Recent quotes:

Blame everything but the gift horse...

I was in an emotional free-fall, so I visited a psychiatrist. He said the antidepressant my general practitioner prescribed to help with my life-long struggle with anxiety wasn't what I needed, so he prescribed a new one. This seemed to only make things worse. Within a few days, I found myself thinking the unthinkable: I want to die.  I couldn’t imagine a life without my father and our hours-long conversations about, well, everything. The pain was debilitating, getting out of bed was an Olympian event, and life was utterly devoid of meaning. I stopped eating and shed 15 pounds in a month. I couldn’t see any reason to be alive.

Merciful Love Can Help Relieve the Emotional Suffering of Extreme States - Michael W. Cornwall, 2018

I do not believe such love can easily well up inside us while we are distracted by ponderous, analytical mentation. Doesn’t the “clinical gaze” that sometimes may emerge in the eyes of “mental health” caregivers reflect the detached or even defended inner emotional state of the caregiver? That impersonal clinical gaze strives to keenly identify and measure the severity of the “symptoms” of mental illness in order to ascertain definable patterns of “psychopathology.” The clinical gaze also searches for the degree of deviance from codified societal norms. But the inner clinical stance of the caregiver that fosters the caregiver’s own emotionally detached, impersonal objectifying gaze, tragically, can reinforce the inner self-judgments and the inner devaluing and self-shaming of the suffering person the caregiver would hope to help. One’s very self-identity is called into question as the inevitable psychiatric diagnosis process unfolds. We are then redefined as “disordered” beings who are fundamentally failing to pass as equals with those more “healthy” and successful persons than ourselves. A psychiatric diagnosis almost always brings a diminution of self-worth to those so often already in the grip of harsh self-judgments about their worth and inherent value (Cornwall, 2016b).

Current head of AACAP -- Texas Psychiatrist Karen Wagner Under Scrutiny - AHRPAHRP

Dr. Wagner co-authored the notorious, ghostwritten Paxil pediatric study #329, whose lead author, Martin Keller, MD, was replaced last month as chairman of psychiatry at Brown University. The Glaxo-paid authors of study #329 helped the company promote the myth that Paxil was "safe and effective" for use in children as early as 1998: in a poster presentation, Dr. Wagner claimed "The results of this study demonstrate the safety ofparoxetine in the treatment of adolescent depression. Side effects were modest with paroxetine." [2]  But internal Glaxo emails show the data from pediatric Paxil trials were negative.

Reddit Has a Really Surprising Effect on Users' Mental Health, Study Shows

Using three other subreddits - r/happy, r/bodybuilding, and r/loseit - as their control group, the researchers determined that contributors to the mental health subreddits appeared to have trouble clearly communicating initially. However, over time, those users showed "statistically significant improvement" in both their lexical diversity and readability. "I started to notice that as they come in more, and they participate more, they're more calmed down, and they're articulating a little bit better," study author Albert Park told Healthcare Analytics News.

Research Center Tied to Drug Company - The New York Times

A June 2002 e-mail message to Dr. Biederman from Dr. Gahan Pandina, a Johnson & Johnson executive, included a brief abstract of a study of Risperdal in children with disruptive behavior disorder. The message said the study was intended to be presented at the 2002 annual meeting of the American Academy of Child and Adolescent Psychiatry. “We have generated a review abstract,” Dr. Pandina wrote, “but I must review this longer abstract before passing this along.” One problem with the study, Dr. Pandina wrote, is that the children given placebos and those given Risperdal both improved significantly. “So, if you could,” Dr. Pandina added, “please give some thought to how to handle this issue if it occurs.” The draft abstract that Dr. Pandina put in the e-mail message, however, stated that only the children given Risperdal improved, while those given placebos did not. Dr. Pandina asked Dr. Biederman to sign a form listing himself as the author so the company could present the study to the conference, according to the message. “I will review this morning,” responded Dr. Biederman, according to the documents. “I will be happy to sign the forms if you could kindly send them to me.” The documents do not make clear whether he approved the final summary of the brief abstract in similar form or asked to read the longer report on the study.

Research Center Tied to Drug Company - The New York Times

A February 2002 e-mail message from Georges Gharabawi, a Johnson & Johnson executive, said Dr. Biederman approached the company “multiple times to propose the creation” of the center. “The rationale of this center,” the message stated, “is to generate and disseminate data supporting the use of risperidone in” children and adolescents.

Research Center Tied to Drug Company - The New York Times

In a November 1999 e-mail message, John Bruins, a Johnson & Johnson marketing executive, begs his supervisors to approve a $3,000 check to Dr. Biederman as payment for a lecture he gave at the University of Connecticut. “Dr. Biederman is not someone to jerk around,” Mr. Bruins wrote. “He is a very proud national figure in child psych and has a very short fuse.”

