Psychoactive Medication

“The ethical use of Psychotropic drugs is perhaps the single most important aspect of Psychiatric care that requires urgent attention” ~ Dr Phil Thomas

I watched the movie All that Heaven Allows (1955). There is a line in it where Jane Wyman goes to the doctor after the breakup of a relationship and he says “Do you expect me to give you a prescription to cure life?”. While there are some tranquilizers that can help people short term, there is no prescription that will cure life’s emotional problems, some of which may have stemmed from trauma in a person’s past or more recent distress.

There has to be a better way than drugging people into oblivion or disabling a person’s cognitive abilities as part of “treatment”. Anatomy of an Epidemic by medical journalist Robert Whitaker researched the disabling and devastating effects of overprescribing in the US [1].

Medication can actually intensify or magnify mental health problems for some of us. I personally found that some tranquilizers can help short term, but long term these drugs fuelled my symptoms, caused damage and delayed my healing. While a person may need some tranquilizers if in acute distress, what they really need is someone to listen with empathy non-judgmentally, to try to understand what’s happening and set them on the right path.

Adverse effects of Prescribed Psychotropic substances

Prescribed psychotropic substances can have very damaging effects, especially when used long term. In 2005, a study funded by Eli Lilly, the maker of Zyprexa / Olanzapine, found that long term exposure to this major tranquilizer causes shrinkage of the brain, “significant reduction in brain volume that affects both gray and white matter” [2]. I first learned this from honest Psychiatrists Dr Peter Breggin and Dr Joanna Moncrieff. After I had an adverse reaction to the drug Citalopram, I was put on Olanzapine at what I now consider too high a dosage (10mg) long term in 2008. I did not have informed consent about this powerful but potentially damaging drug. There are no words to describe my shock and feeling of being let down by the medical profession when I learned the truth. The damage is there and can be felt in subtle ways. I have to be compassionate with myself and hope that neuroplasticity will help, which is the brain’s ability to repair some of the damage and injury.

Over three years I was given Olanzapine, Seroquel/Quetiapine, Lamictal, Lithium, Rivotril and a number of other drugs. No doctor seemed to care about the weight gain or damage their overprescribing caused. I gained 25 lbs and it took many years to lose this weight again. There are lawsuits in the US relating to the drug Zyprexa / Olanzapine [3]. According to Robert Whitaker (in his book Anatomy of an Epidemic) twenty people died in the trial for Zyprexa which is a scandal in itself.

Withdrawal from prescribed psychoactive substances

It is necessary to be cautious with Psychiatric medication. It’s easier to get on them than to get off and easier to prescribe than deprescribe. While some people may want to stay on these drugs, those who would like to come off prescribed drugs should be supported and given alternatives.

It is very difficult to have a proper recovery in a system that revolves around the biomedical model. Some people are told they will be on drugs for life and are called “non-compliant” if they try to go down an alternative route. Coming off these drugs will usually be severely frowned upon. You are basically left to your own devices in what can be a very difficult process.

Sometimes people are taken off the drugs too fast, leading to failure, but this can also take away hope of ever becoming drug free. Withdrawal has to be done very slowly, under the supervision of an expert who has the most up to date, honest psychopharmacological information on the withdrawal process. I’ve added a section entitled Resources to help withdraw from prescribed Psychoactive drugs.

Supporters and family need truthful information and advice about the withdrawal process. It is important to prepare well for withdrawal with nutrition, exercise, getting enough sleep (if possible), talking therapy and holistic work on health.

Relapse on discontinuation of psychoactive drugs can be a form of drug withdrawal state [4]. A person may experience return of symptoms while coming off the drugs. In the current biomedical system, any relapse will usually be seen as a sign of “illness” as opposed to the process of withdrawal.

In 2011, when I was trying to withdraw from the drugs, I was told by a doctor in a disapproving tone “These drugs are not made for a’la carte people like you!”. That particular day was a major turning point and I’m grateful for his valuable one liner. I knew for sure I wanted to get off these drugs. However, without support from doctors or others, it was a bumpy ride.

When I was coming off the drugs I got no support or correct advice. In the first 2 years I was prone to relapse, as my brain/body readjusted. I did keep some Olanzapine 5 mg on standby during that time. I am now drug free for several years. Sleep is an important part of the healing journey and something I struggle with since the overuse of these psychoactive substances. I never get a full night’s sleep and continue to work on that. My circadian clock is also out of sync. Circadian rhythm is an internal process that regulates the sleep / wake cycle.

Yearly explosion in prescribing of antidepressants

An article in the Sunday Business Post (SBP) by Susan Mitchell in February 2018 investigated our growing dependence on prescribed painkillers and psychoactive substances. “From antidepressants to sedatives, from painkillers to sleeping pills, the use of prescription medication is spiralling” [5]. Some of the headlines in this edition of the SBP include “We are definitely overprescribing. We’ve all seen what has happened in America, so we can’t be complacent. The figures are fairly stark”.

