Toxic Psychiatry

A few months ago I ordered a hard copy of a book called Toxic Psychiatry. toxic_psychiatryIt took over a month to get here via Media Mail. I have since finished it, as well as The Book of Woe, and I happened upon a documentary called Letters from Generation RX (which conveniently features both authors) on Prime. I can assume it’s obvious where this post is heading.

Before I go further maybe it’s worth noting that it’s rare that I have any opinion about anything without extensive research. I have had often changed my mind doing this, which is how it’s supposed to work: I don’t read an article on CNN and then decide I’m right… 99% of journalism today fails to render any objectivity anymore, or to separate truth from opinion. I truly am interested in how the world works. It’s the reason I can take anyone through the last 500 years in the Balkans; I can tell you about the history of pollution in the Great Lakes; I can talk all day about the Farm Bill and the ills of the American agricultural-industrial complex; I could start a lecture series about the history of Communism, Nordic geopolitics and culture, the history of Arctic exploration and its effects on indigenous circumpolar people. The list goes on. Puking out headlines and sound bytes is worthless.

I also believe individuals have more agency than they think. When I was younger, I fell prey to this lack of confidence as well. Now well into my 30s, I have a strong internal locus of control. I also do not believe I am special in any way: I actually believe that every individual possesses at the very least the potential to get to this point, where they are bursting with agency within themselves. Feeling this way doesn’t mean I’m a control freak, or naively believe anything that veers off-course of my expectations is my fault, but it does mean I believe I can get through everything. This is a misunderstood quality in people like me: I like to solve problems in a world where people increasingly want plain sympathy (or a sort of inactivated empathy, where you understand where the person is coming from but don’t move to help them resolve their issue(s)). I feel that trying to help someone figure something out is empathy… many people have disagreed. To me, my time is valuable, and if I’m trying to help you resolve an issue, it means I care about you. My advice to my friends and loved ones is based on my belief in their human potential.

Some related facts: I’m from an overweight family, and while my parents have made inroads to be healthier especially now that the pandemic is winding down, I’m the only one who has managed to maintain a normal body weight over the years (I have been overweight in a few periods of my life, so it’s not an effortless affair). I am the only one of my siblings to go to college, or maintain excellent credit, to have built a fairly bulletproof career. I have never, ever believed this is because they are lacking in ability or intelligence: it is solely a matter of discipline and mindset. I chose. I have had quite a few headwinds: impostor syndrome. A high ACE score (this feature is obviously shared with my siblings). Many tragic hiccups along the way. Multiple autoimmune comorbidities. For whatever reason, I decided when I was a kid I was not going to live the kind of life that was laid out for me, and became meticulously focused on doing things differently. I’ve been fascinated by this process in people for years: are some people born with this level of ambition or initiative? Can you learn it? There’s a lot of varied research; what I’ve found the most distressing is the ACE research: struggle and tragedy pass through generations, leaving some people with fewer resources, knowledge and fewer life skills than others. Worse, these people rarely have a sense of what they can get out of life — they lack encouragement and people to look up to. This all results in even further lack of agency, which is why I absolutely freak the fuck out when I hear about white privilege… convincing people they are victims, or that they have to own a kind of historical shame over who they are, will not help them get further in life. There is nothing worse than growing up believing the deck is stacked against you. It is the literal opposite of encouragement and respect and dignity. But, I digress.

Two things have transpired over the past few months that have pushed me into another vortex of information acquisition:

  • Every member of my immediate family is now taking an antidepressant
  • Two people I know have been diagnosed with bipolar disorder in the past 3-4 months

I’ll start with #2. Knowing two (newly diagnosed) bipolar people is fairly rare, though it’s not impossible, of course.  The prevalence among the general population is somewhere between 1-2%, if even that, thanks to documented over-diagnosing for at least the last 10-15 years. I don’t know even know 30 people well enough for them to share this with me; what are the chances two people who are struggling with a variety of circumstances would both be bipolar? It doesn’t quite sit well, though it’s a small sample size and could be a fluke.

