Moon of Alabama Brecht quote
June 21, 2011

Is Psychiatry Itself A Mental Disorder?

In the NYRB Marcia Angell, a senior lecturer in social medicine at Harvard Medical School, reviews seven books on psychiatry and the use of psychotropic drugs. The two part article, The Epidemic of Mental Illness: Why? and The Illusions of Psychiatry, are currently available for free. Both are recommended reading.

I am especially concerned about children and teens taking psychoactive drugs. No, that does not mean that I mind when fifteen year old teens drink a beer or smoke a joint. But I am very suspicious when I am told by parents that their child has this or that disorder that gets fixed by taking some chemical mixture which has unknown effect-chains in the body and especially in the brain.

Being hyperactive and/or inattentive is part of being a child. It is normal. It can be ´cured just by increasing outdoor activities. Being partly depressive is practically the definition of a teen in puberty. These are not illnesses but important and necessary parts of growing up. Taking psychotropics daily, often with serious side effects, will not heal such illnesses but cause damage.

The first part of the article demonstrates that there is huge increase in the numbers of people who are diagnosed with some mental disorder and get prescribed one or more psychotropic drugs. It shows how this increase is not a real increase in mentally ill people, but an increase in the definitions of what is considered mentally ill. These definitions are made up and marketed by people with an interest to increase the number of patients and drug sales, doctors and the drug industry.

The way drugs get approved for this or that mental disorders is also troublesome. Notice also how the state is again willingly asleep at the wheel:

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

If a new drug is introduced for this or that illness, all studies about that drug should be publicly available. Today a new drug may have one industry paid study with positive results and nine negative ones. Only the positive one gets published and no one except the industry and the FDA knows about the others.

The incentives on the doctor's side favor drug prescription over other successful and less harm causing therapies:

Like most other psychiatrists, Carlat treats his patients only with drugs, not talk therapy, and he is candid about the advantages of doing so. If he sees three patients an hour for psychopharmacology, he calculates, he earns about $180 per hour from insurers. In contrast, he would be able to see only one patient an hour for talk therapy, for which insurers would pay him less than $100.

But interestingly it ain't just the industry and the doctors that have an incentive to increase the number of mentally ill.

As low-income families experience growing economic hardship, many are finding that applying for Supplemental Security Income (SSI) payments on the basis of mental disability is the only way to survive.
Hospitals and state welfare agencies also have incentives to encourage uninsured families to apply for SSI payments, since hospitals will get paid and states will save money by shifting welfare costs to the federal government.
In December 2006 a four-year-old child named Rebecca Riley died in a small town near Boston from a combination of Clonidine and Depakote, which she had been prescribed, along with Seroquel, to treat “ADHD” and “bipolar disorder”—diagnoses she received when she was two years old.
The parents had obtained SSI benefits for the siblings and for themselves, and were applying for benefits for Rebecca when she died. The family’s total income from SSI was about $30,000 per year.

The state setting incentives in a way that practically makes people declare their children mentally ill and let them take psychotropic drugs with hospitals and psychiatrists supporting such behaviour - how sick is that?

As what would a psychopharmacists classify that mental disorder? What is the pill against it?

Posted by b on June 21, 2011 at 18:12 UTC | Permalink


2 years old, bipolar??
for potato's sake!!!

meanwhile, adiction to money is not even an issue..
and it's bloody harmful to a whole bunch of people, not only to the sick damned soul who's ill

Posted by: sKol | Jun 21 2011 20:28 utc | 1

They are playing a game. They are playing at not

playing a game. If I show them I see they are, I

shall break the rules and they will punish me.

I must play their game, of not seeing I see the game.

by R.D. Laing

Posted by: Uncle $cam | Jun 21 2011 22:18 utc | 2

Comfortably Numb: How Psychiatry Is Medicating a Nation

Child antidepressant doctors took millions from drug makers

Psychiatry - Making a Killing with Dr. Rima Laibow & G. Edward Griffen By CCHR

Note: in all fairness, the last link/video is produced by Scientology but, is a greatly interesting documentary none the less...

