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As I've told Bob Whitaker and many others, it's taken me 45 years in my career to get to the point where I feel completely free to "do the right thing." By that I don't mean to downplay the work I've done in the public mental health and addictions systems. But now, the Mad in America Continuing Education project moves me in a more recovery-oriented direction than ever, and has a specific focus on the ways in which most programs have over-used psychiatric medications to the detriment of the people we are serving.

The mission statement for the Western Mass Recovery Learning Community’s peer respite (Afiya) is “To provide a safe space in which each person can find the balance and support needed to turn what is so often referred to as ‘crisis’ into a learning and growth opportunity.” Although I sometimes question our choice to use the word ‘safe’ (given how impossible an absolute version of ‘safe’ is to achieve and how saddled with distasteful meaning such a term can be within the mental health system), I’m not sure that statement could otherwise be any more straight forward and meaningful. Yet, so often, It’s unclear what meaning people are truly making of it.

More than ten-percent of adults in the United States are currently prescribed at least one psychiatric medication but there is currently a lack of research on the prevalence of adverse drug events (ADEs) associated with these prescriptions outside of clinical trials.

In the October 2015 issue of The Behavior Therapist (pages 206-213), Jeffrey Lacasse, PhD, and Jonathan Leo, PhD, published an article titled Antidepressants and the Chemical Imbalance Theory of Depression: A Reflection and Update on the Discourse. I thought the article had particular merit, and I drew attention to it in a post dated November 2.  In an email, Dr. Ronald Pies raised two objections: That the phrase "little white lie" as applied to the chemical imbalance theory was misattributed to him, and that he has never accepted payment from pharmaceutical companies with the intent or purpose of promoting their products. (Editor's note: Dr. Pies' response is now appended to this post.)

A paradigm is a way of thinking about things. For the past 60 or so years, our thinking about mental health and illness has been dominated by what can be referred to as the "DSM (Diagnostic and Statistical Manual of Mental Disorders) paradigm." What this looks like in everyday practice is that when a child is referred to my behavioral pediatrics practice for anxiety, the questions that parents, referring doctors, and teachers ask is, "Does he have anxiety disorder?" followed by "How to we manage his behavior?" and "Does he need medication?"

The University of Colorado has a long history of discrimination against people with lived experience of recovery from mental health labels. One Colorado advocate has made attempts for over 20 years to interact successfully with a faculty member who was a leader in the mental health community. Several of the CU faculty members are leaders in disease-mongering, or causing people to have false positive mental health diagnoses. This is what happens when clinical services are emphasized and recovery is unheard of.

Thousands push the limits (their own and the system’s) on a daily basis to fight the oppression of individuals labeled with psychiatric diagnoses, and to change the way the world understands various kinds of distress. Some of us call the body of people engaged in this work a ‘movement’. I am one such person who is often referring to a ‘civil rights’ or ‘human rights’ movement within this context, although I recognize the problems with referencing a singular ‘movement’, as well.

I don't know about you, but sound, audio, music, making mixes on spotify, catching up on my favorite standards on pandora keeps me well...

Many people are now familiar with the BPS report, Understanding Psychosis and Schizophrenia, and they have appreciated how it integrates both science and a humanistic understanding to convey a fresh and progressive approach to difficult and extreme experiences. But it has come under attack by psychiatrists, using arguments that are often quite slick, and sound reasonable to the uninformed. But they are wrong, and the better we can articulate how and why they are wrong, the better we can advocate for a more humane and skillful response to people having the experiences that are called “psychosis.”

In August of 2011 I started working on a document about alternative treatments for “schizophrenia” while taking a class on Microsoft Word at a local college. The document was about 20 pages long when I finished, and Dan Stradford posted the article on Safe Harbor. It is still there today and is one of the most viewed articles on the Safe Harbor website. I decided to turn it into a book: “Codex Alternus: A Research Collection of Alternative and Complementary Treatments for Schizophrenia, Bipolar Disorder and Associated Drug-Induced Side Effects”

Over at CounterPunch, Carl Boggs takes on the knee-jerk mental illness response that pervades the airwaves after every mass shooting. He writes: “What the mental-health fixation lacks is any semblance of historical or social context. Given the persistence of U.S. imperialism and militarism — and mounting fascination with combat and guns in a society transfigured by its warfare state — Washington remains a thriving center of global violence: repeated armed interventions abroad have found their domestic parallel in the world’s largest prison system, a deepening gun culture, home-bred terrorism, police atrocities, and a media culture filled with spectacles of warfare and bloodshed.”

Ronald Pies, MD, is one of American's most eminent and prestigious psychiatrists.  He is the Editor-in-Chief Emeritus of Psychiatric Times, and he is a Professor of Psychiatry at both Syracuse and Tufts. I disagree with many of Dr. Pies' contentions, and I have expressed these disagreements in detail in various posts. But there is one area where I have to acknowledge Dr. Pies' efforts:  he never gives up in his defense of his beloved psychiatry, even in the face of the most damaging counter-evidence. For instance, on more than one occasion, he has asserted, with apparent sincerity and conviction, that psychiatry never promoted the chemical imbalance theory of depression!

