gap. They often perform this research at the expense of their free time after working long hours in an area of medicine that is extremely challenging, with patients who are often ungrateful, difficult, and not infrequently dangerous, at rates of remuneration that are far less than comparably demanding medical specialties.

For this, they get the thanks of being called quacks and cranks by idiots who have no understanding of what they are talking about, nor any inkling of the cost to society if these fine, dedicated individuals did not contribute their time and expertise to managing mental illness.

|2.16.07 @ 1:15AM|#

For this, they get the thanks of being called quacks and cranks by idiots who have no understanding of what they are talking about, nor any inkling of the cost to society if these fine, dedicated individuals did not contribute their time and expertise to managing mental illness.

When I became an atheist, I never thought I'd say this ever again, but...

AMEN!

The Wine Commonsewer|2.16.07 @ 1:39AM|#

Ahhhhh, drugs, so much easier than being a fucking parent.

|2.16.07 @ 1:52AM|#

I'm not all that familiar with Dr. Szasz's position on mental illness, but diagnosing someone based on a list of the symptoms in the DSM-IV is *not* methodologically on par with diagnosing cancer based on a biopsy. (Need I trot out the cliched reminder that homosexuality used to be listed as an illness in the DSM?) That doesn't mean the entire field of psychiatry is baseless, but it does mean we should take care before, say, letting a man in a white coat prescribe lithium for a two-year-old.

I've had some experience with psychiatry. Early one summer I suffered a manic episode, stopped getting enough sleep, and on the recommendation of a psychologist eventually voluntarily checked myself into a mental hospital. I was bouncing off the walls and they quickly diagnosed me as bipolar and got me on lithium and Ativan, which seemed for the moment to just rev me up even more. After a week's worth of supervised care and interminable "let's discuss our feelings in a group with the other nutsos" sessions, they let me out, and my shrink kept me on lithium and Zyprexa, without which, he assured me, I would quickly go nuts.

Well the lithium made it impossible to concentrate and after a couple of months of very inconsistent doses I stopped getting enough sleep and went manic again. I had since moved so I had a different shrink, but the outcome was much the same; I spent a week in the hospital and was released on a slightly reduced regimen of lithium and Zyprexa.

This time I settled down and stayed on the drugs. And it was AWFUL. Without a doubt, it was the worst year of my life. I was regularly sleeping 12 hours a day. My metabolism slowed down and I gained thirty pounds. It screwed up my kidneys too, leading to a couple of kidney stones.

Luckily I had some very good friends to help me through all this. One in particular had urged me not to give up too easily on the possibility of managing myself without medication. After about a year I stopped taking it, and monitored myself closely. I made sure to get enough rest and tried to "keep an eye out," as it were, for the grandiose and frenetic thoughts that had signaled my earlier episodes.

It has been over four years without meds now, and I have not suffered any of the relapses that I was assured would happen. I'm sure if I asked one of my old shrinks, they'd insist that it will still happen someday, or, if it doesn't, well, I'm just "one of the lucky ones," and it's a risk that's just not worth taking.

In the meantime, I've obtained a college degree and my private pilot license (after lying on the FAA form about ever having been diagnosed with a mental illness). I'm rediscovering my love of reading, which was largely lost when lithium made it difficult to concentrate on any but the most elementary prose. I still monitor my sleeping and my thought processes, but this is becoming a background process now, more of a habit or a reflex than a conscious exertion. In short, I think my life is immeasurably better because I went against the recommendations of my psychiatrists and went off my meds. So you'll have to excuse me if I'm not jumping up and down to thank the psychiatric profession for all the good they've done me and society.

I've been insane before, and whatever you want to call it, mental illness is real (once we get past conceptual quibbling). But the problem with many psychiatrists is that so many of them seem to just want to make a diagnosis and hand out a 'scrip. Particularly in the case of bipolar, it seems, patients are told that medication is *absolutely the only way* to avoid hospitalization and to lead a normal life.

I believe that mental illnesses do have a biological basis and that they can often be very effectively treated with medication. But the implications of Akira's statement that "mind and body are the same" run both ways: just as altering the chemicals in the brain can improve the structure and clarity of one's thought, altering one's thoughts may improve those chemical processes. (Here's where determinists will usually say that you really can't alter your thoughts because they arise from mechanistic chemical processes; I'm not a determinist and disagree.) Not to mention the influence of diet, exercise, and sleep, all of which can improve one's mental health without the use of medication.

|2.16.07 @ 2:13AM|#

Here's a hint: psychiatrists base diagnoses on the DSM-IV.

Yes. And exorcists base their diagnoses of demon possession on the Bible. So what?

The DSM is a product of a political process, not a scientific one. It is, quite literally, written by committee. In the past, diagnoses have gone in and out of it on the basis of political and religious belief -- such as the removal of homosexuality as a diagnosis; or for that matter its earlier inclusion.

The DSM (since 1980) is atheoretical; it describes categories of "disorder" without reference to etiology (cause). This is by itself unscientific. If general medicine were done in the same way, "leg pain" would be a diagnosis without reference to whether the pain was caused by bruising, strain, a broken bone, or a tumor.

The psychiatric medication of children is done largely for the comfort of parents and the school system. This has been the case ever since babies were given laudanum to make them stop crying. The child is treated as a malfunctioning, annoying machine making "behaviors" and "acting out", rather than as a person to be taught greater awareness and control of him/herself.