Posted by: Uncle $cam | Jun 22 2011 0:08 utc | 3

Just me, but, I don't consider Psychiatry a valid science. With enough education, I could too, invent names for supposed illnesses, and treat them with harmful drugs that don't cure. Just another part of the vast snake-oil marketing arm of modern day society. Invent a name for an "illness", create a new drug to treat it, put a bit on TV to advertise it, and bingo, sales go off the charts.

Posted by: ben | Jun 22 2011 1:40 utc | 4

Being hyperactive and/or inattentive is part of being a child. It is normal. It can be ´cured just by increasing outdoor activities.

You’re not alone in advocating this b. Richard Louv in his exceptional book “Last Child in the Woods” agrees. He points to “a growing body of research that links our mental, physical and spiritual health directly to our association with nature - in positive ways.”

Disturbing is Louv’s look at how children are being deprived of nature. It is not just TV and computers and video games that act to keep kids out of nature but cultural, structural (e.g. city life) and familial (instilled fears) factors. My skeptical and conspiratorial self will also find a more nefarious and deliberate profit oriented reason but that’s me and isn’t mentioned in the book.

This review by Daniel G. Deffenbaugh will give you a good flavor of the book if your interest is piqued.

Posted by: juannie | Jun 22 2011 1:50 utc | 5

As I remember we were self-medicating with alcohol, drugs and danger. Quite a few did not survive.

Posted by: somebody | Jun 22 2011 5:37 utc | 6

Could there be a correlation between eagerness to drug kids and the pupil/teacher ratio?

Dealing with children wo do not want to sit still and shut up takes time, and the bigger the size of the classroom the less time the teacher has for individual pupils. Cheaper to give them pills.

Posted by: a swedish kind of death | Jun 22 2011 12:48 utc | 7

Is Psychiatry Itself A Mental Disorder?

Sure, if one wants to ignore the valid medications for schizophrenia or clinical depression (for examples).

It's come a long way from Freud's stuff, and, certainly, has further to go. As the article shows; there's the issue of malpractice.

Posted by: nobodee | Jun 22 2011 12:59 utc | 8

I think first one has to admit having a mind is a disorder in and of itself...) Sort of like stating the obvious in a health care discussion - life is a preexisting condition.

Posted by: Eureka Springs | Jun 22 2011 13:49 utc | 9

I have seen the diagnosis of ADHD way over used (even in my own family!) but on the other hand, I have seen kids who actually have this disorder. These kids cannot control themselves at all, and can open and trash every drawer in a dresser faster than you can say "don't open those drawers".

And since I currently work as a pediatric audiologist with kids ages zero to three, I have seen kids whose nervous systems cannot even handle someone turning on a small table lamp without having a total meltdown. I have seen children who will lose it ever time they are touched, no matter by who or for what reason. I have seen children who seem totally disengaged from reality. I have heard parents claim the child never sleeps for more than 30 minutes at a time, and then just once or twice a day. I saw a child today who I think might be schizophrenic. Often the parents are the last to know that something is really wrong, and they surely don't know about SSI until we tell them. And NONE of the kids I see (at least when I see them) are on medications.

One time a parent will say to me: I wish he had a hearing loss! we could fix that! Instead he had a kid who seem not to hear because he did not respond, but in fact, had normal hearing.

One thing I do when testing a small child in the sound booth is turn on a lighted toy when they look for the sound that I presented. A normal child will like that, and want you to do it again. An autistic child will totally freak out that a toy is lighting up where there was a black box before. If I go on to make the (sometimes unseen) toy start moving and making noise, they will totally lose it. It is like they have a instant nervous breakdown. A normal child will laugh, or maybe get bored with it all.

So, yes, the diagnosis of mental illness is overused, but the actual fact of mental illness (especially autism) is on the rise in the USA in very young children. My suspicion is that this has to do with environmental toxicity that impacts some more than others.

Posted by: Susan | Jun 23 2011 1:25 utc | 10

So, yes, the diagnosis of mental illness is overused, but the actual fact of mental illness (especially autism) is on the rise in the USA in very young children. My suspicion is that this has to do with environmental toxicity that impacts some more than others.

