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Everyone has beliefs that seem too bizarre, illogical, or fantastic to someone else to accept. Religious views, paranormal interpretations, political convictions, interpersonal conflicts — all can put us in a category where other people consider what we think to be incomprehensible. We've learned to co-exist with different beliefs as one of our most cherished values of tolerance in a multicultural society. That lesson can be key for encountering the different realities that in situations where someone is being called psychotic, delusional, schizophrenic or mentally ill. Respect and support may stretch our thinking, but can be vital to recovery.

This week, MIA featured a news item regarding a recent “proof of concept” study conducted at Washington University of St. Louis to investigate whether nitrous oxide, commonly known as laughing gas, was effective in reducing symptoms of depression. Why is this a problem?

The mental health industry has a lot to answer. The psychologization of everyday life has eroded the range of human experience seen as normal, disempowered people to manage their own life challenges, professionalized helping relationships and undermined the already decaying support structures through which people found meaning and connection, stigmatized people through psychiatric labeling, led to iatrogenic misery from harmful treatments and traumatized already vulnerable individuals through excessively coercive practices.

The article “Special K, a Hallucinogen, Raises Hopes and Concerns as a Treatment for Depression,” by Andrew Pollack in the New York Times, December 9, 2014, tells how far afield my field, psychiatry, has really gone - that it is even a consideration to use an hallucinogen for the treatment of depression.

ProPublica is well known for creating interesting data bases that allow anyone hooked up to a computer to see by name whether a physician is accepting Big Pharma payments — from dinners to speaking engagements to consulting services. What may be lesser known is that occasionally ProPublica will publish other data that when carefully mined can reveal even more about the use of psychiatric drugs especially when there is a public funding source available.

On December 1, Mad in America published an article titled When Homosexuality Came Out (of the DSM). The author is Vivek Datta, MD, MPH, a British physician. The article was also published the same day on Dr. Datta's blog site, Medicine and Society. The article focuses on the removal of homosexuality from the DSM, which occurred in 1973. Dr. Datta discusses this issue and various related themes, and he draws some conclusions that, in my opinion, are unwarranted and misleading.

How do we genuinely heal from the damage of racism and internalized racism, as well as mental health oppression, adultism and all form of oppression? We can change all the laws in the land – and we have changed many laws (civil rights laws, employment laws via the Equal Employment Opportunity Commission and the Americans with Disability Act laws) but that doesn’t change attitudes.

On November 28, Psychiatric Times published an article titled Psychiatric Diagnosis and Treatment of Somatizing Neuropsychiatric Disorders. It addresses the phenomenology, epidemiology, and developmental course of the so-called somatization disorders. Under the heading "Postulated pathogenic influences," the authors present working hypotheses from psychoanalytic theory, learning theory, behavior analysis, social-affective neuroscience, autoimmune sensitization, and theories of dissociation. But they advocate a discussion of the role of medications in "normalizing brain neurotransmitter function."

Depression during pregnancy is an important issue. Depression should not be ignored and depressed pregnant women deserve good treatment and care. Part of that good care, though, is providing them with full and correct information. I care for pregnant women taking antidepressants on a daily basis and too often they tell me that the only counseling they received about the medication was, “my doctor told me it’s safe in pregnancy.” This post will review the evidence in this area and address the counterarguments.

In many respects it is difficult to fault the report Understanding Psychosis and Schizophrenia, recently published by the British Psychological Society (BPS) and the Division of Clinical Psychology (DCP)[i]; indeed, as recent posts on Mad in America have observed, there is much to admire in it. Whilst not overtly attacking biomedical interpretations of psychosis, it rightly draws attention to the limitations and problems of this model, and points instead to the importance of contexts of adversity, oppression and abuse in understanding psychosis. But the report makes only scant, fleeting references to the role of cultural differences and the complex relationships that are apparent between such differences and individual experiences of psychosis.

On August 11, Pediatrics, the official journal of the American Academy of Pediatrics, published an article that was based on data derived from a random selection of families concerning their health problems or concerns. Surprisingly, the incidence of disability due to physical conditions declined by 11.8%, while disability due to mental/neurodevelopmental conditions increased by 20.9%. The highest increases were among children under the age of 6, and children from more advantaged homes. At least part of the reason for this stems from the fact that while the prevalence of physical disability is limited by the prevalence of the particular pathology in question, no such limitation applies to "psychiatric disabilities."

The Mad in America Continuing Education Project is preparing for takeoff after months of planning. The project will provide on-line classes on the full range of psychiatric medications, and the ways in which they affect the neurology, physiology and outcomes for people taking them. The overarching goal is to change the standard of practice so that it becomes consistent with well-designed research.

This week we launch Mad In America Continuing Education. It is an enormous privilege to be a part of this project and to proudly announce that the first course offering is a series of lectures by me on neuroleptic drugs. I review the history of the development of these drugs as well as their short and long term effects. I discuss what conclusions I have drawn from the data; I recommend that we need to work harder to keep people off these drugs or – if we use them – to minimize the dose and stop them as soon as possible. But there remain other pressing concerns for those individuals who are currently taking these drugs.