“In 2016, €25 million was spent on the drug (Lyrica / Pregabalin which is a neuropathic pain drug) for medical card holders – up from €5 million in 2006” (1086% increase). “The number of prescriptions for the SSRI (antidepressant) Lexapro soared from 190,109 to 631,000 – a 232 % increase” (2006 to 2016). Sertraline prescriptions are up 252%. And Venlafaxine (Effexor) prescriptions up 107%. These are shocking increases in drug use.

The money used on the over prescribing of painkillers and Psychotropic drugs could be redirected into a more humane system. But that would require a major shift in thinking from the current biomedical based model to a system that is based more on a Psychosocial and holistic approach to healing.

For example, the Power Threat Meaning Framework describes an “alternative to Psychiatric classification in relation to emotional distress” [6]. One of the lead authors, clinical Psychologist Dr Lucy Johnstone, came to Dublin in May 2018 to talk about this approach. She was invited by the youth mental health charity Jigsaw.

Do doctors give out antidepressants too easily?

In April 2013 The Right Hook (presented by George Hook on Newstalk) discussed an article in the Irish Examiner which saw journalism student Niamh Drohan approach seven GPs telling them she was suffering from stress and anxiety problems from her final year in college [8]. All of the GPs diagnosed her with a mild form of depression. All doctors prescribed her with antidepressants.

I was in shock at what I heard on The Right Hook. A doctor went on the show and claimed that these drugs are not addictive and far more seriously she claimed during the interview that antidepressants are safe at overdose levels. Her exact words were “Not even dangerous at high levels at overdose”. Nothing could be further from the truth. A number of years ago, in a documentary on suicide, I heard a doctor say that if someone takes an overdose of certain prescription drugs they can end up alive and brain damaged.

In Ireland in 2009 the very tragic Shane Clancy case involved an overdose of the SSRI antidepressant drug Citalopram. SSRI is a Selective Serotonin Reuptake Inhibitor. The tragedy happened 17 days after starting this mind-altering drug. Thankfully Shane Clancy’s mother Leonie Fennell and Prof David Healy got to speak on the George Hook show shortly after that.

Evidence Based Medicine (EBM) 

I’ve included a presentation by Prof David Healy [9]. 6 minutes into the presentation you will see that the negative trials on SSRI antidepressants have been hidden.

Evidence Based Medicine is broken is an article from the British Medical Journal (2014) written by Scottish GP Des Spence [10] ~

“Now doctors can prescribe a pill for every ill… Medical experts who should be providing oversight are on the take…the current incarnation of EBM (Evidence Based Medicine) is corrupted, let down by academics and regulators alike. What do we do? We must first recognise that we have a problem.”

The following is a quote from Psychiatrist Dr Allen Frances (chair of the taskforce that wrote the DSM-IV) “It’s been many years since I have trusted anything I read in a medical or psychiatric journal. There is an enterprise-wide positive bias; findings never seem to replicate; benefits are hyped; harms are hidden” [11]. In academic research it’s important to know who funded the research and if there was any pharmaceutical company linked to it, which can create a conflict of interest.

Placebo

This is from an article by Charlotte Blease [12].  Irving Kirsch is a Harvard Professor.

“The placebo effect is a genuine therapeutic mind-body effect … The branding, the expensiveness, the colouration of pills, the number of times you have to take them per day … can increase the placebo effect … Kirsch and his colleagues discovered that antidepressants are not more effective than placebos for mild to moderate depression”. At the same time there are a significant number of us that antidepressants are not suited to and these drugs made our symptoms worse.

DSM (Diagnostic and Statistical Manual)

Mental health is an area where there are powerful vested interests. The pharmaceutical industry is a multi-billion dollar industry. This has a major impact on the approach taken in treating people and the fact that the biomedical model is still dominant.

DSM stands for Diagnostic and Statistical manual and is now at revision 5. When 69 % of the DSM-5 taskforce had financial links to the pharmaceutical industry, this leads to overdiagnosis and overprescribing of drugs. These drugs can delay recovery and cause disability leading to a huge burden on the social welfare system. This burden could be reduced with more ethical prescribing and more honesty about the drugs.

The biomedical model is the dominant approach in use but it can cost the individual and society a lot in the long run. It is possible to get people through recovery and back to being a productive member of their community faster. This is not always possible if the person is on high doses of strong tranquilizers which can affect their ability to function e.g. in a work environment.

Conflicts of Interest 

In 2016 one high profile doctor and author, that promotes the use of antidepressants and influences public opinion, received a payment of €32,000 from Lundbeck. As someone that regularly speaks via the media, Ive never heard him publicly declare this serious conflict of interest.

“Doctors, consultants and other medical practitioners will be obliged to declare gifts or donations from pharmaceutical and healthcare companies under new legislation” [13].
“The HSE wants pharmaceutical companies to name those in receipt of payments for travel, sponsorship, medical education, grants and other activities” [14].

