Drug Therapy: Does The Easiest Mean The Best?

From a conversation with a psychiatrist one typically gets the impression that the medications are the most powerful tool for treating mental disorders. Yes, you can try therapy, or lifestyle modifications, but if you are dealing with anything serious, the drug treatment is the only thing that has the real power to help.

At least partly, this conviction is based on the practical difficulty to use alternative treatments. For example, good psychotherapy exists but is hard to find and expensive; life style is possible to modify, but it requires significant time and energy invested into patient education and follow-up. Some patients cannot use these treatments even if they want to, because their mental disturbances result in the inability to understand and follow complex directions. The lifestyle modifications may be unattainable for economic or social reasons: someone whose entire family of nine lives in a one-bedroom apartment might want to modify his lifestyle, but be unable to do so.

A pill is certainly the easiest means of treatment, whether or not the most helpful. It can be used in any circumstances and by people of any economic, educational or social background. It is therefore true that medication therapy may be usable in cases when other types of treatment may not; however, any further implications about efficacy are much harder to prove.

Psychiatry Critique and Antipsychiatry

I would like to make myself clear: I am not an antipsychiatrist.

The easiest way to change your point of view is by changing its sign to create the opposite. In this manner, religion is converted into atheism, love into hatred, promiscuity into puritanism, and psychiatry into antipsychiatry. Although the result is as far from the origin as possible, the similarity between the two points of view is still apparent.

An atheist spends as much time and effort as a preacher thinking about God, only trying to prove His non-existence instead of existence. An antipsychiatrist still limits his thinking to the arguments of psychiatry, only trying to prove them wrong. And all of these people remain rigidly faithful to their points of view.

I don't know if psychiatry - in general - is good or bad. I think that psychiatry could be used to help people. I think it could be one of the most humane and rewarding professions. This is why I had become a psychiatrist (I wouldn't like to practice in the United States today, but that's another story). I am fascinated by the works of Jung, Assagioli, Laing and others who took the art of psychiatry one step further, from simply "fixing" people to fit the social average, to helping them achieve self-realization and spiritual growth.

This said, I can't help noticing that today psychiatry in America is practiced in a very strange fashion. It is no longer art, but science. It is not uncommon to meet a psychiatrist who knows a lot about biology and chemistry but has no idea how to talk to people. (You wouldn't go to a concert where the musicians know all about the physics of sound and theory of composition, but cannot actually play, would you? What if they had shown you their certificates?)

People are being lied to or confused on every step of the way. Every first-time patient that I saw at the hospital was convinced that since he had signed in voluntarily, he may leave at any moment - which was of course not the case. People are distracted from solving their real-life problems by the unnecessary talks of genetics and chemical imbalance. People are told that the prognosis of schizophrenia is better with drug treatment, but it is not proven. People are told that what matters is the symptoms, and not the cause of their depression, but it is ridiculous. They are told that modern drugs are safer than the older ones, but it is a lie. They are told that the drugs are scientifically proven to work, but it is a mystification.

At the same time, most of the doctors are very nice people, and they really believe that what they do is good. I don't know how that happens, but I see that for some reason many professionals have adopted rather simplistic and superficial views of human nature, reducing it to mere behavior, and refusing to understand its depths. I have seen psychiatrists making a diagnosis of schizophrenia and prescribing a drug to the patients complaining of hearing voices, without even so much as asking what those voices were saying. They are simply not interested - and with good reason: the drug that they prescribe will still be the same.

I am not even going to mention here the enormous financial pressures that psychiatry now has to endure. It is a subject for a long discussion.

To sum it all up: psychiatry in general is not good or bad per se, but at this point of its development in America it seems to be hurting more people than it helps, while proclaiming the opposite. Thus, although psychiatry may be helpful to some people, in dealing with it a healthy degree of skepticism and common sense needs to be maintained.