Last updated on January 8th, 2024 at 10:10 am
Is your doctor sufficiently trained in this specialized health area?
General physicians, including other medical professionals (physician assistants, nurse practitioners and even pharmacists with additional training), have become the largest “mental health” profession in the country! These medically trained providers, usually in a 10 minute office visit, listen to the patient’s complaints and with the Diagnostic and Statistical Manual of the Mental Disorders make a diagnosis and prescribe drug treatment.
General physicians prescribe the full range of psychiatric drugs to their patients and from one study 62% of the medications prescribed were for the treatment of depression. Often from the just mentioned study many of these “depressed” patients received from one to five different antidepressant drugs looking for the putative neurotransmitter giving rise to symptoms.
Many of these patients were prescribed two and often three different classes of psychiatric drugs, perhaps some of which were prescribed to treat adverse side effects of the primary psychiatric drug.
Non-psychiatric physician training to diagnoses and treat the mental disorders.
During the physician’s one year clinical internship physicians usually have a 6 week rotation in psychiatry which emphasizes drug treatment of the mental disorders. When physicians enter practice the training in the mental disorders includes the pharmaceutical representative reporting and recommending psychiatric drugs for the full range of the mental disorders.
General physicians are very open to modern drug psychiatry with the idea that mental disorders are diseases of the brain, and like other medical diseases, psychiatric drugs are seem as a critical if not the sole treatment of the mental disorders.
In contrast what is the training of a clinical psychologist (Ph.D.) in the diagnosis and treatment of the mental disorders?
In a Ph.D. program in clinical psychology the first 2 years of the 5 year doctoral training are in normal human behavior. Doctoral candidates in psychology must have at least a minor in psychology at the undergraduate level. The thinking in the field is that one should have a good understanding of normal behavior before understanding and treating abnormal behavior.
Unlike an MD degree the PH.D. is both a practitioner and research degree; the latter includes training in statistics, experiment design, the ability to conduct research and to critically evaluate the research of others. Psychologists are the only health professionals trained in the scientific method and how to conduct scientific experiments.
Even though MDs have very extensive training in the bio physical sciences, certainly much more than health psychologists, the MD is a practitioner degree. Some MDs, including some psychiatrists, want to add scientific training and earn a Ph.D. degree as well in preparation of conducting research studies.
Is the source of the patient’s mental disorder in the patient’s brain, which is the theory proposed by psychiatry, or is the source multi factorial including psychosocial, personality, current stressors, adverse life difficulty that are giving rise to the patients symptoms?
In the 1950s psychologists and psychiatrists were both very active in treating these psychosocial and life factors with psychotherapy but since then psychiatry has become more and more biological in its view of the mental disorders and proposes psychiatric drugs as the primary focus of treatment.
From depression to bipolar to schizophrenia, modern psychiatry focuses on drug treatment on what are referred to as chemical imbalances in the brain and prescribes the appropriate psychiatric drugs to restore the imbalance.
If one looks at the escalating prescribing of antidepressant and other drugs in the treatment of the full range of the mental disorders from the 1950s to now, it is apparent that the chemical imbalance view of the mental disorders has taken hold and is embedded throughout society.
Even in the judicial system judges in probation hearings often require that certain felons stay on their psychiatric medications to protect the public. Do these drugs help or harm the patient? Despite claimed drug breakthroughs over the past 50 years, why do the incidences of the mental disorders continue to increase?
Are mental disorders just like “medical” diseases?
Lab work and proof of tissue damage are usually required for the diagnosis of a disease. Unlike medical problems a mental health diagnosis is made exclusively from an examination of the patient’s behavior! I believe it was in the 1960s that psychiatry believed it had finally discovered a lab marker for depression.
For about a year psychiatrists sent their patients to the lab for evidence of the depression marker. Psychiatrists, however, soon gave up on the practice when the marker proved to be unreliable and invalid.
Unlike real disease some cases of diagnosable depression and anxiety appear to be self-limiting, that is, they get better on their own without any treatment much like a cold or the flu which does not sound like a disease. Moreover, in my recent book I report studies indicate the chances of a remission of depression is better if the patient is on placebo rather than an antidepressant!
In FDA depression drug clinical trials, subjects with diagnosable but only mild depression are excluded from the clinical trial because these patients are known not to benefit at all from antidepressant drugs. In the world of real disease are subjects with mild degrees of cancer or heart disease excluded from FDA clinical trials? Either the person has a disease or not.
In FDA 6 to 8-week randomized depression drug/placebo-controlled clinical trials those on inert placebo have a 30% reduction of symptoms vs a 30 to 50% symptom reduction with the medication, which is only slightly in favor of the drug. However, does this outcome sound as if a disease is being treated?
About 50% of all FDA submitted depression drug-placebo-controlled clinical trials finds no superiority of the drug over the inert placebo in the reduction of depressive symptoms! Does this result sound like antidepressants are treating a brain disease?
The idea that mental disorders are in fact brain diseases is a myth manufactured by psychiatry, the pharmaceutical industry and the medical profession. The general public has bought into this myth with skillful marketing despite the fact that there is no scientific evidence to support it.