To alter a person's awareness with drugs, without that person's consent, is cruelty. If one believes that the child is not of age to consent, this certainly does not give the parent the right to drug the child, any more than it would give the parent the right to mutilate the child.

tros|2.16.07 @ 2:26AM|#

I am going to give ya'll the shortest version I possibly can. I was raised on ADD brainwashing and I pretty much recognized it from the start. I have a conspiracy theory that you might have heard of. Don't get hooked on their drugs. Take psilocybin if you need to convince yourself that you have a soul. Don't be a robot.

ADD is caused by chronic television watching and exposure to advertizing. There is no biological basis. You are probably going to get it if you are a smart person watching a stupid television show.

tros|2.16.07 @ 2:34AM|#

Btw the DSM whateverthefuck it is is bullshit for real, I can act like I got all of that shit if I want to. Too bad all the "mental health" patients aren't smart enough to just read the huge book of stupid all by themselves.

This is really a disgrace, I might have to drop out of school just because I can't bring myself to attend BRAINWASHING 101 at Northeastern University.

tros|2.16.07 @ 2:36AM|#

This is some cutting edge shit, people. Does any one have any good ideas about how we should define sanity? I'm listening.

*|2.16.07 @ 6:14AM|#

Here's a hint: psychiatrists base diagnoses on the DSM-IV.

Yes. And exorcists base their diagnoses of demon possession on the Bible. So what?

A rather disingenuous attempt to divorce my comment from its original context. Yawn.

As you should have recognized, were you not a bit too dim, this comment was a response to tarran's claim that psychiatry was based on non-scientific Freudian and Jungian theories. I was pointing out that psychiatrists make diagnoses based on the DSM-IV, which does not contain reference to any such "cockamamy" theories. Reading comprehension is hard for some people, I know.

The DSM is a product of a political process, not a scientific one. It is, quite literally, written by committee.

Yes, and diagnostic and practice guidelines in other areas of medicine are written in much the same way.

An example: today in the pediatric ED, a young man presented with neck pain after a low-speed, rear-end motor vehicle collision. There were two ways to determine whether or not this young man had a C-spine fracture. One is with radiography, the other is use of clinical information.

The Canadian C-spine rule, a practice guideline that many EDs use to determine whether radiography is necessary, states that radiography must be performed if:

- the patient's age is >65 years old.

- The mechanism of injury is dangerous, as defined by: fall from 1 meter (3 feet) or 5 stairs; axial load to the head such as diving; motor vehicle accident at high speed (>100 km/hour [>62 mph]); motorized recreational vehicle accident; bicycle collision with an immovable object such as a tree or parked car.

- the patient has paresthesias in the extremities.

My patient was/had none of these things immediately demanding a C-spine film. Thus, I looked for low-risk factors which allow for safe assessment of range of motion. My patient met several of these criteria. Thus, I un-collared him and assessed his ROM. It was normal. I then had him ambulate. This too was normal. At this point, I cleared him of C-spine fracture without exposing him to unnecessary radiation.

Why do I give this example? Because the Canadian C-spine rule was formulated in a manner similar to the DSM-IV. Medical experts discussed the likelihood of C-Spine injuries based on certain clinical information they had observed in their own medical practice and developed a rule that allowed for diagnosis (myofacial strain rather than c-spine fracture) based on that clinical information. The rule was shown in a prospective study of 8283 patients to be 99.4% sensitive. Not bad for a rule that was arrived at so very un-scientifically.

To say the DSM is written "by committee" is highly disingenuous, because it makes the process out to be one that is not evidentially based. However, the observational evidence of many expert practitioners is brought into the process along with a great deal of evidence from peer-reviewed published sources ranging in content from case reports, neurobiology papers, neuroimaging papers, and a great deal more.

It is true that in other areas of medicine we are able to avail ourselves of better diagnostic tests than those available to psychiatrists. However, the majority of diagnoses in medicine are made solely with clinical information. I suppose every psychiatrist could do fMRI, PET and EEG at great expense on every suspected schizophrenic to confirm what they already can diagnose quite accurately based on available clinical evidence, but that would be a lot of expense just to make the diagnostic process look more "sciency" to mental-illness skeptics. I also suppose I could do an abdominal CT on every child who has right lower quadrant pain that began peri-umbilically, has been vomiting and febrile for three days, has a distended abdomen with peritoneal signs, and vitals consistent with sepsis, but since there aren't a lot of appendicitis deniers out there, most people will probably be content to just let the clinic information speak for itself and have me get their kid to the OR before he or she dies.

In the past, diagnoses have gone in and out of it on the basis of political and religious belief -- such as the removal of homosexuality as a diagnosis; or for that matter its earlier inclusion.

Yes, and if you go back far enough you can find plenty of examples in general medicine political or particularly religious belief influenced medical theory. Highly inaccurate statements from medical authorities regarding the addictive qualities or harmful effects of certain drugs or physical effects of masturbation were fairly common up to the 1950s.

The DSM (since 1980) is atheoretical; it describes categories of "disorder" without reference to etiology (cause). This is by itself unscientific. If general medicine were done in the same way, "leg pain" would be a diagnosis without reference to whether the pain was caused by bruising, strain, a broken bone, or a tumor.

