When a patient experiences mental or physical pain, it is the desire of those of us in the healing professions to effectively treat their discomfort. Ideally, the pharmaceutical industry was to be our ally in this noble task. However, we have arrived at a place in our culture where our so- called treatments may be more damaging than the condition itself. Additionally, we “pathologize” all sorts of previously normal conditions from childhood through adulthood, and rather than address and treat their underlying causes, we reach for the “magic bullet” and take medications that are often toxic and carry short and long term negative consequences for ourselves and our children.
The History and Explosion in Numbers:
While analyzing the history of psychiatric disability in the US, investigative journalist and author Robert Whitaker reported that “a century ago, one in 500 people were considered “disabled” by mental illness and in need of hospitalization. By 1955, with the advent of Thorazine that number reached nearly one in 300. Over the next 50 years, as psychiatric drugs became the primary treatment, the disability rate climbed steadily. Today, nearly one in 50 US adults receives Social Security Disability Insurance or Supplemental Security Income (SSI) for psychiatric disability.”
What about the Kids?
According to author John Breeding, Ph.D., between 1970 and 2000 there was a 40 fold (or 4000%) increase in the number of children receiving psychiatric drugs. Dr. Breeding estimates “that 1 in 7 school children take at least one psychiatric drug” (many take several). At the present time, in this country, at least 12 million young people are on psychiatric medications (1)
Quite a Racket…I mean Market!
In the book A History of Psychiatry, author E. Shorter, MD reports that the introduction of Thorazine “initiated a revolution in psychiatry, comparable to the introduction of penicillin in general medicine.” And so began the era of psychopharmacology which evolved into a multi-billion dollar per year industry!
“In 1985 outpatient sales of antidepressants and antipsychotics in the US were approx. $500 million. In 1988 Prozac, the first of the second generation of psychiatric drugs was introduced. By 2008 the sales of antidepressants and antipsychotic reached $24.2 billion per year and total sales of all psychotropic drugs in 2008 topped $40 billion. 1 in 8 Americans today take a psychiatric drug on a regular basis. “(2)
In 2008 the US spent $170 billion on mental health services which is 2 x the amount it spent in 2001
If the tremendous increase in the number of people being diagnosed with mental illness and the phenomenal amount of medications they receive to treat these disorders were effective, and there were a multitude of reliable studies reporting positive patient outcomes, as a society we might be able to justify the high cost. However, it when one examines this issue more closely it becomes apparent that the aggressive push to screen for mental illness, resulting in more and more children and adults being assigned labels and given frightful diagnoses (with subsequent prescribing of medications) seems more like a profit- driven strategy on the part of the collaborative efforts of the psychopharmacology industry and the psychiatric profession, than a positive or legitimate advancement in mental health care.
From Cradle to Grave…the pharmaceutical industry dominates
As the cartoon at the top of this article highlights, we are living in very unique times: Within 24 hours of a child’s birth, a newborn receives his or her first of 36-45 vaccines. It is worth noting that the US has the highest vaccination rate in the world, and coincidentally the highest rate of autism (now 1 in 88 children.) Additionally, it is estimated that approximately 32 million of our children suffer from one or more chronic illness (including Asthma, Allergies, Diabetes, Obesity, ADD etc). (3)
Moving on from the cradle…during infancy, toddlerhood and preschool years if a child manifests signs of an infection, rather than providing nutrients to support the immune system in doing what it was designed to do, typically antibiotics will be prescribed. One or two during childhood would not amount to much of a problem. 10-12 in one year however (as I’ve often seen in my practice) can lead to alterations in the gut flora, food allergies, candida overgrowth, low levels of nutrients needed for optimal brain function etc. — all of which can result in poor attention and or negative patterns of behavior. (4)
Now let’s take it one step further -should a child also be consuming a heavily processed diet (90% of the average US family’s food budget is spent on processed food) leading to imbalances in their blood sugar level or any number of other physical problems including an inability to process environmental toxins, undetected food allergies and nutrient deficiencies, he or she may exhibit symptoms of distractibility, impulsivity, hyperactivity, mood swings, obstinate behavior, anxiety etc. Rather than investigate the root causes of these behavioral problems, the chances are quite good that the child will be labeled ADD (Attention Deficit Disorder) or ADHD (Attention Deficit Hyperactivity Disorder) and stimulant drugs such as Ritalin will be prescribed. (An interesting side note is that Ritlalin was created by Ciba-Geigy in 1956 to treat narcolepsy.)
Most older or retired teachers will tell you that there were always children in the classrooms who were fidgety, disruptive and had difficulty controlling their behavior. In 1980, however, the American Psychiatric Association decided (by a vote, as there are no biological or blood tests available) to create the official but very subjective diagnosis of ADD. In 1987, that same group decided ADHD was also a legitimate diagnosis. Following this action by the APA, the sales of Ritalin and other stimulants skyrocketed!
