Mind War: Part Two -- Mental Health

Part One -- Mind Virus

In part one I talked about memetics and the war for our thoughts that's currently raging throughout the Western world. Memetics are hip, indeed memetics is a meme at this point -- how meta! -- and so talking about fighting them is kind of fun and revolutionary. But it's time to head into darker territory. Because far from just filling our minds with LOL cats and screeds and Kardashians, it's pretty clear that the modern world is driving a significant number of us insane.

Note, I don't mean insane in a:
  • fluffy (Joan has always been just a bit nutty)
  • or gentle (I don't really like closed spaces)
  • or counter-culture (I reject your reality and substitute my own)
  • or rebellious (I'm an artist, man, people think I'm crazy because I don't subscribe to the norm)
way.

I mean in a literal, scary, your brain is hurting you and not operating correctly and it's ruining your life kind of way.


Disclaimer: I'm not a doctor. This isn't a treatment plan. If you're undergoing treatment or are on medication, don't stop on my account.

Crazier?

Recent rates of increase

Whether or not there is more insanity now than previously in history is surprisingly controversial. Accurate, unbiased data isn't easy to find. The information is filtered through the pharmaceutical industry, one of the three "Big's" that currently run our world.

For the record, these are big AGRO (including industrial farming, food science, biotech, and chemicals), big DEFENSE (including big oil/gas/coal, weapons, and the war machine), and big PHARMA (who have captured most of the medical and insurance industries, including the mental health industry). The three are ruled over by big finance -- big $$$ -- (the One Ring of the modern age).

The argument against an increase in the rate of mental illness is that rates have remained constant but we're simply diagnosing mental illness more frequently through a combination of better diagnostic tools and a de-stigmatization of sufferers. More people are willing to admit when they have mental problems and there are better methods for identifying what mental problems they have.

This is bullshit. Not even because it's wrong -- though it is wrong, but because it doesn't matter -- as I'll be demonstrating.

"Even within mainstream psychiatry, few continue to argue that the increase in mental illness is due to previous under-diagnosis of mental disorders. The most common explanations for the mental illness epidemic include recent over-diagnosis of psychiatric disorders, diagnoses expansionism and psychiatry’s pathologizing normal behavior."


The Book of the Damned
The Diagnostic and Statistical Manual of Mental Disorders (DSM), is the standard reference of mental illness as published by the American Psychiatric Association. It's what defines mental ill-health and it's used by doctors, therapists, researchers, drug regulators, insurance companies, pharma, the legal system and the government.

I find the mushrooms an unintentionally ironic choice here...
It's also growing. The first version, back in 1952, listed the diagnostic criteria for just over 100 disorders. By the third version in 1980, the number had increased by 2.5 times, to 265. Being gay was no longer a mental illness in this version, but there were a hundred new problems humans could have. The fourth version (1994) increased the number again. To quote the same Salon piece:

"DSM-5 was published in May 2013. The journal PLOS Medicine reported in 2012, “69% of the DSM-5 task force members report having ties to the pharmaceutical industry.” DSM-5 did not add as many new diagnoses as had previous revisions.

"However, DSM-5 has been criticized even by some mainstream psychiatrists such as Allen Frances, the former chairman of the DSM-4 task force, for creating more mental patients by making it easier to qualify for a mental illness, especially for depression."

Like all diagnostic tools, the DSM is symptom driven. And that makes sense within our illness-driven (as opposed to wellness-driven) model. You don't feel good. You go to the doctor and tell her what's wrong. Based on what you tell her she gives you advice, additional tests, and/or medication. The difference between medical disorders and mental ones is that there's almost no actual diagnostic tools apart from the symptoms.

