Article The drug-based approach to mental illness has failed. What are alternatives?

[Magical Realist]

Who said anything about deception? That would imply a conspiracy

Science about mental illness is based on actual replicated and peer-reviewed studies and patient reported experiences. Over the past century it has learned much about the types of mental illness and their natures and effective treatments. If there were some profit-motivated effort across the board to distort that information, it would have be done deliberately and as a conspiracy. There would have to be a coordinated and agreed upon project of consistently lying about and misreporting results of studies all over the world that is simply too ludicrous to believe in. The problem with such conspiracies is they can never be disproven. That's why they are so convincing to those who have a political agenda they are trying to advance. No disproof equals proof for them. And fortunately we have a large reliable body of scientific evidence to refute such conspiracy claims. That and firsthand experiences with medications now available by the thousands on every medication's "patient reviews" site.

[Syne]

Apparently someone is in the dark about the replication crisis and shenanigans with peer-review in tons of journals.
Again, like your previous straw man of "deception," no one said anything about intentional distortion either. You just keep making up bullshit so you can argue with yourself.
Scientisst put their finger on the scales in myriads of ways to arrive at their assumed conclusions, to make the statistically insignificant significant, etc. All to forward their individual careers. Zero coordination required.

No intentional lying necessary. Just the natural human confirmation bias without enough rigor to keep it in check.
Yes, of course patients are going to report improvement. Between the placebo effect and the lack of education on any alternative, what else do they have to hang their hopes on? These people are desperate.

[Magical Realist]

Scientists put their finger on the scales in myriads of ways to arrive at their assumed conclusions, to make the statistically insignificant significant, etc. All to forward their individual careers. Zero coordination required.

To come up with the same fake results with every replicated study with every medication would require some sort of deliberate coordination between scientists all over the world to make the data look the same. In this case your unfounded claim that saying psych meds are effective in treating mental illness is a lie. Imagine all those scientists putting their fingers on the scales over and over in just the right amount to produce what looks like valid and replicated studies. That's clearly a conspiracy of fantastic proportions. And like I said that defies all credulity. Scientists and doctors are not all some devious group of money grubbers just out to make a buck. Here's an example of the history of one of the most effective psych meds of all time and how it remains effective to this day:

"The modern discovery of lithium as a treatment for bipolar disorder was made in 1948 by John Cade, an Australian psychiatrist who selected lithium because it would neutralize uric acid, which he believed at the time to be the cause of mania. As it turned out, bipolar disorder has nothing to do with uric acid, but lithium worked magically to calm manic patients. As such, it became the first specific drug to target a particular psychiatric disorder. More than seventy years after its discovery, lithium remains the most effective medication in all of psychiatry, with a response rate of more than 70% for patients with bipolar disorder. It also has useful applications in the treatment of unipolar depressions.

After its original discovery in Australia, lithium carbonate was brought to America by the psychiatrist Ronald Fieve, who was influential in opening the first lithium clinic in the U.S. at Columbia University in the early 1960s. Despite lithium's well-established efficacy, there is broad agreement that the drug is now underprescribed in favor of the newer, more profitable mood stabilizers and antipsychotics.

Nonetheless, lithium's discovery as an effective treatment for bipolar disorder ushered in the psychopharmacological revolution in psychiatry. For the first time in history, something could be done to treat serious mental disease."---- https://www.psychologytoday.com/us/blog/...s-all-time

[Syne]

Of course, you completely ignore the replication crisis. You have to. It could cause you to doubt your only hope.
Makes me wonder how much pharmaceuticals could come to supplant faith. One's only hope and one's salvation.

[Magical Realist]

I don't selectively disbelieve what decades of scientific studies have proven just to suit my personal beliefs if that's what you mean. So yeah...I accept the science on this as well as what my own firsthand experience has been as well as what many others have experienced with meds.

[Yazata]

The drug-based approach to mental illness has Failed. What are alternatives?

