Are you surprised? "Creators Of Psychiatric Treatment Guidelines Deeply Tied To Pharma"

[dixiegrrrrl]

I am a retired Mental Health Social Worker ( was certified and LIcensed..the whole 9 yards ).

And I watched the as the "bible" of Mental Health diagnosis got changed, new symptoms added, new terms added, and more and more medications recommended for "treatment".
Kids being put on heavy duty drugs, many levels of anxiety now needing "treatment" with meds, etc.

Now this story surfaces ( dated 2 days ago) that may explain some things.

http://www.furiousseasons.com/archives/2009/04/creators_of_psychiatric_treatment_guidelines_deeply_tied_to_pharma.html

[NeedleCast]

1. No surprise at all

It's amazing the number of drugs we have to treat the symptoms of these diseases. Equally amazing how few we manage to cure.

[Dennis Donovan]

2. Recommended!

:thumbsup:

[cbayer]

3. Just to clarify, they are talking about the newly developed treatment guidelines.

The DSM is an entirely different entity and does not contain recommendations for treatment.

:hi:

[CoffeeCat]

4. I hear ya...

I saw a therapist due to childhood abuse--and I was constantly given labels and then the corresponding drugs
that would wipe me of that label.

Therapy was new to me, but I knew this was wrong.

I was NOT mentally ill. I was processing deep trauma.

I found a therapist who listened to me, and I trusted---and allowed me to process horrendous amounts of rage and sorrow--without
slapping a label on me OR pushing me to take meds.

I spent four years in therapy processing it all and I did it without meds. I didn't need meds. I needed to learn how to
get through intense feelings, and how to cope.

Also, my nine year old daughter choked on some food last December. It was a very frightening situation because she was
eating alone upstairs. She was ok, but she was terrified to eat and had generalized anxiety. We took her to a therapist
who insisted that we put her on Zoloft to alleviate her anxiety.

This seemed so absurd to me. As if anxiety is an abnormal reaction that must be squashed. We found another therapist who
helped our daughter work through her fears. We talked a lot. We helped her to understand that fear is not bad. In
fact, it can be good! It took two months before she could eat normally, but she got through it and she learned.

I have so many friends who try and talk with their doctors about feeling overwhelmed and anxious about motherhood, kids, work
and life. So many friends tell the same story--that the doctors rarely listen or have time to hear their concerns. Rather,
they immediately suggest Prozac or some other anti-depressant.

We're human. We're supposed to feel. We don't need to run to the medicine cabinet because we have a little frustration
when our washing machine breaks.

This new model has been constructed to enrich big Pharma, and it is a disservice to us.

[drmeow]

9. Was your treatment paid

for by insurance - if so even the therapist who listened to you gave you a label. They have to for reimbursement.

[Juche]

5. My depression responded much better to therapy and nutrition

Finding a decent therapist, group therapy and doing EMDR helped me tons. So did learning about all the nutrients the brain needs to function effectively and be resilient (omega 3s, zinc, magnesium, selenium, b vitamins, antioxidants, methyl donors, etc).

It is quite sad that such a narrow field of healthcare has overrun medicine. Allopathic pharmaceuticals have great uses, but they are only about 10% of what medicine has to offer.

[AllentownJake]

6. I was suffering from depression 2 and a half years ago

and the drugs made me worse. :shrug:

[HysteryDiagnosis]

7. A link for those wondering if there are other avenues

www.orthomed.org

Middle-Aged Depression
A 45-year-old executive had become restless during the day. His attention wandered, He couldn't sleep at night and was constipated. His thinking was beset by notions of inferiority and disillusion. His physicians had treated him with antidepressant drugs for several years with moderately good results. He sought another treatment option.The man was placed on a program consisting of L-tryptophan at bedtime (1000 mgms.) and L-phenylalanine (1000 mg.) in the a.m. At noon he took phosphatidyl choline (1200 mg.) along with supporting vitamins and minerals. Among these were 6 grams of vitamin C and 150 mgms. of niacin daily.
The man remained on this regimen for a year with good results. With good sleep at night and markedly improved bowel pattern, his days were no longer restless and he was able to focus on his work. Furthermore, his thoughts became distinctly "upbeat" and his self-confidence greatly improved.