For the past four years, I have been deconstructing my views of my profession. My focus has been primarily in two areas: the efficacy and safety of the drugs I prescribe and the so-called “alternative” approaches (in this I include many things such as Open Dialogue, Hearing Voices groups, and Intentional Peer Support to name a few). I have shared much of this in the blogs I wrote during this time. I am also interested in how we can improve and reform the public mental health system since this is not only where I work but where most people seek services and help. I wonder where – if anywhere – psychiatrists fit in to a reformed system.

In a 2013 edition of the Journal of the History of Biology, Norbert Wetzel and I published an article on the Swiss-German psychiatric geneticist Ernst Rüdin (1874-1952) and his close colleagues, and how their work and crimes in the Nazi era have been discussed or ignored by contemporary psychiatric genetic writers and researchers. Here I would like to summarize the main points we raised in that article, and to make several additional observations. Whether Rüdin reluctantly aided and helped implement the “euthanasia” killing program in support of the war effort, or more likely, that he saw it as the crowning achievement of his decades of psychiatric genetic research based on racial hygienic (eugenic) principles, is an issue that may be decided in the future.

So, thanks to everyone who has read and commented on my stories of reentry into the mental health system. I have now had eight nights of very good sleep and my mental health symptoms are back to the baseline. Baseline for me means I only get separated from consensus reality when a significant trauma occurs at the same time I'm having a pretty good sleep deficit. Usually I can manage it myself simply by being aggressive about handling — and increasing — the sleep. So this time I was unable to break that cycle and got some more drugs to help.

One of psychiatry's most obvious vulnerabilities is the fact that various so-called antidepressant drugs induce homicidal and suicidal feelings and actions in some people, especially late adolescents and young adults. This fact is not in dispute, but psychiatry routinely downplays the risk, and insists that the benefits of these drugs outweigh any risks of actual violence that might exist.

We are among an increasing number of people around the world who know the importance of holding on to a humanistic idea, and of keeping in mind that people need—first and foremost—other people. People who are willing to take part, to share with us the horror and confusion, to invite the telling of a narrative, and to keep the hope alive.

For most people in the transgender community our earliest memories are experiences of being bullied, or not being loved by some family members because we looked and acted differently than other male or female-bodied persons. For me this led to an early onset of depression and being diagnosed in the third grade. My first attempt at leaving this world and the body I had grown to hate was at the age of eight. Feeling unloved by my family, and being in a body that had betrayed me, I felt disconnected from the world in general.

Integration of physical and "mental health" care has been a popular topic in psychiatric circles in recent years. I've never been entirely clear about the nature of this proposed integration of psychiatry with primary care, though from what I've gathered, it sounds like there will be a psychiatrist, or other mental health worker, attached to primary care practices, either in the flesh or via computer screens. What has always been crystal clear, however, is that the proposal would entail a huge expansion of the psychiatric net.

The controversy over “Study 329” on the effects of Paxil in teen depression has raised questions about the state of ALL medical research. I decided to look at the research for the most recent psychiatric drug approved by the FDA, a new antipsychotic called cariprazine or Vraylar.  I located twenty studies of Vraylar on www.ClinicalTrials.gov, the U.S. government-sponsored registry for clinical trials.  Three were still in process, and seventeen were completed.  Not one had shared its results on the government website, a supposedly mandatory step.

Prior use of benzodiazepines, such as Xanax, Librium, or Ativan, may increase the risk of treatment-resistant depression (TRD), according to a new study published in The Journal of Nervous and Mental Disease.

Benzodiazepines may be the most popular, widely used, and immediately effective of all the psychiatric drugs. At the same time they are perhaps one of the most dangerous, addictive, and abused mind-altering substances on the planet. Since the 1980’s psychiatry and their partners in the pharmaceutical industry have spent billions of dollars marketing these drugs and justifying their efficacy in the “treatment” of anxiety and insomnia. Psychiatry has been able to create a patient base of millions of people who are dependent on these drugs and are forced to remain “co-dependent” customers of psychiatrists and other medical doctors in order to procure them.

Recent calls for screening for a range of mental health problems point to an important recognition of the need to identify and address emotional suffering. Such screening offers an opportunity to decrease the stigma and shame that often accompany emotional pain. A powerful new documentary, The Dark Side of the Full Moon, calls attention to the under-recognition and under-treatment of postpartum depression. In one scene, a mother refers to resistance from doctors who lack resources to address positive screens as "absurd.” She is correct, if the alternative to screening is to look the other way in the face of women who are suffering.

I think it is indeed true that many people go to psychiatrists specifically to get drugs. This is because it is widely known that psychiatrists will prescribe psychiatric drugs readily. In fact, since about 1980 or so, they really don't do much of anything else. For most psychiatrists, a "patient" returning at regular intervals for "med-checks" and refills is the ideal scenario. Within the psychiatric community, there is, I think, a great deal more concern expressed about non-compliant "patients" than there is about those who adhere faithfully to the prescription and keep coming back for more.

'How to Touch a Hot Stove' (the centerpiece of what is being called 'The Hot Stove Project') is a film that professes to be about a new civil rights movement. It employs interview clips from a wide array of 'big names' on all sides of the 'mental health' world, in a purported effort to compare and contrast the many voices that lay claim to that concept. In fact, the filmmakers did a fairly good job of writing about a film that would surely have stood out in a sea of chemically imbalanced cinema. Unfortunately, the film they wrote about is not the film they made.