August 4, 2013Kelly Brogan, MD ABIHM
I came through integrative medicine as a stepping-stone to holistic care. As someone who has always had an intellectual rebellious streak, I like to question, push, and think outside of the box. Alternative medicine had always been a circus curiosity for me until I sat in a lecture by Dr. Richard Brown, and learned about supplements and herbs like Rhodiola Rosea and S-adenosylmenthionine (SAMe) that could be added on to medications or used on their own to change mood and enhance wellness. I practiced in this way for a couple of years, prescribing and strategically augmenting, before understanding that true personalized, lifestyle medicine obviates the need for medication. It gets to the root. I no longer wanted to enhance psychotropics, I wanted to eliminate them.
It was around the time of this awakening that I began to read the work of a psychiatrist Peter Breggin MD, journalist Robert Whitaker, and psychologist Irving Kirsch PhD. Here are some highlights of what they taught me and how they changed my practice:
Peter Breggin MD – Dubbed the “conscience of psychiatry”, Dr. Breggin believes the use of psychotropics is not only insufficiently evidence-based, but it is dangerous. The experience of withdrawal from these medications highlights the extremity of these effects and should be assumed to represent the body’s efforts to requilibrate rather than relapse of the underlying illness. He highlights risks such as tardive dyskinesia, akathesia, and more subtle risk factors that accumulate over time that he terms: “medication spellbinding”, affective volatility, and chronic brain impairment. He promotes a compassionate model of family therapy and calls on evidence from Soteria House and the Finnish model of Open Dialogue to argue for the efficacy of non-pharmaceutical treatments for illnesses as severe as schizophrenia.
Irving Kirsch, PhD – Careful analysis of the role of the “active placebo” in available clinical trials (38 trials including 3,000 patients) on antidepressants reveals that the placebo effect is the driving force behind these agents (75% of the treatment effect). He discusses medical ghostwriting, the selective publication of positive data, suppression of negative data and the recirculation of data so as to create the impression of a greater evidence base. He explores the relationship between the FDA and pharmaceutical companies and the levels of enmeshment that preclude effective monitoring. He, also, like Breggin and Whitaker, debunks the chemical imbalance theory exposing that there is no evidence supportive of serotonin deficiency, and that, moreover, a placebo-controlled trial of reserpine – the medication that was stated to pivotally support the monoamine hypothesis of depression – didn’t make people depressed at all. And Stablon, a serotonin reuptakeenhancer is also effective as an anti-depressant. SNRIs, SSRIs, TCAs and heterocyclics all work equally well (26% according to STAR-D), once again, arguing against a cohesive mechanism underlying the disease. He states:
“The biochemical theory of depression is in a state of crisis. The data just do not fit the theory. The neurotransmitter depletion studies… show that lowering serotonin or norepinephrine levels does not make people depressed. When administered as antidepressants, drugs that increase, decrease or have no effect on serotonin all relieve depression to about the same degree. And the effect of anti-depressants, which was the basis for proposing the chemical-imbalance theory in the first place, turns out to be largely a placebo effect.”
Robert Whitaker – Mental health disability rates are higher than they have ever been, and in many ways parallel the increased prescribing of psychotropics to the masses. Medication exposure, on the other hand, does exact meaningful perturbations to bodily systems that force the accommodation to the body over time. We no longer have an understanding of the natural course of mental illness, and if we look at naturalistic and observational data, it suggests that patients who are never treated have higher functioning in society. Medication plays a significant role in transforming what would otherwise be an episodic acute illness into an unremitting, recidivistic chronic one.
What was potentially more disturbing than insights into the corrupt nature of our regulatory agency around licensing of pharmaceuticals was the fact that I had never, in a decade of training, heard a whisper – not even to refute or criticize – of studies discussed by these thinkers. I was never introduced to a culture of caution around these agents, and certainly not introduced to any alternatives, or any consideration of what might truly be driving some of these states. I hope that the cards begin to fall in psychiatry’s house because people who are suffering deserve better.