There are many diagnoses made in general medicine in which we can recognize a pathologic syndrome, but do not understand the underlying cause. We still make the diagnosis based on the cluster of presenting signs and symptoms. Somehow, this does not arouse the ire of those who apparently consider this sort of thing un-scientific and therefor utterly without merit. If your wife or daughter develops HELLP syndrome, Freud Pickle, I imagine you won't want us to hold off treatment until we can give you an adequate, scientifically rigorous explanation of the underlying cause. Instead, you will be quite happy that we can recognize the clinical presentation and the cluster of signs and symptoms that accompany the syndrome, and treat accordingly, just as those with a schizophrenic relative would expect the same.

The psychiatric medication of children is done largely for the comfort of parents and the school system. This has been the case ever since babies were given laudanum to make them stop crying. The child is treated as a malfunctioning, annoying machine making "behaviors" and "acting out", rather than as a person to be taught greater awareness and control of him/herself.

Says the person who obviously has no understanding of child psychiatry. The problem with externalizing disorders in children in particular is that they cannot simply be "taught greater awareness and control of him/herself". In fact, in the absence of controlling medication, they can't be taught much of anything, and will actively resist to the point of physically attacking those who try to work with them.

Do you really think that it is all so simple? That all that needs to be done is utter some banal platitude and magically the child's behavior will change? Any specifics you'd like to share on this "teaching of control". I'll be glad to send you the next child I see with oppositional defiant disorder or conduct disorder for your magical treatment. I'm sure the world is listening with open ears to your revolutionary teaching methods.

To alter a person's awareness with drugs, without that person's consent, is cruelty.

I agree, but in the field of psychiatry, the issue of consent is a very tricky one. Certain types of mental illness, particularly externalizing disorders and those which involve breaks with reality, have high risk for harm to self and others. Furthermore, they have lost the level of executive function that would allow them to make a rational decision regarding treatment. Some people are simply so mentally ill that they cannot give or withhold consent in any meaningful way, which is where the "rational actor principle" comes into play.


If one believes that the child is not of age to consent, this certainly does not give the parent the right to drug the child, any more than it would give the parent the right to mutilate the child.

Right, because giving a child a drug to treat a diagnosable medical disorder is the same thing as mutilating the child.

By the way, both legally and (I believe) ethically speaking, the parents do have the right to make decisions for their children regarding their medical care up to a certain age. This is because 5 year olds, like schizophrenics, don't yet possess the cognitive skill set necessary to recognize the treatment that is in their own best interests. That is why the parents, who presumably do in most cases (the case Jacob cites may well represent an anomaly, granted) should make the final decision acting on the child's best interest.

tros|2.16.07 @ 7:56AM|#

Right, because giving a child a drug to treat a diagnosable medical disorder is the same thing as mutilating the child.

I'll diagnose your face. I don't care what you call it if you give kids CIA brainwash drugs it is mutilation.

tros|2.16.07 @ 7:56AM|#

tooooo eeeaarlyyy X-P

|2.16.07 @ 9:14AM|#

"more like screaming at your coworkers for no apparent reason, or breaking off a 5-year friendship because of a sudden and overwhelming attack of paranoia."

The problem is who decides what's a justifiable reason for screaming or breaking up a 5 year relationship. With 50% of marriages ending in divorce, is a large percent of the population suffering from paranoia? If someone has a short temper the day after his parents die, is that crazy? Mental illness isn't like diabetes, because the same symptoms can be normal or disease depending on the social situation. If a diabetics blood sugar is too high, he has hyperglycemia, whether he is at a wedding or a funneral. If someone is depressed at a wedding or happy at a funneral, we call him crazy. Keep the symptoms the same and change the cerimony, and we call it normal. This subjectivity makes it possible to use psychiatry to force social norms on others. I'll believe that mental illness is like diabetes when hospitals start locking the doors on diabetes patients to prevent them from leaving.

Yes, some psychiatrists help patients a lot, but others do much more harm than good. Ultimately, the patient must decide if the doctor is helping or hurting.

Jennifer|2.16.07 @ 9:55AM|#

My little brother was a hellion agent of destruction at age two, started to outgrow it by age three and was fine by four. Today he's a boringly respectable banker and family man, but I shudder to think of what damage he would have suffered if the drugging-of-children fad had been around back then.

My mom would have jumped on a pill with both feet if a doctor told her it would "cure" my brother's case of the Terrible Twos.

|2.16.07 @ 9:57AM|#

If a journalist had written this story, he would have noted that the parents were giving the child far larger doses than the doctor prescribed, rather than implying that following the doctor's orders led to her death.

But that would totally screw up the narrative.

tros|2.16.07 @ 9:58AM|#

The people on this forum should know this already: The intersection of "mental health" and "public health" is state brainwashing. The purpose of psychiatric medication is to make the patient continue in the life path that is making them depressed/unwell. Regardless of how much the patient thinks he/she is being "helped" by the shrink, they are going out of their way to fit into a society that is DISEASED by all RATIONAL standards. Naturally one would expect them to be depressed.

Now you won't find REAL "disorders" in the DSM. By "real" I mean the mental issues that are pervasive in American society such as sexism, homophobia, infophobia (a.k.a. religious fundamentalism), alcoholism, the list goes on. NO TREATMENT. I have an idea about how to CURE ADD: How do we get all of our kids off of pharmaceutical speed?

The main issue here is the definition of "medicine". A was native American once said, "White Man's medicine makes you feel good now, bad later. Indian medicine makes you feel bad now, good later."

It is my opinion that in order to fix your mental health, it is better to rely on chemicals that are used one time and cause a permanent change in the brain, as opposed to chemicals that must be used every day. These daily chemical regimes are entirely unneccessary, and are only instituted in order to foster dependence on the state and secure the lavish income of the medical priesthood.

