1. "Prozac and SSRI's: Twenty-fifth
gets fundamentally changed
psychiatry is now
4. Then what about the DSMs?
Today I am writing about anti-depressives, and in particular Prozac,
because I have been on that pill for quite a while. My basic source is
David Healy's site, and in particular his paper/blog "Prozac
and SSRI's: Twenty-fifth anniversary".
Also, I will be talking about the DSM-5.
and SSRI's: Twenty-fifth anniversary"
This essay starts as follows:
For me, that is stark, raving
insanity - and I am not criticizing dr. Healy, who is one of the few
making the argument.
Prozac was approved in
1987 in the US, and launched in early 1988, followed by a clutch of
other SSRIs. Twenty-five years later, we now have one prescription for
an antidepressant for every single person in the West per year.
Twenty-five years before
Prozac, 1 in 10,000 of us per year was admitted for severe depressive
disorder – melancholia. Today at any one point in time 1 in 10 of us
are supposedly depressed and between 1 in 2 and 1 in 5 of us will be
depressed over a lifetime. Around 1 in 10 pregnant women are on an
First, note that this is something like a 1000-fold increase:
Either humanity has radically changed, or else psychiatry has totally
lost its marbles.
Clearly, I think the latter is the case.
Indeed, what I think is the case is that the whole of psychiatry was
ready - and fit! - to be thrown out of science by 1980, when three
1. The DSM-III was introduced, and was introduced
explicitly as if it were not science, because making any
pretensions whatsoever was worse than making no pretensions whatsoever,
and it did so by throwing out every theory, and replacing this by a mere
"diagnosis", on the pattern of "you have X if you have at least 5 out
of 9 of these marks".
2. For some strange reason, this worked:
Instead of - as would have been quite just - ridiculizing
psychiatry, and kicking it out of science, as being clearly not even
theoretical, thiis was welcomed, especially since
3. there soon was Prozac - a supposedly fail-safe,
totally non-dangerous, anti-depressant, that in fact was dangerous and
helped few, but that was prescribed as if it were hosannah, and by all
kinds of medical people.
As to 1.: You have no diagnosis if all you have
is a statement to the effect that "you
have X if you have at least 5 out of 9 of these marks". Clearly, you
may call this a "diagnosis", but it is one only if this
implies a statement that relates the diagnosis to a disease, and the
disease to a provable absence or presence of something that should not
You may be wrong in this, but then psychiatry is very often wrong - and
that is, by itself, no reason not to do it: What definitely is wrong is
to insist that there is no theory, for that means that absolutely
anything may be correct.
As to 2.: My best explanations for the strange fact that
psychiatry was welcomed rather than ridiculed is in part that
psychiatrists were at least as pretentious and dishonest as they always
had been and in part that by 1980 the first segment of the new
intellectual class had arrived on the scene: The far more stupid, far
less well educated, buit also far more numerous baby-boomers.
As to 3.: The main problems with Prozac - and indeed with other
SSRIs: Prozac is out of date because it patent was finished by the
beginning of 2000 - are that it is quite dangerous for some, for
reasons that again are not well understood, and also that it has
many unknown problems, notably with taking it a long time.
Psychiatry gets fundamentally changed
What then happened
- in a space of 10 years or so, mostly because there simply was
no science -was this:
Generalism went out of the
doors basically because of three reasons: First, with far more people
diagnosed with "a mental disorder" there was no money for long time
talk-therapies; second, since there were no theories, there was nothing
to test; third, psychiatry itself radically changed: From
someone trying to deal with 1 in a 1000 or 1 in 10.000 of people with
whom clearly something was wrong, psychiatrists changed to pill
pushers, "who deal in heroic
combinations and doses of pills",
and for just any kind of compaint whatsoever.
Prozac has killed
Generalism. It did so by focusing attention on mood in the way
neurologists hyper-focus on nerves. Psychiatrists have become the
doctors who deal in heroic combinations and doses of pills rather than
doctors who, like generalists, step back and take a broader view.
Prozac has also killed
therapy – just like Prozac CBT has a hyper-focus on thoughts rather
than the big picture. CBT has also become a conduit into
antidepressant prescribing as therapists regularly suggest softening up
a depression with pills.
What is true is that psychiatrists still have a technique: Cognitive
Behavioral Therapy aka CBT, but this is mere bullshit, as you can
see for yourself by trying to find out what it is from
Wikipedia. (If you think you succeeded, all I can assure you is that
you led yourself be bewitched.)
So what was left?