That causal relation is hard to prove. Better diagnosis/more false positives could also be the cause. Maybe the autistic %age is x% and it's only being discovered now due to more people testing their kids. It also appears that ADHD,autism and other kid related stuff seem specifically targeted at pushing drugs for a lifelong purchase cycle.

When I flip through psychiatric textbooks, it really, really seems to be a variation of the old saw, you pay the shrink for advice that your mother would give you for free.

It would be interesting for someone with data to plot this information i.e. the appearance of a new drug e.g. Paxil and the number of cases registered YoY for symptoms needing that drug; covering 3 distinct phases; before the drug was introduced, the patent covering years and finally when it goes off patent.

You probably know the answer, I think.

Posted by: shanks | Jun 23 2011 16:37 utc | 11

What I am reporting seeing is what I have seen with my own eyes over 20 years. There are more kids with mental health problems - and I see them BEFORE they are on any medication at all. They are generally healthy in the physical sense, and are not on any medication for anything. And as to more people getting their kids tested - my guess is most folks would bring their kids to the doctors if the kid was having a meltdown every time a light was turned on or off, or if they don't sleep for more than an hour a night.

I have not seen more kids with ADHD - but that is at least partly due to the fact that that diagnosis is not made in the under age 3 crowd. I did see ADHD when I worked in the schools a couple of decades ago, and it is easy to spot if the kids are not on meds. However, lots of doctors try out the meds on any kid that comes along, just to see if it helps. This is the school age crowd, not preschoolers.

Posted by: Susan | Jun 23 2011 17:17 utc | 12

A million ways ..

sit back, matter of fact
teasing, toying, turning, chatting, charming
hissing, playin the crowd
play that song again
another couple Klonopin
a nod, a glance, a half-hearted bow

This whole nation needs a spiritual enema, a philosophical ethics readjustment, a twelve step program, for it's ills, or a dose of Pink Freud.

"The Nausea is not inside me: I feel it out there in the wall, in the suspenders, everywhere around me. It makes itself one with the café, I am the one who is within it."
- Nausea, trans. Lloyd Alexander

American is the drug...

"You think my fallacy is all wrong?"
-Marshall McLuhan's favorite line for hecklers

Posted by: Uncle $cam | Jun 23 2011 17:37 utc | 13

Unintended Consequences continues to be the name of the game.

I had a little quiet fun with the DSM myself recently. It's such a big juicy target, it's almost not fair to make fun of the damn thing.

Posted by: DeAnander | Jun 24 2011 7:39 utc | 14

Here's an excerpt from my DSM-V draft, for those who don't feel like clicking over... it's mildly amusing to roll your own syndromes!

Another syndrome inflicting considerable social costs in the current era is Alimentary Discrimination Failure Disorder (ADFD), in which the patient has become completely unable to distinguish real, edible food from synthetic, non-nutritious industrial products. In advanced cases the patient will actually demonstrate a marked preference for brightly-coloured and artificially-flavoured packing material with a high toxic content, over (e.g.) a ripe fresh tomato. Many patients manifest a phobic reaction to any food item which is not packaged in cardboard, glass, or plastic: some will, for example, refuse to eat fresh fruit off a neighbourhood tree, believing that it is in some way “dangerous”. ADFD is usually contracted in childhood or youth from overexposure to artificial low-cost food substitutes such as army rations or corporate “fast food”. If real-food bonding and socialising are not acquired in early childhood (the critical age is disputed but probably varies between 7 and 10 years), the patient may never learn the basic animal skill of detecting and evaluating food sources, or seeking adequate nutrition.

Posted by: DeAnander | Jun 24 2011 7:41 utc | 15

Big Pharma and the Authority bodies (professional associations, like the APA) as well as Gvmt. are in cahoots to promote new mental illnesses with quick-pill cures.

Pharma sells, the Authority bodies reap indirect benefits, in short get part of the profits, and Gvmt. + affiliated types don’t mind spending when it goes to the big and powerful (again, there are many indirect sources of revenue, like having one’s pol campaign funded), and moreover in the ‘fascist - socialist’ line, very prevalent in the US, demeaning ppl and forcing them into a treatment queue is absolutely traditional. Parents can have their children removed for refusing to force medication on them.