OMG U FUCKING MONEY LENDERS GET OUT OF THE FUCKING TEMPLE OR YOU ARE GOING TO GET IT I AM SERIOUS MOTHERFUCKERS!

tros|2.16.07 @ 10:00AM|#

Oh, that's a *wise Native American.

Single Issue Voter|2.16.07 @ 10:05AM|#

joe,

RTFA

tros|2.16.07 @ 10:08AM|#

Then why should we toss out over a centuries worth of data that has yielded fantastic treatments like Prozac, Paxil, Lithium, Ritalin, that have helped improve the lives of thousands, if not millions, of people on the advice a politically motivated quack or a celebrity UFO cult/pyramid scheme devised by a bad sci-fi author turned con-artist?

Have you actually taken any of those "treatments"? I you are on them and spouting this insectoid propaganda, I am truely sorry, your life must be a living hell of some sort. If you haven't taken any of these, I would advise you to shut the fuck up and stop misinforming the public. I have friends who have (collectively) been on every one of those drugs. Those drugs do not help anyone. You are telling people that they should be a slave if they can't control themselves. I think that's very counterproductive considering what we are trying to do here at this magazine.

The Wine Commonsewer|2.16.07 @ 10:10AM|#

Back in the 1970's, the shrinks dragged patients through years of weekly therapy, dwelling on long forgotten childhood trauma and offering nothing but a long slow healing process that sometimes worked and often did not.

Then one day the nasty old insurance companies decreed that they weren't paying for it anymore, limiting shrink visits to 5 or 10 a year. And voila, the head shrinkers discovered that, hey, it turns out that people can get cured in jig time and they don't have to know squat about why mom liked Tommy better.

That phenom speaks volumes about both the market process and about you being depressed and angry.

tros|2.16.07 @ 10:17AM|#

BTW, Akira, I think that your brain-computer analogy is VERY apt, despite what the New Age establishment says. I would suggest reading a book called "Living From The Source" by Deepak Chopra. He is a member of Ken Wilbur's Integral Institute of which Alex Grey is also a member. These people are interested in integrating science and spirituality.

Yes, your thoughts come from not only the drugs you take, but the air you breath and the food you eat as well. Self-sufficiency is a value that free human beings should pursue. The trick to this is making sure that your fluid biocomputer has an OPEN SOURCE operating system.

|2.16.07 @ 10:28AM|#

If psychiatrists are held to the standards of proof required in hard science then psychiatry would really melt into voodoo and suchlike and we don't want that to happen, do we?

tros|2.16.07 @ 10:33AM|#

...voodoo and suchlike...

So I was talking to my shrink yesterday about why ADD was (or should be) a joke to poor people who can't afford mental health coverage. I tell him they might as well do their manual lober on a hemp farm and get their medicine for free. He tells me (in all seriousness) that there is "no such thing" as a self-sufficient commune. And I tell him then hell I must have been hallucinating when I went and saw one in California. All legal too. Yes, money actually DOES grow on TREES.

I like this place because people don't think I'm insane when I tell them it is possible to live in peace and harmony without governmental interference. Most people just can't wrap their minds are the technical details.

tros|2.16.07 @ 10:43AM|#

people on the advice a politically motivated quack or a celebrity UFO cult/pyramid scheme devised by a bad sci-fi author turned con-artist?

Akira are you referring to L. Ron Hubbard or Ayn Rand?

Or maybe Heinlein?

I once considered writing science fiction but after a while the future got all up in my face and decided it would be better to go into journalism.

|2.16.07 @ 10:43AM|#

SIV,

I was commenting on the blog post.

|2.16.07 @ 11:30AM|#

I would suggest reading a book called "Living From The Source" by Deepak Chopra.

Oh no you didn't...

http://skepdic.com/chopra.html

http://www.googlesyndicatedsearch.com/u/JREF?q=Chopra&q=-intitle%3AForums&q=-intitle%3AForum&sa=Go!

Chopra has nothing to offer me or science what so ever. In my estimation is either insane or another scam artist like Sylvia Browne or John "The Biggest Douche In The Universe" Edward.

Being the cynic that I am, I opt for the latter.

Akira are you referring to L. Ron Hubbard or Ayn Rand?

I don't seem to recall Rand or Heinlein ever talking about Xenu or body theatens or bilking millions out of the gullible.

Mrs TWC|2.16.07 @ 11:34AM|#

All two year olds are Bipolar.

tros|2.16.07 @ 11:51AM|#

bilking millions out of the gullible.

The Ayn Rand Cult has bilked TRILLIONS out of the gullible public. You might have heard of this monetary cartel it is called the FEDERAL RESERVE.

As for Chopra... It's funny that people go to such pains to disprove him. I have never read a single one of his books, but I am familiar with the ancient wisdom that he casts before the collective SWINE in the American media market. All I can say is that I base my life on rational empricism, and after trying various schemes of "mental health" I have settled on this approach for my mind and body.

If you are a rational person and you take LSD, you will grok this without reading his book.

|2.16.07 @ 11:57AM|#

Yes, your thoughts come from not only the drugs you take, but the air you breath and the food you eat as well.

Evidence? If you can show that "thoughts come from... the air you breath and the food you eat..." I have a little proposition for you.

The trick to this is making sure that your fluid biocomputer has an OPEN SOURCE operating system.