[Mira]

8. Here too the masses are not served and they are enlisted to enrich the top and

big Pharma. This is one more symptom of what has gone wrong in this country, which has eviscerated the middle class with promises, misrepresentations, and brought the economy to its knees. Health Care is a large component of that, and one where truth has especially gone missing.

K&R

[drmeow]

10. Psychiatrists

are MDs so prescribing meds is much more likely to be part of the treatment guidelines for psychiatrists. Also, psychiatrists who do research are as likely to be linked to big pharma as any other MDs who do research ... it is an unfortunately result of the way teaching/research hospitals operate and the limits of non-pharma funding in medical research (big pharma's pockets are WAY deeper than NIH's).

What bible are you referring to? DSM?

[Occam Bandage]

12. That was my thought as well. "They're likely to be involved in research,

which means they're going to be taking paychecks from pharma companies, since they fund the research."

[drmeow]

13. Its not that straight forward

Its not like the pharma company gives them a paycheck. The grant is awarded to the hospital with them as the PI. The hospital pays part of the MDs salary out of that grant - how much of the salary comes from the grant depends on a lot of variables (such as how much of their salary is covered by insurance reimbursement for patients they see, how many other grants they have, what percentage of their salary needs to be covered by external funding, how much teaching vs research they do).

[northzax]

17. And the amount pharma spends

Is dwarfed by the amount the Feds spend. In 2008 PHARMA spent about two billion on research. The Feds, through NIH alone spent that on mental health research grants alone. Plus another nine billion for cardiovascular, six billion on aging, twelve billion on cancer, four billion on women's health, I could keep going. There are 14 disease categories alone that NIH gave out more than two billion in grants. There are another 201 categories NIH funds, with a median of over 300 million each. No one spends money like Uncle Sam. NIH spent more on breast cancer research last year than the Komen Foundation has since it's inception.

Nine of every ten medical research dollars in this country comes directly from the Medical Center stop on the red line.

[dixiegrrrrl]

39. The DSM is what I was referring to...

It is the Diognostic manual, and as some of us know, does not pro-scribe treatment.
However, some diagnosis' were entirely removed and others were added during 2 revisions of the manual, meaning a supposed "problem" you had, and were treated for, and insurance covered, suddenly no longer existed.
I always thought that was strange.

[Occam Bandage]

11. What "bible" are you talking about? The DSM? That's purely diagnostic.

[Political Heretic]

25. Yes but the medical model itself in dealing with menatl health is part of the problem

In my opinion. Deficit-based rather than strengths-based and focused on over-pathologizing

I'm a young social worker, so your milage with my opinions may vary :)

[Djinn]

26. that REALLY depends on what kind of mental illness

you're talking about. Schizophrenia is not something that should be unpathologised (I like to make up words) neither is Bi-polar and a host of other conditions.

We never hear people talking about physical illness being pathologised, nobody suggests eschewing medical cancer treatment (actually they do but I'm excluding the irresponsible) mainly because they are accepted as diseases. There doesn't seem to be that acceptance with mental illness.

The medical model is most certainly NOT the problem for many many people. You can not remove schizophrenia with any amount of therapy nor the best, most well meaning social worker.

Even at the less acute end, many people simply do not respond well to CBT or other therapies. Of course people should have a choice, if they do not wish to medicate and see benefits in a non medical model all power to them, but lets not pretend that therapists, social workers et al aren't also making an income, every bit as much as psychiatrists and pharma researchers.

Many people ARE helped by medications that get a thorough drubbing from people who haven't had the misfortune to need them. I can absolutely without a shred of hyperbole tell you that were it not for medical intervention in my mental health ten years ago I would not still be here.

Making people feel like dupes of big pharma because they rely on medication is not helpful. (not saying you're doing this PH it's a general ob)

I spend most of my working life in acute mental health facilities these days (don't ask) and therapy is not an option for most of these people, at least not without at least some time on medication because they are simply NOT in a position to benefit from talking to someone.

Social workers and many other non medical therapists don't tend to see people in this highly acute phase, they see them when they are responding to medication and able to benefit from other forms of treatment and I sometimes wonder if it skews their perception a little.