None of these experts, however, speak to why so many people are suffering – to the role of lifestyle and a toxic environment. I believe my perspective dovetails nicely with the abandonment of psychiatry as a discipline and the awakening to a whole-body wellness discipline called functional medicine.
https://www.madinamerica.com/2013/08/faith-lost/
Hours after Texas Child Protective Services removed 5-year-old Tristen from the care of his mother and placed him in a foster home, Tristen’s foster parents took him to see a psychiatrist, citing concerns the young boy was depressed. That day, a psychiatrist prescribed Tristen three medications: one for anger, one for depression and one to help the 5-year-old relax.
Now an adult and out of the foster care system, Tristen says he recognizes he was depressed that day, but he says he never needed any medication — his feelings were only natural given the circumstances.
“They just took the thing that meant the most to me,” he said. “My family.”
Passed from foster home to foster home all over the state of Texas, Tristen says no one ever asked him how the pills made him feel, despite the fact that he would often spend time in his room crying because he felt his medicines were slowly tearing his chest apart.
Doctors also never tested Tristen to see whether the drugs were working or whether the combination of medications he was on was safe. And whenever he asked his case worker or foster parents if he could stop using the drugs, they threatened to call the police, take him to a psychiatric hospital or kick him out of the foster care system.
Unfortunately, stories like Tristen’s are all too common in the U.S.
Of the more than 400,000 children in the U.S. foster care system, it’s estimated that more than 50 percent are on some sort of psychiatric drug.
Money is part of the reason. Foster parents are paid more to take care of a child with mental health issues.
On average, a foster family earns about $17 a day for taking in a child who needs a basic level of care. But a child who is taking drugs such as antidepressants, antipsychotics, mood stabilizers, anxiety medications or anticonvulsant medications is worth around $1,000 a day.
And foster parents are not responsible for paying for the medicines, either, as they are covered by Social Security.
Many child and human rights advocates are concerned about the dramatic number of children who are classified as “special needs” after entering the foster care system. One reason doctors, psychiatrists and therapists may not be speaking out against the unnecessary drugging of these children is because those who prescribe the drugs often benefit financially, receiving big payouts from pharmaceutical companies.
But for foster care alumni like Tristen, placing children on several different medications is a common practice that needs to change, especially since the “medication only makes foster parents richer” at the expense of a child.
Dr. John Breeding is a psychologist who has long spoken out against prescribing children psychiatric drugs. He calls the increased reliance on pharmaceuticals to keep kids in line “institutionalized child abuse,” and says these medicines are as damaging as hitting a child on the head with a pipe.
He says children are being used as experimental guinea pigs and “as profit points for a corrupt, cynical, evil industry,” referring to big pharmaceutical companies.
“It’s a shame and disgrace,” Breeding said.
According to Breeding, in 2011, psychiatric drugs were prescribed to 12 percent of children age 5 and under, 55 percent of children ages 6-12, and 67 percent of children ages 13-17 in the Texas foster care system. Of those children, 73 percent were taking two or more drugs, while 42 percent were taking three or more drugs.
National statistics are not available on the number of foster kids on psychiatric drugs because each state is responsible for overseeing its own foster care program. However, many speculate the numbers would be similar to those in Texas, since despite the fact that only 3 percent of the U.S. population has a medical condition that would benefit or require the use of antipsychotics, that type of drug is the top seller in the U.S.
Despite protests from medical experts like Breeding and testimony from foster care alumni, some medical professionals say there is nothing wrong with prescribing psychotropic drugs to children.
At a 2004 Texas committee hearing on psychotropic drugs and foster care children, psychiatrist Joe Burkett said he prescribed the medications to kids partly because “they are very sick” and “come from a bad gene pool.”
Breeding, who was in attendance at the hearing, said many like Burkett view mental illness as a genetic brain disease and therefore justify prescribing the pills.
Since activists such as Breeding began calling for change, some states, such as Texas, have begun to see legal changes regarding medicating children. Breeding told Mint Press News that while foster kids are the hardest-hit group of kids when it comes to use of psychiatric drugs, the number of kids on multiple drugs has declined.