Some might add, note this is not my argument in this post, the medications ruin ppl and make them incapable of concerted actions, as they are treated as ‘exceptional, dysfunctional, crazy’ ppl or children - and their brains become fried, they become special snowflake outcasts who are pandered to who also become, well, quite odd.

Often, the label or categorization confers advantages, that is built into the system - special ed, special meds, special personal advantages, in the family, in love relationships, in society, can be claimed, etc. Basically for the middle class insured, or course, as they pay in.

This is the reason why the ‘brain chemistry’ explanation for lack of learning, compliance, or integration to e.g. schools has been touted, as no other therapies except chemicals will act on ‘brain chemistry.’

Oh I could go on and on and on...What is staggering and should be paid attention to is the wholesale junk science and corruption going on.

That said, a few psychiatric medications work well for some ppl and should not be condemned out of hand.

Posted by: Noirette | Jun 24 2011 14:11 utc | 16

BTW @Susan above, I do believe that alongside overmedication and shameless shilling by the med mafia, there is an unacknowledged epidemic of some kind of neurological damage or deficit in children -- possibly due to maternal, fetal, and infant body burden of various industrial toxins? Or poor nutrition? Or some hitherto unsuspected side effect of some technology or practise that has seemed quite normal for a generation or two?

All I know is that I seem to see a larger proportion of young adults and youngsters who seem a bit mentally or emotionally deficient -- not quite functioning in terms of social or practical skills. And I have no idea why. Meds may, I guess, help control day-to-day behaviour in the more extreme cases, but... controlling behaviour is not the same thing as curing a person or fixing a problem. It's one on my long list of worries: if something about the way we are conducting our culture is damaging to our cognitive/emotional capacities, then may we not be sabotaging the very resources we most need in order to tackle our present predicament (i.e. smart, caring people)?

Posted by: DeAnander | Jun 24 2011 15:24 utc | 17

Psychiatry reflects current social pathologies

for example, the principle of not being content with what you have, and that of permanent competition, on which our societies are founded, are quite extraordinary in human history

there's also an unspoken but pervasive and powerful stimulus at shaking off conscience constraints in the search of success

still, the values taught in families and at schools are traditional, based on common sense, getting along, resolving disputes through compromise and understanding, sharing, taking responsibility, etc;

so we live in a schizophrenic society, which is reflected on our schizophrenic policies (make war to have peace, paranoid sense of being menaced, impoverish to enrich, etc)

Orwell's double-think in full display

psychiatry today reflects the current dehumanizing and manupilatory tendencies of social control, the old omnipotence delirium of certain applied sciences, plus the prevailing logic of business

Posted by: claudio | Jun 24 2011 18:09 utc | 18


Your “roll your own syndromes” was hilarious, well actually to me, more so poignant, especially your ADFD syndrome which touched a subject close to my heart, well actually my alimentary tract. And as a special bonus, alerted me to your site being open and active again. I’ve book marked it and will visit often. I hope your sail making doesn’t get in the way of your erudite contributions there, but then again I recognize the importance of a love of yours. My wife and I had the wonderful opportunity years ago to sail from Ft. Myers across the inland waterway to Ft Lauderdale and then down the Atlantic to Miami on a junk rigged 52 foot two master. An unforgettable experience and the ship, Whisper, was truly a beauty.

But back on thread, I think it is important to recognize that the childhood drugging is only a prelude to a life long addiction of enriching the pharms at the expense of the addicts health. How many of our friends can’t get of Paxil or whatever. It is pathetic and more criminal than the dealers so demonized over the years of the drug wars.

Posted by: juannie | Jun 24 2011 21:01 utc | 19

A little more: Potted history.

Non conforming - difficult, devilish, hopeless, handicapped, rebellious, dumb, underperforming children were for a long time simply accepted as is, with explanations focussed on religion, folklore, or other mega framework.

Diagnosis and treatment slowly became fashionable after 1850 - the perception that some fault could be fixed, or at least kindly acknowledged, grew, or became part of the public discourse, with the rise of medicine, psychiatry, social services, universal primary education, the importance of educational attainment outside an agrarian society, and other factors.