[Political Heretic]

34. Those were very great points.

I know that there must be a balance. And as one who needs long term medication to reach a good chemical balance, I never want to become "anti" medication. Finding the right medication changed my life.

But I do think that, culturally speaking, we have a tendency to over-pathologize. And what I'm talking about is not just meaning we over-medicate. I'm saying that we tend to need to label every behavior almost to the point where it sometimes feel like we're reinforcing social "norms" without even asking ourselves whether the "norms" are valuable or even just.

Anyway, coming back down to earth from all that abstract stuff - one of the things I've taken away from my work and education now that I'm about start a new chapter of that work with my MSW is the idea of a more biopsycosocial approach to people. Biology is critically important - sometimes things just need medical/pharmacological treatment.

Psychology is important, and for me I tend to lean more to the psychodynamic side of the spectrum than the CBT side (though I believe everything has its place and different people respond to different approaches), and then the social dimension is important - understanding ones resources, culture, connections, community, etc.

Anyway.... I'm a macro guy so, that's more micro talk than I care to indulge in ha ha ha :D

Again, really nice post. I thoroughly enjoyed it.

[Hanse]

14. Treatment of illness with medicine?

My god! Don't these people understand that mental illness is properly treated with auditing via an e-meter and a substantial donation to the Church of Scientology?

[ColbertWatcher]

18. The horrors! n/t

[Cessna Invesco Palin]

15. Yes.

It's terrible that someone with a background in medicine should be tied to the medical industry. Whatever shall we do?

[Djinn]

16. guidelines change

because our knowledge does. Schizophrenia was once widely agreed to be demonic possession. Personality disorders used to just be explained away as "arsehole"

You might not be fond of treating anxiety with meds but I know a whole lot of people who got their life back thanks to those evil pharma's including myself - medication is not ALWAYS the answer for mental health problems but sometimes (and certain conditions ALL the time) all the therapy in the world is useless.

[ColbertWatcher]

19. Thank you. We don't need to fall into the trap of the big brush.

I hate big corporations as much as the next liberal, but that doesn't mean I see no need for medicine.

Maybe we should be working to get universal healthcare in this country and use that as a way to get all profit out of the system, not just the insurance companies but big pharma as well.

[Djinn]

20. I find the either or mentality strange

few people would struggle on with a bacterial infection just because someone makes a profit from antibiotics. Just because someone is making money from anti anxiety/depression medicine doesn't mean everyone would be better off seeing a therapist.

Universal health care would go part of the way but in order for it to work you also need a pharma benefits scheme - essentially the drugs that are the cheapest and most effective are listed and subsidised through the health system. Pharma's like it because if their drug is listed it'll be prescribed far more often. People like it because in order to become listed drug companies have to prove that their new medicine has benefits over and above one already listed so we don't waste money on drugs simply because the pharma has a great new marketing campaign.

I'm amazed at the way drugs can be directly marketed in the US, it's insane and simply fuels so much misinformation.

[ColbertWatcher]

21. I hate how much anti-psychiatry "information" there is.

And why it's promoted so often.

[Djinn]

22. Xenu is very powerful

:evilgrin:

[ColbertWatcher]

23. ...

[Political Heretic]

37. I've really appreciated your perspective in this thread. Both perspectives really.

I think the DSM for example can be uneven at times (better in some areas) precisely because our knowledge evolves. It is more evolved in some areas than others. And I also appreciate people bringing up things that can potentially skew such a powerful book (like biases, privilege, patriarchy or personal gain). I think its important to be conscious of how those things can influence some of our professional tomes.

On the other hand, there are a lot of checks and balances to mitigate some of those risks. And over-diagnosing is no more a problem than under-diagnosing is. And the stigma to medication for dealing with serious disorders keeps too many people from finding the kind of chemical balance they need.

Some depression is emotional, comes from specific situations and can essentially be worked out extremely well in counseling. Some depression is chemical, and while I would always plug therapeutic relationships as potential helpful for anyone, asking someone with a chemical imbalance to just "feel better" is like telling a diabetic to just "make more insulin."

