A few things I wish I had known at the beginning of my mental health journey (part one)
Updated: May 9, 2021
Over the past three years I've been on a journey of unlearning most of what I was taught to be true within the framework of allopathic medicine in regards to my mental health and the support available to me. This journey has felt incredibly disorienting, lonely, isolating and even scary some days, as I've started to question most of the beliefs that I inherited throughout the years. One of the hugest shifts that I've made is moving from the belief that I am broken and diseased to understanding that my body and all of its responses, coping strategies and adaptations are brilliant survival mechanisms that are always on a mission to protect me, no matter what the cost.
When, after close to two decades of accessing various forms of mainstream care, I continued to get worse, not better, I finally started looking beyond what I was being told by the allopathic practitioners that I was utilizing. I want to share some key things that I've learned that changed the scope of my healing journey in a significant way. Take what you like the leave the rest. I've come to understand everyone's journey as unique with no general 'one size fits all' approach. My intention is never to tell anyone how they should manage their health or to shame anyones personal choices. My aim is simply to share information that I have found supportive on my own path that has helped me to make informed decisions from a place of empowerment. Sending love to you on the healing path.
1) Diagnosis is subjective.
The Diagnostic and Statistical Manual (DSM) is used like a bible for modern psychiatry. It contains diagnostic criteria for mental disorders, as well as a series of codes that allow therapists to easily summarize patients symptoms for insurance purposes. Every mental health professional must refer to the DSM's codes in order to bill treatment to insurance companies.
This manual is currently in its fifth edition (DSM -V) and each time is it renewed, various diagnosis are either added or taken away due to the cultural and medical beliefs of the time. For example, until in the 1980s, homosexuality was listed in the DSM as a mental disorder until it was eventually removed because belief systems changed. As UCLA Child Psychologist Dan Siegel has put it ‘The DSM is concerned with categories, not with pain’.
Crosbie Watler, a practicing Psychiatrist from Vancouver Island addressed the ever changing nature of psychiatric diagnosis in his article 'A call for action: transforming mental health care’.
‘The image of a group of endocrinologists debating whether Type 1 diabetes should be a legitimate diagnosis is laughable, yet this is precisely how psychiatric “diagnoses” are minted. If something is objectively real, we don’t debate its existence, and what was truth does not simply become untruth with the next edition of DSM. The DSM committee meetings provide forums for so-called experts to lobby for their pet “diagnoses”, ones they feel comfortable treating and ones that will enhance their credibility and prestige'
I have received a myriad of diagnosis over the years, which continued to change depending on what the doctor of the day decided. With time, I came to see these labels as just that, labels. I took what helped and directed me towards healing and left the rest. I no longer chose to identify with these diagnosis as I realized that they were not set in stone, and, as I continued to grow, change and heal, so too would the symptoms that led me to receive them in the first place. I learned more about the nature of early trauma, the nervous system and my overall physical health in relation to much of what I was experiencing and realized that I wasn’t a victim to genes and lifelong prognosis in the ways I had been led to believe.
I would encourage anyone who has received diagnoses to look inside and ask for themselves if/how they feel this label is serving them with the understanding that it is to some degree or another, subjective. If the diagnosis resonates and there is healing and context to be found through it, wonderful. But labels don‘t make us who we are - our commitment to ourselves and our journey of self understanding does.
2) The efficacy of psychiatric medication has never actually been scientifically evidenced (The importance of Informed Consent).
Disclaimer: this one was extremely tough for me to swallow and even to believe given the decades that I was treated using only pharmacological approaches. Please know that in sharing this I am by no means intending to shame anyone who utilizes pharmacology as a tool. I have and do use it myself. My aim is to simply provide a broader lense on the topic than I was given throughout my many years of seeking medical support.
With all that being said, here goes...
The chemical imbalance theory of mental disorders has never actually been scientifically proven - psychiatric medications, while shown to provide relief for some, have never been scientifically evidenced to impact brain neurochemistry and have been shown in studies to work only slightly better than placebo.
