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We need to rethink how we treat mental illness: the author

Before a public lecture in Montreal, author Robert Whittaker said the way drugs shape long-term outcomes must be understood against our natural ability to recover.

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For decades, the common wisdom was that mental illness was a disease of the brain, a biological disorder caused by a chemical imbalance.

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As award-winning American journalist and author Robert Whitaker told Montreal, the model had “a chronic condition, something was wrong in the brain, and the best thing you could do was have diabetes.” The Gazette – and recovery meant stabilizing within that model of care.

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That model has collapsed.

Despite decades of research, no findings show that people with mental illness necessarily suffer from biological abnormalities, nor do psychiatric medications offer long-term benefits. There is no evidence that, said Whitaker, who has written extensively on psychiatry and the history of psychiatry.

The current understanding is that conditions such as depression, psychosis, and mania have many different causes, including life events, setbacks, trauma, and other factors, and many resolve over time. This opens up new avenues for facilitating definitive recovery from mental disorders, he said.

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“You’re not on drugs, but you’re functioning all over your body: employment, social functioning, sexual functioning, marriage,” he said.

“That’s where I guess we’re headed,” said Whitaker, who will give a public talk Thursday in Montreal hosted by AMI-Quebec.

“This disintegration of the old disease model leads to this lovely, optimistic and evidence-based narrative. Certain difficulties are often temporary rather than chronic. We need a paradigm of care for

Psychiatric drugs are approved based on short-term clinical trials, but many people continue to take them long-term, says Mad in America, a web magazine that presents a critical perspective on modern psychiatry. Whitaker, founder and publisher of

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The way drugs shape long-term outcomes must be understood for our natural ability to recover, he said.

Journalist and author Robert Whittaker will be the keynote speaker at the AMI-Quebec Low-Beer Lectures in Montreal and online on November 10th, and the Grand Round of Psychiatry at McGill University Health Center on November 11th. do.
Journalist and author Robert Whittaker will be the keynote speaker at the AMI-Quebec Low-Beer Lectures in Montreal and online on November 10th, and the Grand Round of Psychiatry at McGill University Health Center on November 11th. do. Photo by BD Koren /adior

In The Anatomy of Epidemics: Magic Bullets, Psychiatric Drugs, and the Incredible Rise of Mental Illness (Crown, 2010), Whittaker examines drug-focused paradigms of care and examines depression in the past two decades. and the burden of mental illness had soared, as measured by the number of Americans on government disability for mental illness.

In a 2017 presentation to the UK Parliament, Whitaker examined antidepressant drug use and disability in the UK, Sweden, Australia and New Zealand and found that disability increased sharply as drug prescribing increased. Did.

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Examining the course of mental disorders in Epidemic Anatomy finds “significantly worse outcomes” and affective disorders such as depression and bipolar disorder go from episodic to chronic problems Did.

At the time the book was published, there was general social and professional belief that these psychiatric drugs were essential and would improve outcomes, Whitaker said.

Initially, his findings were viewed as a kind of heresy, he said.

But if he was dismissed as a freak, today, “at the societal level, it is accepted that the drug-first approach has not alleviated the burden of mental health on society,” Whitaker said. Leading psychiatrists are rethinking paradigms.

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He cited a 2022 paper by Nassir Ghaemi, professor of psychiatry at Tufts University School of Medicine. He says there is no evidence that psychiatric drugs have long-term benefits. He said it should only be used for short periods of time and at the lowest doses possible. (The exception is lithium, which benefits by reducing the risk of suicide.)

In a 2020 report, UN Special Rapporteur Dainius Pulas said that “structural conditions such as poverty, discrimination and violence are the root causes of mental distress and suffering,” and that mental health services should not be used. This allocates a large proportion of resources to individual treatment of mental health conditions.

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“Good mental health and well-being cannot be defined by the absence of mental health conditions, but instead are defined by the social, psychosocial and They must be defined by their political, economic, and physical environment, to fully enjoy their rights and to pursue their potential fairly,” said a mental health and child health expert. Dr. Pūras said.

In a podcast shortly after The Anatomy of Contagious Disease was published, Whitaker told Rob Whitley, an associate professor of psychiatry at McGill and a researcher at the Douglas Research Center: Mental health and the ability to thrive occur within social contexts such as having friends, finding meaning in life, and having relationships, helping people maintain friendships, find meaning, and improve their physical health. To help find out, we need to provide this intensive psychosocial care. Such that. ”

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Robert Whittaker will give a public talk on November 10th at 7pm at Concordia University’s Oscar Peterson Concert Hall. 7141 Sherbrooke St. W. Admission is free and no reservations are required. Attendees are encouraged to wear masks and maintain social distancing. To watch online, visit amiquebec.org/rethinking. On November 11th, Whitaker will make a grand round in psychiatry at the McGill University Health Center.

sschwartz@postmedia.com

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We need to rethink how we treat mental illness: the author

Source link We need to rethink how we treat mental illness: the author

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