Psychiatry

On December 29, 2009, in Society, by mascalzona

I was whining as usual today about our troubled, troubled world to my friend Carmen and how if only I was Dictator, all dissenters would be silenced and everywhere there’d be naught but rivers of milk and honey.

Me: Whenever kids whine about depression, i want them to stop. ugh. zoloft culture. need to man up. UGH.
Carmen: Whenever a crippled person whines about not being able to walk I want to slap him and tell him to get over it.

On that note, my stance on depression may very well be ridiculous so take me half-seriously. Please don’t be offended by what follows below.

With that qualification in mind, I don’t think that depression [especially teenage depression] ought to be treated with medication [a strong social support network is optimal but I guess that isn't often possible] and believe that much of psychiatry, especially medicalization of childhood conditions, is a money-making racket that preys on silly parents [e.g. ODD appears to be either "I spoiled my kids rotten and now I don't know what to do, fiddlesticks!" or "I have a brain tumor when it comes to understanding human nature. Let's bust out the drugs and therapy, that'll fix 5-year-old Tommy's temper tantrums."] The kids who getting pill’d today would have been known as ‘problem children’ once upon another time, before this all got overmedicalized. Just spank your children if they are hyper [ADHD] or defiant [ODD]. All hand-holding/”sensitive to a child’s needs” culture creates is entitlement and spoiled kids. Spare the rod and spoil the child. As the Chinese proverb goes, da shi qing, ma shi ai. [= hitting is affection, scolding/nagging is love]. Children aren’t spun out of sugar and glass; they have no moral compasses. This is what we fondly refer to as “mischievous”. If an adult acted that way, the descriptor would be jerkface. Children have some license however because they are still ‘unsivilized’. Still, no great need to worry so about their fragile psyches.

I am unconvinced that either of these two [ODD and ADHD] are not simply part of the human condition. Also, Stendhal syndrome?! ADHD sounds like “I hate school and sitting still” or “I’m disruptive”. Sure, some children are just too hyper to function in the school system, which requires sitting for hours at a time. Either deal with the problem kid and force him to ‘behave’ in a school context [punish him...but what does timeout or 'talking to him' do, seriously, if you can't inspire fear properly?], or home-school him. Is Ritalin really the way to go? Giving unwitting children something similar in structure to amphetamine seems cruel if nothing else.

In addition, many parents exploit ‘conditions’ like ODD/ADHD to get their children ahead; extra time on standardized testing, tax benefits for parents of ‘special/handicapped’ kids. If one psychiatrist doesn’t diagnose the child with the condition, another may. It’s fairly easy to induce an ADHD state in a child – give them tons of sugar. Also, you can just teach your kid to act a certain way in the office. That is, tell them to be disruptive. If you think this doesn’t happen, keep in mind that some people have no scruples. Most of the information the psychiatrist receives is from 1) the parents, who are talking about their child’s behavior or 2) the child’s behavior in the office.

I suppose depression is a different can of worms, though many who like to sit on pity pots will offhandedly say, “Yeah, I was depressed last year. It was so bad, man.” The vast majority of my friends has reported ‘depression’ at one time or another; none of them were ever on Zoloft. The thing everybody has got is cyberchondria. Hell, even I self-diagnosed with SAD. Self-fulfilling prophecy when you whine. Cease whining, or get deported to Haiti, where 80% of the population is under the poverty line. If kids at Yale [for example] hate their lives, they need to get some perspective. There is never any excuse to hate the following: your life, either of your parents, yourself. Cease!

I always hear “depression only ‘really counts’ if it happens without a reason” [i.e. no divorce, no death in the family, nothing wrong with your life, etc. The logic goes that if a traumatic event happens, a subsequent bad mood is 'normal' and doesn't have to be treated medically.]. How can the psychologist know for certain that his client is depressed ‘for no reason’? Self-reporting, which is ever unreliable. Any wuss is going to self-report as depressed for no reason, life without purpose, doesn’t enjoy activities he once did. How does one know that adolescent depression isn’t just growing pains or Angst? Apparently the subjective interpretation of the patient and his psychiatrist, who has a vested interest in finding problems. It’s his job!