In his article 'The Chemical Imbalance Myth', Functional Medicine Specialist Chris Kressner writes:
'there is not a single peer-reviewed article that can be accurately cited to support claims of serotonin deficiency in any mental disorder, while there are many articles that present counterevidence. Furthermore, the Diagnostic and Statistical Manual of Mental Disorders (DSM) does not list serotonin as the cause of any mental disorder. The American Psychiatric Press Textbook of Clinical Psychiatry addresses serotonin deficiency as an unconfirmed hypothesis, stating “Additional experience has not confirmed the monoamine depletion hypothesis'
He goes on to explain that the concept that mental disorders were a result of a chemical imbalance in the brain was established in 1952 when the first 'antidepressant', iproniazid, was discovered accidentally when
tubercular patients became euphoric while being treated with this drug. However, motivation of Psychiatrists to accept the chemical imbalance theory expanded due to growing competition from non-medical therapists such as psychologists, social workers and counsellors and a drive to differentiate as medicalized specialists focussing on physical treatments like drugs and electroshock therapy. And yet, while medication does seem to support some people in providing relief from symptoms, there is no scientific understanding as to exactly why.
Furthermore, where pharmacological treatments for mental health conditions may be standardized and utilized as common practice, there is good reason to also question their efficacy and even their safety. Dr. Arielle Schwartz, a clinical psychologist who specializes in the treatment of complex trauma, has written in depth about the contraindication and potential harm of the use of benzodiazopines, a medication commonly prescribed to treat symptoms of PTSD such as anxiety and panic.
She writes, ‘In my experience treating trauma for the past 15 years I have seen the negative impact of medical mismanagement of PTSD. I have witnessed clients suffer trying to recover from their psychopharmacological treatments and painfully try and rebuild their lives from the impact of physiological and psychological dependence upon medicine; conditions that are sometimes equally painful or worse than the initial traumatic events’.
Throughout the many years that I accessed medical support for my symptoms, I was prescribed benzodiazepines and various other pharmaceuticals (including anti-psychotics, though I never experience Psychosis) to manage them. They were offered as more of a silver bullet solution, rather than one potential piece of a complex condition and at no point was it suggested that there could be potential harm or side effects as a result of taking the medication. As there was no link made between my presenting symptoms and past trauma, I took the medications prescribed to me while not undergoing the therapy required to process those experiences in a supported environment. This lead to more strain on my brain and body and gradually, a worsening of symptoms both physical and mental. Whenever I reported that the medication I was receiving was either a) not helping and/or b) making things worse, I was met with disbelief or complete dismissal. It’s been important for me to recognize how, many times when these medications were prescribed to me, I was not in an informed position or in a place where I felt strong enough to advocate for myself or to question the directive of the medical providers I was seeing. When we are struggling with our health it can leave us feeling more vulnerable then when we are thriving. Whether we like to admit it or not, there is a power differentiation at play when we seek medical support from professionals that should always be acknowledged.
I am extremely grateful to have never suffered from benzodiazepine withdrawal and/or to have developed a dependence on that specific class of drug.
See the journey of Toronto’s Dr. Jordan Peterson and his long road to recovery from benzodiazepine withdrawal as a result of routine medical care: https://m.youtube.com/watch?v=3ktjZhih3LQ).
The worst outcome of my consumption of psychiatric medication has been my need to process the years of built up emotional material that accumulated due to the numbing qualities of the psychiatric drugs I was prescribed. I was also not informed about the difficult road of cessation ahead of me or the impossibility of finding medical support to safely come off these medications, as medical practitioners are rarely if ever educated on withdrawal symptoms and the potential for discontinuation syndrome (a very real condition where symptoms emerge upon cessation due to a withdrawal of the drug from the body rather than evidence of the return of the ‘underlying illness’). My process has involved needing to self research and seek support outside of the medical system in order to safely wean off of medications. It has also involved pulling open capsules and counting beads with a micro scale in order to create dosages small enough to gradually wean in a way that my body could tolerate, as the drugs were not created or offered in dosages small enough for me to wean gradually and safely, and even my pharmacy wasn’t able to compound them for me. I was very quickly and flippantly prescribed these medications but was not able to find any support to come off of them within mainstream medicine. While that journey has been a difficult one unto itself, I am grateful every day that I wasn’t harmed in a more significant way.
To summarize, where I used to believe that psychiatric medications were the gold standard to treat mental health conditions and that they were not only completely safe but a required element of treatment, I’ve since learned through reading, studying and speaking with other survivors that the reality is that they will help some people, others they won’t and some they will harm. It is my belief now that the assumption should never be made that they definitely will help somebody or that they are the best and/or the only treatment option available - and the realities of those individuals who aren’t helped and/or are harmed by these medications should never be denied. While I believe that psychiatric medications have the potential to be an effective tool to support symptom management, not eradication (symptoms carry messages that are very important to hear), I also am a firm believer in the importance of informed consent - ie. ensuring that the consumer has a complete understanding of the potential benefits and risks of the treatment options that they are offered and that they are empowered to make decisions around treatments that are best for them given their unique circumstances.
To be continued...