Drug Maker Told Studies Would Aid It, Papers Say - The New York Times

In a contentious Feb. 26 deposition between Dr. Biederman and lawyers for the states, he was asked what rank he held at Harvard. “Full professor,” he answered. “What’s after that?” asked a lawyer, Fletch Trammell. “God,” Dr. Biederman responded. “Did you say God?” Mr. Trammell asked. “Yeah,” Dr. Biederman said.

Biederman designed studies to deliver results desired by drug makers

One set of slides in the documents referred to “Key Projects for 2004” and listed a planned trial to compare Risperdal, also known as risperidone, with competitors in managing pediatric bipolar disorder. The trial “will clarify the competitive advantages of risperidone vs. other neuroleptics,” the slide stated. All of the slides were prepared by Dr. Biederman, according to his sworn statement.

What's in a name? Researchers track PTSD's many identities during war -- ScienceDaily

The paper revealed that PTSD symptoms were known as shell shock during World War I, and irritable heart or soldier's heart during World War II. The term gross stress reaction was introduced in the first edition of the Diagnostic and Statistical Manual in 1952, but was omitted in a second edition in 1968 during the Vietnam War. It wasn't until 1980, with the publication of the manual's third edition, that the term PTSD was introduced to describe military trauma and non-war related factors, such as sexual abuse. "PTSD has existed forever," Chekroud said. "It's just a question of what we've been calling it." Chadi Abdallah, MD, Assistant Professor of Psychiatry at Yale and the editor of Chronic Stress, said the history of disjointed terminology resulted in a 60-year delay in understanding traumatic symptoms experienced by veterans and others.

The Future of Therapy: Becoming Someone Else in VR - WSJ

Later, I ask Sanchez-Vives what might have been happening neurologically during my talk with virtual Freud. She explains that different areas of the brain are activated when we think about ourselves as opposed to others. Becoming someone else in virtual reality, she says, “can give us access to different brain resources and, therefore, to different ideas about how to solve a problem.” “You are always better at giving advice to a friend than yourself,” Slater adds. “And when you see yourself sitting there, you become like a friend.” I imagined that Freud would be both wise and direct, and I tried to channel that when dispensing advice from his body. But I was also kinder than I normally would be. Hearing my problems from his perspective underscored for me that the criticisms I level at myself are often not based in reality and sound ridiculous when spoken aloud. Even though I already knew everything Freud had to say—after all, those were my words coming out of his mouth—the emotional distance of being someone else helped me access a different part of myself. “It’s a novel way of perspective taking,” Sanchez-Vives says. “You take a distance from your emotions and yourself.”

Yale neuroscientists have debunked the idea that anyone's personality is normal — Quartz

trying to define people one way from a psychiatric perspective is a failure of imagination and opportunity, which hobbles people rather than empowering them to inhabit their full selves. Classic psychiatry categorizes people in limiting, linear ways, while the world is inherently wide-ranging, according to the researchers. They propose instead that each individual be assessed and understood singularly from a psychiatric perspective, but according to a wide range of fluctuating behaviors and tendencies.

Teaching skills

In 1959, she was offered an internship in the psychiatric unit at Manhattan State Hospital, where she tended to forty schizophrenic women. They were guinea pigs, she wrote in her memoir, enrolled in an experiment to test the efficacy of new medications and LSD. Her job was to administer these experiments and complete the research logs, but instead, she taught the women independent living skills. They learned to comb their hair, dress themselves, and arrive to appointments on time. She took them on field trips and helped them find jobs and their own apartments.

Shhhh

Investigators turned to Paddock’s physician. The doctor described Paddock as “odd” and as a man who showed “little emotion.” He believed that Paddock may have had bipolar disorder but told police that his patient had refused to discuss the issue further. Paddock didn’t appear to be abusing any medications, the doctor noted. In fact, he seemed fearful of medication in general. While he had been treated for anxiety, Paddock had refused antidepressant medication.

Awaken in the Dream - Paul Levy

Spiritual emergences/emergencies oftentimes become activated because of a deep experience of wounding, abuse, or trauma. In its initial stage, a spiritual awakening can look like and mimic a nervous breakdown, as our habitual structures of holding ourselves together fall apart and break down so that a deeper and more coherent expression of our intrinsic wholeness can emerge. The spiritual awakening aspect of my experience was so off psychiatry’s map that it wasn’t even remotely recognized. Instead of hearing me, about either the abuse or the awakening, I was immediately pathologized and labeled as the sick one. Being cast in the role of the “identified patient,” I was assured that I was going to be mentally ill for the rest of my days, as if I was being given a life sentence with no possibility for parole, with no time off for good behavior. The fact that I wanted to dialogue about this and question their diagnosis was proof, to the psychiatrists in charge of me, of my illness. The whole thing was totally nuts. Fully licensed and certified by the state, the psychiatric system’s abuse of its position of power was truly unconscionable. What the profession of psychiatry was unconsciously en-acting was truly crazy-making for those under their dominion. I was lucky to escape the psychiatric world with my sanity intact.