“Irish doctors share €6.8m payments from pharma companies” [15]. “Details of the payments made by IPHA (Irish Pharmaceutical Healthcare Association) members and some other companies are available in the report on transferofvalue.ie. Subsequent reports will be published on a yearly basis and made publicly available for three years”.

When doctors speak publicly or in court they should declare any conflicts of interest. It can potentially result in the public being uninformed about the serious risks that go with certain drugs.

GP training in mental health 

“Most GPs in Ireland do not have specific training in mental health. In the sample of GPs questioned in the SWAHB survey, 68% indicated they had no specific training in mental health” Vision for Change policy document [16].

That is a staggering statistic. Hopefully it has improved since this document was written. I personally feel that GPs should have more training in mental health. That is where a lot of emotional issues are dealt with. In my experience a prescription for pills rarely solves anything long term and can sometimes cause more harm than good. While doctors can be supportive, they work under time pressure in busy surgeries. Inadequate training can lead to damage to the patient and long-term trauma. There has to be a better system than the current one.

The Power of your Subconscious mind 

The Power of your Subconscious mind is a book by Dr Joseph Murphy [17]. Here is a quote from it: “You should carefully watch all ideas and thoughts entertained in your conscious mind”…”You can interfere with the normal rhythm of your heart, lungs, and other organs by worry, anxiety and fear. Feed your subconscious with thoughts of harmony, health and peace”. A doctor’s suggestions and opinions can also impact our subconscious mind.

I was initially informed by a doctor that I would need to be on the antidepressant Citalopram for the rest of my life to treat anxiety and panic attacks. When this drug caused an adverse reaction, including mania, I was taken off this drug cold turkey by someone in the mental health system. The serious issue of withdrawal was never considered or mentioned. I was told I was ill and had a disorder. Bipolar Affective Disorder. BPAD for short in doctor’s notes.

From reading and researching the work of honest Psychiatrists I eventually started to realise the drugs were contributing to my symptoms.  The extreme lows and lethargy as well as the highs and altered sense of reality. Becoming aware of this was a major turning point in my healing journey but breaking free from the indoctrination of the flawed biomedical approach was no easy task.

I could still be living the illness and disorder model of mental health but decided that believing in this was unhelpful, harmful and kept me stuck. “It is foolish to believe in sickness or in anything that will hurt or harm you. Believe in perfect health, prosperity, peace, wealth and divine guidance” Joseph Murphy.

In my experience mainstream Psychiatry is a belief system. One that is very lucrative for the pharma industry and doctors but not very helpful long term for the person in distress, who wants to heal and live a productive life. Natural balance, harmony, meaning, purpose and Peace of Mind are important to me. I still have days that I struggle and those are the days I need to stay self-aware, rest and be kind to myself. Mental and physical health requires daily work and the ability to deal with any setbacks. I feel hopeful of healing. When sedated with drugs I felt no real hope at all. I am a work in progress, but a lot further along the road than if I continued in the biomedical view of emotional distress.

References

[1] Anatomy of an Epidemic by Robert Whitaker, 2010 ~
www.amazon.com/Anatomy-Epidemic-Bullets-Psychiatric-Astonishing/dp/1491513217

[2] “The Influence of Chronic Exposure to Antipsychotic Medications”, 2005 ~ www.nature.com/articles/1300710/email/correspondent/c1/

[3] Lilly Settles With 18,000 Over Zyprexa / Olanzapine ~ www.nytimes.com/2007/01/05/business/05drug.html

[4] Psychiatry in Context : Experience, Meaning & Communities, Dr Philip Thomas, 2015 ~

www.amazon.com/Psychiatry-Context-Experience-Meaning-Communities/dp/1906254729

[5] Hooked: Ireland’s hidden addiction to prescription drugs, Sunday Business Post, Susan Mitchell, Feb 2018 ~
www.businesspost.ie/health/hooked-irelands-hidden-addiction-to-prescription-drugs-b7fce3be

[6] The Power Threat Meaning Framework overview ~ Lead authors Dr Lucy Johnstone (clinical Psychologist) and Prof Mary Boyle, 2018 ~
www.bps.org.uk/power-threat-meaning-framework

[7] Main talks from the Power Threat Meaning Framework launch, 2018 ~
https://vimeo.com/267401691

[8] “Depressing truth about treating depression in the young” Niamh Drohan ~ www.irishexaminer.com/news/arid-20227126.html

[9] “Time to abandon evidence based medicine?” Prof David Healy (2012) ~ www.youtube.com/watch?v=A3YB59EKMKw

[10] Evidence based medicine is broken, GP Des Spence, 2014 ~ www.bmj.com/content/348/bmj.g22

[11] The Crisis of Confidence in Medical Research, Dr Allen Frances, 2015 ~ www.psychologytoday.com/us/blog/dsm5-in-distress/201501/the-crisis-confidence-in-medical-research  