I worry about the habit-forming nature of many anti-depressants. Certain sources on the Internetz claim that Zoloft is in fact not habit-forming. However, “in discontinuing psychiatric medications, a taper dose is a rule.” Hm, I wonder why! Due to withdrawal symptoms, and whyever would those occur? In addition, anything that makes you feel better or induces a state of pleasure [or at least 'fixes' your bad state] will build a dependence, even if it’s not a very strong ‘chemical dependence’ like the ‘observable’ kind the smoker’s brain creates for nicotine. Nobody claims that sugar is a drug, but the taste buds can be acclimatized very quickly to a certain amount of sweetness and thereafter during your meal, food that is just as sweet won’t taste as good as the first bite. We even build ‘tolerance’ for a certain workout regimen, which is why weight loss plateaus and why running intervals or switching up the type of exercise is more effective than jogging 3 miles a day, every day. This is the whole, “the body adapts/builds dependency to almost everything” thing. e.g. Alcohol tolerance, ‘tolerance’ for a ‘good’ lifestyle that makes a worse lifestyle now seem unthinkable [=being spoiled], caffeine tolerance, sugar tolerance, leisure tolerance [Do you ever hear people who watch 2-3 hours of TV a day say, "But I never have any time to do anything I want to. I just can't imagine doing X. That takes an hour and I simply don't have time" ?] The pharm companies/psychiatrists can tell me that anti-depressants have ‘zero risk of addiction’, but that doesn’t mean I have to believe them! Even if it’s not a strict chemical dependence, there could be a psychological dependence. i.e. One begins to think they need the drug, just out of habit. If it’s hard for somebody to cut out the one cup of coffee they “need” to stay awake in lecture every day, how difficult will cutting out a controlled substance like Zoloft be?

In short: Anti-depressants are over-prescribed, especially for adolescents, most of whom go through good ol’ growing pains, insecurity, conflict with parents, bullying, self-image problems etc. and should just learn to deal instead of being coddled and given pills. Conflict and pain build character more than drugs do. Also, ODD/ADHD seem dubious at best to me, but ODD especially.

For additional reading:
Christina Hoff Sommers’ One Nation Under Therapy: How the Help Culture is Eroding Self-Reliance.

Serotonin
and Depression: A Disconnect between the Advertisements and the Scientific Literature.

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6 Responses to Psychiatry

  1. Stephen Marsh says:

    Ellen,

    I see two problems with the argument you’re making: (a) you’re too willing to assume bad motives on the part of psychiatrists, parents, etc. on a large scale, and (b) you don’t seem to be making a distinction between pharmacological solutions and behavioral tactics (time-outs, etc.), but rather positing that spanking and violence is the only solution to child behavioral issues. The first goes way too far — yes, there are *some* people without scruples, but it doesn’t follow that no one has scruples and everyone is greedy and self-serving. Also, there are social stigmas that come along with these diagnoses. Do you think any parent really wants their kid to be labeled “the special kid” that needs extra time on tests or has to do PE separately unless it were really necessary?

    I’m also concerned about point (b). I don’t know how you’re feeling about science these days but if you throw “spanking” into Google Scholar the overwhelming majority of the studies there show a manifest increase in antisocial behavior, aggression, etc. that stems from spanking. Further, the argument that it teaches a pain association with certain behavior doesn’t hold. This is the same way it works with dogs (dogs tend to function on about the same cognitive level as two-year olds). The cognitive association doesn’t form unless the correction (in your case, the spanking) happens immediately following the bad act in question, and by “immediately”, I mean within a few seconds, which is impossible to do if you’re concerned about keeping things at least moderately civil and contained (calming down, being careful about not seriously hurting your kid, etc.) and aren’t really interested in brutalizing your kid in a fit of rage immediately when the act in question takes place.

    I agree that there is a tendency to rely a lot on medicine when it isn’t necessary (and this applies to physiological conditions too, mind you), but that does not mean that ODD or ADHD or clinical depression don’t exist at all — each one of them is defined as “abnormal behavior beyond x, y, or z normal behavior”, mind you, and certainly that nonviolent discipline is in the same purported league of uselessness as medicine. If that’s the case, I and a lot of the people on Facebook you asked about this must have missed the memo.

    Best,
    Stephen

  2. Sandy says:

    Hi Ellen:

    there are three statements that I especially disagree with you about:

    1) Nobody claims that sugar is a drug, but the taste buds can be acclimatized very quickly to a certain amount of sweetness and thereafter during your meal, food that is just as sweet won’t taste as good as the first bite.

    sugar works the brain, not the tastebuds. and in fact, sweet food often tastes better upon 2nd bites, which is why they are so addictive–because you can’t stop. it stimulates the production of a chemical in your brain (i’ll try to google out the specific name later) and keep you wanting more of the same sugary food, instead of more sugar intensity, at least in the same eating session. i do realize that this is largely irrelevant to your depression arguments, so i’ll move on.