After about 1950, the importance or desire to keeping children ‘at home’ or ‘integrated’ and not ‘abandoning’ them to cold and cruel asylums facing death meant that state support had to be offered.

It came in the shape of special ed, specialist care, social support, in all of its manifestations.

In the *US*, Diagnoses varied - historically, from minimal brain damage locating the problem in the brain, not the heart, or the family, heritage, social conditions, to learning disabled which label was an effort by the cognitively ‘impaired’ to be treated as well as those with only physical difficulties (Harvard should accept both ppl in wheel chairs and the ‘learning disabled’), to today’s mix of attention-deficit and hyperactivity, oppositional disorder, social anxiety, and so on.

Lack of success or ‘deficits’ were attributed to individual characteristics that are somehow inborn, intrinsic, an accident of history (today, ‘genes’) which was radical at the time - the sins of the father, and all that, were dismissed.

Subsequently, though, explanations shifted once more to micro-societal, family considerations, bad parenting, bad mothers ...eventually a medley was born as it suited those in power ...push pills *and* blame parents! (see typically new Labour in the UK..)

The new diagnostic criteria or definitions are just a variation, a mix, but becoming more all-encompassing.

Historically, hyperactivity was a very circumscribed description of observable behavior reserved for ppl who did not, could not, control their major limb movements - desperate twitching, uncontrollable tics, pacing, etc. The patients themselves complained about it, so it entered the symptom list. In its strict ancient definition, it is due to neurological damage that affects motor control, many post ww2 vets were affected.

As for attention deficit, it is absurd. There is no way to define attention except by authority. (Outside of receptor damage or serious central treatment snarls - aphasia, for ex.)

@ Susan, i have also seen with my own eyes the rise of autism.

Posted by: Noirette | Jun 25 2011 17:21 utc | 20

I think both premises are true - there IS more mental health problems in children (a lot more!) and there is also over-diagnosis and over-medication of older children (which is bullshit).

It is also interesting to reflect on the fact that many of the hackers of today have autism or asperbergers - they are smart, they are not socialized as society would expect, and in some cases they are doing a lot of good.... in others, a lot of bad. But if the US DOD can interfere with Iran's nuclear plants, then I am all for hackers interfering with the DOD computers and bringing them down.

I will never be smart enough to join them, however.

Posted by: Susan | Jun 25 2011 17:58 utc | 21

I agree in general about how attention deficit is stamped to normalise sitting straight and following what the teacher tells you. But I have actually met a young but adult person who had the attention spann of a two year old on a sugerrush, so I guess that happens too. Given the amount of social problems it caused, she probably would have benefitted from some kind of treatment (if successfull, and without grave sideeffects). Then again many mellow down eventually.

thanks for the link to your blog, I had lost it. On your long post on how to deal with food without a refrigerator, I note this:
Hubbert’s Toboggan » Blog Archive » Without benefit of refrigeration

Sometimes it seems that the whole purpose of industrial civilisation is to persuade us not to pay attention — that we don’t need to pay attention — to ordinary things like food. We are busily inventing gizmos that navigate for us so we don’t need to pay attention to where we are; all kinds of devices that automatically alert us to various conditions internal and external, so that we don’t have to pay attention to what’s going on with them (or ourselves or our surroundings). We even invent marvelous gizmos to distract ourselves from the ordinary things, so that we can live in a constant state of distraction and inattentiveness. I find this quite understandable (monkey like shiny thing, twinkle twinkle) but also rather alarming.

Kids pay attention to everything around them, which frustrates parents who do not see the need to stop and examine every stone. But as we grow up we are taught what to pay attention to (authority, shiny things) and what not to pay attention to (nature). And if a pupil sits and looks out at the splendors of nature they have an attention deficit. Best feed them drugs until they pay attention to the right things.

Posted by: a swedish kind of death | Jun 28 2011 19:13 utc | 22

Shameless Manipulative Marketing Moves, Chapter Bazillion... How the antidepressant industry keeps redefining depression to sell more pills.

Posted by: DeAnander | Jun 30 2011 5:45 utc | 23

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