Are you Depressed? Seek Psychiatric Help at Your own Risk

Robin Williams was undergoing Psychiatric treatment for a long time. Pic: Reuters

Robin Williams was undergoing   Psychiatric treatment when he   committing suicide. Pic: Reuters

 

(An edited version of this piece was published  in Mumbai Mirror, Aug 2014)

I was somewhat relieved. My partner was diagnosed with Borderline Personality Disorder (BPD) – a serious mental illness they said. And, like anyone caught in a messy relationship, I thought, so after all, it wasn’t my fault. She was the crazy one.

Perhaps she was relieved too. Now her constant irritability, the outbursts of anger, the lethargy, could all be put down to the disorder. Plus if she flew off the handle, I would have to understand and suck it up.

She had begun by asking, Buddha-like, “What is the point of living?” It was a philosophical query, which could have been resolved  philosophically. After all, all the mystics went though intense mental anguish before arriving at bliss. But  we did what is becoming increasingly fashionable these days: we went to the shrinks.

And voila, their quick diagnosis would put even Nirmal Baba to shame. They declared, within 15 minutes flat, that she had a chemical imbalance in her brain that  needed fixing. Just like that. Without any scans, bio-chemical tests and other medical rigmarole.

My partner had begun by asking existential questions but after our rendezvous with shrinks, the very symptoms their pills and therapy were supposed to defeat, came alive. There was anger, there was abuse and there was paranoia. And to ‘cure’ it all we had to meet the experts. It was a vicious circle.

In the end (after 5 years in purgatory) I realized, with the luxury of retrospect of course, that there was nothing wrong with her as there is probably nothing wrong with millions of women (and men) diagnosed with this ‘disorder’ or many other mental illnesses listed by psychiatrists. They all are, “a victim of society’s low tolerance for deviant behavior,” as Susanna Kaysen writes in her book Girl Interrupted– which documents her 18-month stay at a mental institution after being diagnosed with BPD.

nirmal baba ji

Psychiatric diagnosis of ‘mental illnesses’ is as scientific as Nirmal Baba’s.

There is no denying that psychotropic drugs alleviate the emotional distress of the people who take them. But that’s no surprise. The drugs are powerful and they artificially release the ‘happy hormone’ – serotonin into the brain. (Which can just as naturally be secreted by a jog in the park or a session in the gym).  And the relief people get, makes them come back again and again for the  ‘fix’. Sigmund Freud had at one time even endorsed cocaine for its mood uplifting properties. Morphine and opium have been used for centuries, to numb emotional and physical pain.

But the drugs come with a long list of side effects including impacting liver, disrupting sleep patterns, causing sexual dysfunction and worse. (The side effects are not very well known as pharmaceutical companies themselves fund mental illness research). There are devastating relapses often leading people to take the extreme step.

In all the recent implorings in the media to seek help for depression, the fact that Robin Williams had been under psychiatric care for a long time, has been completely forgotten. His family physician Dr Gary Kohls, has thankfully come out and said that an inquest is needed to access how the cocktail of psychiatric medications given to Williams affected his brain.

A Sophisticated form of Quackery?

Unfortunately, it takes many years and sometimes decades for one to realize that psychiatry is but a sophisticated form of quackery,  preying much like many Indian Gurus, on one’s insecurity and vulnerability.  That,  it’s nothing but the latter-day Inquisition where behavior, which is somewhat, out of the ordinary,  is demonized. The disorders are decided not on the basis of scientific analysis but on what’s unacceptable in society.

Thankfully, eminent psychiatrists, like Thomas Szasaz, who wrote “The Myth of Mental Illness” and “The Manufacture of Madness”, have come out strongly to call psychiatry’s bluff. Szasaz asserts that there are no real mental illnesses and that psychiatry is more akin to  astrology than science.

114491961_szasz_344577c copy

Psychiatrist Thomas Szasz,  author of “The Myth of Mental Illness”.

Psychiatry’s holy book, the DSM (Diagnostic and Statistical Manual), which psychiatrics around the world swear by, enlists more than 300 mental illnesses. You name a human behavior and there is a disorder and a pill for it. Do you have difficulty sleeping after drinking coffee? You suffer from “Caffeine-Induced Sleep Disorder’. Are you skeptical of authority?  You suffer from the dreaded ‘Oppositional Defiant Disorder’. Do you disagree with the diagnosis some charlatan hands you? You suffer from Non-compliance with Treatment Disorder.