[12] “Research on the placebo effect is a bitter pill for pharmaceutical firms to swallow” Dr Charlotte Blease, 2015 ~
www.herald.ie/lifestyle/research-on-the-placebo-effect-is-a-bitter-pill-for-pharmaceutical-firms-to-swallow-31219408.html

[13] Bill will require doctors to declare gifts from pharma firms. Healthcare companies gave €30 million to hospitals, medical staff in 2016, says Minister ~
www.irishtimes.com/news/politics/oireachtas/bill-will-require-doctors-to-declare-gifts-from-pharma-firms-1.3263608

[14] HSE warns pharma firms about payments to doctors, 2017 ~
www.businesspost.ie/health/hse-warns-pharma-firms-about-payments-to-doctors-5f272f97

[15] Irish doctors share €6.8m payments from pharma companies, 2016 ~

www.irishtimes.com/news/health/irish-doctors-share-6-8m-payments-from-pharma-companies-1.2705795

[16] Vision for Change (Report of the expert group on Mental Health Policy), 2006 ~
www.hse.ie/eng/services/publications/Mentalhealth/Mental_Health_-_A_Vision_for_Change.pdf

[17] The Power of Your Subconscious Mind, Dr Joseph Murphy, 2011 (Reprint of 1963 Edition) ~

www.amazon.com/Power-Your-Subconscious-Mind/dp/1614270198

Other Relevant Information

* Massive rise in antidepressant prescribing ~
www.rte.ie/news/investigations-unit/2019/0218/1031271-massive-rise-antidepressant-prescribing/

* Study 329 – where the hell is the outrage? by Dr Malcolm Kendrick ~

www.drmalcolmkendrick.org/2015/10/01/study-329-where-the-hell-is-the-outrage/

* John Rengen Virapen ~ Pharma whistleblower ~ www.youtube.com/watch?v=pmnOni0xlM4

* Dr. Allen Frances on the Risks of DSM-5 (Diagnostic and Statistics Manual) ~

www.youtube.com/watch?v=-AMvrcBvYWk

* Does long term use of psychiatric drugs cause more harm than good? ~

www.bmj.com/content/350/bmj.h2435

* AstraZeneca Settles Most Seroquel Suits ~
https://prescriptions.blogs.nytimes.com/2011/07/28/astrazeneca-settles-most-seroquel-suits/

* SPECIAL REPORT: The anti-depressant generation ~
www.irishexaminer.com/news/arid-20319128.html

* Our €40m drug problem ~

www.irishexaminer.com/opinion/commentanalysis/arid-20319134.html

* Recording from The International Society for Ethical Psychology & Psychiatry (ISEPP) Conference. A mother (nurse) speaks of how difficult it was for her son to come off Paxil (Seroxat).

www.youtube.com/watch?v=R8ReARNiAHI

* Yolande Lucire ~ Adverse reactions to Psychiatric drugs:

www.youtube.com/watch?v=IEoSs6Yo0DA&feature=youtu.be

* Outcome of mood disorders before psychopharmacology: a systematic review.
“This review provides no support to the belief that pharmacological treatments have resulted in an improvement in the long-term outcome of patients with mood disorders”.
www.ncbi.nlm.nih.gov/m/pubmed/24285565/

* Deadly Medicines and Organised Crime: How big pharma has corrupted healthcare,
Peter Gøtzsche, 2013 ~
www.amazon.com/Deadly-Medicines-Organised-Crime-Healthcare/dp/1846198844

* Deadly Psychiatry and Organised Denial, Peter Gøtzsche, 2015 ~
www.amazon.com/Deadly-Psychiatry-Organised-Denial-Gotzsche-ebook/dp/B014SO7GHS

* Interview with Peter Gøtzsche (co-founder of the Cochrane Collaboration) ~
www.youtube.com/watch?v=VIIQVll7DYY

* The Emperor’s New Drugs: Exploding the Antidepressant Myth, Irving Kirsch, 2009 ~

www.amazon.com/The-Emperors-New-Drugs-Antidepressant/dp/0465022006

* Psychiatrist / Psychopharmacologist David Healy, Making Medicines safer for all of us ~
www.davidhealy.org

* Will Self ~ Psychiatrists: the drug pushers ~

www.theguardian.com/society/2013/aug/03/will-self-psychiatrist-drug-medication

* Government needs to see mental health as an economic issue,  Keith Gaynor ~ www.independent.ie/opinion/analysis/government-needs-to-see-mental-health-as-an-economic-issue-30104711.html

Information and Resources to help with withdraw from prescribed Psychoactive drugs

* Inner Compass initiative ~ www.theinnercompass.org/

* Psychiatric Drug Withdrawal –
A Guide for Prescribers, Therapists, Patients and their Families ~
http://breggin.com/a-guide-for-prescribers-therapists-patients-and-their-families/

