Biological Psychiatry

Here are both the original article and the review in “Mad in America,” a fairly radical review of opposing viewpoints in psychiatry which, I am often downright embarrassed to have to agree with.

The two German psychologists are right. Their initial assertions are unquestionable, Mental illness is going up indescribably quickly. Psychotropic medication is going up indescribably quickly.

At this point, it is hard to defend the assertion that we are correcting a “chemical imbalance” in the brain when we prescribe psychotropic drugs. I was told by my professors a long time ago I was being trained as a “biological psychiatrist” according to a strict “medical model.”

Now, more years later than I want to admit — even with our marvelous windows on the brain like functional MRI and such — it seems to me we haven’t yet established the causal molecules for anxiety, depression or schizophrenia. Nor can we show clearly that such a molecular mechanism is “corrected” by psychotropic drugs.

It is certain there is more depression than ever,and people more often treated by antidepressants than ever, but I have reviewed (surprisingly reasonable) arguments that depression is caused by a virus or atmospheric pollution or farming practices lowering the nutrition in food. None of these arguments has a really good set of evidence to prove it is false. They may all be true to some extent.

Their criticism of diagnostic constructs is valid. It has been a long time (and a couple of editions of the Diagnostic and Statistical Handbook) since the Radical British psychologist R.D. Laing called it a “Nazi Handbook.”

It certainly is true that is purely behavioral and externally descriptive and seems to have little or nothing to do with what we know about brain chemistry.

It is not written, it seems, for use by doctors or scientists, but government officials and insurance company employees who must allocate payments and pensions and such.

Any therapist who is honest with herself or himself and who has been exposed to the so-called “medical model” can only notice that we are more like our patients than someone who needs heart or stomach surgery is like the surgeon. We all have transient states of “depression” or “anxiety.”

Like Pogo said in the comics a long time ago, “We have seen the enemy and they is us.”

As for our emphasis on “causal” pathways like genetics, well, I am telling people life consists of “beating” your biological destiny. This sets up hope, which is a good move for any practitioner.

I love to say things like “It’s not your fault, honey — you were set up for this genetically. But I’ll do the best I can to help you beat it.”

Genetics are NOT a commandment to have a rotten life.

I even agree with the authors when they plead for professionals from different fields to work together. I only urge them to include those disenfranchised but spirited psychiatrists who want better for humanity. And send patients to buy some safe, inexpensive psychoactive substances at Wal Mart, trying to escape the financial and governmental dictates of a profession too easily weakened by false hopes and too easily to drown in an ocean of nihilism.

I was in the generation told “you have to know all a psychologist does — and more,” and I bought it.