By "OPEN SOURCE" I assume you mean seriously contemplating every bit of religious and spiritualist drivel that vomits forth from the mouths of illiterates the charlatans. Sorry, I don't work like that. I only accept claims based on evidence, observation, and experimentation,and even then it better be peer reviewed and tested again and again. The evidence is in, and it doesn't look good for the woos: There is evidence no spirits, nor "psychic powers," nor ghosts, angels, daemons, fairies, UFOs, lake monsters, proto-humans wandering America's woodlands and the Himalayas, no Mexican Goat suckers, and while more than a few are assholes, the heads of state are most likely not clandestine lizard men from another dimension.

The universe is wonderful enough without denying reality and buying into bullshit. I don't need some guru who will tell me--for a "reasonable" fee--that I fly if I just believe I could, or that I can live off air, or that when I die I'll dwell for eternity in some magical place or be reborn in some other form.

Nor should anyone else for that matter. Humanity has held itself back for to long thanks to superstition and magical thinking. Whether you call this nonsense "new age" or "Christianity" doesn't matter. This is the 21st Century. We've been out of the caves for to long to continuing believing in gods and devils.

It's time to grow up.

tros|2.16.07 @ 11:58AM|#

Dr. Chopra has done more than any other single person to popularize the Maharishi's Ayurvedic medicine in America, including some New Age energy concepts that boldly and falsely assert a connection between quantum physics and consciousness.

This is where skeptics start sputtering. I would suggest a book called "Entangled Minds" by Dean Radin. He does the legwork in exposing scientific fundamentalism for the bullshit that it is. The truth is that, while we can not have objective proof of what is going on in another person's brain, there are many reasons to believe that there is a connection between quantum physics, choas, and consciousness.

Again, taking LSD and thinking this through would be key to understanding for yourself. Instead of making stupid and pointless arguments to promote your own self-importance.

Yes, I am sure you are completely sane. I just think you could be enjoying yourself a little more if you opened your mind more often.

|2.16.07 @ 11:59AM|#

EDIT: There is no evidence for spirits...

tros|2.16.07 @ 12:02PM|#

EDIT: There is no evidence for spirits...

Ha ha nice edit that was quite a claim you made before I'm glad you caught it :-)

tros|2.16.07 @ 12:06PM|#

I only accept claims based on evidence, observation, and experimentation,and even then it better be peer reviewed and tested again and again.

Well, Akira, when we remove the chains of fundamentalism and have free access to Dimethyltryptamine you can smoke as much as you want and see the spirits/aliens yourself. That is unless you are too afraid to have your precious little fragile house of cards world shattered.

I have smoked DMT before and the resulting experience was much more real to me than the conversation I am having right now.

|2.16.07 @ 12:22PM|#

This is where skeptics start sputtering.

Really? How? So far the only "proof" you offer that "quantum mechanics" (BTW, it disgusts me to think how quantum physics has been raped by woos like Choopra and J.K. Knight) is connected in any significant way to consciousness is that "Dr" Choopra said so in a book. What's his evidence? What is his lab apparatus? What are his findings? Have they been peer reviewed and what were the findings of other scientists?

Even Einstein had to show his math. What's Choopras?

Doesn't have any, does he? I thought so.

I just think you could be enjoying yourself a little more if you opened your mind more often.

I'm enjoying my life just fine without the help of priests, ministers, rabbis, clerics, shamans, gurus, mystics, fakirs, "psychics" or other related confidence artists, thank you. So keep your condescending advice in your cake hole.

And spare me the "open mind" crap. You woo-woos have also raped that term almost as badly as "quantum mechanics."

|2.16.07 @ 12:26PM|#

Dimethyltryptamine you can smoke as much as you want and see the spirits/aliens yourself. That is unless you are too afraid to have your precious little fragile house of cards world shattered.

Anecdotal evidence is not evidence.

tros|2.16.07 @ 12:31PM|#

You are pointedly ignoring the EVIDENCE.

LSD, psilocybin, and DMT beat Prozac, Lithium, and Amphetamines hands down. Again, if your are a slave to these STATE REGULATED substances I am truely sorry. I only thought I would point out that you look absurd defending the scientific opinions of people that want you to be their slave.

Yes, I am sure you enjoy being a slave.

And it seems to me perfectly in the cards that there will be within the next generation or so a pharmacological method of making people love their servitude, and producing … a kind of painless concentration camp for entire societies, so that people will in fact have their liberties taken away from them but will rather enjoy it, because they will be distracted from any desire to rebel by propaganda, brainwashing, or brainwashing enhanced by pharmacological methods.

- Aldous Huxley

Incidentally Huxley DID believe in the reality of prana, as well as the the cycle of birth and death. The entire point of classical yoga is to reach a point of permanent serenity so that when you die, your soul can peacefully depart from the body and escape entanglment in the physical world.

Huxley's last words on planet Earth, said to his wife, were "One hundred micrograms LSD"

tros|2.16.07 @ 12:35PM|#

Anecdotal evidence is not evidence.

It's only anecdotal if I am telling you a story about it. You have the option to prove this to yourself, but you choose not to judge the reality for yourself, and instead rely on the OPINIONS of the medical priesthood who say it is not real.

VM|2.16.07 @ 12:35PM|#

Akira - I think you're arguing with an incarnation of Jane/Juanita! Or at least this person is as fucking loonie (sic, of course) as she is!