Interestingly, I too had to have anxiety treated with medication, and that's exactly my story. In fact I wrote about it:

Living with Panic
http://practical-vision.blogspot.com/2008/07/living-with-panic.html

Life after Panic
http://practical-vision.blogspot.com/2008/08/life-after-panic.html

[Political Heretic]

24. I cringe every time I am confronted with the DSM-IV - Political Heretic, MSW

[Djinn]

27. why?

[Political Heretic]

35. Because its so powerful.

Diagnosis follow a person around practically forever.

You label a kid with Conduct disorder, for example - that changes their life. Hopefully for the better but.... not always.

I know why its important, but still its a power that can be poorly used to sad ends in incompetent hands.

[Mari333]

28. heres a BOOK thats an eye opener!

From Publishers Weekly
Self-Defeating Personality Disorder, Nicotine Dependence, Hypoactive Sexual Desire Disorder, Premenstrual Dysphoric Disorder-these are some of the 400 "mental illnesses" described in the American Psychiatric Association's diagnostic bible, Diagnostic and Statistical Manual of Mental Disorders (DSM). Caplan (The Myth of Women's Masochism), a psychologist and former consultant to the DSM, compellingly argues that "much of what is labeled 'mental illness' would more appropriately be called problems in living." In a disturbing insider's look at how the mental health establishment decides who is normal and who is "sick," she charges that the DSM board's decision-making process, dominated by a handful of conservative white male psychiatrists, is arbitrary, condescending, profit-driven and riddled with personal biases and political consideration. Facile labeling of personality problems, she shows, can cause personal suffering as well as material harm because DSM categories figure prominently in who wins child custody, who gets hospitalized against their will and whose psychotherapy is covered by insurance





http://www.amazon.com/They-Say-Youre-Crazy-Psychiatrists/dp/0201488329

[Djinn]

30. careful of what you read

DSM categories figure prominently in who wins child custody, who gets hospitalized against their will and whose psychotherapy is covered by insurance

total and utter horseshit. People are involuntarily hospitalised only if they are a danger to themselves or others, there are NOT anywhere near enough mental health beds to put people suffering from the range of DSM described illnesses.

No-one has EVER been hospitalized for nicotine dependence (except in a lung/heart ward).

You can't even get a bed if you have PD is most countries because it's not completely accepted as a mental illness.

The misinformation this psychologist (meaning she has ZERO experience in pharmacology and chemical biology) is dangerous and she should be ashamed of herself.

Why is it that pharma's are always viewed as money grabbing vultures but people with spurious claims to expert knowledge who write books are viewed as having no lucre motivation. Notice the mention of whose psycho therapy gets covered by insurance? Nah she wouldn't have a personal barrow to push there at ALL. Funny, if these are pretend illnesses that are just people who fall outside societal norms why on earth would they need to visit a psychotherapist?

[Mari333]

32. she tried to establish a disorder with the DSM that recognized aggressive male

dominance. they denied it. and then she explains why.
I find her refreshing.
I remember a time when a wife could be put in the nuthouse for not performing her wifely duties at home.
keeping an eye on these guys makes sense to me.

[Djinn]

40. so she tried to have a new disorder recognised

without having the qualifications that would enable her to make that call, it was rejected so she wrote a book saying there's too many disorders that shouldn't be on there? Nah no agenda there at all.

BTW referring to an acute ward/institution as a 'nuthouse' is offensive and doesn't do much to demonstrate you're understanding of these matters

[Mamacrat]

31. Personality Disorders

Aren't many of those types of problems labeled personality disorders?

[Political Heretic]

36. Have you ever read Michel Foucault? A History of Madness (or Madness and Civilization)

Check it out.... :)

[Vinca]

29. Check out this Rolling Stone article. Apparently they develop

drugs and then go in search of an illness (or illnesses) to pair them with.http://www.rollingstone.com/politics/story/25569107/bitter_pill

[Mari333]

33. thanks for that link

eye opening.
I have been offered pharmaceuticals by general practitioners...
and I am always shocked when some guy with an MD behind his name offers me Prozac. Hes not even a psychiatrist!!
I dont think GP's should be able to hand that shit out like candy. they have 'samples' in their offices.
I read once they get kickbacks for pushing it from the pharma companies.
suffice to say, I dont take anything. I dont trust the medical experts as far as I can spit, most of the time.

[lonestarnot]

38. This coupled with financial attacks enough to do a take down.