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I wrote these as comments on another blog in response to the writer’s lament that so many Christians were reluctant to seek treatment for depression, fearing that they would be sent home with a prescription. I tried to help this writer understand that there is good sense and even good science underlying that hesitation to turn to psychoactive drugs.
Dear _______,
Have you read those depressing reports about the effects of anti-depressants recently published in the New York Review of Books? The author is Dr. Marcia Angell, former Chief Editor with the New England Journal of Medicine, currently lecturer on issues of Public Health at Harvard. The articles, “The Epidemic of Mental Illness, Why? and “The Illusions of Psychiatry” have generated tremendous controversy.
In her cogent and jargonless essays Ms. Angell reviews three books about the current state of psychiatric research and practice, and the new edition of the DSM. Clearly there is a crisis in that particular corner of the world–these books describe, in her words, “the baleful influence” of Big Pharma on the practice of psychiatry.
She reports on research into the placebo effects of these meds, but also about their dangerous side effects, which are much more deletrious than a little dry mouth or lack of libido. With long term use of psychoactives, the brain has been shown to be damaged, creating a class of persons permanently impaired and crippled by mental illness, instead of recovering from a short season of depression or mania.
In her response to critcs in letters printed in the NYRB , she writes that they “simply assume that psychoactive drugs are highly beneficial, but none of them provides references that would substantiate that belief. Our differences stem from the fact that I make no such assumption. Any treatment should be regarded with skepticism until its benefits, both short-term and long-term, have been proven in well-designed clinical trials, and those benefits have been shown to outweigh its harms. I question whether that is so for many psychoactive drugs now in widespread use. I have spent most of my professional life evaluating the quality of clinical research, and I believe it is especially poor in psychiatry.”
We have something greater than this bad “physic”. We have the Great Physician. We have the Gospel, and we have the ‘one anothers’ that this benighted industry completely lacks. Until there is better and proven outcomes from meds, I think we do better to stick to exercise and biblical counseling for depression.
And I speak not only as one who struggles with anxiety and depression myself, but also witnessed my own mother’s renal failure from lithium and the life sucking effects of carbamazepine that followed –until she was healed by Jesus, shortly before her death, to the amazement of her social workers. Both of us learned how to take our thoughts captive to truth, and how to speak truth in love to others, which precipitated the physical healing of our symptoms. I walk in continuous peace, hope and rest now.
Dear _________,
I am glad you have read the articles– but please, don’t mischaracterize Dr. Angell’s career. She is not some hysterical crusader riding out against Big Pharma. She was not just an ‘Editor’ of the prestigious New England Journal of Medicine, she was ‘Chief Editor’ for two decades of this most frequently cited journal of clinical medicine. Her respected stance in the medical community arose from her judicious critiques of medical research, not that she was given to any tendency towards polemics. So please, don’t say that her book, “The Truth About the Drug Companies: How They Deceive Us and What to Do About It” somehow made her reputation. Dr. Angell was already an authority on evaluating clinical data .
Learning that you have read these articles, I am even more surprised to hear you repeating the disproven theory of serotonin imbalances in the brain. It was distressing to read your comment, ” There is actually increasing evidence for the “chemical imbalance theory” or that you subscribe to disparities between men and women’s serotonin– without any citations of current research.
Although Dr. Angell’s critics distort her stance on the biological basis for mental disorders, none argue that the serotonin theory is anything but hokum in their rebuttal to her essays –both writers, Dr. Friedman, the director of Psychopharmacology at Cornell and Dr. Nierenberg of the Bi-Polar Research Center at Harvard, say that ” it is an outdated and disproven chemical imbalance theory of depression (i.e., serotonin deficiency).” It is indeed embarassing, _______when “20 and 30-year-old medical research, theories, and cliches (are) still being quoted in modern Christian counseling books.” Or in their blogs.
And what Orthodox Christian would argue that our brains have suffered as a result of the Fall, or that its orderly working suffers as a result of our own sin? Although Dr. Angell probably would not ascribe to our worldview concerning sin and suffering, she states, “Contrary to Friedman and Nierenberg, I do not ‘deny that depression has any biological basis at all.’ I know very well that all thoughts, emotions, and behaviors have their origin in the brain. But it is a great leap from recognizing the obvious fact that mental states arise in the brain to knowing why and how they arise. Friedman and Nierenberg make much over recent advances in neuroscience research, but so far this research hasn’t produced much improvement in diagnosis and treatment.”