If I go into the Dr. and tell her I've got a sore throat, she'll probably probe to find additional symptoms in order to identify the problem. Do I also have a runny nose and itchy eyes? Do I have a fever? Based on the symptom profile, she might take a culture to test for streptococcus. If I have it, I get antibiotics, if I don't I get a suggestion to take allergy pills or get some rest and drink chicken soup. If I have a lump in my throat, they take a biopsy to determine whether it's malignant or benign. And if my breathing is compromised, they may do a chest x-ray to rule out pneumonia.

This is the key -- there is no culture or blood test or scan to test for mental illness because no one really knows what mental illness is:

"The notion that psychiatric drugs work by balancing brain chemistry was first raised in the early 1960s . Once Thorazine and the standard neuroleptics were shown to block dopamine activity in the brain, researchers hypothesized that schizophrenia was caused by too much of this neurotransmitter. Thus, the neuroleptics-by blocking the dopamine receptors-helped normalize the brain 's dopamine system. Since the tricyclics raised norephinephrine and serotonin levels in the brain, researchers reasoned that depression was caused by low levels of these brain chemicals. ...

"However, this hypothesis-that the drugs balanced abnormal brain chemistry-never panned out. Although the public may still be told that the drugs normalize brain chemistry, the truth is that researchers did not find that people with schizophrenia had overactive dopamine systems (prior to being medicated), or that those diagnosed with depression suffered from abnormally low levels of serotonin or norephinephrine . As U.S. Surgeon General David Satcher acknowledged in his 1999 report on mental health, the causes of mental disorders "remain unknown" (Satchee, 1999, p. 102)."

Ethical Human Psychology and Psychiatry, Volume 7, Number I , Spring 2005

So there are a lot more ways to be crazy now than there were back in the 1950s. And some of those ways are extremely controversial. This article has a nice overview of the sort of thing we're talking about. Though you should note that some of these didn't seem to have made it into the final release of DSM-5, it's still scary stuff. Interestingly, the author of this article dismissed claims that the task force had financial conflict of interest with the pharmaceutical industry.

This is a good overview of what actually ended up in the 5th version, including wording that critics think pathologize grieving, temper tantrums, and PMS. It also focuses on classifications that encourage treatment with pharmaceuticals rather than environmental changes.

Note, that doesn't mean the mental illness doesn't exist. Is certainly does and it causes very serious problems for people who are suffering. But I wonder whether our current treatment paradigm is actually helpful.

Mother's Little Helper
So we don't know what causes mental illness... but we can treat the symptoms, right? If the drugs we're prescribing are helping people, what's the trouble?

Can someone show me the what the ADHD antibody looks like? No?

"Prior to treatment, patients diagnosed with schizophrenia, depression, and other psychiatric disorders do not suffer from any known “chemical imbalance.” However, once a person is put on a psychiatric medication, which, in one manner or another, throws a wrench into the usual mechanics of a neuronal pathway, his or her brain begins to function…abnormally."

-- "The Epidemic of Mental Illness: Why?" by Marcia Angell
New York review of Books, quoting Robert Whitaker author of Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America (a book now on my to read list)

It's well known that anti-depressants work no better than placebos. What's worse though is that the drugs used to treat mental illness not only don't work, but are also actively harmful.

"...Whitaker concludes that they [anti-depressants] and most of the other psychoactive drugs are not only ineffective but harmful. He begins by observing that even as drug treatment for mental illness has skyrocketed, so has the prevalence of the conditions treated:


"The number of disabled mentally ill has risen dramatically since 1955, and during the
past two decades, a period when the prescribing of psychiatric medications has
exploded, the number of adults and children disabled by mental illness has risen at a
mind-boggling rate. Thus we arrive at an obvious question, even though it is
heretical in kind: Could our drug-based paradigm of care, in some unforeseen way,
be fueling this modern-day plague?"