Check out Quackwatch - there's a page dedicated to some of the stuff you're mentioning.

cheers!
VM

|2.16.07 @ 12:42PM|#

Akira,

Does this qualify under the terms of your proposition?

http://noosphere.princeton.edu/

Akira & Tros,

The vast majority of theists believe in a deity for the same reason that the vast majority of athiests believe in pychiatry. They read a book that says it's true, and most of the people they respect say it's true. For that matter, I believe in atoms mostly because my chemistry book says they're there. There isn't enough time for me to repeat all the experiments myself so after a certain point, I just believe with a healthy reservation. If following a belief turns things from bad to worse, it's time to rethink those beleifs.

VM|2.16.07 @ 12:51PM|#

"The vast majority of theists believe in a deity for the same reason that the vast majority of athiests believe in pychiatry"

sure sign that a fucking quack wrote that.

tros|2.16.07 @ 1:07PM|#

If following a belief turns things from bad to worse, it's time to rethink those beleifs.

Agreed wholeheartedly, and doing my best to facilitate the process.

"Let them pass all of their dirty remarks
there is one question I would really like to ask
is there a place for all the hopeless sinners
who have hurt all mankind just to save their own?"

One love
One life
LEGALIZE

Thank you, that is all.

VM|2.16.07 @ 2:42PM|#

waddle waddle
duk-duk-froot-froot
goon goon goon
don't worry cuz batshit's here.

|2.16.07 @ 2:51PM|#

It got lost in the crazy bullshit -- but someone stated that speed doesn't cause concentration issues.

You must never have taken speed. Amphetimenes wake you all the way up. Jittery, hyperactive, concentration issues (you can focus really well but you jump from concept to concept). It's got a bunch of other psychological affects, but it's like going on the world's biggest caffiene bender.

I'm not sure what the Air Force uses for their go-pills, but it's not purely amphetimenes -- they want their pilots awake, not twitching and trembling.

Unless you have ADHD. In which case, it does the exact opposite. You calm down, have a much easier time focusing -- the exact opposite of what it does to everyone else.

You give a non-ADHD kid Ritalin, and he'll turn into an unholy hyperactive terror. You give it to a kid WITH ADHD and he stops being an unholy hyperactive terror. It's pretty much night and day there.

Interesting fact, for the non-crazies -- people with undiagnosed ADHD (primarily adults) tend to have excessive caffiene consumption. Caffiene is also a stimulant, although a mild one compared to amphetimenes. Many adults with undiagnosed ADHD unconciously self-medicate, with doses of caffiene that'd have most people buzzing.

______|2.16.07 @ 3:19PM|#

Ooooh fuck. The Scientologists and the worshipers of Szasz are going to have a field day with this.


No, the field day was had by the self-identified crazy people on psych meds and a science worshipping fundamentalist Atheist.

The fact that a little girl was killed by "treating" her for a non-existent disease was
largely lost.

tros|2.16.07 @ 3:31PM|#

Interesting fact, for the non-crazies -- people with undiagnosed ADHD (primarily adults) tend to have excessive caffiene consumption. Caffiene is also a stimulant, although a mild one compared to amphetimenes. Many adults with undiagnosed ADHD unconciously self-medicate, with doses of caffiene that'd have most people buzzing.

I experience this phenomenon of which you speak, because i have the "UNDIAGNOSED" ADD. The question I ask myself is this: Did I have the all-consuming drive for chemical stimulation before I was put on Ritalin in 3rd grade? Because I was only on it for about a month, but after that I was chained to any form of stimulant I could get my hands on. Honest injun ;-)

In fact I struggled with stimulant addiction up until the point when I started my self-treatment with REAL MEDICINE. For those interested in advocating the right of SELF TREATMENT I would suggest reading up on this concept over at mutualist.blogspot.com

tros|2.16.07 @ 3:51PM|#

Consider these lyrics knowing that Sage Francis is what is called "Straight Edge" meaning that he fervently advocates that you SAY NO TO DRUGS.

Every midnight we sit at the coffee table and we share a cup of
tea
He stays up with me and we discuss things
Most of
the time he just listens
Other times offers suggestions or
he just ignores my questions
It gets more depressing as
time passes, because every night
I ask this one question
and all he does is wipe his glasses
It's aggrevating
as hell and I'm just waiting to tell
whether or not he
can even remember the answer..
Or whether or not he's
choosing not to tamper with his memory..
Or whether or not
he can even fucking remember me.
What a waste of time
But every night it's that same damn routine:
One
green cup of tea and me stuck all by myself once its empty
Then I'm off to bed with plenty of caffiene to keep me up
and thinking
The cup I'm drinking from is never
clean
I can't remember if it's a dream once I
awake and I walk..
From my messy bed and anticipate the
next late night talk

Every midnight we sit at the
coffee table and we share a cup of tea
He stays up with me
and we discuss things
Most of the time he just listens
Other times offers suggestions with his awful expressions
Altered refelctions...his whole aura is see-through
With
more confessions...I don't want to leave you
"This cup
should be bottomless!"...as my insecurities spill
I see his
face fading away. I surely need a refill
I purposely keep
still and don't move much
Except to wet my lips with
sips. With every kiss of death I lose touch
I sip the tea
carefully because its at the degree of seperation
Tasting
the forked tongue in bi-lingual conversation
Waiting for
his answer still...and at any given chance I will
Sweet and
Low my bitter past...let the cancer kill the small talk
"Alright, man...this bitter taste in my mouth needs to get
washed out
Ghosts in this house don't have anything
timely to talk about."
The concept is dead. There's
nothing death should interrupt
I went to bed last night
with one sip left in the cup

|2.16.07 @ 4:38PM|#

"I'm not sure what the Air Force uses for their go-pills, but it's not purely amphetimenes -- they want their pilots awake, not twitching and trembling."

