Off Their Meds 

Modern psychiatrists prescribe pills for hundreds of "biological" disorders. The radical mental health movement isn't so sure

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"Here is a woman, and I care about Brooke Shields because I think she is an incredibly talented woman. You look at, where has her career gone? ... These drugs are dangerous. I have actually helped people come off. When you talk about postpartum, you can take people today, women, and what you do is you use vitamins. There is a hormonal thing that is going on, scientifically, you can prove that. But when you talk about emotional, chemical imbalances in people, there is no science behind that. You can use vitamins to help a woman through those things." -- Tom Cruise

When Tom Cruise made a late-May appearance on NBC's Access Hollywood, he talked about his new movie, and his high-profile love affair with Katie Holmes. But what garnered most attention were his comments on psychiatric medications and actress Brooke Shields -- who wrote about using therapy and the antidepressant Paxil to fight postpartum depression in her memoir, Down Came the Rain. Shortly after Cruise defended his comments in a subsequent appearance on Today, the American Psychiatric Association issued a statement of its own. "It is irresponsible for Mr. Cruise to use his movie publicity tour to promote his own ideological views and deter people with mental illness from getting the care they need," association President Dr. Steven S. Sharfstein said. In other words: "Tom, you're an actor, not a doctor; stay out of it."

According to the American Psychiatric Association, antidepressants and other psychopharmacological medications "can be an important and even life-saving part of a comprehensive and individualized treatment plan." Prozac, Xanax, Effexor, Depakote, and the various brands of lithium carbonate, they say, are a safe, efficient way to improve the quality of millions of American lives. Surely only religious fanaticism would make someone question the validity of psychiatry and the medications that have changed so many lives, Cruise's critics postulated.

"Scientology has always been antipsychiatric services," says Vivian Jackson, copresident of the East Bay chapter of the National Alliance for the Mentally Ill, a national nonprofit founded by the families and loved ones of mentally ill people. And indeed, a publication called Pseudoscience: Psychiatry's False Diagnoses, available from the Citizens Commission on Human Rights, Scientology's psychiatric watchdog group, makes the following points.

1. Psychiatric "disorders" are not medical diseases.
2. Psychiatrists deal exclusively with mental "disorders," not proven diseases.
3. Psychiatry has never established the cause of any "mental disorders."
4. The theory that mental disorders derive from a "chemical imbalance" in the brain is unproven.
5. The brain is not the real cause of life's problems.

Most of these are as oversimplified as the commercials that say Zoloft will turn you from a frowny little doodle into a bouncy, happy one. Some mentally ill brains do look different. Some psychiatrists deal with the whole person, not just what the Diagnostic and Statistical Manual says is wrong with them. And if the brain isn't the cause of life's problems, then what is?

Given Scientology's vaguely disreputable image among the general public -- possibly due to a creation myth involving volcanoes, movie theaters, nuclear weapons, intergalactic baddies, and clusters of confused souls called thetans -- many in the radical mental health movement wish to maintain a reasonable distance from the church. But many agree with its criticisms nonetheless. Speaking out against the dominant biomedical paradigm and the big business of pharmaceuticals takes courage, they say.

As the leader of an organization that often finds itself on the same side of the fence as the Citizens Commission on Human Rights, David Oaks has been labeled a Scientologist more times than he cares to count. Oaks compares this to the labeling of communists in the McCarthy era, and finds it quite troubling. It's insulting, he says, "that we who went through the mental health system are incapable of organizing ourselves, and that if somebody has a criticism of the mental health system, they must be under the control of a mind-control cult."

"There's always a group of people who feel that [medication is] not the way that they want to be treated, and they have a right in this country to choose their treatment," says San Francisco psychiatrist Dr. Larry Lurie. "It doesn't matter whether it's cancer treatment or psychiatric treatment, they can say yes or no, this is what I want to do for myself. And I think it's a wonderful thing that they have that right to make choices."

That said, Lurie thinks the treatments used in psychiatry are effective and scientifically proven, citing the effectiveness of mood stabilizers to level out dispositions, antipsychotic medicines to counter hallucinations, and shock treatment to help older people in particular out of severe depression.

But the treatments Lurie refers to are dictated by the Diagnostic and Statistical Manual, a book whose radical revision may be imminent. The fourth version of the book claims that 374 separate mental disturbances actually begin in the brain. But many psychiatrists, authors, and academics quarrel with that claim.

By Dorman's calculations, fewer than twenty disturbances actually have biological causes. Symptoms of injury or disease should be supported by objective evidence, he says: "There's virtually no objectivity but for a small subgroup of disorders listed in the Diagnostic and Statistical Manual."


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