"Moreover, Whitaker contends, the natural history of mental illness has changed. Whereas conditions such as schizophrenia and depression were once mainly self-limited or episodic, with each episode usually lasting no more than six months and interspersed with long periods of normalcy, the conditions are now chronic and lifelong. Whitaker believes that this might be because drugs, even those that relieve symptoms in the short term, cause long-term mental harms that continue after the underlying illness would have naturally resolved."
[ibid]

So there's the rub. We give drugs that change brain chemistry, that work on the problem no better than a sugar-pill, but that also cause more problems and potentially life-long mental illness. And this is why it doesn't matter if we're really just diagnosing more mental illness now than before... because the way we tend to treat it can cause the problems it's trying to solve.

I also need to point out that this issue with medications is where we see a divergence between what mental health practitioners want, which is honestly just to help people who are suffering, and the economic drivers of the pharmaceutical industry.

Just go read that article, and part 2 already. I can't quote the whole thing.

Ignore the Man Behind the Curtain
My spouse and I had this friend. Decent guy. Smart, but kind of aimless, bit of a reprobate. Good musician. One day he brings over this girl he's dating to meet us. The girl is, oh how can I put this gently? She was really troubled and had been for a really long time.

The next time we saw him, alone, I tried to warn him. "Crazy is contagious" I said, "be very careful."

Of course crazy isn't supposed to be contagious. It's not viral (or is it?) or bacterial (or is it?). Yet sure enough, this women took our friend with him to the land of crazy. He ended up checking himself into the ER as suicidal and getting onto some medication himself.

Eventually they broke up. I helped him move our of her apartment. But he wasn't the same and he hasn't been the same since. He's slowly getting himself back together. At one point he said to me "you warned me and I didn't listen. You warned me early on."

So, does everyone know about toxoplasmosis by now? It's a parasitic infection caused by a protozoa. It's found in undercooked meat and feces. And among other things, it can cause "crazy cat lady syndrome." That is to say that in addition to causing issues with the body, particularly in those with weakened immune systems, it also manifests in brain changes. It can cause mental illness. It's contagious.

And don't forget social contagion. This is very controversial indeed and flies in the face of our efforts to normalize mental illness so that sufferers are treated with respect and not ostracized. I agree with this in principal, however in practice mental illness can travel through social channels, somewhat directly, but also through shared experience (like the impact of poverty or a violent neighborhood). So as I warned my friend, be careful. You don't want to start avoiding a friend just because they're going through a rough time, but you may not want to live with them either.

Other Causes
So we don't know what causes mental illness, except for the research like:

The brain/gut connection. There's increasing evidence that our gut flora has huge impact, not only on our physical health, but on our mental health.

"I simply cannot overstate the importance of your food choices when it comes to your mental health. In a very real sense, you have TWO brains—one in your head, and one in your gut—both of which are created from the same tissue during fetal development.

"These two systems are connected via the vagus nerve, the tenth cranial nerve that runs from your brain stem down to your abdomen. It is now well established that the vagus nerve is the primary route your gut bacteria use to transmit information to your brain."

So yeah, back to food again. You knew we'd get here eventually, right? Too much crap in your diet can make you depressed or anxious, as well as sick and diabetic.

Chemical exposure. Metal poisoning, pesticides, solvents. All are known to cause the symptoms of mental illness. But usually the discussion is around major or long-term exposure. But there seems to be less research into cumulative and cross-exposure. Take a look at the fact sheet I've linked. It's fascinating on several levels and particularly because many of the substances that can cause mental illness symptoms are completely legal. Of course exposure may not cause mental illness, but if the symptoms are mistaken for one, and you end up with a prescription, you can cause an issue where there wasn't one.

The Limits of Normal
We live in a society that's increasingly tolerant of different ways of living. Progress is slow, but people are more able than ever to express non-traditional sexual orientation or gender, practice alternative religions, or live a lifestyle that's different from traditional norms. This is excellent. But I worry that at the same time we tolerate different ways of being, we are less tolerant of different ways of feeling. We increasingly limit normal to a small range of allowable emotional perspectives and call anything outside those limits mental illness.

Cutting your own bangs is a clear sign of mental illness.
Friends don't let friends cut bangs.

