Nine Reasons Why Psychiatrists Believe In Drugs

It is very tempting sometimes to blame the evil psychiatrists for everything, as if they were in some kind of conspiracy against the rest of us. It is obvious, however, that such a large and diverse group of people cannot maintain any conspiracy for long. Besides, many psychiatrists I've seen are very nice people.

Of course there are financial "incentives," but they would not mean much if the doctors did not really believe that their drugs work.

I've been trying to think of the reasons why they believe it. It looks like the practice of a typical psychiatrist is organized in such a way that the more medications he prescribes, the more convinced he becomes in their helpfulness - sometimes in spite of his own logic and common sense. It is a classic self-reinforcing loop, and drug prescription almost becomes a bad habit.

Once you start prescribing drugs, you are practically doomed to continue, unless something causes you to strongly suspect that something is not right, and make a forceful effort to break out of the vicious circle. (Incidentally, this is probably the moment when the financial incentives play a major role, as the sudden exacerbations of suspiciousness in a psychiatrist are soothed by the large doses of cash.)

So far I have though of nine mechanisms of the erroneous self-reinforcement that the psychiatrists fall prey to.

1. Placebo response.
2. Lack of control group.
3. "Could be worse" logic.
4. Selective memory.
5. Selective interpretation.
6. Short-term efficacy of drugs.
7. Long-term dependence on drugs.
8. Lying to psychiatrists.
9. Attributing success to drugs instead of doctors.

I will discuss each one in more detail in the following posts.