The Washington Post 30 August 2003
Raising Doubts About Drugs
Calif. Hunger Strike Challenges Use of Antidepressants
By Kimberly Edds
PASADENA, Calif., Aug. 29 — After two weeks, four mental health advocates are still on a hunger strike, protesting the widespread use of prescription drugs to treat mental illnesses and challenging psychiatrists to document their rationale for prescribing them. Over the last few decades, doctors have embraced the view that depression, schizophrenia and other mental illnesses result from imbalances in brain chemistry, and they have treated such illnesses with drugs intended to rebalance that chemistry. In recent years, the use of antidepressant drugs has grown dramatically in the United States, with the number of prescriptions nearly doubling since 1998, according to the pharmaceutical consulting company IMS Health.
As more people turn to antidepressants, mental health experts and patient advocates are beginning to raise questions about side effects and the potential for addiction.
The strikers are calling on some of the strongest voices in the psychiatric profession, including the American Psychiatric Association and the National Alliance for the Mentally Ill, to provide concrete evidence that mental illnesses are the result of brain chemistry imbalances. They also want to call attention to alternative treatments.
“Millions of people are signing up for these prescriptions because they are convinced they have a chemical imbalance. But there is not one piece of evidence that can back that up,” said David Oaks, executive director of MindFreedom Support Coalition International, or SCI, an organization of current and former psychiatric patients that organized the strike.
A spokesman for the American Psychiatric Association referred a reporter to a letter the association’s medical director, James H. Scully, wrote to Oaks on Aug. 12. “In recent years, there has been substantial progress in understanding the neuroscientific basis of many mental illnesses,” it said. “Research offers hope and must continue.”
The National Alliance for the Mentally Ill (NAMI) did not respond to several requests to comment, but Oaks made available an e-mail he received today from Rick Birkel, NAMI’s national executive director.
“NAMI has never stated to my knowledge that ‘mental disorders are caused exclusively by biological factors,’ ” it said. “Instead, we are saying that biological or genetic vulnerability appears to be pre-requisite to serious mental disorder.”
Birkel added that “mental disorders result from complex interactions of many factors, including environmental forces, stress, personality, social support, illness and injury.”
Birkel’s e-mail reflects a growing consensus in the psychiatric establishment. Most psychiatrists say that complex mental disorders are like arthritis and other chronic physical ailments — no less real because they cannot be spotted with laboratory tests.
The hunger strikers, who include three former mental patients, said that the responses were not satisfactory and that they wanted a study and a diagnostic lab test that proves the connection. Until then, they plan to continue their protest.
They began with six hunger strikers, but two, including Oaks, left because of health difficulties. The remaining four have been downing daily a dark red brew of juices from garlic, beets, kale and carrots, and spending their time answering supporters’ e-mails and making phone calls to media outlets.
Hunger striker David Gonzalez said he spent two years confined in an inpatient facility after being diagnosed with major depression and, later, manic depression, and that he was forcibly drugged during that time. He said the drugs impaired his eyesight and memory.
“When someone has cancer, they don’t lock the door behind them, and they show them the tests,” Gonzalez said. “But when someone has a mental illness, they lock the door behind them and show them no tests. When they lock that door behind me, I want to know why.”
Oaks said he, too, had been confined in institutions and forcibly drugged for what was diagnosed as schizophrenia. He recovered, he said, through the love and support of his family, rather than drugs.
“People do not know what it’s like to be on these drugs,” Oaks said. “If you want to take it and it obliterates your pain, that’s one thing, but when you are pushed to be on it, it’s like a wrecking ball to your thoughts and feelings.”
Studies have shown that daily exercise, psychotherapy and even changes in diet and nutrition are as effective as, if not more effective than, prescription drugs, said Stuart Shipko, a Pasadena psychiatrist and panic disorder specialist who serves on an SCI scientific panel. But there is not widespread support for such treatments.
“We’re overdiagnosing. How many of these supposed mental illnesses are really just problems in your family life? They’re anxious, and they’re being put in a chemical straitjacket,” Shipko said.
© 2003 The Washington Post Company