(Author’s Note: This is a follow up article to the one I wrote for the AVA several weeks ago about my experience as a mental health client.)
In the last 20 years there has been a proliferation of psychiatric drugs prescribed in the United States, not only by psychiatrists but by general practitioners. Anti-depressants, specifically SSRI's (selective serotonin reuptake inhibitors) like Prozac have become commonplace, and anti-anxiety medications are also popular. Not to be excluded are anti-psychotics used mostly for psychosis and schizophrenia.
I had been a consumer of psychiatric drugs for the last 21 years until earlier this year, and my views toward taking them have changed quite drastically in the last year and a half. With a diagnosis of depression and obsessive-compulsive disorder, over the last 21 years I took anti-depressants, anti-anxiety drugs, anti-psychotics, as well as sleeping medications.
I was definitely never one who expected a "miracle" from psych meds, as I had taken them for a few years in my early twenties and never saw them as anything other than a possible boost to my mood along with doing psychotherapy. But last year I began to question whether they were really doing any good and if in fact they were doing harm to me based on my being exposed to the work of a psychiatrist and author named Peter Breggin who is critical of conventional psychiatry and the proliferation of psychiatric medication.
What had not changed in my 21 years on psych meds was my social isolation and low functionality as far as participating in society whether through employment, school, volunteer work, etc. I have done psychotherapy for well over half of those 21 years, but it seemed pretty clear that psych meds were not providing much benefit to me while definitely financially benefitting my psychiatrist (charging a discounted rate of $250/hour) and the pharmaceutical companies. Resentment motivated me to attempt weaning off psych meds with my doctor's assistance.
In August 2014 I started tapering off the anti-psychotic I was taking, and by January I was off it. In April I went off my anti-depressant in only three weeks with no palpable withdrawal. Around the holidays last year while tapering off the anti-psychotic I noticed being more in touch with my emotions as I was able to cry on several occasions. I started writing again, keeping a journal, and listening to music, whereas for months I had spent a lot of time watching TV which was merely a numbing behavior. These expressive/creative habits and hobbies continue today as I have not only kept a journal but written an article for the AVA as well as letters to editors and a submission to a literary magazine. I listen to music every day and almost never watch more than two hours of TV a day.
A major concern I had after reading Dr. Peter Breggin's book was his assertion that psych meds merely blunt emotions much like alcohol and narcotics. This was kind of a blow to my ego as I had had a little bit of smugness around the belief that psych meds were "medicine" and I was not resorting to "getting wasted" on alcohol or illegal drugs. Years ago after noticing that I never cried on Prozac after being able to cry while off meds I wondered aloud to my psychiatrist if Prozac was nothing more than a "sophisticated anesthetic." He tried to assert that it wasn't but I don't remember his argument being convincing.
The therapist who referred me to my psychiatrist in 1994 asserted that psych meds would aid in therapy by getting me in touch with my emotions, but my experience hasn't shown that not to be the case. Peter Breggin argues that psych drugs "suppress feelings and estrange people from themselves. This makes it more difficult to explore, identify, and channel emotions."
Dr. Peter Breggin, 79, of Ithaca, New York has been a psychiatrist in private practice since 1968 and is a reformer in the mental health field who is opposed to the escalating overuse of psychiatric medications, the oppressive diagnosing and drugging of children, electroshock, lobotomy, and involuntary treatment. He acts as a medical expert in criminal, malpractice and product liability suits, often involving adverse drug effects such as suicide, violence, brain injury, death, and tardive dyskinesia. Dr. Breggin's book that I read is "Your Drug May Be Your Problem — How and Why to Stop Taking Psychiatric Medications" (1999, revised 2007), co-authored with David Cohen, PhD.
Dr. Breggin argues that the concept of biochemical imbalances in depression, anxiety, and other mental illnesses is highly speculative and suspect, and that there is no way to measure it. I would point out that whereas legitimate physical diseases like diabetes, HIV, high cholesterol, prostate cancer, etc. have blood tests to detect them, depression has no such tangible physical test to prove serotonin deficiency. Instead a doctor's biased judgment is relied on. Over the last year I have encountered the opinions of quite a few psychiatrists and other mental health professionals on the Internet who question or discount the notion that depression is caused by serotonin deficiency.