Still, many foster care alumni remain concerned about kids “being drugged to the gills,” especially since most of the kids get off the medications once they age out of the system.
Aisha was in foster care for 15 years and spent a great deal of time in a home with her brother and 13 other children. Of the children in Aisha’s home, she says everyone was on medication when she arrived — except for her. But the first time she was taken to the doctor, she was prescribed 200 milligrams of Prozac to help her depression, as well as 200 milligrams of Seroquel so she could sleep at night.
“Foster parents should not be allowed to diagnose foster children,” Aisha said.
While Aisha was taking two medications, the other children in the foster home were taking at least five pills each. She said some kids took as many as 13 pills and were so accustomed to medication that they would swallow all of them at once.
“It’s absolutely tragic,” Breeding said, “We’re killing these kids. This is poison; this is not medical treatment. This is not an illness. These drugs are not medicine. They’re toxic poisons that disable and kill — physically many times, psychologically always.”
When 14-year-old Elnita was taken away from her family by Texas Child Protective Services and placed in a foster home, she was given a medication for depression that she says she did not need.
“I was a shy person,” Elnita explained, adding that she was struggling to get used to her new living environment, which was filled with several other young girls and caretakers she didn’t know. “I wasn’t ready for that.”
But like Tristen, she was forced to take the medication.
Elnita was prescribed 500 milligrams of an antidepressant and said every time she or one of the other girls in her foster care home cried or screamed out of frustration, they were put into an isolation room or given more drugs to calm down.
While in foster care, Elnita was on four different kinds of depression pills. Despite the fact that the medicines made her slow, caused her to struggle to focus at school and gave her terrible nightmares, her foster parents and her social worker denied her request to be taken off the high dosage.
While each state has its own version of Child Protective Services with its own rules and policies, the general requirements to become a foster parent are similar throughout the U.S. Foster parents are required to be at least 18 years old, be healthy physically and mentally, and live in an environment that protects and promotes the well-being of children. Single people and married couples are eligible to apply.
Elnita said the behavior of children in foster care is often “not normal because of what we’ve been through and what we’ve seen.” But all children in the foster care system are normal, she said — they just have “a little bit of extra problems.”
Elnita said that a problem with the current system is that foster parents “treat us like we’re only there for the money.”
“They don’t love us,” she said.
Judge Janson A. Kauser is a retired municipal court judge, attorney, Guardian ad Litem for abused and neglected children, and former police officer who investigated suspected child abuse and neglect cases. He agrees with Elnita that the current foster system isn’t working and told Mint Press News that he doesn’t see much value in the current program.
While Kauser recognizes many Child Protective Services agents are well-intentioned individuals, he says based on his experience, they are doing loads of work without the necessary qualifications. Most of the agents “couldn’t spell investigation much less handle” one, he said.
Elnita is out of the foster care system now and has been off her depression medications for a year. She says she feels better and has found she can fit in with other people. She realized that what she needed all along was a person to talk to.
Ciara Jackson, a foster care alumni from Colorado, agrees. She said that when she first entered the system at 13, she was diagnosed with bipolar disorder. Until she was 17, Jackson fought with her foster parents and caseworker after realizing the drugs were making her slow mentally and physically. But she says the more she refused the drugs, “the more defiant social services labeled me and the angrier I became.”
When she emancipated herself at the age of 18, Jackson says she refused her medication and discovered that she was not bipolar, but had a mood disorder.
“If you had been in my surroundings and seen the things that I witnessed, your moods would change rapidly too,” she said.
Pleading with current and future foster parents, Tristen said foster parents need to recognize that the children in the system are already dealing with a life that has been halfway destroyed. He said the best thing a foster parent can do is not medicate a child, but ask him or her how she’s doing, how he’s feeling.
“Take the time to talk to them,” he said. “It’s going to shock you.”
http://www.mintpressnews.com/america-foster-care-system-psychiatric-drugs-dep...
I took my video camera to a Foster Care Alumni meeting and asked seven foster kids to tell me about there experiences in Child Protective Services while wards of the state.
One thing they all had in common was massive over drugging with psychiatric drugs.