For example, in the 70s and before, certain kids were considered rambunctious, energetic, or wild. Others kids were shy, sensitive, or artistic. Adults could be hot tempered, or passionate, or quiet or sad. People could be phlegmatic, or bilious, or melancholy by temperament. Sure, if someone's behavior was extreme because of those emotions, that would be a problem. If they beat their kids or drank themselves half to death or couldn't get out of bed, they needed help. But if they were just more quiet/sad/anxious/giddy/cranky than others... well, that was just who they are.

Today our society pathologizes strong emotions and treats increasingly treats those "disorders" as mental illness. And the drugs used for mental illness actually cause mental illness... so it's a vicious circle.

It's like you can be gay, but you can't be unhappy. You can be a single mom, but not worried. You can be a bi-racial family, but not angry.

The Budding Little Psychonaut (aka the kid) is a fan of dystopian fiction (which is hot in YA right now, so there's a lot of good reading). We often discuss the difference between Orwellian and Huxleyan dystopias. It's pretty clear to me that we are living in an increasingly Brave New World here in the west (though there are plenty of places who are Oceania all the way). And medication of the population in order to control them is a central feature of the Huxleyan dystopia.

Think of how dangerous this trend is. It's mentally ill to be too sad, too worried, too angry... and yet look around... The only way to keep from being sad, worried, and angry at what's going on is to a) ignore it and go back to watching America's Got Talent before you end up on Prozac or b) end run into the weird world of the spirit. Which is also pathologized, but we know to keep our magical proclivities to ourselves.

The Opportunity Cost of Medication
There really are people who are suffering. Nothing else I've said here changes that fact. The fact that we over-diagnose doesn't change the fact that there are also higher rates of accurate diagnosis. The Mayo Clinic (who's going to take the most conservative and non-controversial, allopathic, view) says that one in four adults suffer from a mental illness. As the old joke goes, look at the three people closest to you. If they look normal, well...  But the Mayo website also lists the following risk factors for mental illness:
  • Having a biological (blood) relative, such as a parent or sibling, with a mental illness
  • Experiences in the womb — for example, having a mother who was exposed to viruses, toxins, drugs or alcohol during pregnancy
  • Stressful life situations, such as financial problems, a loved one's death or a divorce
  • A chronic medical condition, such as cancer
  • Brain damage as a result of a serious injury (traumatic brain injury), such as a violent blow to the head
  • Traumatic experiences, such as military combat or being assaulted
  • Use of illegal drugs
  • Being abused or neglected as a child
  • Having few friends or few healthy relationships
  • A previous mental illness
Of that list, only the first and the last are not environmental in some way. I'm not saying that a person chooses all those things, but that they are caused by the person's environment. If our society focused on reducing poverty (which also reduces violence and child and drug abuse while improving the health of pregnant women), eliminating war, fostering community, and supporting people who have experienced the bad but inevitable losses, accidents, and trauma that life will throw at us... well, there'd be a lot less mental illness, which means that even the first and last items would be less of an issue.

Begin poor can drive you crazy apparently
Yeah, I'm a dreamer. But the point is that when we approach mental illness first a diagnosis to be medicated, instead of a problem to be treated, we lose an opportunity. When we hand out a pill before anything else, we're ignore the rest of the causes listed above as well as the others, like diet and chemical exposure, that we've talked about here. By continuing to perpetuate the myth of chemical imbalance to cover scientific ignorance, we squelch inquiry that could help us identify other causes and treatments.

Speculative Territory
The world has changed more in the last century than the millennium before. The rate of change has increased so rapidly that you have to wonder at the human ability to adapt to it. 

Well, maybe we haven't. Maybe we'd do better in a slower, calmer, less over-stimulating environment. Maybe the stress and anxiety that plague us and depress us is something we brought on ourselves through our advancement. I'm not about to go live in a monastery, but I do have to wonder.

Practical Advice
I'm not going to give people advice on the care and feeding of their own brains. That's dangerous territory right there. However, here are a few things that are helpful to consider:
  • Stop eating shit
  • Change the elements of your environment that you can change
  • Watch out for social contagion; make sure you have level-headed friends
  • Give yourself permission to feel unpleasant emotions and check with trusted friends to make sure you're still healthy about it
  • Shop for a treatment provider the way you shop for a mechanic or used car salesman... cautiously and with liberal use of checks and second opinions
  • Start with therapists, who can't prescribe medication
  • Don't get an Rx from a doctor who hasn't given you a full once-over or who doesn't know your baseline emotional state
  • Keep your kid from getting labeled and try everything else before you give them pills
Most of all you have to find a way to look at the world that has a greater balance of joy, wonder, and awe. If you can do that, and it's not easy, you will be protecting yourself against the larger forces of fear, anger, sadness, and worry. They'll still be there, but you'll have an alternative to turn to.

Hang in there and keep your wits about you.

Comments

  1. Well-said.

    About once a month, my internet service provider calls me to ask me to sign up for better cable service. They're never polite about it, never take my no for a permanent answer. I've gotten rude about it: the last time one of them called, I said, "please skip to the end of your pitch, and ask the question: do I want to upgrade my cable service? No. I haven't owned a television since 1992, and I don't intend to start now. Goodbye." And then I hang up. But I realized that owning a television was a vector for mental illness; and increasingly I'm wondering if the Internet is a similar vector.

    But yes, you've identified the major culprits: diet, chemical poisoning, and the social vector. Living with someone crazy is almost as bad as being crazy yourself. On point here!

    ReplyDelete
    Replies
    1. We only have very basic cable, though we do stream movies, documentaries, etc. Because we have cable internet, the basic cable only costs us a dollar or so a month (because of a discount for having multiple services). So we have a couple of oldies stations (old movies are fun) and the local affiliates (useful for morning traffic) and several stations that we still don't watch (Spanish language, shopping network, etc.)

      Still, even with that very limited palette, I'm constantly surprised at the sheer amount of crap on.

      I think that certain kinds of TV and Internet are definitely vectors. But others not so much. For example, my parents watch a constant stream of police procedurals, at ear shattering volume. And they seem completely oblivious to the quality of the shows as well. So every night their house is bombarded with a constant stream of dead bodies, all killed in increasingly creative ways. That can't be healthy!

      Ditto with Fox News, click-bate sites, and comment wars.

      Delete
  2. Yep; you're on it.

    Let go of the hot rock that is burning the shit out of your hand. Your hand will not heal while ever you continue to grasp that $#@!&^* rock!!

    Great analysis of out western societal hot rocks! ( What constantly surprises me is how similar our situation is to China around 600BC, leading to the Tao Te Ching. Very applicable remedies for burnt hands in Esoteric Taoism.)

    Now, where are those bastards that said I couldn't be in the club unless I picked a rock up......?

    ReplyDelete
    Replies
    1. What's really troubling is how hard the medical establishment makes it to drop the rock. Once you have a diagnosis, it's very challenging. This is why I recommend that we put down as many of those hot rocks as possible NOW, before things get bad.

      Delete
    2. Mmmm.
      I have watched,( in disbelief and horror, and not very passively) 2 fathers in the last four years be handed a diagnosis, become very scared, and follow recommendations out of fear.
      Both tapped out at 14 months. They we talked out of their lives, as much as they were medicated out of them.
      As a result, anything in "The System" is questioned by me now, and questioned hard.
      Some rocks I drop, some I throw back through the window! :)

      Delete
    3. You have exactly the right attitude here -- drop the rock, throw it, smash it. Because as you've seen the diagnosis and fear make it so much harder to let go. I too have increasing suspicion of 'the system' as well, though I also think there are rewards to working within it. More on this in an upcoming post.

      Delete

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