* Stopping antidepressants – Royal College of Psychiatrists in the UK (2020) –

www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/stopping-antidepressants

* Stopping Antidepressants (under supervision of medical professional) ~

https://rxisk.org/guide-stopping-antidepressants/

* An independent drug safety website to help you weigh the benefits of any medication against its potential dangers. www.rxisk.org

* Council for Evidence Based Psychiatry. Includes a support page, Recovery stories and withdrawal advisors ~ www.cepuk.org

* A systematic review into the incidence, severity and duration of antidepressant withdrawal effects: Are guidelines evidence based? James Davies and John Read, 2019

www.sciencedirect.com/science/article/pii/S0306460318308347

Youth mental health and CAMHS

“If You Tolerate This Your Children Will Be Next” Manic Street Preachers

Many children and young people are in distress and struggling with their emotional well being. The 2017 National Youth Mental Health Taskforce Report discusses helping young people develop self-worth, self-acceptance, coping mechanisms and active listening. Also the use of digital technologies and safe spaces in local communities.

“People come to parenthood with different capacities, different beliefs and values. Prevention and early intervention has been shown to be more cost-effective when compared to intervention in later life” [1].

Some recommendations in the report include ~

5.1 “The Department of Education and Skills should support teaching professionals in schools and centres for education with the knowledge and skills to understand their role in supporting young people with mental health issues and how to access information about services and supports available to them” 

6.1 “The current provision of counselling and mental health supports in higher level institutions should be maintained and enhanced”

10.1 “A funded strategic national research programme on youth mental health will be developed” 

My World Survey 2 (UCD and Jigsaw)

UCD School of Psychology and the youth mental health charity Jigsaw did a study of 19,000 young people’s mental health and well-being. It was launched in Smock Alley Theatre in Dublin in November 2019. The full report and a summary of key findings are available online [2].

Youth WRAP (Wellness Recovery Action Plan)

Youth WRAP is “Wellness Recovery Action Plan by and for Youth. This WRAP presents a system that helps young people make their lives more the way they want them to be, to choose and enjoy more of the things they want to do, and to get through the hard times that can come with finishing school, finding work, and moving into new situations for home, school and family” [3].

The book Youth WRAP may “help you:

• Do what you want with your life 
• Discover your own simple, safe wellness tools 
• Develop a daily plan to help you stay as well as possible 
• Identify upsetting events or circumstances and develop action plans for responding to them” [4].

In the next paragraph I summarise some of the information from a set of WRAP slides on WRAP for Adolescents [5]. I recommend reading the information in this presentation.

Adolescence is a time for change and difficult transitions, new responsibilities and experiences, as well as less family supervision and support. Writing a WRAP plan is an opportunity to develop self-awareness. It teaches personal responsibility and self-advocacy (being able to stand up for yourself), helps build new habits and assists in discovering interests and opportunities. At times of transition people can develop mental health challenges. WRAP can help a person deal with these issues and put a plan in place for when another crisis may develop in the future. WRAP can be used to address an issue like beginning, improving or ending a relationship. Avoiding alcohol may be part of a daily maintenance plan, if alcohol adds to the person’s difficulties.

There is a free WRAP App [6]. Some organisations in Ireland provide WRAP training and WRAP facilitator training.

Youth Groups

Foróige “is the leading youth organisation in Ireland and has been working with young people since 1952. Our purpose is to enable young people to involve themselves consciously and actively in their development and in the development of society” [7a].

“Comhairle na nÓg are child and youth councils in the 31 local authorities in Ireland. They enable young people to have a say in decisions affecting their lives” [7b]. 

Children Hearing Voices

There are a number of experts in Voice Hearing including Dutch Psychiatrist Dr Marius Romme, his wife Sandra Escher, Jacqui Dillon, Rai Waddingham and Eleanor Longden. Jacqui, Rai and Eleanor were victims of abuse as children but have worked hard on their healing and are now helping others.

Rai Waddingham runs courses to help those who hear voices and on how to help young people with mental health difficulties [8]. One of the courses she has given in NUI Galway was “Supporting Young People who have Distressing Beliefs & Paranoia”. Jacqui Dillon also runs training courses [9]. Sandra Escher specialises in hearing voices in children and young people.

From a multi-disciplinary point of view the child/adolescent would need extra help in school when it comes to building self-esteem and learning relaxation techniques. There are therapeutic ways of dealing with aggression. Within the health service there are Occupational and Play therapists.

This is a summary from a presentation in Trinity College at the launch of Irish Hearing Voices Network in 2015.

What helps children who hear voices?

• It’s about understanding the voices, empowering the child and giving them hope
• The child needs to learn skills to manage overwhelming emotions such as fear, sadness, hurt, anger and shame
• Learn ways of coping with the voices ~ send the voices away, negotiate with them, distract from them … This way a child can feel more in control of the voices. 

