May 23, 2010

Our Psychiatric Civilization

By Dr. Peter Breggin

It has been a routine week in my clinical and forensic practice. I evaluated a malpractice case involving a woman on the West Coast whose family doctor from a decade earlier kept prescribing Prozac to her for ten years without ever seeing her again. When she ran into emotional difficulty, she called this doctor who simply raised the dose and added a new drug, still without seeing her for a decade. This woman, a respected professional and parent in her community, then landed in a hospital where her adverse drug reaction was mistaken for a mental illness, more psychiatric drugs were added, and she soon killed herself in a most horrendous fashion.

In this same past week of routine events, one of my own patients came to the office for an emergency session. He had sought my help to come off a cocktail of psychiatric drugs that had been prescribed for him during a personal crisis. We had recently cut back on his tranquilizers and he had become unable to sleep all night. He was feeling anxious and scared. “Am I going crazy, or is it drug withdrawal?” It turned out to be a withdrawal reaction that was easily handled by a slower taper of his medication. A very bright, creative young man, he had a series of traumatic events in his background. He needed counseling and encouragement, not a psychiatric diagnosis and drugs.

Meanwhile, my wife Ginger has been handling the flood of mail we get from our books, websites, and public appearances. People email and call the office identifying themselves as “bipolar” or “clinically depressed.” Or they describe their children in the same terms, as well as “ADHD.” By the time they contact our office, their lives or those of their children have been deeply complicated, compromised and sometimes ruined by psychiatric drugs. They can no longer separate their original emotional problems from their complex array of drug side effects. They devote themselves to adjusting their diagnoses and their drugs instead of addressing their lives. After yet another week like this, Ginger tells me, “You’ve got to write about our Psychiatric Civilization.”

The culture is so imbued with biological psychiatry — which is to say, modern psychiatry — that self-defined patients diagnose themselves, sometimes with the help of a one-minute TV ad. They visit their family doc, give him the diagnosis, “I think I have an anxiety disorder,” and get the appropriate drug. If they arrive a few minutes early, or the doctor is a few minutes late, they’ll get a chance to get educated by a flat screen TV in the waiting room which instructs them about the symptoms of the psychiatric diagnosis de jour as well as its treatment with a propriety drug.

I can’t tell you how many times a new patient has looked at me with a mixture of apprehension and eagerness, and asked, “Do you think I have bipolar disorder?” We all hope to find a magic key to this hard business of being human. And if we cannot find community through our shared humanity, we will find it through our shared diagnoses.

This rampant diagnostic labeling puts an end to all other human considerations and concerns. This labeling does far more than imposing a pseudo-medical diagnosis on you, it defines you as a person. “I’m bipolar.” Not “I’m full of life” or “I have trouble managing all these marvelous passions” or “I need to find a way to direct my creative energies” or “I’ll have to find the courage and make the effort to make my dreams come true in the real world.” No, never mind about all of that, “I’m bipolar.” Your diagnosis becomes your personal final solution to your most vital challenges in life.

In the Age of Aquarius, we greeted each other with “What’s your sign?” In our more mundane and pseudo-scientific times, it’s “What’s your diagnosis?” As our definitions of normal get squeezed tighter and tighter by the increasing breadth of the official Diagnostic and Statistical Manual of Mental Disorders, Woodstock could never reoccur. All those 60s weirdos would be sitting around taking psychiatric drugs and diagnosing themselves with borderline personality disorder.

In the sixties, if you panicked on LSD, your friends knew it was a “bad trip” and they “talked you down” from it. That bit of wisdom is lost in our Psychiatric Civilization. Doctors rarely acknowledge it when they cause a horrendously disturbing reaction with one of their psychiatric drugs and it won’t occur to anyone to keep you company while you recover.

Want to experience how deeply psychiatric our civilization has become? Go to any minister, priest or rabbi — even your most conventional Catholic priest or Orthodox rabbi — and explain that you’re feeling “depressed.” Forsaking the most important role of any spiritual consoler, to help those in emotional anguish and despair repair their lives with meaning, even your most orthodox minister, priest or rabbi is likely to send you off to a psychiatrist for a diagnosis and a drug. It is dismaying to see how the leaders of our religious faiths so eagerly sacrifice their flock before the altar of psychiatry.

What does this say about our shared values as a culture? Are we ultimately a society of rugged individualists? No more. Are we members of a Judeo-Christian community and tradition? No one dares to say that in public. So if we are not seeking to promote our own self-interest nor seeking salvation through God, what is our first and last resort in time of need? Psychiatric drugs. We want, above all else, to be pain free and emotionally undisturbed. At the first inkling of an existential crisis, we seek to be … less full of feeling. We’re not the dumbed-down society, we’re the numbed down society.

Psychiatric diagnoses reflect the lowest common denominator of humanity. We lose ourselves in our diagnoses. Psychiatric drugs, by blunting our spirit, level our experience of our souls.

Patients ask me, “Should I join a bipolar support group?” If I were flippant, which I never am with patients, I could respond, “Only if you want support in believing you’re bipolar and need to take psychiatric drugs.”

So what is our sense of community? It’s not religion and, except for occasional moments when we feel gravely threatened by outside events, it’s not politics. Is the nation becoming one gigantic psychiatric support group?

Depersonalization has become the norm. Bare yourself to others — your family, friend, your teacher, your minister, your doctor or your therapist — and they will urge you to “get help.” Of course, you were trying to get help from them when you shared your feelings; but they mean, “Get help elsewhere.” Everyone will shunt you off to a pill provider. Even psychologists, social workers and other therapists are taught that they cannot handle a patient’s more powerful emotions without first dampening them down with psychiatric drugs. It is said that this facilitates therapy; but there can be no effective therapy when people are afraid of their emotions or have lost them in a drug-induced fog.

We can’t get close to our own emotions for fear of thinking we’re abnormal and in need of diagnosis and treatment. The Psychiatric Civilization reinforces our worst tendencies to be out of touch with our selves, to be burdened down by self-diagnosis, and to seek false solace in drugs, prescribed or otherwise, rather than in the comfort of each other’s company.

We human beings have always found life difficult. Indeed, we’re born, we struggle, and we die. But how will we struggle? With passion, creativity, love, and principled living? Or confined within our diagnoses and our drug-impaired brains?

Our children are the worst victims of our Psychiatric Civilization. They are being taught they have broken brains instead of broken families, broken schools, and broken communities. Feeling disempowered as parents and teachers, we leave our children looking for love in all the wrong places, and when they flounder, we send them off for “medication.”

Psychiatry and the mental health care establishment won’t reform itself. Its power, identity and income are inextricable from our Psychiatric Civilization. Any change must be imposed from the outside by people like you and me who hold to higher values than our diagnoses and our drugs.

Originally published on The Huffington Post