I wouldn't say that it's "failed". I'd rather say that it's still far less effective than we would like.

Whitaker presents evidence that bio-psychiatry, which views mental illness as biochemical disorders best treated with medications, has failed.

If Whitaker (whoever he is) thinks that mental illness (at least the major psychoses) aren't neurophysiological disorders, then what alternative 'paradigm' does he offer up? Demon possession?

I'm more inclined to agree that at the low end, the pop-psychologization of mood, especially among females, is more sociological than real. Today, anyone who is unhappy, anxious, dissatisfied or shy is encouraged to seek psychological care, where in past generations they were just expected to get on with life. Today more than 50% of young left-leaning females say that they have had a professional psychological diagnosis, which I'm inclined to attribute to today's hugely self-indulgent culture more than anything. Any deviation from unrealistic life expections becomes a disorder to be treated.

But even if we acknowledge that perhaps the majority of psychological diagnoses are bullshit, the fact remains that more severe psychiatric disorders like bipolar disorder and schizophrenia are very real. So is severe clinical depression. And I'm very much inclined to attribute these more severe difficulties to neurophysiological causes.

The problem is that neuroscience isn't advanced enough to specify with any detail or confidence what those neurophysiological causes are. The brain is still something of a black box, inputs go in, something happens with lots of neurons and stuff (insert hand waving here) and then outputs come out.

Which leaves the practice of psychiatry in pretty much the same situation that physicians were in before physiology was understood, when sick individuals were bled in an attempt to adjust their 'humors'.

And that leaves psychiatry pretty much in the position of just trying to suppress symptoms rather than actually treating whatever the underlying neurophysiological causes of the symptoms might be.

I don't think that justifies the assertion that drug-based interventions have "failed", if they are the best thing that we currently have. Antipsychotic meds, for all their poor efficacy and sometimes devastating side effects, are still better at keeping schizophrenics from going off the rails than any amount of Bible study or Freudian talking cures. Unfortunately, those medications are still pretty much useless at helping the schizophrenic stop being schizophrenic.

[Secular Sanity]

Maybe an alternative is brain stimulation.

https://www.youtube-nocookie.com/embed/e0YsLIIrgVw

[Syne]

The drug-based approach to mental illness has Failed. What are alternatives?

I wouldn't say that it's "failed". I'd rather say that it's still far less effective than we would like.

Whitaker presents evidence that bio-psychiatry, which views mental illness as biochemical disorders best treated with medications, has failed.

If Whitaker (whoever he is) thinks that mental illness (at least the major psychoses) aren't neurophysiological disorders, then what alternative 'paradigm' does he offer up? Demon possession?

Trauma, damage, genetics, disease. Notice it says "biochemical," which are the purported targets of many psych drugs, not neurophysiological.
Quite the straw man to erect that ad absurdum upon.

...
But even if we acknowledge that perhaps the majority of psychological diagnoses are bullshit, the fact remains that more severe psychiatric disorders like bipolar disorder and schizophrenia are very real. So is severe clinical depression. And I'm very much inclined to attribute these more severe difficulties to neurophysiological causes.

I don't think anything in that article refutes that severe mental illness is real. Again, there's a difference between a supposed "chemical imbalance" in the brain and neurophysiological problems in general.

[Magical Realist]

Trauma, damage, genetics, disease. Notice it says "biochemical," which are the purported targets of many psych drugs, not neurophysiological.

The brain is a biochemical machine. That's how it operates. How does mental illness encoded in our genes NOT express itself biochemically in the brain somehow? That's how DNA works, by determining how a brain is structured and functions. Everything about you is based on the biochemical processes of the brain. Why wouldn't mental illness be too? Since the 1940's lithium has been proven to be a very effective treatment for 70% of bipolar patients. How is that not proof that mental illness is biochemical in nature?

[Secular Sanity]

MR is right. Neurobiology includes neurophysiology. Neurophysiology is just a more specific branch of neurobiology that focuses on the activity and function of the nervous system.