Maybe all pilots have ADHD. Yeah, that must be it.

At least you're smart enough to realize there are some holes in your story.

*|2.16.07 @ 4:55PM|#

Right, because giving a child a drug to treat a diagnosable medical disorder is the same thing as mutilating the child.

I'll diagnose your face. I don't care what you call it if you give kids CIA brainwash drugs it is mutilation.

It's hard to even know where to begin with such a fascinatingly strange statement. You realize that "your face" is not a medical diagnosis, whereas schizophrenia, for example, is, right? I mean, I know, difficult stuff.

And "CIA brainwash drugs"? Seriously? You sound like someone who would benefit from a trip to the psychiatrist yourself, and I'm not saying that to score rhetorical points either--you really do. If any patient of mine told me in the course of a medical interview that they believed that the CIA came up with, for example, Ritalin, to brainwash children (to what nefarious ends I wonder? Better school performance? Better relationships with peers and parents? Damn you CIA!!) I would arrange a psych. consult for them.

*|2.16.07 @ 4:58PM|#

BTW tros, I'm a big Sage Francis fan myself, so I guess we have that in common. I'm not exactly sure how posting the lyrics from one of his songs furthers the discussion on this subject, though.

|2.16.07 @ 5:14PM|#

No, the field day was had by the self-identified crazy people on psych meds and a science worshipping fundamentalist Atheist.

The fact that a little girl was killed by "treating" her for a non-existent disease was
largely lost.

I agreed that what happened to this firl was an overreach of psychiatry, but that is a failure of the doctor, not the science.

I also said:

One of the few times I'll ever agree with Akira, but I look to the Szasz psychiatric denying pigfuckers to inundate this thread with their nonsense. They can all feel free to read this comment and fuck off, but Idoubt that'll happen.

I've seen plenty of the nonsense I predicted, from the types I predicted it from. Deepak fucking Chopra?

_____|2.16.07 @ 5:35PM|#

Tufts-New England Medical Center, where Rebecca was treated, is backing the doctor who made these diagnoses, declaring the care she received "appropriate and within responsible professional standards."

I agreed that what happened to this firl was an overreach of psychiatry, but that is a failure of the doctor, not the science.


There is no "science" of psychiatry.

|2.16.07 @ 5:51PM|#

Police departments often back their officers when innocents are killed in drug raids gone wrong. I suppose that's not a failure of those departments, but of law enforcement as a whole.

|2.16.07 @ 5:54PM|#

How care that resulted in the death of a physically healthy 2 year old can be called "appropriate and within responsible professional standards" is a mystery to me.

And how they can charge the parents and not the psychiatrist is also something of a mystery. They seem equally culpable to me.

|2.16.07 @ 6:29PM|#

This is just one case study, but it's still interesting.

http://www.sciam.com/article.cfm?chanID=sa003&articleID=7232A90EA7D391905F9EE07BCC7C5967

|2.16.07 @ 6:36PM|#

"And "CIA brainwash drugs"? Seriously? You sound like someone who would benefit from a trip to the psychiatrist yourself, and I'm not saying that to score rhetorical points either--you really do. If any patient of mine told me in the course of a medical interview that they believed that the CIA came up with, for example, Ritalin, to brainwash children (to what nefarious ends I wonder? Better school performance? Better relationships with peers and parents? Damn you CIA!!) I would arrange a psych. consult for them."

And yet colleges are full of people who think environmental skeptics are secretely funded by corporations or that any disagreement is evidence of cultural bias. My skepticism of psychiatric lables grew when I saw how many tenured professors hold conspiracy theories. Jim Carrey makes millions doing things in front of a camera that would land the average person on the street in a psych ward. If a patient wants to see a psychiatrist, fine, but there aren't many diseases that disapear once you put the patient in front of an audience.

Mendelism|2.16.07 @ 6:37PM|#

How care that resulted in the death of a physically healthy 2 year old can be called "appropriate and within responsible professional standards" is a mystery to me.

And how they can charge the parents and not the psychiatrist is also something of a mystery. They seem equally culpable to me.

It doesn't seem so odd to me. What I gathered from the story was that a physically healthy 4-year old, who had been receiving drug treatment for 2 years, died when her parents deliberately gave her an overdose of the drugs. At least, that's the allegation.

If a child with diabetes died because her parents gave her an overdose of insulin, the case against the parents vs. the physician would be more clear-cut. It would be an easy malpractice case if the physician didn't prescribe insulin, and the blame would lie with the parents if they gave the kid an overdose, whether deliberately or due to negligence. The fact that we're talking about kids with mental illness is what makes it interesting. Tufts appears to be taking the position that, among practitioners who specialize in the treatment of children with severe cognitive and behavioral disorders, the child's doctor in this case made the appropriate diagnosis and prescribed the appropriate therapy at the appropriate (i.e., non-lethal!) doses.

I don't think anyone would argue that parents or doctors should withhold insulin from diabetic children because they can't provide consent. But then bipolar disorder isn't the same thing as diabetes, which is why this thread is so long.

|2.16.07 @ 6:58PM|#

Consent trumps advice. That's why an adult should be able to take or not take any drug regardless of how wise that decision is.

