Jimmie* was your average young adult; at 21 years old he was in essence living the American dream, going off to college beginning his independent life in his junior year at a new university. After months of anticipation, the final preparation of packing, leasing an apartment, purchasing furnishings, checklists, registration, excited to finally cut the umbilical cord took a 180° turn in the course of a month and open up a can of worms that none of us were ready for. Just a brief history on Jimmie before we go any further; Jimmie was always an introverted child; he was the oldest of three with a mother and father that were still together. He always seemed to be a little different than the other kids, he never liked hugging, physical contact, hypersensitive to sounds, extremely quite, very polite, never did anything that would put him in any danger. He had no friends even as he was in middle and high school, he never joined any clubs, no going out with anyone, stayed to himself, very isolated. Despite his separation many of us (his family/uncle) tried to encourage him to go out, do “normal” things, but he continued to keep to himself, we all felt that this was his personality and he would blossom as he got older. Jimmie was very bright, he did remarkably well scholastically, and as he finished up at Miami Dade College he applied to several universities including the University of Florida and Perdue. Anxiously waiting to hear from them he really wanted to go to Perdue but it was very expensive in the ballpark of $50,000 a year and financially his parents couldn’t afford to completely cover the cost and encouraged him to try UF. He decided to go to UF based on it being his only option financially. The time came when he finally moved and began his journey, but it didn’t take long before the bump in the road appeared. It started with a few phone calls to his mother, the separation set in, the solitude, he started hearing noises, voices, he stopped eating, sleeping, stopped going to classes, the phone calls began to be every 15 minutes, his mother knew it was serious. He called the school’s health office to talk to someone and they gave him an appointment for the following week, that was until he made a second call and left a message, he was told to come in immediately. The university’s psychiatrist saw him diagnosed him with psychosis, bi-polar disorder, and said he met criteria on all axis’s and put him on Zoloft and Ambien right away, he was inconsolable and seemed worse, the psychiatrist thought he would benefit from being admitted but he refused and after a week got on a plane with nothing but the clothes on his back and came home. He was unrecognizable, he looked like a zombie from the lack of sleep, hollowed bones form not eating and a look on his face no one had seen before, a stoic, flat expression that just broke your heart. He didn’t speak he just sat there a stared off into space. His mother made numerous phone calls around the community to find a psychologist and psychiatrist but it was harder than anyone could have imagined, in spite of them being self-paying patients it was still difficult to find someone. She finally found a qualified psychiatrist that began switching medications right away; she began to wonder what are these psychiatric medications?
*Mental illness is defined as a wide range of mental conditions, disorders that affect your mood, cognition, and behavior. Some illustrations of mental illness include depression, anxiety, schizophrenia, eating disorders, etc. When you think of mental illness what would designate it as a mental condition? Well, if it interferes with your daily functioning, your interactions with your family, your work, and your responsibilities. What happens in some instances is that it can be in a person’s blind spot, which means they themselves are unable to acknowledge that they have a problem, which can occur in illnesses such as bi-polar disorder and schizophrenia. In America there are 1 in 4 people that experience mental illness in a given year, 1 in 17 are living with a serious mental illness (NAMI). That is a huge number of individuals dealing with mental pain and the only ones benefiting from this is the Big Pharmaceutical companies, making over $193.2 billion in lost earnings per year. This ponders the question is the Big Pharm the culprit for the new epidemic that is plaguing our society and are the people that are supposed to be “helping” us by surrendering to the easy way out with medication.
What are Psychiatric Medications?
Psychiatric medications are licensed psychoactive drug taken to exert an effect on the chemical makeup of the brain and nervous system. They are used to treat mental disorders. They are typically made of synthetic chemical compounds, although some are naturally occurring or naturally derived. They are also known as psychotropic or psychotherapeutic medications, they are thought to change the lives of people living with mental disorders for the better.
- There are six main groups of psychiatric medications:
- Antidepressants
- Clinical Depression
- Dysthymia (persistent depressive disorder)
- Anxiety
- Eating Disorders
- Borderline Personality Disorders
- Antidepressants
- Stimulants
- ADHD
- Narcolepsy
- Appetite suppressants
- Antipsychotics
- Psychotic disorders
- Schizophrenia
- Mood disorders due to psychotic symptoms
- Mood stabilizers
- Bi-Polar Disorder
- Schizoaffective Disorder
- Anxiolytics
- Anxiety Disorder
- Depressants
- Hypnotics
- Sedatives
- Anesthetics
Robert Whitaker began his research for a series on abuses of psychiatric patients for the Boston Globe with a self-professed conventional understanding of psychiatry. As he furthered his research he dug deeper into scientific research and what he found was alarming. He questioned where was the proof of the chemical imbalances? Why did short-term use show improvement yet the long-term show the polar opposite? They actually showed that the patients did far worse than their un-medicated counterparts. Whitaker’s research eventually became Anatomy of an Epidemic ; this video is a brief description about his book. It looks at the wide use of psychiatric medications and discusses the questions many of us have. It also discusses the effectiveness and long-term use of such psychiatric drugs.
*Although Whitaker believes psychiatric medications must be used selectively and in a very cautious manner. He emphasizes that they are not fixing any chemical imbalances and should only be used on a short-term basis.
What do psychiatric medications do?
Psychiatric medications work by targeting the complex chemistry of neurons and neurotransmitters in the brain and central nervous system. Neurotransmitters are known as serotonin and dopamine and they are produced in the neurons that carry messages from cell to cell, crossing synaptic gaps between axons from neuron to dendrites. It is believed that any change that occurs in the neurotransmitter’s chemical structure or imbalance at any point in the process will affect mood, emotions, thoughts, behaviors, and mental status. Whitaker unveils in his book how psychiatric medications came from side effects of antihistamines, gram-negative antibiotics, and the anti-tuberculosis agents. The way these medications worked in the brain was not well know but was described and called as major tranquilizers, now known as typical antipsychotics, minor tranquilizers now benzodiazepines and psychic energizers now anti depressants. This was the development of “Magic Bullets” was the side effects in physical medicine to treat a problem and an unexpected side effect happens and used it to their advantage to develop medications for the pharmaceutical companies.
There is a market that has honed in on millions upon millions of unknowing people in this mental health system of sorts. Robert Whitaker has captivatingly discussed in his book, Anatomy of an Epidemic, the detrimental effects psychiatric drugs have on society and how big of a problem it is becoming. The pure genius that he had in unveiling this secret and ambiguous information and deciphered it into a comprehensible format is great in moving forward with my research into this grey area of mental illness. It is no surprise that our society has embraced the idealization that a magic pill can “fix” it. Well as history has proven time and time again that, it’s not all it’s cracked up to be, there is not a one size fits all approach to mental illness and cocktails of medication is not only harmful it can be fatal. 1 in 10 death in the United States is related to suicide that is huge; a red flag should be waving every time someone dies of suicide. What pushed them to take their own life? Why? Is it possible a medication they were taking could be to blame? NAMI, National Alliance of Mental Illness has a great factsheet on the specifics.
*Jimmie was a prime example of what psychiatric medication do, he became slightly more social, after about 2 months, he began sleeping a little, eating a little more, bathing, grooming himself. His medications changed also; they added Seroquel to the cocktail of Zoloft 150mg, Ambien, Abilify was also added. They played with the dosages and tweaked them on a bi-weekly basis; he seemed to be on the right path.
Which medications are most prescribed?
Top 10 Psychiatric Meds in the US
Top 10 most prescribed psychiatric drugs
The most prescribed psychiatric medications include Xanax being the number one most commonly prescribed psychiatric medication. Anti-anxiety medications like Xanax, Valium, and Ativan remain at the top of the most prescribed psychiatric medications, they are fast acting and have short half-life, meaning the effects only last a few hours. Lexapro is the second most prescribed psychiatric medication for anxiety and depression. Zoloft is number 4 on the list and was introduced in 1991 for major depression and OCD, it is an SSRI. Prozac is number 5 of the top ten and was one of the first SSRI developed. Desyrel or Trazodone number six on the list and is a second generation anti-depressant. Cymbalta is an SNRI (serotonin and norepinephrine reuptake inhibitor) and is number 7 on the list of top prescribed. Seroquel tops off at number 8 on the list and is a short acting atypical antipsychotic approved to treat schizophrenia, bipolar disorder, and when combined with anti-depressants it can help major depressive disorder. Effexor is number 9 on the list and is an antidepressant in the SNRI family. The final of the top 10 is Valium is commonly used for anxiety, panic attacks, insomnia, seizures, muscle spasms, restless leg syndrome, alcohol, benzodiazepine, and opiate withdrawal. It helps with tension and anxiety and induces amnesia.
These list change every year some moving up and some moving down the list but in recent years they have remained fairly consistent reaping in billions of dollars by leading in the amount of prescriptions written and dispensed.
What are the beneficial effects of psychiatric medications? 
The beneficial effects of psychiatric medications improve many of the most distressing symptoms of mental, emotional and mood disorders. They are said to reduce the stress of living with chronic disease and conditions. They are also thought to improve the efficacy of counseling and psychotherapy. Some of the most beneficial effects are:
- Decrease feelings of hopelessness, darkness, and indifference in depression.
- Prevents relapse of depression.
- Reduce cravings, anxiety, obsessions, compulsions, and phobias.
- Prevents panic attacks.
- Reduce hallucinations, delusions, inappropriate behaviors, and the voices that often accompany schizophrenia.
- Calms impulsivity, hyperactivity, and mania.
- Improving concentration, memory, and sleep.
What are the adverse effects of psychiatric medications?
There are serious adverse reactions that can occur when taking psychiatric medications that include but are not limited to:
- Restlessness or wakefulness at night.
- Headache, dizziness, or blurry vision.
- High blood pressure
- Nausea or vomiting
- Drowsiness or sleepiness at the wrong time of the day, making it dangerous to operate machinery.
- Skin rashes
- Unwanted weight loss or unwanted weight gain
- Unwanted changes in thoughts or behavior, such as losing interest in dating, creativity, and suicidal thoughts that have not occurred before.
- Seizures, especially if medication interacts with certain foods or other medications.
- Muscle spasms, slurred speech, or a movement called tardive dyskinesia.
The complex nature of the psychiatric drugs is mind blowing and their affect on the central nervous system and other organs in the body that include blood, bone marrow, liver, kidneys, heart, thyroid gland, endocrine, etc. all interact with the way they function. These medications can interact with MAOIs that can cause seizures, addiction, and withdrawal symptoms.
*Whitaker highlighted in the studies he found from the NIMH psychiatric medications create perturbations in neurotransmitter function. The brain goes through compensatory adaptations in order to maintain their equilibrium in the face of alteration of environment or changes in the internal milieu. The chronic administration of the drugs then causes substantial and long-lasting alterations in neural function. After a few weeks the person’s brain is now functioning in a manner that is qualitatively as well as quantitatively different from the normal state. The etiology of most mental disorders is unknown that means the medications do not fix its pathology. The medications impede normal function of the neurotransmitter pathways, which lead to significant side effects. Over the long term, the medications induce changes in the brain the opposite of what’s intended, and this increases the risk that a person will become chronically ill. These 16 Studies uncovered by Robert Whitaker have changed what many have though about medication and mental illness, it is an amazing presentation/slideshow from Mad in America that is worth reading.
DSM V
The DSM V is the universal tool used for psychiatric diagnosis. Healthcare providers use the DSM V for level of care for payments used for treatment recommendations in combination with fees based on classification by the DSM. The new DSM V was released in May of 2013 and it replaces the former DSM-IV-TR that was last updated in 2000. The new edition has some noteworthy changes such as the removal of Asperger syndrome as a distinct category and is under the autism spectrum disorder that also includes pervasive developmental disorders, the subtype of variant schizophrenia, bereavement exclusion for depressive disorder. Gender identity disorder changed to gender dysphoria, and they removed the axis 2 criterion for PTSD due to specific emotional reactions to trauma weren’t relevant to combat veterans and first responders. Mental retardation has been renamed as intellectual disability, phonological and stuttering have been reclassified and named under communication disorder. There is a new sub category of motor disorders that includes developmental coordination disorder, stereotypic movement disorder, and the tic disorder that includes Tourette.
There is a lot of controversy surrounding the revised edition of the DSM because the changes do not have the empirical support to back vicissitudes. Another interesting fact is that the DSM has become poorly written, contraindicative, and down right confusing for even trained individuals. Many doctors have to make decisions based on the DSM V but not actual evidence that are backed by scientific proof. This creates the huge problem that we are facing today many individuals who are prescribed medication because they fit a certain criterion in a list of numerous symptoms. A key fact to keep in mind is that many health insurances cover based on symptoms thus, they must meet x, y, and z + 1,4, and 7 just to be covered under their plan. The real problem is that this book will determine the fate of millions to be place on some type of psychiatric or antipsychotic medication. These drugs are new and the long-term effects even short-term effects are often obscured and unknown until it is to late for many. The APA doesn’t have the expertise nor the competence to know the efficacy and destruction these drugs can and will have on people; the very patients they claim to help are in essence playing Russian roulette.
This Video of the DSM V discusses changes the DSM V has had in its updated version. It is the guidebook that allows physicians to diagnose and treat. It is a great brief video of the pros and cons of the DSM V. It highlights its imperfections and also focuses on it being a dictionary versus a bible for mental illness.
Below is a chart that names common psychiatric drugs and their side effects, scary to think we have so many people on such powerful, tranquilizing, mind-altering medications.
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