Increasing Concerns

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Now seems to be such a pivotal time. We have a Netflix series ‘Painkiller’ which is so important when it comes to the prescription of opioids -specifically Oxycontin – and in recent years there has been a notable change in attitude within the medical profession towards more responsible prescribing.

But we are so far behind when it comes to the myriad of other drugs which are also harming hundreds of thousands, if not millions, of people. Even though NICE guidelines have changed when it comes to prescribing ‘anti-depressants’,  there is still a failure to recognise the harms of psychiatric drugs, which are experienced every single day as people try and get relief for their psychological distress.

There are very few de-prescribing clinics and very few psychiatrists who recognise the serious adverse effects. These can arise not just from the taking of one drug, but also from polypharmacy, when many people end up on cocktails of these drugs. Akathisia is virtually unheard of by the medical profession and even when it is drawn to our attention, the attitude is one of indifference or disdain.

Yet who am I to write, when every single day in my work, I see people not receiving quality healthcare which they have been promised by our beloved NHS. I am part of that system and I know how frustrating it feels to be unable to deliver due to lack of time, physical space and staff availability. I also know how we, the staff, all try to do our best within a flawed healthcare system and many of us feel exhausted. Our energy is low and our sense of outrage gets dampened down because we have no choice but to carry on, or get out.

The medical model has overpromised to the citizens of the world. The drug companies have advertised the possibility of an idealised life, filled with health and happiness, and that is exactly what people of all ages are aspiring to. They would feel robbed and cheated, if when they visited a doctor, they were informed of the reality; that pain and suffering is inevitable, and constant happiness is a mere pipedream. This is a conversation that is largely avoided by the medical profession, especially when it comes to the topic of mental health. It is not surprising that it is also unwanted by their patients who are finding it hard to cope with the pressures of life. So, more often than not, patients will leave with an offer of a referral, a test or a procedure, and at the very least a prescription in their hand.

The stark truth about living today, is that it is difficult. Our whole society has given us an expectation that all of us, as individuals, can put ourselves on a trajectory to success. That success will fulfil our unique hopes and dreams, and may include increasing our wealth, fame and ending up in a perfect, romantic relationship. Running counter to this is an undercurrent that prohibits us from having compassion on those who haven’t quite ‘made it’. The survival of the fittest has surreptitiously become part of our Western, neoliberal culture.

So those of us who find ourselves with ‘mental health problems’ will only be tolerated as long as we remain productive members of society. The fact that increasing numbers of people who have been labelled with psychiatric diagnoses are drawing benefits, is seen as problematic because the ‘able-bodied’ have to support them. If bad things happen to these ‘weaker’ beings, then society is more than likely to blame them and see it as some flaw in their characters.

This is why psychiatric patients and ex-psychiatric patients are so often ignored. We are told that we were not ‘in our right mind’ if we try to complain or to call attention to deficiencies in our care or treatment. The fact that so many needless deaths are occurring from suicide or ‘misadventure’ on a background of ‘mental health problems’ results in cries for more resources, more drug prescribing, more psychiatric treatment, rather than looking at the root causes. Worse still, those who die while under psychiatric care are scrutinised under the same lens. What other drugs might have helped? Often their demise is viewed as inevitable, because nobody is prepared to consider the possibility that the treatment they were given, might have killed them.

In the main, it is the voice of people who have suffered or who are suffering from the consequences of psychiatric treatment with drugs (or ECT and less commonly surgeries), who are calling out for change.  Yet many of us who have survived, feel as though we are being silenced. There is so much risk when it comes to speaking out. There will always be people who can counter our arguments, always be someone who will tell you how antidepressants or ECT helped them.  Who are we to deny that possibility? If you benefitted, good for you. You are one of the lucky ones.

However, I will say this. That just because some drugs have helped some people, even if it is the majority, or just because ECT is thought to have helped some people, or just because psychosurgery is said to have benefitted some recipients…….does that make it right to ignore the serious harms that happen to others?

