I am continually fighting to acquire nutrition on the agenda in psychological health forums, public meetings, survivor communities, conferences, and into programs at different levels. Luckily, the understanding is growing that poor nutrition and nutrient-poor foods are big, main factors in why people’s brains don’t work well or sometimes at all.
On Thursday morning, I was given about 40 minutes to speak, and after I gave a short view of Anatomy of an Epidemic, I spoke at bigger length about this question: Is it real that people diagnosed with schizophrenia (or other psychotic disorders) need to be on antipsychotic medication all their lives? There is a reasonably long line of studies dating back to the 1970s that bear on this issue, and the conclusion to be drawn is this: If psychotherapy desires to maximise long-term outcomes, it needs to use antipsychotic medicines in a selective, limited way. Time and time again, the studies showed that there is a big subgroup of sufferers that would fare better if they were never put on the medicines in the first place, or if they were maintained on the medicines for only a quick time.
The beauty of this particular story of science is that it concludes with a description of how western Lapland, in northern Finland, started using antipsychotic medications in this manner in 1992, and today their psychotic patients enjoy the best long-term outcomes in the western world. Five years after a first psychotic episode, eighty percent of their patients are either back in school or working. About one-third of the patients have been exposed to antipsychotics during this period, and about twenty percent end up taking the medication regularly. And what I like most about this success story is that it cannot be viewed, in any way, as an “anti-medication” story. It’s a “best-practices” story.
Most of the audience understood this to be a “good news” tale, with science telling us of a therapeutic path that led to high recovery rates. And imagine if the program, at this national conference, had been structured to have psychiatrists (or other providers) discuss the talk I had just given. We could have spoken about whether a similar therapeutic approach could ever be tried here, and with representatives from SAMHSA there, perhaps this possibility could even have leapt onto a national agenda. This could have been a moment for transformative change in the treatment of first-episode psychosis in this country, a change designed to put young people back onto a path of real recovery, rather than down a path that led all too often to chronicity and disability. But unfortunately, in that Hyatt Regency ballroom, a much different process was underway. Several SAMHSA officials were nervously huddled with the psychiatrist, Mark Ragins, who had been selected to rebut my talk, apparently with a sense of urgency that he effectively counter what I had said. No good news allowed!
When Dr. Ragins took the stage at lunchtime, he was remarkably candid. He was here because SAMHSA wouldn’t let me speak unless a psychiatrist had a chance to rebut what I had said. This, of course, was startling news to most in the audience, as few had ever been to a conference where a second keynote speaker was brought in to discredit the first.
There was, however, no real discussion by Dr. Ragins of the talk I had given, or the issues brought up in Anatomy of an Epidemic. Instead, Dr. Ragins used this metaphor to criticize Anatomy: In the book, he said, I had provided readers with a “compelling picture” of a “close-up of a car accident,” but “we have to widen our view to decide if freeways should be torn down.” Dr. Ragins then discussed other factors besides medication that might be causing the astonishing rise in the number of disabled mentally ill in our society, such as the fact that once people are on SSI or SSDI, there is a financial disincentive to return to work (which I agree is a factor.) Finally, in apparent reference to the many studies I cited in the book that had found that medicated patients have worse long-term outcomes than the off-medication group, he said:
“Medical interventions are always correlated with worse (long-term) problems. It is likely that all interventions ‘done to’ someone to give them help or take care of them will have short-term benefits that wane over time and may well become long-term negatives.”
I still am not quite sure how that was supposed to be a “rebuttal” to Anatomy of an Epidemic. But that is how it was being pitched, and then when Dr. Ragins detailed some of his thoughts on what promoted long-term recovery — “Love other people, family, partners, kids” was one of the things he advised — I could only think: Am I supposed to be against this? Indeed, I had the feeling that if Dr. Ragins and I had been on a panel together, we would have found much common ground, and that he might have thought that there was considerable merit to the Western Lapland approach. But the chance to have that productive discussion had been lost.
During the conference, D. J. Jaffe, who has close ties to the National Alliance on mental Illness, having served on its national board of directors, wrote a blog about the conference for The Huffington Post, describing it as a waste of taxpayer money. My presence there, he argued, was evidence of why this was so. The keynote speaker, Jaffe said, had written that “antipsychotic drugs do not fix any known brain abnormality nor do they put brain chemistry back into balance,” and readers were left to understand that, given that everybody knew that psychological disorders were caused by chemical imbalances, I was a bit of a loony-tune.
Now I must confess that I start to lose all wish. It seems fairly not possible that our world will ever be able to have a considerate, truthful debate on what is really known about psychological issues, and about the merits of psychiatric drugs. The forces lined up against such a discussion are just too great.