What psychiatry is now
What was left is this - and I quote the final piece from
dr. Healy's article, who takes quite a lot for granted:
ago, no one could have imagined that the bulk of the treatment
literature would be ghostwritten, that negative trials could be
portrayed as glowingly positive studies of a drug, that controlled
trials could have been transformed into a gold-standard method to hide
adverse events, or that dead bodies could have been hidden from medical
academics so easily. Twenty-five years ago no one would have
believed that a drug less effective for nerves or melancholia than
heroin, alcohol or older and cheaper antidepressants could have been
brought on the market and that almost as a matter of national policy
people would be encouraged to take it for life.
"Ghostwritten": Much of
what one reads in medical journals (!), by "the famous
doctors X, Y and Z", in fact these days is written by totally other
persons, and was only signed by X, Y and Z (if that was done). And the
totally other persons who did write the stuff were employees of the
That is: One gets lied to - deceived, duped.
"Negative is positive": Much of what one reads in medical
journals (!) is not the outcome of experiments, but got reported there
only because it supports a drug - and everything else
"Controlled trial": Because it now are the pharmaceutical
companies that have the data, there is in fact no more objective
experimentation: Again what you get to read in medical journals (!) are merely those outcomes that are
favourable to new drugs.
"Dead bodies": This is an outcome of the foregoing: People who
suicided while on test for an anti-depressive are deleted, or their
suicide is reported quite differently from what it was.
"Take it for life": This is what happens "automatically": Your
psychiatric medicine remains with you for the rest of your life.
I take it that is the standard:
By now, there is no more understanding of how the human mind
works, but there is an enormous amount of (very expensive) pills
to be pushed that - somehow, for reasons no one really understands -
may or may not help, but certainly do pay; there are no
longer any large fair trials with fair outcomes that everybody can
access, for there is an enormous amount of data that is kept secret;
there are no more people getting cured from psychiatric complaints, but
instead almost everyone - who is not a psychiatrist - these days is
considered to be insane, or to have been insane, or (at least) will be
4. Then what about the DSMs?
I am sure nearly all psychiatrists and psychologists will disagree with
me, but then I am only a psychologist because I got denied the chance
to take an M.A. and Ph.D. in philosophy: I never made any money through
my degree, and never will.
Maybe even dr. Healy will disagree with me - but I do have an excellent
M.A. in "the science" of psychology, and for me it is very
There is NO science of psychiatry; almost everybody who
seriously claims there is makes money from it; and in fact the
whole show should be terminated, and the sooner the better, for
it is almost all totally without real content.
Of course, there will remain people who are mad - insane, bonkers, out
of their mind - and serious cases need help and treatment, but not
by such methods or such pills as have been used massively for the last
25 years, possibly with a few exceptions.
Most cases will not be serious, and will go away.
And unless humanity has changed in major ways over the last 25 years,
in fact at most 1-5% of ordinary people will have mental problems that
are serious enough to try to get something done about it, instead of
the - at least - 78% that "should be" on psychiatric drugs, if the DSM
(IV in this case) is correct.
And see my Brit. Jn. Psychiatry: 78% of
the British are not sane, e.g. in case you doubt that 78% - and even it it is "just"
a third, I still say all this shows is that psychiatry
is mad, rather than the third or indeed four fifth of ordinary
people psychiatrists declare insane really are insane.
Surely, there are only a few psychiatrists, and they all have a
personal interest in it: It is much cheaper to stop their utter
nonsense, and to take proper care of the few who are really mentally
Finally: I have not had and do not have any serious interest in
psychiatry: Ever since I was 17, I rejected it as a science, and
believed it only would help few, and I still think the same.
The only reason for me to write about it is that the disease I
have since 1.1.1979 now has the serious risk to be diagnosed as
psychiatric, and that I happen to be a psychologist. Then again, I will
probably not be maltreated, if only because I will be pensionable in
two years, and because there are no reasons of any kind to declare me
mentally ill - apart from the fact that I am physically ill, with a
disease that has no known explanation.
 About me and Prozac: I
am not certain when I first got Prozac, but I think it was in 1998, and
that was because I had remained depressed, as I described that in 1994,
in Dutch: Over M.E., depressies
en mijn woonsituatie. I took it first for about three to four weeks
without any noticeable change, and then quite suddenly my mood got a
lot better. Since then I have taken it for about 10 years (far
too long, at the very least), and then gradually gave up on it, also
without any problem that I am aware of (!). I do think I am one of
those who had a fairly good reason to take it, but since I know a lot
better what is involved, I am sorry I did do so.
(that I prefer
to call M.E.: The "/CFS" is added to facilitate (that I prefer
to call M.E.: The "/CFS" is added to facilitate search
is a disease I have since 1.1.1979: