Is Psychiatry Keeping Us Sick?

What if the very system designed to heal us is actually keeping us sick? Psychiatric diagnoses shape our identities Therapy becomes a lifelong routine, and medication is often the first rather than the last resort. Are we truly getting better or just stuck in an endless cycle? In this episode, we uncover the hidden costs of modern psychiatry and what you need to know to take control of your mental health.

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Is psychiatry keeping Us Sick? The Iatrogenic Effects of Psychiatry Something is deeply wrong with the mental health system. Instead of leading to recovery, it often perpetuates cycles of dependency on therapy, medication and diagnoses. Psychiatric diagnoses, which are unreliable to begin with, have become our identities rather than tools for recovery. While more people are going to therapy than ever before, our collective mental health isn't improving. For some disorders, such as ADHD and ptsd, medication is prioritized over education or therapy that teaches people how to cope. Thus, we see medication as a cure all and don't learn tools that can help us heal. As mental health awareness and interventions become increasingly common, we have to be aware of the iatrogenic effects unintended harmful consequences of psychiatric diagnosis and treatment. Normal behavior Pathologized medical professionals and unqualified individuals alike routinely medicalized normal behavior and feelings. Sadness and anxiety, once considered everyday emotions, have become problems to eradicate. As a result, many of us have succumbed to the false idea that negative emotions are bad when in reality they are healthy and useful. Just like hunger prompts us to eat, emotions are siren calls that alert us to tend to our well being and but as emotions have become pathologized, there's a growing belief that any emotional discomfort needs to be fixed. Psychiatry has a history of categorizing normal feelings and behaviors as disorders. Homosexuality was listed as a mental illness in the Diagnostic and Statistical Manual of mental disorders until 1973, and sexual orientation disturbance until 1987. Controversy remains over the addition of prolonged grief disorder to the DSM in 2022, which researchers have argued will lead to medicalization of normal grief responses and over diagnosis. As mental health awareness has increased, it's led to both more accurate diagnoses and over interpretation or over pathologizing common psychological experiences, a 2023 study showed. Psychiatric terms have crept into the way we talk about ourselves. Spurred by wellness culture Someone particular about the cleanliness or organization of their home describes themself as OCD obsessive Compulsive disorder. Another person has a few nights of poor sleep and fears they're an insomniac. People who are shy or introverted describe themselves as socially anxious, even taking it as far as avoidant personality disorder or social anxiety disorder. An overconfident person gets dubbed a narcissist. Worse, overinterpretation engenders a self fulfilling prophecy. Interpreting difficulties as a mental health problem, the study authors wrote, can lead to changes in self concept and behavior that ultimately exacerbate symptoms and distress. They warn that the more mental health awareness increases, the higher the rates of mental health problems. For example, I've heard several people say they think they have ADHD because they can't concentrate at work or they never seem to get everything done. The mental health system reinforces these beliefs by making it simple to get a diagnosis and prescription. All it takes is one trip to a psychiatrist or physician, or they can even do it on an app. Meds for anxiety are also super easy to get a hold of. This recently happened to a friend of mine. He complained to me that he just never seemed to be able to get anything done at work and that he was a procrastinator who could only work late at night when the pressure was on. He believed he had adhd. But when I asked my friend to describe his workday, he told me about being in meetings for five hours a day and sometimes all day. No wonder he couldn't get anything done. And no wonder he waited till the quieter hours of the evening to focus. Between the distraction of constant meetings, which were often ineffective and inefficient, and trying to task switch to focused work, I'm not surprised he found it difficult to concentrate. His environment, not his brain, was the problem. Still, he walked away from his doctor's appointment with a prescription in hand, yet little advice on how to cope with his diagnosis. Unfortunately, pills don't teach skills. As mental health awareness has increased, it's led to both more accurate diagnoses and over interpretation or over pathologizing common psychological experiences. Has therapy become too routine? The pathologization of normal feelings and behavior has made many of us think we need therapy even when we don't. Furthermore, there's ample evidence that many people who spend years in therapy don't get much better. Richard Friedman, professor of clinical psychiatry at Weill Cornell Medical College, wrote that psychotherapy, even for people who legitimately need it, is simply not designed for long term use. Friedman says therapy should last only until patients learn how to cope with their problems. Terminating therapy and returning to it when needed is fine, but continuous long term therapy is problematic. A 2023 meta analysis of studies on how cognitive behavioral therapy helps people with anxiety disorders suggested that long term therapy is no more effective than short term therapy. However, psychologist Julie Fraga said those results make sense as cognitive behavioral therapy teaches people to manage their symptoms rather than to address the root cause of their problems. Some people say they are quitting therapy because it causes them to dwell on their issues rather than move on from them. Perhaps that's why mental well being is decreasing even as more people are going to therapy. That's not true for cancer survival, it's not true for heart disease survival. It's not true for diabetes diagnosis or almost any other area of Medicine. Psychiatrist Dr. Thomas Insel, former director of the National Institute of Mental Health, told Time magazine. People are unsure when to end therapy and the mental health system doesn't help. Getting stuck in the mental health System the mental health system tends to medicate rather than rehabilitate, mainly because it's easier. Doctors are so burned out that they tend to prioritize easy patients or easy fixes like medication over challenging cases because they don't have enough time to give all types of patients the care they need. According to Time magazine, psychiatrist Paul Minot feels psychiatry leans on medications so it doesn't have to do the more difficult work of helping people understand and fix life circumstances, habits and behaviors that contribute to their problems. Fraga says doctors are taught to rely on medication. I supervise psychiatry residents, she says. They have virtually zero training in psychotherapy. When I finished my doctorate, I had close to 100 hours of clinical work, and my internship and postdoc resulted in 2000 more hours. Guess how many therapy cases most 3rd year psychiatric residents have seen? 3. Psychiatry leans on medications because this is what residents are trained to do. Over reliance on medication means some people never recover, even when they otherwise could. For example, experts are starting to wonder whether antidepressants prevent PTSD patients from healing. Another example people often think an ADHD diagnosis is for life, but that's not true. A third of kids diagnosed with ADHD don't have it as adults. If through behavioral therapy, people learn the coping skills to control impulses, foster positive behavior, and build executive functions like organization and time management, they can manage their ADHD to the point that they don't exhibit symptoms. Yet up to 81% of children with ADHD are on medication in some US states these medications come with side effects, while behavioral interventions like teaching kids to become indistractable do not. Are we medicating kids for their benefit, or are we doing so to make life easier for doctors, teachers and guardians? Of course, some people do suffer from severe psychiatric disorders and require special care. In those cases, overmedication is often used as a band aid for a broken mental health system. There's not enough funding for mental health and not enough beds in psychiatric hospitals to give patients the thorough long term treatment they need. Since the earliest days of deinstitutionalization, the number of psychiatric hospital beds in America has declined relentlessly, so that it is rarely possible to treat the full episode of illness in hospital. Harold Arthur Schwartz, a psychiatrist in chief emeritus at the Institute of Living Hartford Hospital, wrote in an opinion letter to the New York Times, it is not unusual to be discharged after three or four days, even when hospitalization was prompted by a suicide attempt or a psychotic episode. In a 2021 study, 87 of the 88 U.S. pediatric hospitals used their emergency rooms to regularly board children who had to wait for an average of 48 for space to free up in a psychiatric hospital. Mental health experts admit that we lean on therapies and medications that only skim the surface of a vast ocean of need. Rehabilitation is a lot harder for psychiatry to achieve. Instead, it medicates no Offboarding Plan Unlike physical health care, mental health care medication but also therapy often lacks an off boarding plan. Once a mental health patient is on medication, there's little emphasis on helping them get off. It's take antidepressants, for example. According to Professor Friedman, doctors are experts at prescribing medication but not so good at knowing when a drug has served its purpose and can be safely stopped. In 2004, the American Psychological association said that antidepressants are typically recommended for 16 to 20 weeks after depressive symptoms end. However, the guidelines further recommend that maintenance treatment be strongly considered in order to prevent relapse. Recent research from 2003 has indicated that continued antidepressant therapy for at least one year and as long as three years can significantly reduce the risk of relapse. In 2011, the APA said that the continuation phase should last four to nine months and that people who have a chronic major depressive disorder or have had three or more episodes of major depression should maintain their use of antidepressants. The United Kingdom's National Health Service says that antidepressants are typically recommended for at least six months after a depressive episode, but they may be prescribed long term if the patient is at a high risk of recurrent illness, that is has had more than one depressive episode before, which increases the likelihood of it occurring again. About 2 million people in England have been taking antidepressants for five years. In the United States, more than 60% of people on an antidepressant have taken it for two plus years, 14% have taken it for 10 years or longer. So does that mean all those people are at high risk of recurrence? Not according to one 2021 study which found that 44% of UK participants on long term antidepressants were able to stop taking the medication without relapsing. Therapy too, lacks an offboarding plan, for example. Measurement based care, the process of assessing patients progress during mental and behavioral care, has been shown to improve patient outcomes. Yet less than 20% of behavioral health practitioners use MBC. One study found that 84% of people who had recently ended their psychotherapy said they, rather than the therapist, initiated the termination 23% said the therapy continued too long. While there is widespread agreement that an ideal termination of psychotherapy occurs naturally, with an agreement of the timing between therapist and client, our research reveals that more often than not this does not happen, said study conductor David Rowe, a clinical psychologist and professor at the University of Hifis Department of Community Mental Health. Bad Actors in Healthcare the psychiatric diagnosis process is scientifically meaningless, as Dr. Kate Allsopp famously put it in a 2019 study that analyzed the DSM and found it wanting. The study notes that diagnoses mask the role of trauma, use different decision making rules, and have many symptoms in common with each other, among other issues. An iconic 1973 Stanford study demonstrated that point by having eight healthy people pretend to have hallucinations so they could be committed to a psychiatric hospital. Once admitted, they acted normally, yet all were diagnosed with severe mental disorders. In the second phase of the experiment, the study leader, psychologist David Rosenhan, told a doctor at a prestigious hospital that he would be sending a pseudo patient at some point during the next three months. Of the 193 patients the hospital saw in that time, psychiatrists labeled 23 as fake patients. But Rosenhan never sent anyone at all. After the three year study, he concluded that the psychiatric diagnostic process is unreliable. That's a dangerous weakness, and bad actors have exploited it. Acadia Healthcare, one of the largest chains of psychiatric hospitals in the United States, has been accused of hospitalizing people longer than necessary against their will, all to squeeze the highest insurance payout. It has been able to do this by falsifying psychiatric reports and exaggerating patients symptoms. This is more common than you think across the United States. Substance abuse centers, residential treatment centers for kids, and psychiatric centers, including in Colorado, Arkansas and Texas, have allegedly held people against their will for profit how to Navigate Psychiatry it is important that people who are suffering get the care they need. This post is not intended to discourage anyone from seeking help, but those who enter the mental health system need to know that it's riddled with problems. Individuals and families need to be careful that the psychiatric system is helping them get better, not keeping them sick. Here are some strategies to help people navigate the mental health system and get better rather than get stuck 1. Be an informed patient. Before accepting a diagnosis or starting a medication, take the time to research and understand it. Ask your doctor about the medication's pros and cons, potential side effects, and alternative treatments. Remember that you have the right to a second or third opinion. 2. Learn behavioral coping skills for your diagnosis. Medication is an essential part of treatment for some, but it's not the only solution. Prioritize therapies designed to help you form strong, healthy habits and skills for managing your mental illness or disorder. 3. Build a support system. It's not enough to have a doctor. Therapy is not a replacement for friendship, and friendship is not a replacement for therapy. Surround yourself with people who understand and support you, whether they're friends, family, or members of a support group. 4. Set clear recovery goals Enter treatment with a clear understanding of what recovery looks like for you. Work with your therapist or doctor to set tangible, achievable goals that signify progress and a clinical plan. This will help you track your recovery and prevent you from becoming stuck in a treatment. Ruth Therapists should invite feedback from you so they know what's working or not, and they can tailor treatment more effectively. Yet, many therapists don't do this, so be proactive about sharing your thoughts. Getting professional mental health support is critical, but we must always remember caveat empter Buyer beware.

Sam.