Illness is the lack of health as much as anything else. What we ought to be discussing about as we apply and use informed, guided, and sustained nutritional treatment, is ‘side benefits’, numerous benefits for other physical systems that willingly translate to psychological and emotional factors and build healthier, new life and more completely functioning people.
On Thursday morning, I was given about 40 minutes to speak, and after I gave a short view of Anatomy of an Epidemic, I spoke at bigger length about this question: Is it real that people diagnosed with schizophrenia (or other psychotic disorders) need to be on antipsychotic medication all their lives? There is a reasonably long line of studies dating back to the 1970s that bear on this issue, and the conclusion to be drawn is this: If psychotherapy desires to maximise long-term outcomes, it needs to use antipsychotic medicines in a selective, limited way. Time and time again, the studies showed that there is a big subgroup of sufferers that would fare better if they were never put on the medicines in the first place, or if they were maintained on the medicines for only a quick time.
The beauty of this particular story of science is that it concludes with a description of how western Lapland, in northern Finland, started using antipsychotic medications in this manner in 1992, and today their psychotic patients enjoy the best long-term outcomes in the western world. Five years after a first psychotic episode, eighty percent of their patients are either back in school or working. About one-third of the patients have been exposed to antipsychotics during this period, and about twenty percent end up taking the medication regularly. And what I like most about this success story is that it cannot be viewed, in any way, as an “anti-medication” story. It’s a “best-practices” story.
Most of the audience understood this to be a “good news” tale, with science telling us of a therapeutic path that led to high recovery rates. And imagine if the program, at this national conference, had been structured to have psychiatrists (or other providers) discuss the talk I had just given. We could have spoken about whether a similar therapeutic approach could ever be tried here, and with representatives from SAMHSA there, perhaps this possibility could even have leapt onto a national agenda. This could have been a moment for transformative change in the treatment of first-episode psychosis in this country, a change designed to put young people back onto a path of real recovery, rather than down a path that led all too often to chronicity and disability. But unfortunately, in that Hyatt Regency ballroom, a much different process was underway. Several SAMHSA officials were nervously huddled with the psychiatrist, Mark Ragins, who had been selected to rebut my talk, apparently with a sense of urgency that he effectively counter what I had said. No good news allowed!
When Dr. Ragins took the stage at lunchtime, he was remarkably candid. He was here because SAMHSA wouldn’t let me speak unless a psychiatrist had a chance to rebut what I had said. This, of course, was startling news to most in the audience, as few had ever been to a conference where a second keynote speaker was brought in to discredit the first.
There was, however, no real discussion by Dr. Ragins of the talk I had given, or the issues brought up in Anatomy of an Epidemic. Instead, Dr. Ragins used this metaphor to criticize Anatomy: In the book, he said, I had provided readers with a “compelling picture” of a “close-up of a car accident,” but “we have to widen our view to decide if freeways should be torn down.” Dr. Ragins then discussed other factors besides medication that might be causing the astonishing rise in the number of disabled mentally ill in our society, such as the fact that once people are on SSI or SSDI, there is a financial disincentive to return to work (which I agree is a factor.) Finally, in apparent reference to the many studies I cited in the book that had found that medicated patients have worse long-term outcomes than the off-medication group, he said:
“Medical interventions are always correlated with worse (long-term) problems. It is likely that all interventions ‘done to’ someone to give them help or take care of them will have short-term benefits that wane over time and may well become long-term negatives.”
I still am not quite sure how that was supposed to be a “rebuttal” to Anatomy of an Epidemic. But that is how it was being pitched, and then when Dr. Ragins detailed some of his thoughts on what promoted long-term recovery — “Love other people, family, partners, kids” was one of the things he advised — I could only think: Am I supposed to be against this? Indeed, I had the feeling that if Dr. Ragins and I had been on a panel together, we would have found much common ground, and that he might have thought that there was considerable merit to the Western Lapland approach. But the chance to have that productive discussion had been lost.
During the conference, D. J. Jaffe, who has close ties to the National Alliance on mental Illness, having served on its national board of directors, wrote a blog about the conference for The Huffington Post, describing it as a waste of taxpayer money. My presence there, he argued, was evidence of why this was so. The keynote speaker, Jaffe said, had written that “antipsychotic drugs do not fix any known brain abnormality nor do they put brain chemistry back into balance,” and readers were left to understand that, given that everybody knew that psychological disorders were caused by chemical imbalances, I was a bit of a loony-tune.
Now I must confess that I start to lose all wish. It seems fairly not possible that our world will ever be able to have a considerate, truthful debate on what is really known about psychological issues, and about the merits of psychiatric drugs. The forces lined up against such a discussion are just too great.
Illness is the lack of health as much as anything else. What we ought to be discussing about as we apply and use informed, guided, and sustained nutritional treatment, is ‘side benefits’, numerous benefits for other physical systems that willingly translate to psychological and emotional factors and build healthier, new life and more completely functioning people.
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