Mental Illness or Mental Injury? | Psychology Today

n fact, we do know from scientific research and the burgeoning field of epigenetics that most of what we call “mental illnesses” are really injuries and not just post-traumatic ones, but chronic and repeated complex trauma.  Even our very biological genetic material is affected not only by our own experiences, but those of our ancestors. The field of epigenetics has revived the evolutionary theory of Lamarck[1] from the dustpan of history.

The concept of schizophrenia is coming to an end – here's why

I expect to see the end of the concept of schizophrenia soon … the syndrome is already beginning to breakdown, for example, into those cases caused by copy number [genetic] variations, drug abuse, social adversity, etc. Presumably this process will accelerate, and the term schizophrenia will be confined to history, like “dropsy”.

Freud's repressed negligence

Anna Freud provided Masson access to more than 75,000 documents to complete his task, but Masson quickly saw that something was awry in the history. “I began to notice what appeared to be a pattern in the omissions made by Anna Freud in the original, abridged edition,” he wrote in The Atlantic in 1984. “In the letters written after September of 1897 … all the case histories dealing with the sexual seduction of children had been excised. Moreover, every mention of Emma Eckstein … had been deleted.” When he asked Anna Freud why she had deleted certain sections, she said, according to Masson, that she “no longer knew why” and that “she could well understand” his interest, but that “the letter should nevertheless not be published.”

Can Big Data Help Psychiatry Unravel the Complexity of Mental Illness? - Scientific American

Psychiatrist Charles DeBattista of Stanford University and colleagues, compared electroencephalograms (EEGs) collected from depressed patients, with a database of EEGs from over 1,800 patients that included information about response to specific treatments. Using EEG measures to guide decisions about treatment alternatives led to significantly better outcomes than clinical treatment selection.

data driven future... or not

As Harvard Psychiatrists John Torous and Justin Baker recently wrote in JAMA Psychiatry, “Data science and technology can provide a nearly limitless set of decision-support and self-monitoring tools. However, without individual psychiatrists and the field at large making a concerted push to drive the technology forward…these advances will likely fail to transform our troubled system of care.”

The Rise of Evidence-Based Psychiatry - Scientific American Blog Network

Psychiatry remains an outlier in the medical profession regarding the use of data; even after the rigorous Osheroff v. Chestnut Lodge debate, the importance of data in practice remains unsettled. In particular, objective data and data science remain underutilized by the psychiatric community. Has your therapist ever used a predictive algorithm to guide your treatment?

Abysmally primitive

as Dr. Sophia Vinogradov, Chief of Psychiatry at the University of Minnesota Medical School, recently wrote in Nature Human Behavior, “There's a secret that we psychiatrists do not like to talk about: the abysmally primitive state of how we assess, understand, and treat mental illness.”

Why Are There No Biological Tests in Psychiatry? - Scientific American Blog Network

we must also not minimize the grave practical problems and limitations associated with not having biological tests to identify psychiatric disorders. Most troubling is the fact that the overwhelming majority of prescriptions for psychotropic medicines are written by primary care physicians who often have little training in psychiatry; little time to perform an adequate diagnostic evaluation; a tendency to depend on tests rather than talking to patients; and too great a susceptibility to quick trigger diagnosis and poorly chosen pill solutions (fostered by aggressive and misleading drug company marketing). The lack of precise and easily available biological tests in psychiatry permits much loose diagnosing and cowboy prescribing.

DSM versus neuroscience

Compared with the psychiatric diagnoses listed in the Diagnostic and Statistical Manual of Mental Disorders (D.S.M.), which can be vague and flawed, brain-based research holds out the promise of a precise and truly scientific understanding of mental illness.

Dr. Nestler is dean for academic and scientific affairs and director of the Friedman Brain Institute at the Icahn School of Medicine at Mount Sinai. Dr. Hyman is a past director of the National Institute of Mental Health.

Virtually all of today’s treatments are based on serendipitous discoveries made six decades ago.

Study bias

Selective publication of clinical trials on antidepressants also could cause a bias about their perceived effectiveness, according to a study led by researchers at the Portland Veterans Affairs Medical Center (New England Journal of Medicine, 2008). The study examined 74 FDA-registered studies for a dozen antidepressants and found that most studies with negative results were not published in scientific literature or were published in a way that conveyed a positive outcome. The FDA studies showed that half of the drug trials had positive results, but 94 percent of the trials cited in published literature were positive.