They throw the net wide. In DSM III, they even had a disorder for babies who cried too loudly. Till DSM II, homosexuality was a mental illness requiring pharmaceutical treatment. It was removed when the ecclesiastical reasons for which it was put in were outweighed by the political.

Back in the days of slavery that had a disorder called drapetomania. A ‘mental illness’ which made slaves flee captivity as described by the American physician Samuel A. Cartwright.

And if you wondered wistfully, if they have any disorder to rein in recalcitrant women, you would be pleased. BPD, the ‘disorder’ my partner was diagnosed with, is the one.

A quick look at few symptoms of a Borderline will tell you why its not a coincidence that more than 80 percent people diagnosed with it  are women.

Moral judgments that would do the Old Testament and Manu Smriti proud are used to identify the wild ones of the female species.

The Borderlines are too impulsive they say. What they actually mean is that they are just too forward with the opposite sex and that they are promiscuous. In other words – the girls behave too much like boys. And of course that can’t be tolerated.

 (sanjay austa austa)

Not too long ago, Homosexuality was a ‘Mental Illness”, requiring treatment, according to psychiatry.

 

Women, unfortunately, have always been defined by their relationships. So if your relationships have been less than wonderful,  you are that much closer to being branded a Borderline.  My partner was judged by her relationships with her exes and me.  Not by who she actually was.

The clergy had recommended physical isolation of  ‘unclean’ women during their monthly cycle. The shrinks go a step forward. They prefer keeping them on a short leash. Mood swings trigged by biological factors are not ‘normal’ anymore. They need to be tempered with pills.

But while the anti-psychiatry movement is very vocal in denouncing psychiatry they have left the question about the plight of the depressed, hanging in the air.

Depression is a sign of intelligence not disorder

If one cared to look, the  answers have always been in the East. But Carl Gustav Jung downwards, western psychologists have always displayed ambivalence towards eastern mysticism. (Jung, after his India visit,  trashed  eastern mysticism but later  admitted he was  fascinated by it. His belated  enchantment  with Ramana Maharishi showed this amply enough)

In the East, people with mental distress were considered  seekers, not mental patients. Had the psychotropic drugs been available during Buddha’s time, he would have been just another mediocre Hindu king we would have never heard of. Depression was then seen as a sign of intelligence not illness.

In an insane world, it is natural for the intelligent to be depressed.  Depression is our unconscious rebellion against the settled notions of life. And a questioning of all the social constructs- love, marriage, relationships, ambition, etc. Psychiatry, on the other hand- like the clergy before it- is intolerant of diversity in behavior,  seeking forever to homogenize it.  It aims at making you socially acceptable and fitting you in.

Meditation is a holistic approach devised in the East to silence the chatter in the mind and bring awareness. Interestingly, in a typical sleight of hand, the West has appropriated meditation as its own. It goes by the name of Dialectical Behavior Therapy (DPT). To admit that they are falling back on meditation would be to discount western psychiatry completely. But DPT- which is nothing but smartly re-packaged meditation- and  popularized by American psychologist Marsha Linehan, is now one of the prescribed treatments for depression, including BPD. Ironically, in  India,  the  land of Buddha and Bodhidharma,  the educated elite today flock to see the shrinks. Meditation is  considered  too ‘desi’  to warrant attention.

Dinanath Batra and the Hindu right would do well to push this legacy of ours forward,  rather than make ridiculous claims that India  had aeroplanes, cars and stem cell research in the Vedic times.

 (sanjay austa austa)

Meditation was a holistic approach in the East,  practiced to  understand existential issues.

 

 

 (sanjay austa austa)

If Buddha was living today, the shrinks would have put him on therapy and  a heavy doze of pills to treat  him of his ‘depression’.

 

 

 

29 Responses to “Are you Depressed? Seek Psychiatric Help at Your own Risk”

  1. SM says:

    Thank you Sanjay.

  2. sweta says:

    Can the psychiatrists reply? It is shocking to lose faith in a discipline.

  3. Vivek Mohan says:

    In the 2nd last page of the same MM reverse and the Quote Uncode says – There are sadistic scientists who hurry to hunt down errors instead of establishing the truth !

  4. Parul Khandelwal says:

    Thought provoking.

