Cracked: Why Psychiatry is Doing More Harm Than Good

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In recent years such disproving research has begun to erode the profession’s faith in the chemical imbalance theory. This has led increasing numbers of prominent figures in the mental health profession to declare their defection publicly. To pique your interest in this sea -change, here are a few quotations I’ve managed to gather: The most frustrating book I have read in a long time. I am interested in the sociology of mental illness, and believe that critical approaches to psychiatry and the medicalisation of conditions have a place in modern treatment of mental illness.

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Being a young medic who will very soon find himself in the chair making referrals to psychiatry and psychotherapy, I considered myself having a deep personal stake in reading what Davies had to say. And I am glad that Davies puts forth his case so convincingly. Being a medical trainee who devoured every moment of soaking every word of psychology at A-Levels where utterly disparate models of human behaviour could co-exist in a curriculum, I went on to get completely disillusioned after reading psychiatry with its all-explained-through biology model taught during medical school. This means there is a reliability problem in the field, which casts serious doubts on the entire DSM-structured paradigm. Indeed, the problems within the field of psychiatry often see the same patients receiving differing and possibly conflicting diagnoses at an alarmingly high rate: In Britain, approaching a quarter of the adult population take a psychiatric drug in a year, an increase of over 500% since 1980. Despite this rise in prescriptions, the prevalence of mental health problems and disability have also increased.

Dr Davies said, “by sedating people to the causes and solutions for their socially rooted distress – both literally and ideologically – our mental health sector has stilled the impulse for social reform, which has distracted people from the real origins of their despair, and has favoured results that are primarily economic while presiding over the worst outcomes in our health care system”. This thought-provoking book will make people think twice before sitting on a psychiatrist’s couch or filling a prescription." Perhaps this altered state of mind can be helpful to alleviate painful emotions and give us a chance to make changes to our lives so the drugs are not needed. Yet, this is not the case if we are told that those drugs are a cure and we must stay on them for life. And not if we are left finding the withdrawals from those drugs unbearable. I find it worrying that a practising psychological therapist in the NHS knew so little about mental illness, diagnosis and treatment (!) as he claimed at the outset of writing this book. I learnt all about the problems with the diagnostic system (most prominently, the DSM) and how antidepressant medications work (or don't) during my undergraduate degree in psychology, and so what bothers me the most is that the picture he paints is one of a completely clueless psychological and psychiatric profession - which is plainly not true. And yes, it is correct that there are very few (if any) biomarkers for mental illness, but that does not mean they are not real illnesses. I would like to remind (or inform) James Davies that Alzheimer's disease does not yet have a biomarker, nor do any of the other dementias at present. Does he not think they are real illnesses either? This is why we keep doing research. Furthermore, his keenness throughout the book to keep referring to mental illness as 'perfectly normal human reactions' made me quite sad, because who is he to trivialise the suffering of people who are quite literally crippled by depression, social anxiety, schizophrenia? While I completely agree that the grief of losing a loved one and similar reactions should not be thought of as illness, and while I agree that medication should never be the first option (especially in children), I find his argument hopelessly one-sided. The points he is raising are extremely important and equally, we should be critical with regards to how psychiatry, psychology and medicine works. But reporting only one side of the story is not helping anyone, it just creates a basic mistrust in the psychological and psychiatric profession which is unwarranted. He is painting a picture of psychiatrists as pure, money-minded evil and completely fails to see the complex picture of treatment that psychiatry can form part of. Psychiatrists go to work every day wanting to help alleviate people's suffering. They chose that profession wanting to make a difference. His claim that "the only ones who have ever benefitted from psychiatric drugs are the drug companies" is not just biased, but very ill-informed. For anyone interested in the sociology of psychiatry and other themes raised in this book, I recommend instead:

Cracked: Why Psychiatry is Doing More Harm Than Good - Goodreads

that while diagnostic reliability remains a problem, the third generation of psychiatric diagnoses “from 1980 to present… more reliability papers were published and the reliability of psychiatric diagnosis has improved,” and I usually love books about how messed up the DSM, Big Pharma, and the social sciences are, but this book was terrible and here is why:

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In fact, although not mentioned by the author here; regular vigorous exercise can be as (or more) effective in reducing depressive episodes as pharmaceutical intervention, without any of the accompanying side effects. Exercise regulates hormones and neurotransmitters, reduces inflammation, increases BDNF; among many other benefits and harm reductions. Within the book, Dr Davies argues the widespread medicalisation of mental distress has fundamentally mischaracterised the problem. Many who are diagnosed and prescribed psychiatric medication are not suffering from biologically identifiable problems. Instead, they are experiencing the understandable and, of course, painful human consequences of life’s difficulties – family breakdowns, problems at work, unhappiness in relationships, low self-esteem.

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There has been a change in thinking from the 60s and 70s, where psychiatric drugs were seen as altering mood (in the same way as any mind altering drug, including alcohol and street drugs alter moods) A shift occurred to thinking of psychiatric drugs as ‘curative’. This might not seem an important shift – however it goes along with the idea that much uncomfortable, difficult human emotion is now being seen as potentially aberrant and classifiable as a ‘disease’ - as in the DSM – shyness becomes ‘social phobia’. b) there needs to be more thorough regulation an transparency regarding psychiatry's financial ties to the pharmaceutical industryPlease list any fees and grants from, employment by, consultancy for, shared ownership in or any close relationship with, at any time over the preceding 36 months, any organisation whose interests may be affected by the publication of the response. Please also list any non-financial associations or interests (personal, professional, political, institutional, religious or other) that a reasonable reader would want to know about in relation to the submitted work. This pertains to all the authors of the piece, their spouses or partners. Although this review has criticised the use of psychiatric drugs, I myself and many others have taken these medications for years. They are not easy to withdraw from, and anyone who wants to stop taking medications should approach doing so with extreme caution and preferably professional support. But there is an array of information out there on how to approach withdrawing. The RSP president argues that the current methods enable them to get mental health funding. The DSM people that they expect users, somewhat Biblically, to make their own interpretations rather than taking the DSM literally. The latter seems a general issue in anything to do with personality and social policy – people using questionnaires and methods literally; not finding out who the person/s are before making decisions about them. You can add your own here. The first thing you’ll notice is that all the groups actually get better on the scale of improvement, even those who had received no treatment at all. This is because many incidences of depression spontaneously reduce by themselves after time without being actively treated. You’ll also see that both psychotherapy and drug groups get significantly better. But, oddly, so does the placebo group. More bizarre still, the difference in improvement between placebo and antidepressant groups is only about 0.4 points, which was a strikingly small amount. ‘This result genuinely surprised us’, said Kirsch leaning forward intently, ‘because the difference between placebos and antidepressants was far smaller than anything we had read about or anticipated..." One has to question the validity of the DSM when (by a relatively close vote of the US Psychiatric Society) homosexuality was removed from the DSM as a psychiatric illness. And one must also question the validity of ADHD diagnostics when in Canada there was an explosion of diagnosis of kids with ADHD and it was found that it was highly correlated with the month of the year. What had happened was the kids in the one class could be over a year different in actual age and the younger kids had lower attention spans.