Since a 2 year old can't give informed consent, we debate whether or not the drug is in the 2 year old's best interest. A 2 year old with diabietes has an abnormal blood sugar level that we can objectively measure. Bipolar is more subjective, so there is debate. Healthy normal behavior is also age dependent. Giving a todler meds for mood swings is a bit like giving her growth hormone for dwarfism.

tros|2.16.07 @ 7:28PM|#

You know I need to ask all you ignorant pigheaded motherfuckers who believe in Attention Deficit Disorder why you hate America's children. Because you know it's just an excuse to sell child-crack to lazy parents. You would have to be a moron to not see that, I'm afraid.

I would like to put forward the proposition that any parents who give their children drugs for "Attention Deficit Disorder" are harming their children in a serious way. I would say that Social Services should do something about it but hell, they're the crack dealer! What the fuck do we do about this?

tros|2.16.07 @ 7:38PM|#

O yes, and by the way I am in serious need of a psychiatrist, I just can't tell if I am a paranoid schizophrenic or not. I am having trouble convincing myself. This blog is an interesting machine for generating criticism.

So yeah, uh, everyone who disagrees with me is an idiot.

And I will just sit here until people run out of rational criticism. When do you think it counts as "peer reviewed"?

|2.16.07 @ 8:19PM|#

I'd suggest that if you are worried about being a paranoid schizophrenic, you do everything in your power to investigate the symptoms and potential remedies, and find a doctor willing to listen to you and not impose his own diagnosis upon you. There are good psychiatrists out there; they just need to be found. Mine is the president of the Northeast Ohio Psychiatric Association; he gives talks on various psychiatric maladies, and has never pretended to be God to me.

|2.17.07 @ 1:33AM|#

"I'm not sure what the Air Force uses for their go-pills, but it's not purely amphetimenes -- they want their pilots awake, not twitching and trembling."

It might be modafinil, aka Provigil in the US. It's supposed to prevent you from feeling sleepy, but without being a stimulant. Allegedly it can allow a person to function for 40 hours on 8 hours of sleep.

|2.17.07 @ 1:37AM|#

"Tufts-New England Medical Center, where Rebecca was treated, is backing the doctor who made these diagnoses, declaring the care she received "appropriate and within responsible professional standards.""

Of course they are. The alternative would be for them to open their checkbook and ask, "How many zeroes would you like on that?".

It's pretty much standard operating procedure to deny any mistakes, and probably what any hospital's lawyers would advise.

I've read that the radical new approach is to quickly apologize when a medical mistake is made, rather than stonewalling, because the stonewalling just sets up an escalating confrontation, and a quick open apology may be cheaper - if the wronged party seeks compensation at all.

|2.17.07 @ 12:46PM|#

Low-dose stimulants help anyone pay attention.

They can't be used for diagnosing anything.

This is well demonstrated in NIMH-funded research.

The posts on this thread are scary to me.

People are so defensive about someone arguing that 2-year olds shouldn't be on unproven psychiatric medication cocktails with no long-term data on safety or efficacy.

Blows my mind, really.

|2.17.07 @ 12:47PM|#

Oh and this deceased little toddler had two siblings who were similarly medicated. By the same psychiatrist. Who bears all responsibility, in my opinion.

tros|2.17.07 @ 1:39PM|#

Mine is the president of the Northeast Ohio Psychiatric Association

Wow, what's it like to have Premium Sanity installed in your brain?

In all seriousness, that was a joke. I am "convincing" myself that I am not a paranoid schizophrenic by testing my theory. I'm sure there are some psychiatrists that do good things for people, but I am sure that they are the exception. They can't all be the president of the Premium Sanity Cartel.

|2.17.07 @ 3:32PM|#

People are so defensive about someone arguing that 2-year olds shouldn't be on unproven psychiatric medication cocktails with no long-term data on safety or efficacy.

I must have missed those defenses.

In all seriousness, that was a joke. I am "convincing" myself that I am not a paranoid schizophrenic by testing my theory. I'm sure there are some psychiatrists that do good things for people, but I am sure that they are the exception. They can't all be the president of the Premium Sanity Cartel.

I was only stating that I know that my doctor is accepted by his peers as being extremely qualified. I know that there are quack psychiatrists out there; and that quack qualification certainly applies to any psychiatrist that would medicate a 4 year-old.

Note that I did not qualify with my last sentence with the phrase "to death". 4 year-olds should not ever, under any circumstances, be medicated with psychiatric drugs.

|2.17.07 @ 6:08PM|#

Regarding the effects of pscyh meds on people who don't have the disease they're intended for, there was a mail order mix up recently.

http://www.fda.gov/bbs/topics/NEWS/2007/NEW01564.html

The report says, "Haloperidol can cause muscle stiffness and spasms, agitation, and sedation"

The risk is that doctors might mistake agitation for mania and sedation for depression in a patient on Haloperidol. Since the side effects of one drug can simulate the syptoms of a DSM catigory, caution is necessary.

Simon SoboMD|2.22.07 @ 8:38PM|#

"Showing ADHD is a bona fide chemical imbalance is easy. If I were to take ritalin, I'd get seriously hyper and be unable to focus. It's basically speed, after all. Given to someone with ADHD, they calm down and have much better focusing abilities"

This is simply not true. If the writer of this quote took Ritaline his concentration would improve just like someone with ADHD. Indeed the New York Times ran a story about how it was being used by normal students to improve their SAT scores. See "ADHD and Other Sins of Our Children at this URL http://www.geocities.com/ss06470/ADHD.html for a discussion of what ritaline and amphetamines do for children with ADHD