  5. Lisa Beth Aronson says:

    caretaking of people in pain is the province of psychiatry, psychology and clinical social work-as well as religion as you point out…there are very caring and capable people in these fields…one must look for them…

    • sanjay austa says:

      Lisa Meditation is not the same as religion. There is a myth about the capabilities of these professions you mention. They provide a feel-good factor with pills and therapy but they do more harm than good in the long run. Both physically and mentally. People forget that Robin Williams had been under intense psychiatric care before he took his life.

  6. Sunil Umarao says:

    In India very few are trainned in best tradition of psychiatry…..for most it is pop psychology n medicines to koool nerves !

  7. Aarti says:

    My experience with one of the best known names in Delhi was harrowing. I was consulting him for my mom and his smugness made me lose my mom sooner than I should have.

  8. Sunil Umarao says:

    Sanjay, well written as you personal experience with the rut of so called psychiatrist ….in america the ‘sittings with ur psychiatrist is a norm’ …..no wonder Yung broke away from Freud thought…..Indian theories of personality have been not been given serious thought in psychology n treatment…..no wonder what is available is only career (life)conuselling n kooling the nerve kind of treatment !

  9. Mukta Naik says:

    Well put Sanjay Austa. I tend to agree though a good shrink will ensure you don’t get dependent on drugs (also prescribe them with caution) but only use them as a temporary crutch to move ahead and fight your own demons. Not all psychiatric conditions are bunkum. I grew up with a schizophrenic aunt and blogged about that recently. Having said that, I feel like the seeming explosion of mental disorders around us is also about chaotic and rapid social changes, increasing loneliness amid a hyper connected world and a growing inability to reach out to fellow humans for help.

  10. Priti says:

    Sanjay thanks for sharing. Mostly people don’t share because of stigma attached to the subject… my first hand experience in this area says.. most of the people do not require any medication. Most can do with life style changes, support, environmental changes and some conscious thoughts. But people do need someone to guide them at those moments. Unfortunately such people are not available easily.. Such care givers need to have in depth understanding of a person.. before they land up diagnosing anything. Even a little deviance from normal is attributed to a disorder.

  11. Shalini Singh says:

    Good piece. Will share with some friends.

  12. Rinea Dourado says:

    I feel like your post is biased and misinformed… As Lisa Beth Aronson points out there are totally capable and caring people in the field of psychiatry, psychology and mental health social work.
    Posts like this can be misleading and detrimental to the field of mental health awareness and support.

    • sanjay austa says:

      Rinea of course it’s biased. Its my personal experience.As for caring people in the field of psychiatry they may well be. Only what they use for healing is unscientific and very random. These are not my conclusions alone. Important psychiatrists have come out and called psychiatry a scam. And that it not only stigmatises people but also causes great harm. If you read my article you will know what I’m referring to .

      • Hi Sanjay, I read your article with interest. Sadly its a misrepresentation. Firstly there are many psychiatric illnesses/ conditions that are actual disorders with estblished science behind it eg. Autism. As an Orthodontist and a dentist I need to have a complete med history of all my patients and I see some patients who suffer from psychiatic disorders. They actually behave and act differently to others. I have also noticed their response to therapy and medication at first hand. Secondly when you quote ’eminent psychiatrists’ debunking Psychiary as a myth, let me say that in all professions you will find its detractors… they may have the gift of the gab and they may throw catchy phrases but it may not be the truth at all. I think your opinion is coloured by your experience but one case report as I would call it can not be used to draw such conclusions especially of such a complex science as Psychiatry.

        • sanjay austa says:

          Ashish.. I think Autism is a neurological disorder. It has nothing to do with so called- ‘mental-illness’. You are confusing the two.
          As for the psychiatrists debunking psychiatry.. beyond saying ‘its not all that bad’ etc no one has been able to challenge them at all. In fact, all psychiatrists agree in private.
          No psychiatrist can prove you have a mental-disorder. Or that psychiatry is a science. There is no test to prove the ‘chemical -imbalance’ theory. My opinion is definitely colored by my experience. Perhaps thats why it should be taken a bit more seriously as its an experience and not a theory. But what is worrying is that as doctors in UK, you are expected to take into consideration the unscientific psychiatric diagnoses of your patients before you treat them.

          • Hi Sanjay, apologies but my use of Autism as an example was deliberate as most lay people consider Psychiatry to deal only with manic- depressive disrders. Autism and conditions like Asperger’s syndrome are diagnosed and managed by Psychiatrists. Recently (in 2011) NICE, which is a body of specialist doctors and who make policies for medical practice published comprehensive evidence based guidelines on Autism. They were produced by Psychiatrists from the the Royal College of Psychiatry.

