Anti-depressant scandal

Note: I think it's important to remember that anti-depressants do seem to work for some percentage of the population and apparently can be life-saving for at least some people and this is not necessarily easily predictable - certainly not across screens by lay persons!

All to say an internet message board shouldn't contradict the advice of medical professionals. Get a second opinion if need be.

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Psychiatry, Fraud, and the Case for a Class-Action Lawsuit

Robert Whitaker

When Mad in America received a notice this past June that Joanna Moncrieff, Mark Horowitz, and colleagues would soon publish a paper concluding that there were no research findings that supported the low-serotonin hypothesis of depression, I initially wondered whether we should bother to report on it. Mad in America readers know well that the low-serotonin theory had long ago been debunked, with numerous articles on our site telling of that fact, and so I quipped to other MIA staff that reviewing the article would be like “beating a dead horse.”

Then, as psychiatrists publicly commented on the paper, a second confession appeared, this one indeed of “landmark” importance. Their comments serve as an admission that, for the past several decades, their profession committed medical fraud. And I am using that term in its legal sense.

As Moncrieff and colleagues noted, there is a long line of research that failed to find evidence supporting the low-serotonin theory of depression. What was new about their work was that they performed a comprehensive review of this research, looking at the different “types” of studies that had been done, and finding that all had failed to produce evidence supporting the theory. In response, a number of prominent psychiatrists in the UK and the United States dismissed the paper as old news. Here is a sampling:....

....

Do antidepressants create more mental illness than they cure?

D: One of the most powerful stories in “Anatomy of an Epidemic” is the 19th century Quaker practice of moral therapy. Can you foresee a return to this sort of model?

B: I love the humility in it. They admitted they didn’t really know what causes madness, but here’s the key: they said, “we know they’re brethren. They’re humans, like all of us.” Then they asked, “What do we like? We all like a comforting environment; we need shelter; we need food; it’s good to have interests; it’s good to have socialization and respect toward each other.”

One of the beautiful aspects of moral therapy is they wanted to create these residences out in the country. They thought nature could be very healing, diet could be very healing, a little glass of port at four in the afternoon could be healing.

This moral model used by quakers seems similar  to the social and professional structures of ships at sea. There are strict rules for everything and outwardly most people would complain or seem to hate it. But inwardly I think it really scratches that community itch that most people lack in the modern world, even if it isn’t ideal or even fun. Most people are comfortable with being told what to do and when, and secretly like it in some fashion.

So I can imagine that holding people accountable directly for everything, with instant feedback on how “good” or “bad” they are doing, helps mentally ill  people.

This moral model used by quakers seems similar  to the social and professional structures of ships at sea. There are strict rules for everything and outwardly most people would complain or seem to hate it. But inwardly I think it really scratches that community itch that most people lack in the modern world, even if it isn’t ideal or even fun. Most people are comfortable with being told what to do and when, and secretly like it in some fashion.

So I can imagine that holding people accountable directly for everything, with instant feedback on how “good” or “bad” they are doing, helps mentally ill  people.

I think it becomes a bit complicated, because authority can all too easy be corruptible.

On the other hand there probably is value to providing structure, especially when it comes to aiding some people who are mentally ill.

It would be interesting to see moral therapy, as well as some apparently beneficial shamanic treatments, get more research. We would probably need to regulate things carefully, lest we end up with the same issues now facing antidepressants, but moving away from over-reliance on mechanistic/materialist models could benefit many. (Of course as noted in my first post some will likely benefit from some kind of anti-depressant medication.)

Most people are comfortable with being told what to do and when, and secretly like it in some fashion.

I think this is often presented in a pejorative or negative light.  I wonder if the reality isn't different and that structure in at least some aspects of life is necessary, healthy, and liberating.

For example, I enjoy knowing that other drivers on public roads have been "told what to do" when it comes to operating their motor vehicle.  It makes me multiples safer and allows me to NOT have to worry about anarchist drivers (generally).  This can apply to a myriad of things.  I always become suspect of those who label this type of behavior as sheep or "sheeple".  The faux intellectual superiority of these types often masks a sort of brazen hubris and stupidity.

(To be clear I don't get that sense from folks in this community.  Sci's opening caveat warning to not take medical advice from internet forums is a great example.  You wouldn't see anything like that in another community I frequent.  )

Mindfulness meditation reduces anxiety as much as a common antidepressant drug, study finds

Spencer Kimball

• The study is the first randomized clinical trial to compare the effectiveness of mindfulness meditation with the antidepressant escitalopram.
  
• After monitoring the two groups for eight weeks, researchers found that people using mindfulness meditation saw their anxiety improve nearly as much as people who were taking the antidepressant.
  

Mindfulness meditation is as effective at reducing anxiety as a commonly prescribed antidepressant, according to a study published in a major journal on Wednesday.

The study, led by researchers at Georgetown University Medical Center, is the first randomized clinical trial to compare the effectiveness of mindfulness meditation with the antidepressant escitalopram. The results were published in JAMA Psychiatry, a peer-reviewed journal.

