this post was submitted on 17 Jan 2024

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Mental Health

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"The status quo, preoccupied with biomedical interventions... is no longer defensible" (documents-dds-ny.un.org)

submitted 7 months ago* (last edited 7 months ago) by [email protected] to c/[email protected]

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I looked at this blog post and it mentions a UN report which seems to be quite critical of modern psychiatry.

The doctor who made the report seems to be saying that drugging people is not a great approach, and really we should recognise that poor mental health is a result of social and psychological pressures:

Public policies continue to neglect the importance of the preconditions of poor mental health, such as violence, disempowerment, social exclusion and isolation and the breakdown of communities, systemic socioeconomic disadvantage and harmful conditions at work and in schools... Reductive biomedical approaches to treatment that do not adequately address contexts and relationships can no longer be considered compliant with the right to health.

Thoughts on this? Is the medical model of psychiatry just created by money-hungry pharma companies? Of course some people think they cannot function without their meds, and I sympathise with that view. But perhaps this belief is reinforced by strong withdrawal effects of these drugs, which are well-known. So somebody who has been on the drug for a while tries coming off, they have strong withdrawal symptoms, and they think "I can't cope without this drug, I must go back on it". Perhaps this is where tapering can help, because it helps people come off drugs (if they choose to do so) while reducing withdrawal effects.

Edit: The report was from 2017 but I still find it interesting. More info about it can be seen here: https://www.ohchr.org/en/documents/thematic-reports/ahrc3521-report-special-rapporteur-right-everyone-enjoyment-highest

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[–] [email protected] 4 points 7 months ago (1 children)

I think there's more to mental health problems than just socioeconomic impacts. I'm a fan of a well rounded approach that uses therapy as well as medicine to treat problems properly.

Depression is a wonderful example, society can easily trigger depression in people, but there's plenty of evidence to suggest that there is a genetic predisposition to having depression. That to me is why I seem to see the best improvements in my friends that find a good antidepressant but also have regular therapy sessions. At least that's my perspective on the matter.

[–] [email protected] 0 points 7 months ago (1 children)

I have seen stats about genetic dispositions, yes. Wikipedia says 40% of a person's risk of having major depression comes from genes.

Still. One thing is that you don't know what your genes are. Your genes might have less of a risk than you think. But also, maybe an increased risk can be dealt with through lifestyle choices. I'm not saying people shouldn't take meds if they want to take them, and I think personal choice is extremely important. But the meds do have annoying and somewhat harmful side effects... so I suppose that has to be weighed up in a decision to take the meds or not.

[–] [email protected] 1 points 5 months ago* (last edited 5 months ago) (1 children)

Genetic predispositions also aren't necessarily written in stone. At this point, we have a lot of research showing genes can be turned on/off by diet and environmental or nurture-based factors.

Pretending it's OK for kids to be traumatized if we can just drug them or have them speak to a therapist once they're older (or increasingly now, starting from childhood) has never made sense to me. It's not like either of those things cures people. The treatment bar being set at life being just okay enough to hold down a job is shortchanging everyone, societally, even those making short-term profits.

We should be looking for ways to eradicate serious mental health issues that affect people's ability to function, not just make them easier to hide.

[–] [email protected] 1 points 4 months ago

Yes this makes sense to me. I definitely think we should look for better ways to deal with mental health problems. And yes you're probably right that we should have a better standard than simply "you can now slave at a job, therefore you're healthy".

I think one good solution for mental health problems (maybe not always, but it can work) is talking to somebody who is willing to listen. This can be hard to find. But there are mental health charities out there who do great work in talking to people who are having problems. There are support phone lines and things like that.

[–] [email protected] 1 points 7 months ago (1 children)

Fearmongering about evil big pharma is always in style. "Reductive" (and other forms) is one of those words that tends to get tagged in whenever evidence-based medicine is in the crosshairs. This report tiptoes back from actually pulling the trigger and explicitly supporting the SCAM^1^ stuff but it'd be easy to pull quotes without context and make it look like an endorsement of new-age woo-woo bullshit.

Supplementary, Complementary and Alternative Medicine

[–] [email protected] 0 points 7 months ago (1 children)

I strongly dislike SCAM stuff, like homeopathy etc. And Scientology (who are anti-psychiatry) is obviously a scam too.

Some people find psychiatric drugs helpful, yes. But I have met psych patients, drugged against their will for months, who were still miserable after months of drugging. I think a psychological approach, such as counselling, is probably better.

I think a lot of psych patients are trying to understand what's going on in their head. If they can reach this understanding, then they no longer need drugs, with all the negative health effects that the drugs cause (such as movement disorders, restlessness, muscle spasms, weight gain, sexual dysfunction, etc).

[–] [email protected] 0 points 7 months ago (1 children)

The if-then in your last paragraph is very weak. Understanding that I'm injured or ill doesn't replace a need for treatment, it just helps me manage my expectations for things like recovery time, lasting effects and follow-up encounters.

Can't just start handing out Pez dispensers full of Prozac and call it a day though, I agree with you on the importance of counseling as part of the process. To borrow an analogy, it's like needing glasses while learning to read. You can squint and stare your way through for a while but it gets much easier with corrective lenses. Some people just need a little extra clarity, others might as well be blind without their glasses. Either way, they still need to go to class or open up a book to make use of their improved vision.

[–] [email protected] 1 points 7 months ago* (last edited 7 months ago)

Maybe people with mental difficulties (and I've been through this system myself, for a long time) aren't injured or ill. Instead they had genuine reasons to feel angry or distressed at the time of their "illness".

I'm reminded of what I heard in an interview with a training psychiatrist who took antidepressants himself (within recent years, he contributed to the advice that Britain's Royal College of Psychiatrists gives to patients trying to come off antidepressants):

Some people call these things [mental illnesses] a chronic illness, but... another way of looking at them is a response to stressful circumstances... if you know the number of stressful life events in someone's life over the last year, you can predict their risk of depression with great accuracy

If some people want to take these drugs then okay. But the evidence shows real negative effects of these drugs. I support patient choice. If we support the right of people to take these drugs, then we should also support the right of people to find other ways to manage their problems.