Would any of us want those children with deformities of their limbs, born to mothers who took thalidomide during their pregnancies, to hear others telling them that thalidomide helped their own mother with her severe pregnancy sickness? Would that sit well with you? Yet that is the truth. There will always be people who were helped by drugs which have subsequently been withdrawn from the market when the harms become apparent.

I am constantly reminded that ECT or antidepressants have saved people’s lives. I thought that was true for me and wrote as much, because at the time I believed what I had been told about my condition. (I have written a subsequent memoir to refute that original belief, as yet unpublished.) I had been told time and time again that the deterioration in my condition was due to the severity of the depression. Now I know that the ‘symptoms’ which signalled this ‘deterioration’  could all have been put down to adverse effects of the drugs which were given to me. But that was never considered.

It is very uncomfortable to conclude that if I had received no treatment at all, no drugs, no ECT, no hospital admissions, that I would certainly have recovered perfectly well on my own. It is even more uncomfortable to conclude that my breakdown was completely normal, when actually it felt so validating when the doctors told me I was ill.

What would had happened if when I was in crisis, finding sleep impossible, feeling miserable, stressed and anxious, the diagnosis of depression had not existed? What if I had been told ‘to pull myself together’, which was the usual retort when somebody was exhibiting such uncharacteristic emotional turbulence? No, that might not have helped at all. But supposing the nice, sympathetic doctor had gently explained that what I was experiencing was my body’s response to overwhelming pain, stress and memory of the past. Supposing I had been told that what I needed was rest, time out and someone to care for me, until I was able to care for myself. What if I had been reassured that what I was feeling was temporary and I would regain my strength and be able to carry on?

Would that have been bad? No, I don’t think so. I didn’t need the pills or the labels, but I did need a sick note and I did need to be cared for, until I recovered, but that wasn’t to be. Instead, I was told I was depressed and needed to take ‘antidepressants’ and that would make me better quicker. The usual trajectory is that without any drugs, even severe depression will get better on its own in two years and is unlikely to return. I didn’t work for almost eight years, and then just over three years later, ended up diagnosed with a relapse which put me on benefits for a further eight years

Today, there are so many people who are disabled with psychiatric diagnoses. Many of these people are suffering really badly. Those on multiple medications face little hope of future recovery and those who do get better, generally do so when they have decided that enough is enough. It is rare for their doctors to support the decision to give up on the treatments that psychiatry has to offer.

Then there are those who are clearly suffering from the harms of psychiatric drugs, whether ‘antidepressants’ or ‘antipsychotics’, lithium, antiepileptic drugs, pain killers, or benzodiazepines or sleeping tablets. Most of the adverse effects go unrecognised by doctors, and their harms underestimated. Suggested treatments for adverse effects usually involve the addition of another drug or switching to something similar, or indeed increasing the dose. The harms of ECT are likewise underestimated, and when your memory is shot to pieces, are difficult to evaluate for oneself.

I feel so helpless to be working in the midst of this deluded medical paradigm. I feel disempowered because my years as a patient prevented me from progressing in my career. As a result, my influence within my own profession is very limited. I do what I can, but I am compelled to do more. I cannot bear the injustice and the discrimination levelled against those who have been courageous enough to speak about the harms of psychiatric treatment. I cannot bear seeing the way current patients are made worse not better, and that there are some who die unnecessarily. For me to stand by and do nothing is intolerable. I feel as though I am witnessing the slow death of the innocents, a form of euthanasia practised against some of the most vulnerable in our society.

1 COMMENT

  1. Thank you Dr. Wield. It does take a Physician of Conscience to bear the the injustice and discrimination levelled against those who have been courageous enough to speak about the harms of psychiatric treatment.

    “But the most pernicious of all is that the system appears to have a complete inability to appreciate when the treatment it gives becomes the problem that it tries to treat by adding more drugs, and if need be detaining us in order to do so”. (Personal communication. Professor of Psychiatry. 2017).