The adult participants in the mindfulness group practiced 45-minute daily meditations using a few different techniques they learned at weekly classes. They also went on daylong weekend retreats.

Dr. Elizabeth Hoge, lead author on the study, said the findings support physicians recommending mindfulness meditation as an alternative to antidepressants for some patients. Many people worry that antidepressants will interfere with their daily lives and others start taking medications but stop.

Hoge, who is director of Georgetown University’s Anxiety Disorders Research Program, said the study also provides evidence for insurers to cover mindfulness meditation as a treatment for anxiety.
Anxiety disorders are the most common type of mental illness, affecting about 301 million people around the world, according to a February study published in Lancet Psychiatry.

Most people are comfortable with being told what to do and when, and secretly like it in some fashion.

I think this is often presented in a pejorative or negative light.  I wonder if the reality isn't different and that structure in at least some aspects of life is necessary, healthy, and liberating.

For example, I enjoy knowing that other drivers on public roads have been "told what to do" when it comes to operating their motor vehicle.  It makes me multiples safer and allows me to NOT have to worry about anarchist drivers (generally).  This can apply to a myriad of things.  I always become suspect of those who label this type of behavior as sheep or "sheeple".  The faux intellectual superiority of these types often masks a sort of brazen hubris and stupidity.

(To be clear I don't get that sense from folks in this community.  Sci's opening caveat warning to not take medical advice from internet forums is a great example.  You wouldn't see anything like that in another community I frequent.  )

Let us imagine if hypothetically, we had a medical profession staffed by dedicated people whose passion was to help people, and who kept themselves up to date with the latest developments and their possible shortcomings, and if we also had a drugs development industry that was utterly honest and incorruptible.

If that were true, I agree with you that going to the internet for medical information/advice would be absolutely crazy.

Unfortunately, even if we had such a service, given human nature, it would soon become corrupted. The corruption probably goes up roughly as the log of the amount of money flowing in these systems.

The most valuable parts of the medical information internet are run by doctors or senior people involved in medical research. Does it make sense to ignore such people just because GOOGLE has determined in some unspecified way that they are peddling "misinformation" - NO, I don't think it does!

In the early years of the software industry, things were pretty idealistic. For example, the entrepreneurs who started GOOGLE were, I think, genuinely focused on making the internet more useful and powerful - which they did. After that human nature changed the company completely.

Fortunately, I haven't needed medical services much in my life, but on the occasions that I did, I can't say they covered themselves in glory.

However, I don't completely disagree with you. I don't take psychedelics, and have only dabbled in oral cannabis. However, when driving, if I see signs that another road user is behaving erratically, I slow down in order to get out of his way - it is definitely safer to assume that some road users aren't reliable.

Note: I think it's important to remember that anti-depressants do seem to work for some percentage of the population and apparently can be life-saving for at least some people and this is not necessarily easily predictable - certainly not across screens by lay persons!

All to say an internet message board shouldn't contradict the advice of medical professionals. Get a second opinion if need be.

I know one person with intermittent depression.

The other side of the coin, is that people with depression do go to doctors, and perhaps they expect to get treated effectively. However, when they find themselves no better, they become disillusioned with medicine. If someone manages to persuade them to have another go, presumably they fare no better when put back on the class of pills (SSRI) that failed the previous time.

I would rather encourage them to explore alternative therapy in various forms, or to make practical changes to their lives, such as to get a pet.

Note: I think it's important to remember that anti-depressants do seem to work for some percentage of the population and apparently can be life-saving for at least some people and this is not necessarily easily predictable - certainly not across screens by lay persons!

All to say an internet message board shouldn't contradict the advice of medical professionals. Get a second opinion if need be.

I am still ploughing my way through your initial link.

The awful truth is that roughly the same story can be found in relation to cholesterol/saturated fat and heart disease, and a variety of other medications.

Perhaps the real lesson is how easily we humans can be lead into corrupt behaviour.

I assume that most doctors felt idealistic at the start. I wouldn't have wanted to do a medical degree, with all the body dissections etc. I'd also not have fancied a stint in accident and emergency when/if I became a junior doctor!

But then after all that it would seem that the idealism drains out of doctors, otherwise why wouldn't they complain about some of these revelations?

This moral model used by quakers seems similar  to the social and professional structures of ships at sea. There are strict rules for everything and outwardly most people would complain or seem to hate it. But inwardly I think it really scratches that community itch that most people lack in the modern world, even if it isn’t ideal or even fun. Most people are comfortable with being told what to do and when, and secretly like it in some fashion.

So I can imagine that holding people accountable directly for everything, with instant feedback on how “good” or “bad” they are doing, helps mentally ill  people.

On the other hand, for many like myself, the feeling of powerlessness and the inability to make my own choices without Big Brother looking over my shoulder can contribute heavily to depression and anxiety.  I don't believe there is  one solution that fits all situations.