          • Secondly Sanjay, as far as our practice is concerned, sometimes we liase with Psychiatrists for our patients and their scientific intervention helps. For example there is a condition called Atypical Facial Pain which has no known organic cause. The pain is intense and changes character and patients actually feel the pain and it makes their life miserable. After excluding all reasons for pain, we prescribe a short course of antidepressants (mostly Amitriptyline) and after some time the pain disappears. You have to see this to know how it improves some patients’ lives.

          • sanjay austa says:

            Ashish for anything like Autism or Asperger, I am willing to concede that Psychiatry may be useful. However I am not sure why other alternatives to anti-depressants can’t be adopted (simple things like exercise for example). Anti-depressants as I have said will definitely work as they are just too powerful. Therefore they are that much more harmful in the long run.

        • kiran says:

          Ashish, Sanjay… please read the research in this book on the history of Autism, Aspergers etc. It is best to not generalise in any matter as less understood as the human mind and its diversity. All sorts of agendas have driven the field of psychiatry and making humans fit into narrowly defined boxes is certainly one of these. Look at the history of Autism , Aspergers- the whole thing is such a tragic tragic tale. Of opportunistic powerful people pushing personal ambitions and the struggle of compassionate and caring parents to seek help for their kids and themselves. It will make your skin crawl to read some parts. There is nothing roved with empiricism in the who eof this field until very very recent times with advances in neuroscience. Or a very few instances of blood testing or other such readings.
          http://www.amazon.in/NeuroTribes-Legacy-Autism-Future-Neurodiversity/dp/158333467X

  13. Cynthia Broze says:

    No, it’s not a hard science and too many diagnoses might have been developed for convenience or other reasons. But some mental illness are undeniable and quite serious, such as schizophrenia. I have both professional and personal experience with it. No joking on how that destroys a life…whatever it is.

  14. Neeraj Sinha says:

    thanks for raising an important issue… http://www.madinamerica.com/…/psychiatry-based-valid…/

    Psychiatry Is Not Based On Valid Science – Mad In America
    http://www.madinamerica.com

  15. Jelenko says:

    Well, I would agree with you to some extent. But, in my experience, we cannot neglect the physiological aspect of depression. What about long term abuse in the childhood, permanent stress in daily life, living in conditions in which you fear for your life (like war), etc? All of them could change our hormonal balance for good and lead us to depression. Even some diseases could cause depression… We would not say to diabetic:”Take a break, move on, it’s only your imagination!”, because now we know the origin of that disease. I have experience with guru in Bhakti yoga who became depressed and could not perform his duties. My wife had a long story of “working on herself” before she asked for Psychiatric Help and, luckily, thanks to medicaments and therapy, she got better perspective. She also had tried with bhakti yoga, prayers, mantras, serving others, love to God but the problem was still out there. Now she is fine , on medications, but has strenght to move on and live. I agree that Psychiatry is still young and largely influenced by pharma industry and sometimes too focused on “easy” solutions but we cannot generalize.

    • sanjay austa says:

      Jelenko.. no one is denying the anguish that people feel. The pain is real and so is depression. I am only suggesting that maybe psychiatry is not the way to go about it. There drugs anti-depressants etc, will definitely work as they are powerful but their side effects are devastating.

  16. easwarc says:

    Agreed human brain and behavior is quite complicated to understand and treat. Some of these diseases do have poor prognosis, but quackery is a harsh term to use.

  17. Nayantara says:

    Being a student of psychology and a practicing counsellor, I’d like to disagree with you on some of the points but also agree. Obviously your thoughts stem from your own experience and it is sad to know that it has not been a good one. Psychiatrists like R.D. Laing do give a wonderful change from the norm.

    A very important part of psychiatric treatment is that it should be ‘wholistic’. You can’t just label and prescribe drugs. Therapy is very important and the most important is a community which not only helps the ‘patient’ but also the caregiver. Dealing with a ‘mental disorder’ is an exhaustive process and the whole family needs support and acceptance. The most horrid feeling a client might feel is that they are different and will be looked down upon. Prejudice in this case can be a traumatic experience.

    We need to look at a community which can render social and emotional support and give genuine acceptance to the person suffering.

    I believe a lot can change just with the knowledge that one is loved for who they are, as they are…

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