Depression has been turned into a medical issue in this culture when I think that ultimately it is not. In my case depression is emotional, related to trauma and the legacy of child abuse. Peter Breggin states that "when emotional discomfort or suffering is defined as a 'disorder' it creates business for doctors and drug companies."
The appeal of a medical diagnosis of depression for sufferers is that it can lift the conventional stigma of depression being a "moral failure" or "character issue" and instead be seen as a chemical issue that's not the individual's fault. I personally didn't feel that way. I took it personally that my brain chemistry was considered "defective."
Depression as a medical issue also distracts from difficult and painful issues for both the individual sufferer and society at large, issues like trauma, child abuse, and social and economic injustice. In my experience, depression is a complex matter and merely reducing it to a medical diagnosis is unintelligent, unenlightened, and dangerous.
Getting back to my psych med experience, it started off innocently enough with a depression/OCD diagnosis and a low dose of Prozac, but gradually the doses were raised higher and higher until reaching the highest recommended daily dose due to it either not being effective or the body needing higher doses for it to be effective. In the first five years with my psychiatrist we also tried several anti-anxiety drugs. Benzodiazepines, being addictive, never appealed to me and I never stayed on them long, but a non-addictive anti-anxiety drug called Buspar was also ineffective.
I spent most of the last 15 years on anti-psychotics, not for psychosis (my doctor never believed I was psychotic) but to "augment" the effect of the anti-depressants. On anti-psychotics my weight shot up to 240 pounds (I'm 6 foot 2 inches), a weight I had never gotten close to before. Peter Breggin asserts that anti-psychotics are especially harmful and goes so far as to say that they are "chemical lobotomy" agents.
My doctor's approach over the years seemed to be to bombard my brain and body with the highest dose of anti-depressants while adding either anti-anxiety or anti-psychotic drugs. Like I mentioned earlier, this approach didn't significantly affect my established social isolation and disengagement from structured activity (I was also doing therapy so I wasn't solely relying on psych drugs). Of course, the more drugs I took and specifically the higher amount of pills I took, the more money the drug companies made off me, not to mention the drug insurance companies.
Peter Breggin in the above mentioned book goes into detail about the possible adverse effects of long term use of psych meds. The list is long and daunting. I haven't noticed much withdrawal symptoms since going off psych meds. On the plus side I'm more in touch with my creative side, but I don't feel much different emotionally since discontinuing the drugs. The fact that I don't feel worse tells me the drugs were not helpful or necessary.
In the last several months I've tried to move away from the stigmatized label of "depression" and focus on the emotions I feel behind it, primarily grief/sadness and anger. Adult Children of Alcoholics literature states that grief in ACA's is often misdiagnosed as depression. Grief is about loss, and my particular losses go back to childhood and have continued on into an adulthood where I've mostly been in hiding. I think Americans are averse to grief, America being a culture biased toward positivity (whether genuine or artificial) and ascensionism and being perpetually UP, thus the stigma against depression.
Writing this article and the previous one for the AVA about my experience as a mental health client have helped get me in touch with anger at what I see as the injustice of my being pathologized on a cultural level essentially for being wounded emotionally by my upbringing. I think the appropriate question for current or former psychiatric patients is not "What's wrong with me?" but "What happened to me?"
One major problem I see in the treatment of depression by both therapists and psychiatrists in this culture is focusing on internal causes for one's depression: one's behavior, chemistry, habits of thought. Depression is often a response to external trouble such as conflicts, abuse, injustice, illness, loss, and upheaval. I'm sure many depression sufferers who initially seek treatment and then stop do so because of this bias toward seeing their problems as internally based. For many this approach would merely encourage the continued habit of turning anger inward, which of course is one definition of depression.
Lastly, one very important thing to mention that is stressed by Peter Breggin is that when someone is trying to withdraw from psychiatric drugs, it is critical for that individual to work with a psychiatrist in going about that process. Psych meds are much easier to start than to stop, and many psych drug users experience serious withdrawal symptoms and need to be monitored by a doctor. If you have a doctor who won't support your desire to stop psych meds then find one who will.
(Keith Bramstedt, age 50, lives in San Anselmo.)