I can feel both dance and music changing and healing my brain’s neurons. Seriously. We can change our brains and I’m doing it. Neuroplasticity. There is a multitude of ways to heal. My self-directed protocol involves many different things.

We are an unlikely duo, sharing secrets only known to insiders, the inmates and staff of Bader 5, Boston Children's Hospital's adolescent psychiatric unit. I am the nurse who blew the whistle that no one heard in 2010, she is the teenager who was imprisoned on Bader 5 for nine months in 2013. We met for the first time on this past Thanksgiving Day at Yale New Haven Children's Hospital, where she has been a *medical* patient for the past nine weeks.

With a diagnosis of schizophrenia, if internalized, comes the erosion of personhood, lowered self-esteem, shattered dreams, and a sense of disenchantment. The psychiatrist Richard Warner has even suggested that those who reject the diagnosis of severe mental illness may have better outcomes as they retain the right to construct their own narrative of personhood and define what really matters for them. Despite public education campaigns (or perhaps because of them), the stigma of mental illness is as enduring as it was 50 years ago.

I’ve been arguing against calling this movement that I’m a part of a ‘peer’ movement for a long time. What has happened with Michael Brown in Ferguson, Missouri has helped me to crystallize that point. If we do not see what happens to some of us in the psychiatric system as connected to what happens to others because they are black or because they are transgender or because they love someone else of the same expressed gender (or because they live in poverty, etc. etc.), then I’m not sure any of us really, fully understands what it is we are trying to accomplish at all.

As awareness spreads about there being something wrong with existing approaches to “psychosis” aka “madness.” Interest grows in exploring what to do instead. One meeting place for exploring this question of “what to do” will be the ISPS conference in NYC in March 2015, which is titled “An International Dialogue on Relationship and Experience in Psychosis.” This conference promises to stand out in terms of the variety of voices,  perspectives, approaches and traditions that it will bring together to focus on the deeper issue of how helpers can best understand and interact with those experiencing what is called psychosis.

Some readers of Mad in America may be aware that Scientific American published a short blog by me on 17^th November 2014 - Why We Need to Abandon the Disease-Model of Mental Health Care. This blog was rather wonderfully (and slightly embarrassingly) described by Phil Hickey on his website, Behaviorism and Mental Health, as “an important milestone.” My blog attempts to summarise many of the key points of a perspective widely shared on Mad in America: 

Evidence based care is supposed to drive up standards, ensure uniformity, establish best practice, guide clinicians and protect patients. This should be celebrated. Instead, evidence-based mental health is openly disparaged, and when psychiatrists don’t get the results they want, they ignore them, suppress them, or denounce them. These attitudes have repercussions on the training of psychiatrists.

Psychiatry clings to the broken brain theory, because without it, there is no justification for the employment of medical techniques in this area. Without the broken brain theory, psychiatrists are unnecessary, and even counterproductive. In their hearts, all psychiatrists know this, which is why they never address the fundamental question: why should all significant problems of thinking, feeling, and/or behaving be considered illnesses?

On November 16, 1989 in El Salvador, liberation psychologist Ignacio Martin-Baró was murdered by a Salvadoran government’s “counter-insurgency unit” created at the U.S. Army’s School of the Americas. This year, 25 years after his assassination, peace and justice activists around the world will honor Martin-Baró. Embarrassingly, the vast majority of U.S. psychologists and psychiatrists know nothing about Martin-Baró and liberation psychology. Why would mainstream mental health institutions keep U.S. psychologists and psychiatrists and the general public ignorant of the life and work of Martin-Baró?

The idea of schizophrenogenic or refrigerators mothers was an embarrassing era for psychiatry, and so psychiatrists were only too happy to explore the brain and the genome to unlock the secrets of mental illness. Today, the rhetoric has shifted away from intrapsychical conflicts and traumatic ruptures, and instead aberrant neurochemistry or delinquent genes are held as the source of mental illness. Regardless, the message is clear: mental illness is beyond our control and requires psychiatric intervention. The moral authority the mental health industry claims over our mental life rests on this claim.

I’ve heard countless horrific stories of abuse, neglect, trauma and most every form of torment that one human can inflict upon another. The sting of such stories never lessens. I’ve often marveled at the mind’s capacity to focus a sustained attention upon ever new ways to perpetuate and promote anguish. Sophia’s story, presented here, is tragically similar in regards to the abuse she suffered.

Is it possible to create a “Rainbow Coalition” with a common agenda of (1) reforming prisons, (2) providing affordable housing, (3) limiting the use of psychotropic medications, and (4) providing community-based mental health and psychosocial support? Prominent psychiatrist Allen Frances asked us at the Mad in America Film Festival to join such a coalition. Rather than rejecting Frances’ agenda outright — as I appeared to do in a recent Mad in America blog — we should give his proposal a fair hearing. As always, the devil is in the detail.