#1, I am now the only member of my family not reliant on a daily antidepressant. My sister and brother have been on some form of drug for depression/ADHD/OCD/anxiety for years; my quite surly grandmother was next, then my mother, during the pandemic, and finally my father. This was difficult news for me to choke down when I was originally told, because I truly hate the idea of my mother especially being sad, and subsequently taking antidepressants. No one wants his or her mother taking antidepressants; I think this is pretty normal.

I have some of my own life experience these drugs, beginning in college. I’d say my first year was a very emotionally challenging stretch of my life, but instead of anyone trying to understand why I was struggling, I was immediately put on Paxil. I was 17-18 and I didn’t know any better. I abruptly stopped taking it a few weeks later after feeling like an empty vessel, and I would never recommend cold turkey to anyone: apart from the grotesque physical side effects, I was constantly wracked with panic attacks and what now, 20 years later, have been termed “brain zaps”. I was then put back on Paxil and began tapering off with the help of clonazepam, a powerful benzodiazepine that I can’t deny improved my quality of life due to it only being used strictly as-needed, and never on consecutive days.

After a second experience where I visited an endocrinologist and was offered tricyclic antidepressants, I gave up. I actually refused any and all help from doctors and instead dealt with my panic “disorder” via exposure therapy, on my own, determined to force myself to stop being afraid of stupid shit by desensitization. It wasn’t easy and it took years. This was an extremely frustrating process for me – I would actually lose consciousness when this began happening, which is not exactly a great scenario when you live in a city and take public transport. At that age, it was also terrifying. I also, at that age, had no sense of self-care and just hated myself for my own weakness, and felt like an absolute busted piece of shit failure of a human being. I can’t think of a harder time in my life than those years in Boston. I truly came unglued into 5,000 pieces and had to painstakingly put myself back together and also excel in school, and support myself.

Fast forward to now (over 15 years later): as recently as this past fall, when requesting the lowest dose possible of Restoril, I was scolded for wanting dangerous and habit-forming benzodiazepines and encouraged to consider an SSRI or a tricyclic for daily use, which I again declined. Neither of these drugs would have resolved my acute insomnia without causing a litany of other issues: I ended up getting 10 tabs of Restoril (and scornful disapproval from my PCP and a required appointment with a “sleep doctor” who tried to convince me I have sleep apnea, despite no history whatsoever of snoring or breathing problems).  In the end, I didn’t take a single tab. My insomnia passed after cutting caffeine out after 3pm (this should have been obvious to me previously, but I never considered that drinking 16 pots of tea all day and night would affect my sleep, as it never had before). I’ve been sleeping normally for months now.

This “hi, here are some drugs” attitude isn’t specific to psychiatry, of course. In 2012 when I had my first (obvious) thyroid issues, I was told it would be in my best interest to simply irradiate my thyroid ASAP and rely on synthetic hormones for the rest of my life: this recommendation was made before there was even any proof of the diagnosis that doctor suspected. I am not a doctor, obviously, but I have very good intuition: I did not agree. I spent many hours reading, and returned a week or two later and ordered radioiodine uptake scans for myself. My insurance deductible was $10,000 (a story for another day, and a hard lesson learned). I paid, on my own hunch, against advice from anyone in that office. And I ended up being right; I had a rarer disease, but a manageable one. If I had listened to that doctor, I would have relied upon a daily dose of Synthroid for the rest of my life and would be walking around with a dead, useless thyroid gland.

This particular incident totally blew my mind, and if I didn’t feel extreme suspicion for American medicine, I definitely felt it after that. My own experience has made me sure this entire pharma-medical-industrial complex is built to keep people sick or misinformed to keep selling prescriptions. In fact, I can recall fewer than 5 doctors in my entire 37 years who gave me actionable advice that lacked a prescription. Some prescriptions I can get on board with: my eye allergy needed eyedrops. I use a topical steroid suspension for psoriasis/ps-arthritis, though many people with this disease are using the much more dangerous biologic medications advertised constantly on TV, which can preserve their smooth skin and their bodily comfort at the risk of strokes, fungal infections of the brain, tuberculosis and lymphoma. Do you want to risk your life to beat back an inconvenient skin disease? I sure as hell don’t. I actually look to Europe regularly on some of these biologic agents: the drug companies cannot incentivize doctors to prescribe them there. Not surprisingly, despite a significantly higher prevalence of psoriasis in Europe, the US sales are many times the European sales. Fucked up, no?