Make No Mistake
There are indeed children who have difficulty focusing and can’t sit still long enough to learn. But I can bet my 35 years as nurse on the fact that these children DO NOT have a Ritalin deficiency! Rather than exploring some or all of the underlying causes mentioned above,( most importantly toxins in the environment, diet and gut issues- since 70% of the mood stabilizing neurotransmitter serotonin is created in the gut), and examine their role in causing behavior and attention problems, these children are instead given strong and often toxic stimulant medications.
“What is the big deal? Parents or teachers might ask. “There are kids that have problems focusing and sitting still and they need something to calm them down. Besides, these drugs do work.” Unfortunately, they may “work” in the short term, but not without a tremendously high cost to that child’s mental and physical health. Here is a sampling of their side effects: apathy, drowsiness, decreased appetite, insomnia, abdominal pain, facial and vocal tics, liver disease, decreased weight, decreased growth, increased blood pressure and sudden cardiac death. Emotional symptoms may include mania, hallucinations, paranoia, psychotic episodes and OCD (Obsessive Compulsive Disorder) in addition to aberrant behavior in adulthood.
Ritalin acts in a similar way to cocaine in that it affects the Dopamine receptors in the brain which control our “pleasure and reward” sensations. . To quote the author of the book The Anatomy of an Epidemic, Robert Whitaker “Ritalin is a Dopamine reuptake inhibitor and cocaine acts in the same way. The result is kid’s brains dial down their dopamine receptors on the post synaptic neurons.” The author goes on to say that 30 years of research has failed to demonstrate any good quality evidence that Ritalin helps.
Moving Right Along to Bipolar
Prior to the era of psychopharmacology, bipolar was a rare disorder affecting one in ten thousand people. In part, due to the expansion of the diagnostic criteria (a patient formerly had to have been hospitalized for mania, before a bipolar diagnosis could be assigned) this once uncommon illness according to the NIMH now affects one in every forty adults in the US. From 1996-2004 the number of adults receiving a diagnosis of bipolar rose 56%.
Prior to the 1990s, diagnosing children under 19 with bipolar was extremely rare. However, Columbia University Professor, Dr. Mark Olson found a 40 fold increase in the diagnosis of bipolar in young (0-19) year olds between 1994-2003. The increase was from 20,000 in 1994 to 800,000 in 2003.
There is much theorizing over why more children develop this disorder. The use of marijuana has been named a trigger for some, as has the use of prescribed antidepressants. Since many kids diagnosed with bipolar had previously been diagnosed with ADD and treated with stimulants, it has also been suggested that symptoms of bipolar may have been caused by, or at least exacerbated by the use of the stimulant drugs prescribed for ADD. Basically, when the use of Ritalin increased in the late 80’s, the diagnosis of bipolar in children escalated.
A complete questioning of why there has been such an explosion in the number of children diagnosed with bipolar, would not be complete without mentioning the work of Dr. Joseph Biederman, one of the most influential researchers in child psychiatry at Harvard and Massachusetts General Hospital in Boston. In the late 90s Dr. Biederman via his lectures and writings began encouraging pediatricians and child psychiatrists to label more children with – yes, you guessed it- Juvenile Bipolar Disorder. During the same time Dr. Biederman was popularizing the use of this diagnosis for younger and younger children, he was also receiving “research grants” from 8 pharmaceutical companies, was a consultant to nine and served as a speaker for eight. In a NY Times expose in 2008, it was reported that he also received millions of dollars in unreported fees for promoting the use of Risperdal (a drug created by Johnson and Johnson) for the treatment of Juvenile Bipolar Disorder (4)
Bipolar treatment often involves a cocktail of medications that includes antidepressants, an antipsychotic, a mood stabilizer a benzodiazepine and perhaps a stimulant. Although some consider these treatments to be a hallmark of medical advancement, some psychiatrists have admitted that bipolar outcomes are worse today than they were 30 years ago. Ross Baldessarini in a 2007 review article wrote “Prognosis for bipolar disorder was once considered relatively favorable, but contemporary findings suggest that disability and poor outcomes are prevalent, despite major therapeutic advances. “
Violence, School Shootings and Prescribed Psychiatric Drugs
While we examine, and hopefully pass better gun control laws, and establish anti-bullying programs in schools, as a society, we also need to do a deeper investigation into what role pharmaceuticals these kids were taking might play in these horrific crimes.
A review of the FDAs Adverse Event Reporting system resulted in a study (6) which showed an 840% increased rate of violence in those taking antidepressants. The following statements were extracted from their report summary:
“We identified 1527 cases of violence disproportionally reported for 31 drugs. Primary suspect drugs included varenicline [Chantix] (an aid to smoking cessation), 11 antidepressants, 6 sedative/hypnotics and 3 drugs for attention deficit hyperactivity disorder.
“Acts of violence towards others are a genuine and serious adverse drug event associated with a relatively small group of drugs.”