Music Therapy

“Music therapy support children with self-regulation and emotional expression through the creative process of music making. This is achieved within the context of an attuned therapeutic relationship with a trained professional” Siobhan Nelligan, Music Therapist.

Organisations involved in Music Therapy include the Irish Association of Creative Art Therapists (IACAT) and the British Association for Music Therapy (BAMT). The Blue Box Creative Learning Centre in Limerick [10] and Every Day Harmony in Belfast [11] provide Music and Creative Arts Therapy services.

Rights of children

More people die in Ireland from prescribed drugs than illegal ones. Article 33 of The UN Convention on the Rights of the Child refers to protecting children from psychotropic substances [12]. In my opinion, children have a right to be protected against unethical use of prescribed psychotropic substances and cocktails of these drugs due to the known damage these drugs can cause to the brain and body. 

In the Universal Declaration of Human Rights [13], Article 23 states that “Everyone has the right to work … and to protection against unemployment”. Article 26 states “Everyone has the right to education”. It’s impossible to study or learn when on high doses of a cocktail of drugs. Education is an important factor when it comes to getting employment. 

CAMHS (Child and Adolescent Mental Health Services)

Children are sometimes referred to CAMHS (Child and Adolescent mental health services) where they end up seeing a Psychiatrist. While some may feel they have been helped by CAMHS, here are a few of the tragedies that I’m aware of. Young people who have had contact with this service.

Dan Hogan (17) was a “bright, kind and sporty teenager who was passionate about rugby” [14]. He died in July 2014. Shortly before his death he was traumatised by a 26-day involuntary stay in the HSE run St Joseph’s Adolescent Inpatient Unit in Fairview. “I want things to be back to normal and just be with my family. I can’t do this much more, it’s exhausting … I’m emotionally wrecked, tired. I feel like an elastic band that has been stretched so far” he said. 

The Dublin Coroner’s Court heard that he had nightmares about his stay in hospital. “Hospital was torture and traumatising and was physically, emotionally and mentally exhausting, like nothing I have experienced before. I felt alone and that no one close to me understood what I was going through” he wrote in his diary.

NC (age 16 in 2013)

These are the words of a young girl that was forcibly medicated with a cocktail of powerful psychotropic substances by CAMHS via the High Court (in the same hospital as Dan Hogan and under the same Consultant). “Sitting on my bed suffering in pain alone. All by myself and nobody cares. I feel so much pain it’s unbelievable. I really want to go home but nobody will let me go home. I have given up. I have lost all hope” [15].

This young girl was forcibly drugged with a cocktail of major tranquilizers against the wishes of her mother. Her mother was very concerned about the evidence that shows these powerful drugs to be very damaging long term. She got an independent consultant Psychiatrist Dr Bob Johnson to speak in the High Court. He believed this young adolescent was suffering from Post-Traumatic Stress relating to a childhood incident, which was triggered by bullying and moving to a new school.

I have met this young woman, who is now in her early 20s. It is obvious that the drugs have seriously harmed her and caused disabilities. The whole experience with CAMHS has left her with lifelong trauma. She has severe akathisia (inner restlessness) and cannot sit still for very long. The long-term use of these damaging drug cocktails caused erratic behaviour and sometimes violence.

Does the High Court, CAMHS the Judge or her Consultant check how she is now and if their intervention has helped or harmed? This continues to happen to others. Many we will never hear about. I know how harmful these overused drugs can be, having taken them as an adult. It was like watching a serious tragedy unfold from 2013. A young girl’s life completely destroyed. There has to be a better way and there is.

Elisha Gault 

Elisha and her family were “sent home to try and cope without direction other than to remove medication from the home and told a follow-up appointment would be made.” It took place two weeks later, when “they determined Elisha was not in need of their services.” [16].

Elisha had already tried to take her own life which means she was in a high risk category. But the system didn’t seem to see it that way. She had allegedly been the victim of sexual abuse in 2012 [17]. A file had been prepared for the DPP but the family got a letter from the Gardai in January 2018 saying the matter would not be pursued! Elisha died in March 2018.

Jake McGill

Jake McGill had been prescribed Prozac six weeks before he took his own life in March 2013. “There is evidence to suggest that antidepressants increase the risk of suicide and suicidal ideation in children and adolescents” [18]. There was a proposed amendment to the Coroner’s Bill. “The bill, to be known as ‘Jake’s Amendment’, would amend the Coroner’s Act of 1962 to allow for a coroner to return a verdict of iatrogenic (medically-induced) suicide” [19].

From Seanad Éireann debate, 18 Oct 2017:

“Jake, who was diagnosed with Asperger’s syndrome, was given the antidepressant drug despite research stating that it has no benefit for children with Asperger’s syndrome and despite the emerging evidence of harm. The coroner in Jake’s case rejected a suicide verdict for Jake. This was due to an email that Jake wrote 24 hours before he took his own life, through no fault of his own. He was writing to a friend and he conveyed his concerns about the medication he was taking, and that he was feeling worse because of it. He said he felt drugged out of his mind and was trying to suppress the bad feelings. Based on those words that were brought to the coroner’s attention, the coroner said that this child was not in his right mind and that he would not elaborate on the medication. He asked Jake’s parents what verdict they would like, open or narrative. They chose an open verdict.” [20].

