3.27.2008

The Emporer's Clothes Don't Keep Him Warm

Aside from my father who is working on a ground breaking book on psychotherapy and consciousness, this Psychology PhD from Austin, TX, John Breeding is the clearest I've seen about the danger of prescribing pscyhotropic drugs for "bogus, made-up" conditions like ADHD and depression. Pretty ballsy given the current climate of psychiatric treatments. Amen, brother.

CLARIFICATION: After a brief comment dicussion (thanks Adam), I wanted to say that I don't think the symptoms of depression or ADHD aren't real, and that certain drugs can't be helpful in certain, specific instances. What I will say is that the idea behind the mechanism of action for anti-depressants is heavily flawed, and basically unproven. Contrary to popular belief, there is no established baseline for the "normal" levels of the neurotransmitter most anti-depressants are supposedly regulating (serotonin and dopamine).

Most studies say it's barely more effective than placebo. Other reports mention how studies showing their ineffectiveness are often shelved, and even worse, the side effects of many of these drugs can be pretty awful - decreased libido, movement disorders, psychotic behavior, and most bizarrely, the zaps. The over-diagnosis of these conditions and the pursuant over-prescription of frankly experimental psychotropic drugs is a sloppy and irresponsible practice.

Actually, this is all stated better in this clip of Dr. Breeding.

6 comments:

Adam said...

Are you saying that ADHD and depression are "bogus and made up" or is the guy in the video (sorry - didn't watch it)? I wouldn't agree with that, but I would agree that a vast majority of the time drugs are not the (only) answer. It's okay (and probably necessary) to feel sad and anxious every now and then, and one shouldn't rush to the doctor immediately upon having a feeling. But there are cases where drugs are, if not absolutely necessary, extremely helpful.

gabe said...

Adam! You're my first commenter, I feel like we should throw a party!

Yes, I *almost totally agree with you. I think what Dr. Breeding is getting at is that the vast majority of clinical diagnoses (and it sounds like in his case, all diagnoses) of ADHD and depression are bogus.

The angle I am leaning towards on this site is relatively consonant with that idea. That angle is that the fields of neuroscience and psychiatry are starving for a unified theory of brain and mind, neurons and consciousness, ghost and its machine.

To understand any individual's symptoms, one has to explore the context of his life history - his relationships with parents, brothers, sisters, friends, his temperment, his character, his religion, his inclinations, his desires, etc. There is of course (for lack of a better word) a relationship between all those facet's of an individual's concsiousness and its correlating neurological substrate, but it is a two way street. To treat someone without any knowledge of one of those streets is careless, arrogant, and dangerous.

Psychiatrists have treated so-called illnesses like depression and ADHD like a cardiologist would treat high cholestoral: write a prescrption for Lipitor and "lay off the donuts." That's how most people are treated for their emotional/psychological symptoms. This practice is basically ubiquitous, and is done without an established neurochemical baseline as to "normal" levels of the neurotransmitter most anti-depressants are suposedly regulating (serotonin/dopamine). It's about as sophistiaced as blood letting.

Overall, that's the history of psychiatry. Electroconvulsive therapy is still used to treat people's symptoms, though thankfully ice pick lobotomies are illegal now (though they were used just a couple decades ago to treat even the lightest symptoms of depression and so-called ADHD).

Though it may appear this practice has evolved with the mass-market advertising of the drug industry and the doctors in its pocket handing out pills like candy, treatments are just as blunt - they just have a wider variety of chemical instruments to use, and insulting over-generalized lists of sympoms in the DSM. This practice hasn't evolved very much, because we are still in the dark ages of neuroscience and it's connection to consciousness.

All that said, I do agree with you, I have read about certain rare exceptions to the rule.

Adam said...

I think I would still take exception with your use of the word "rare." In my opinion, there are a good number of conditions where medication, along with other treatment (therapy, psychoanalysis, etc.) is a valid option. Medication alone, I would agree, is probably never a good idea. To say that "all depression and ADHD" is bogus sounds like close-minded generalism and wreaks of Scientology. I know that's not what you're saying, though. We're in agreement that a greater knowledge of the mind, on emotional and scientific levels, is necessary and preferable to blind scrip writing.

gabe said...

I just shivered when I read you say scientology. Ouch. The scientology stance on psychiatry is sort of ironic to me. Coincidentally, it points out that there are major problems in the field, it just happens to come from an absolutely deranged source. I'm sure we'll get to scientology later ;).

I think I will reiterate on the post that I don't think all drugs are bad and useless, and there aren't consistent symptoms related to ADHD or depression.

My issue is the gross generalizations of the classified "illnesses" and the blunt chemical treatments for them. I know I've had my down moments, but I'm thankful I never went on an SSRI.

Most studies these days confirm they're no better than a placebo and have awful side effects to boot , have you heard of the zaps? yikes...

Oh and check out this report on how the inconclusive studies on the effectiveness of anti-deps are often shelved.

Adam said...

Did you also shiver at my ridiculous mangling of the word "reeks"?

The current attitude towards medicating sadness seems like a slippery slope towards Soma and A Brave New World, but I do know people who it helps, so I'm torn. The overarching problem is that the ENTIRE world is on a slippery slope towards Idiocracy.

gabe said...

I hear you. There are no absolutes, I think we agree on that. Most of the cases I've heard of, anti-deps tend to cause more harm than good, but maybe that's a personal bias. It seems most people that take SSRIs believe it's "medicine." The placebo effect is a powerful thing.

Cause and effect is insanely hazy in this situation. Plus, the subjective reality about mood is pretty slippery too.

It's just especially disconcerting to me when you find out the guy responsible for the Virginia Tech shootings was on prozac. What's at fault there? Is it because he was angrily depressed, and he wasn't on the right drug? Or was there something about having too much serotonin in his synapses? We just don't know enough to tell.

On the idiocracy point, it sure feels like the fall of Rome around here these days.