And I’m assuming (by citing the studies of growth in the hippocampus in mice) that you agree that neurogenesis is this next Big Thing in diagnosis and treatment. Here is a succinct rebuttal to that idea from a psychiatric professional –who uses an alias because of the stigma.
(That individual also helps run a support forum for those who are seeking to wean themselves off anti-depressants, and educate others about it. Many other professionals comment there, and so it seems a generally intelligent and well informed group–important, because peer support is a must in this difficult and dangerous process.)
The issue with meds is not just that they are over-prescribed or have terrible side effects — but more importantly, that they are no good at what they claim to do! And, even worse, with long term use there can be permanent brain damage. All accompanied by ballooning side effects for which even more meds are prescribed–most patients will describe this trajectory:
Antidepressants made me agitated and unable to sleep, so benzodiazepines were prescribed for insomnia and restlessness. When benzodiazepines didn’t get rid of the agitation, I was prescribed antipsychotics. All of that medication left me so sedated, the next step was stimulants. The addiction to benzos left me in tolerance withdrawal, increasing my anxiety and thus led to more benzos. Drugs leading to more drugs leading to more drugs leading to more drugs.
So these drugs are often iatrogenic — they create the very disordered mental states they claim to heal! But every double blind study, even those carefully culled and sponsored by BigPharma, have failed to show any long term benefit beyond the placebo effect for anti-depressives. Considering the brain damage psychotropics do, that should alarm you much more than it does.
Though you chide Dr. Angell and a certain unnamed Christian of painting with an overly broad brush, I think the brush has to be exceedingly wide to display all the harm done by these drugs, whose crippling effects are only increasing, and can only exponentially increase given the current fad of dosing little children off-label with these powerful neuro-toxins; given the number of for-profit companies that are preying on poor and desperate and ill-informed parents to encourage them to sign their families up for SSI – if their troubled children go on meds. Like the case of Rebecca Riley that Angell documents here:
In December 2006 a four-year-old child named Rebecca Riley died in a small town near Boston from a combination of Clonidine and Depakote, which she had been prescribed, along with Seroquel, to treat “ADHD” and “bipolar disorder”—diagnoses she received when she was two years old. Clonidine was approved by the FDA for treating high blood pressure. Depakote was approved for treating epilepsy and acute mania in bipolar disorder. Seroquel was approved for treating schizophrenia and acute mania. None of the three was approved to treat ADHD or for long-term use in bipolar disorder, and none was approved for children Rebecca’s age. Rebecca’s two older siblings had been given the same diagnoses and were each taking three psychoactive drugs. The parents had obtained SSI benefits for the siblings and for themselves, and were applying for benefits for Rebecca when she died. The family’s total income from SSI was about $30,000 per year.
The psychiatrist who prescribed those meds for that little girl took a vow to do no harm. But the profession is severely compromised by its parasitical relationship to Big Pharma, and so the harm will only increase, especially with the advent of “personalized medicine” that the marriage of neuroimaging, psychotropics and pharmacogenomics (which seeks genetic markers in order to target drug treatments) brings to the world, as this member of the profession laments here:
We’ve chased this industry (Big Pharma) interference in psychiatric treatment long enough to know the ropes. It’s time for some application of preventive medicine on our part. If they genuinely find a robust genetic marker for differential drug response, more power to them. I’m way beyond skeptical that will happen. The worry is that they’ll find a little something and blow it up into the greatest breakthrough since the Facebook and attempt to repeat the absurdities of deceit and pseudoscience we’ve endured for the last twenty-five years.
Since there are so few Christians speaking out on these issues because of the stigma that surrounds it, I think you would do better to re-evaluate even your cautious optimism regarding the efficacy of these drugs. I urge you to read the books Angell has reviewed. Especially enlightening is Robert Whitaker’s book, “”Anatomy of an Epidemic”, but there is a good collection of his work at the blog mentioned above to get you started immediately.
Thank you for your kind words about my testimony, and your blessing on its continuance. And as more Christians come out of the psychotropic jungle, I pray they will be emboldened to share their encouraging stories of hope and deliverance as well. I can only hope and pray the number of Christians reluctant to partake of psychotropics will only increase.
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