According to author Deborah Merlin in her book Victory Over ADHD as well as the statistic gathering website www.SSRI Stories.com the following crimes were committed while the individuals were taking prescribed psychiatric drugs.
v “The Virginia Tech shooter …was prescribed the antidepressant drug Prozac prior to his rampage.
v Jeffrey Weiss went on a shooting rampage on March 21, 2005, at Red Lake High School that left ten dead, including him. Earlier that day, Weiss had killed his grandfather and his grandfather’s girlfriend. He was on Prozac and the dosage had recently been increased.
v Eric Harris, one of the killers at Columbine High School, was on the antidepressant drug Luvox. …The Physician’s Desk Reference records show that during controlled clinical trials of Luvox, manic reactions developed in 4 percent of the children given the drug.
v In Houston, Texas, Andrea Yates drowned her five children while taking Effexor and Remero
v Christopher Pittman shot and killed his grandparents at age twelve. He claimed a voice inside his head told him to kill his grandparents on November 28, 2001. Christopher had recently started to take Zoloft to treat mild depression.”
One Plausible Explanation:
According to a published study (6), it appears some individuals lack the ability to breakdown or properly metabolize and detoxify certain drugs such as anti-depressants due to a genetic variant in the Cytochrome P450 (detoxification system of the liver). In one instance, an individual might experience positive results and relief from the medication’s ability to reduce symptoms of depression or anxiety. Another person who has this particular gene variant (which renders him or her unable to properly metabolize the medication), may develop psychosis, mania, hallucinations, violence and become homicidal and or suicidal .
Finding Support and Guidance
Due to the nature of many psychiatric drugs, it is not recommended and indeed can be dangerous to reduce the dose, or stop taking these medications without the supervision of someone trained in this area. Some meds have a relatively short life span in the body and others take days or even weeks to break down or metabolize. It may also be unwise or dangerous to attempt to treat anxiety, depression, symptoms of bipolar or ADD on one’s own. However, there are people who can help. Although it is considered a controversial area of medicine by many in mainstream psychiatry, Orthomolecular psychiatrists are trained to do specific testing and treat mental disorders with high doses of nutrients and dietary changes often resulting in a patient being able avoid psychiatric drugs or lower the dosage of their prescribed medications. A list of physicians in the US and Canada who practice this type of medicine can be found at www.orthomolecular.org. Some holistic MDs who subscribe to the integrative or holistic approach to health and have training in the mental health field can also be helpful. A partial listing of these practitioners can be found at www.holisticmedicine.org.
Finding and, working with a clinician who addresses the full range of underlying emotional and physical issues that lie at the root, or at least could be contributing to, the condition is ideal and will most likely bring about the most positive and long-lasting results.
Without a Doubt: There are real and legitimate mental illnesses requiring safe and more effective interventions and treatments. However when the facts are made clear, the questions we need to ask ourselves are: “Why as a society have we succumb to the absurdity of “pathologizing” so many conditions that were previously considered normal or that have a physiological base that is not being addressed by our current mental health system? Why instead of investigating and treating underlying causes do we choose the route of diagnosing, labeling and medicating millions of our children and adults? I believe a partial answer lies in the simple fact that an estimated $8 Billion dollars is spent each year by the pharmaceutical industry on advertising aimed at convincing us, as well as our health care providers, that they, not our common sense, should dictate how we identify and treat our illnesses.
Educating ourselves regarding these issues as well as the array of factors that contribute to mental and physical health (exercise, stress management, a whole foods diet, removing toxic exposures, appropriate supplementation, adequate rest etc., ) and implementing those life style and dietary changes are essential if we are to slow down the completely unreasonable escalation in the number of people being diagnosed and treated with toxic drugs for mental illness.
1. The Pill Merchants The Relentless and Tragic Marketing of Psychiatric Drugs, Pathways Magazine Fall 2011 issue: authors: John Breeding, PhD., and Amy Philo
2. Anatomy of an Epidemic by Robert Whitaker
3. Summary Health Statistics for U.S. Children: National Health Interview Survey, 2006 NHANES [2003-2004], NCHS; JAMA. 2006;295:1549-1555.
4. Pelsser, et al, Effects of a restricted elimination diet on the behavior of children with attention-deficit hyperactivity disorder a randomized controlled trial, Lancet 2011, Feb 5:377 (9764):494-503 Additional published research on the role of diet and environmental toxins on ADD and ADHD can be found at http://autismbiomed.com/adhd.html
6. Moore, T, et all Prescription Drugs Associated with Reports of Violence Towards Others http://www.plosone.org/article/info:doi/10.1371/journal.pone.0015337
7. Lucire,Crotty, Antidepressant-induced akathisia-related homicides associated with diminishing mutations in the metabolizing genes of the CYP450 family Pharmacogenomics and Personalized Medicine Aug 2011:4Pges 65-81 or http://www.dovepress.com/articles.php?article_id=7993
Wildest Colts Make the Best Horses by John Breeding, PhD
Victory Over ADHD, by Deborah Merlin
Seven Weeks to Emotional Healing by Joan Matthew Larson
Regarding anti-depressants and pregnancy: Prenatal Effects of Selective Serotonin Reuptake Inhibitor Antidepressants …”; Oberlander, Papsdorf,Brain, Misri, Ross, and Grunau; Archives of Pediatric and Adolescent Medicine, 2010;164(5):444-451]