While the amendment didn’t pass I admire Jake’s parents in trying to bring this important change about.

Autism and the tragic case of Oliver McGowan 

Oliver McGowan died in hospital in the UK in 2016. Here is a quote from Oliver’s mother Paula McGowan “Sadly my son, who had mild disabilities, was given anti-pychotics (major tranquilizers) to treat his seizures and agitation even though we told doctors he was allergic to these medications. They caused his brain to swell so badly it was bulging out of his skull”. Oliver was given the major tranquilizer Olanzapine (and Haloperidol) which led to his death. Due to my own experience with Zyprexa/Olanzapine I’ve written about it in Psychoactive Medication and in a number of blogs. Danish doctor Peter Gøtzsche estimates Olanzapine has killed over 200,000 people [21].

His heartbroken parents and family worked hard to raise awareness about Oliver’s tragic and avoidable death. The last investigation showed his death could have been prevented if the Consultant Psychiatrist had listened to his parents and his history. Oliver’s mother wants mandatory training for doctors and nurses when it comes to working with people with autism. You can read more about Oliver’s story here [22].

There is a Learning Disabilities Mortality Review Programme (LeDeR) to improve the lives of people with learning disabilities. ‘’Reviews of deaths are being carried out with a view to improve the standard and quality of care for people with learning disabilities. People with learning disabilities, their families and carers have been central to developing and delivering the programme’’ [23].

Room for improvement in Child and Adolescent Psychiatry Worldwide 

In 2011 “the Harvard Crimson reported that nationally known child Psychiatrists
Joseph Biederman, M.D., Timothy Wilens, M.D., and Thomas Spencer, M.D. were found to have violated conflict of interest policies … They had failed to report all of the income they earned from pharmaceutical companies to Harvard University and Massachusetts General Hospital” [24]. 

Dr Biederman and others led to a 40-fold increase in children and adolescents misdiagnosed with Bipolar between 1995 (20,000) and 2003 (800,000). In the space of approximately 8 years [24]. Sale of legal psychoactive substances to children is a billion-dollar business but with long term consequences for the young people involved and their families.

Antidepressants carry a black box warning in the US for young people. “Antidepressants increased the risk compared to placebo of suicidal thinking and behaviour (suicidality) in children, adolescents, and young adults” [25]. In my opinion young people shouldn’t be put on these mind-altering drugs.

Another drug that I have an issue with is Ritalin which works on the dopamine system of the brain. “Stimulant medications commonly used for ADHD may carry a slight increased risk … of triggering some of the same Psychiatric symptoms as those seen in Schizophrenia and mood disorders, even in patients who did not have previous Psychiatric problems. These Psychiatric symptoms include Hearing voices, Paranoia … and Mania” [26]. I would question the word “slight”.

Children who are put on Ritalin may show short term improvements but long term, by messing with their natural biochemistry as they develop, they are put at risk of more serious mental health issues. There has to be a better way!

In April 2018 on RTE, in a programme called The Big Picture, Young and Troubled it became clear that we are failing young people in distress. The National Youth Mental Health Taskforce Report 2017 gives recommendations that need to be acted on. Investigations and reports gathering dust on shelves are of no use if things don’t change.

I have included links in Other Relevant Information on Play therapy, childhood bereavement, bullying, hearing voices, self-harm, alcohol, eating disorders, LGBT, gambling and parenting courses.  Sleep is an important factor and switching off technology in the evening [27, 28]. The quality of sleep can directly impact how a person feels and functions. 

Nutrition is also an important part of mental/physical health. We should be eating less sugar, less processed and more natural foods. Food allergies and sensitivities are more common these days. Gut health is very important. See Healthy Food, healthy Gut, Happy Child [29].

For expert information on trauma and Post Traumatic Stress check out the great work of Peter Levine [30, 31] and also Dr Bessel van Der Kolk [32]. 

In 2015 I contacted the Ombudsman for children and asked the relevant Minister to introduce a national policy on parental controls on internet services to help prevent children from accessing certain inappropriate material but I didn’t get very far with that. It is an important issue that’s not been addressed with some tragic outcomes.

I think that everyone who deals with children, including parents, should get some training to help them. From birth up and even education before pregnancy e.g. informed consent about antidepressants in pregnancy, which I have written about in another chapter.

Unresolved issues from childhood can lead to lifelong problems, which costs society a lot more in the long run. Investment should be made in education, occupational therapy, play therapy, art therapy and psychological services. As well as helping young people develop coping skills so that they can handle difficult emotions. WRAP (Wellness Recovery Action Plan) may be useful to some.