    2)There is never any excuse to hate the following: your life, either of your parents, yourself.

    in the contrary, i believe that there are plenty reasons to hate one’s life, parents, or oneself. the funny thing in reality is that people who have good reasons to do so, often don’t. true, you see more “whiners” complaining about those things than others do, but that doesn’t mean there is no good reason to hate either your life or your parent. sure, one shouldn’t hate oneself, and i think in the long run, your life is what you make of it so you shouldn’t hate it either. but parents? i see plenty good examples of that. if your whole world is set in a comfortable middle class environment, then no, you don’t have a reason to hate your life. but there are so many people whose situations are drastically different from ours, and it doesn’t do the argument any justice to ignore their existence.

    3)As the Chinese proverb goes, da shi qing, ma shi ai. [= hitting is affection, scolding/nagging is love]. Children aren’t spun out of sugar and glass; they have no moral compasses.

    This is what I disagree with you the most. Hitting is NOT affection, and scolding is NOT love. Teaching discipline is, but hurting isn’t. are there better ways to teach discipline to children? i think so–how about being a role model and practicing what you preach? if you don’t want something to be done to you, don’t do it unto others–that should apply to parent/children relationships too. children who are motivated by fear or pain don’t function very well later in life because they’ve grown fearful of people and they lack the ability to trust. Children are not glasses, but they are not shapeless playdough either. Hitting and scolding are by no ways respectful, and i wouldn’t blame the child if he/she grows up hating what the parents have done. (though, it would be better for the child to forgive and forget in this case).

  3. Hannah says:

    As someone with a brother who suffers from ADHD/anxiety/lord knows what else, I’d like to assure you that these diagnoses are in fact real. I’m sure if you watched him STRUGGLE immensely with trying to focus/control his impulses in a way that I, or I’m sure you, never had to, you wouldn’t doubt that these things are real. Should he just have the ADHD smacked out of him? I’ve worked at a few summer camps, and these experiences have made more than clear to me that the kids who are used to getting a good “ass-whoopin” when they misbehave are the MOST disruptive, violent, and defiant kids, because they’ve learned that hitting people is a good way to respond to things they don’t like. Character building? Really?

  4. LN Song says:

    personal opinion: oughtn’t adminster psychotropics [ritalin, paxil, prozac etc] to kids under 18. Espec. ODD and Social Anxiety Disorder. IDK about you guys, but most people I know recall a period in their childhood when they were antisocial / scared of other people /social situations.

    The DSM-IV was written by doctors paid by pharmaceutical companies, some of the disorders appear to be disease-mongering / medicalizing neurodiversity. Not to say these conditions don’t exist, but ODD at the very least seems to just be the human condition.

    oh, punishment needs to be administered in a rational “you are being punished for X” fashion, not a raged, inarticulate beat-the-kid-to-assuage-own-anger way. If you reward your kid to not be bad, it’s just a trigger to tell them to throw a tantrum whenever they want a reward. Raise expectations pls.

    With respect to Ritalin, “The pharmacological effects of methylphenidate, a schedule II drug, are almost identical to cocaine and the amphetamines. The abuse pattern of methylphenidate is very similar to cocaine and amphetamines.”

    Zoloft is correlated with suicidality in teens [wtfh] and also of course induces withdrawal symptoms once the patient attempts to stop treatment [SSRI discontinuation syndrome].

    ** links above might be broken, sorry! SSRI discontinuation syndrome, paxil, social anxiety disorder.

  5. LN Song says:

    oh, also just against psychotropics being administered to kids under 18, not that adhd/odd etc. may exist as descriptive conditions. perhaps a personality type or growing pains, though? esp ODD.

    Anti-depressants are SSRIs that have serious withdrawal symptoms. SSRI discontinuation syndrome
    http://en.wikipedia.org/wiki/SSRI_discontinuation_syndrome
    Zoloft doesn’t actually induce happiness, it induces apathy.

    Ritalin is similar structurally to amphetamine…i question the ethics of administering Ritalin to a 3-year-old after diagnosing him with ADHD, especially when such a diagnosis is based on the subjective interpretation of parents and the psychiatrist. NB. Psychs and doctors often have a vested interest in signing you up for medication/treatment because they make $$. Boo, hiss.

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