Re: mental health, much of the materialbookofwoe I’ve consumed over the past weeks has further confirmed my suspicion, that these (mental health) drugs are horribly dangerous and there’s no diminishing financial gain in encouraging people to figure out their problems; it costs too many work-hours for doctors to listen to people. They instead whip out their prescription pads. I am sure some people need these medications: surely the truth is somewhere between what’s happening and “these diseases are entirely fabricated to sell drugs and create an industry for psychiatrists.” This extends to all corners of this industry: is it bizarre to anyone else that the same company that caused the opioid crisis is now also peddling buprenorphine? It’s not pretty fucked up that this company manufactures opioids AND drugs to come off their opioids? Why do we let food companies sponsor American medical associations doling out health advice to the general public? Nearly 10% of the population of America is diabetic, and there is no generic insulin, despite it being invented in 1922. Why isn’t nutrition part of medical school? Only now are documentaries beginning to emerge about these troubling facts (quick nod to Crime of the Century, about the Sackler family, which is a must-watch).

I’m not totally opposed to the use of psychiatric drugs: I have been carrying around a few tabs of clonazepam in my bag for the last decade. I have used this drug less than 10x in the last 5 years, but it does prevent me from puking in a public garbage can when I have a sudden and exceedingly rare panic attack (which will absolutely always come out of nowhere). For the most part, I’ve desensitized myself to the point where I allow them to pass while I am living my life and continue on. What I am opposed to is feeding everyone drugs at the slightest hint of anyone feeling sad… life is hard! It’s OK to be sad, angry, hurt, in emotional pain for a few weeks or months at a time. Why do we medicate it away immediately instead of figuring it out?

I strongly believe in talk therapy: I have spent thousands of dollars sorting out some of my own childhood issues with a therapist in Anchorage. It was a large investment for enormous gains in insight into my own life; it was not easy, but there was no medication. I felt I was paying for professional knowledge, and I got what I paid for. When I was finished figuring out what I needed to, I stopped, and that was that. I’m not particularly huge on talking about my feelings: I was raised in a “therapy is for pussies” family. That said, I approached it as though I was paying for expertise someone else had amassed without having to fork through 1000 books to figure it out myself.

To bring this full circle, where does this chronicle of American social tragedy end? I have watched this unfold in my own family for many years: my parents are glued to the “news.” They are fed polarizing trash and prescriptions and processed food commercials and I wonder at what point anyone leaps off the gerbil wheel of selling people shit that makes them sick: toxic lies, appeals to vanity, unhealthy food, diet plans, happy pills. Fads. Scaremongering.

All I can do is throw a link over to them here or there, or suggest a documentary, and hope for the best.  I fully realize not everyone has the luxury of time to learn (or the intellectual curiosity, at that). I realize for many people, solving an issue may just be too difficult, and medicating is easier: but I believe it comes at a steep cost, one we’ll be agonizing over down the road. I am a huge fan of capitalism, but our food and medical industries are the much more sinister wings of the free market. Changing your eating habits is hard. Exercising is hard. People put the time in because they love being alive; how does Joe Schmo get to that point? I don’t really know the answer. Pretty tough when the entire industry is set up to get you hooked on sugar as a kid, turn you into a fat adult, sell you a bunch of bullshit diet plans and then treat your diabetes. There’s a reason you don’t hear a ton about fasting in the media: you can’t sell people anything when they’re not eating. This whole system is just totally fucked.

Until more people become aware of these tyrannies, or we as a country make some deep institutional changes, we will continue to be a Prozac nation, a Lithium nation, a Synthroid & insulin nation of people who are told to take pills instead of change behavior, while people like me and many others just look on in (mostly) quiet horror.

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