There is a short video about a young teenager in the US called Natalie Gehrki [33]. Prescribing psychotropic substances, including antidepressants, to young people can have tragic consequences. Especially when multiple drugs are involved (polypharmacy).

“The ethical use of psychotropic drugs is perhaps the single most important aspect of Psychiatric care that requires urgent attention” Dr Philip Thomas. It’s already too late for some of the young people I’ve written about. Now is a chance for society and the mental health system to reflect and improve how we support the next generation. It’s not just down to the mental health system which has some serious flaws that need to be rectified. Including the costly and potentially damaging process of dragging the cases of adolescents in distress and their families through the High Court process. This money is needed to improve the system and make it into a therapeutic environment. In one case I’ve written about I went and sat in the High Court and watched what was going on. From what I observed and experienced in my own life the current system is causing serious trauma.

Everyone has a role to play in making the world a better place for our Youth.

References

[1] National Youth Mental Health Taskforce Report 2017 ~ 

http://health.gov.ie/wp-content/uploads/2017/12/YMHTF-Final-Report.pdf

[2] My World Survey 2 (UCD and Jigsaw), 2019 ~www.myworldsurvey.ie/

[3] Youth WRAP ~ http://mentalhealthrecovery.com/youth-wrap/

[4] Youth WRAP, Mary Ellen Copeland, 2012 ~
www.wrapandrecoverybooks.com/store/youth-wrap_moreinfo.html

[5] Wellness Recovery Action Plan for Adolescents (Slides from 2012) ~
www.mentalhealthexcellence.org/wp-content/uploads/2013/10/Copeland_ChildrensSummitpresentation_2012.pdf

[6] Free WRAP App ~ www.mentalhealthrecovery.com/wrapapp/

[7a] Foróige Youth Services ~ www.foroige.ie/
[7b] Comhairle na nÓg ~ www.comhairlenanog.ie/who-we-are/ 

[8] Rai Waddingham ~ www.behindthelabel.co.uk/

[9] Jacqui Dillon ~ Training, consultancy and resources on mental health, hearing voices, psychosis, dissociation, trauma, abuse and recovery ~ www.jacquidillon.org/

[10] Creative Art Therapy for Children and Young People, Limerick ~ www.bluebox.ie

[11] Everyday Harmony, Music Therapy, Belfast ~ www.everydayharmony.org/

[12] UN Convention on the Rights of the Child ~
www.unicef.org.uk/what-we-do/un-convention-child-rights/  

[13] The Universal Declaration of Human Rights ~

www.un.org/en/universal-declaration-human-rights/index.html

[14] Teen who took own life ‘failed by mental health services’ (in 2014) ~
https://www.irishtimes.com/news/crime-and-law/courts/coroner-s-court/teen-who-took-own-life-failed-by-mental-health-services-1.2583248 

[15] Anti-psychotic drugs making girl (16) move like elderly woman, court told, 2013 ~
www.irishtimes.com/news/crime-and-law/courts/anti-psychotic-drugs-making-girl-16-move-like-elderly-woman-court-told-1.1476410

[16] Mother of drowned teenager ‘appalled’ at local mental health services ~
www.irishtimes.com/news/social-affairs/mother-of-drowned-teenager-appalled-at-local-mental-health-services-1.3463130

[17] Mother of tragic Elisha Gault reveals she told family about sexual abuse ~
www.independent.ie/irish-news/mother-of-tragic-elisha-gault-reveals-she-told-family-about-sexual-abuse-36821501.html

[18] Irish parents on losing their son to suicide aged 14 (Jake McGill) ~
www.independent.ie/life/health-wellbeing/mental-health/irish-parents-on-losing-their-son-to-suicide-aged-14-after-turning-the-life-support-machine-off-i-threw-the-bottle-of-prozac-against-the-wall-31392882.html

[19] Jake’s Amendment ~ http://antidepaware.co.uk/jakes-amendment/

[20] Coroners (Amendment) Bill 2016: Second Stage ~
https://beta.oireachtas.ie/en/debates/debate/seanad/2017-10-18/10/

[21] Interview with Peter Gøtzsche (4 mins 45 secs in he mentions Zypreza/Olanzapine) ~ www.youtube.com/watch?v=VIIQVll7DYY

[22] Oliver McGowan’s story ~ www.olivermcgowan.org/   

[23] Learning Disabilities Mortality Review Programme (LeDeR) ~
www.bristol.ac.uk/sps/leder/

[24] Child Bipolar Disorder Imperiled by Conflict of Interest, Stewart Caplan MD, 2011
www.psychologytoday.com/blog/your-child-does-not-have-bipolar-disorder/201107/child-bipolar-disorder-imperiled-conflict

[25] Suicidality in Children and Adolescents Being Treated With Antidepressant Medications:
www.fda.gov/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders/ucm161679.htm 

[26] FDA Warns About ADHD Medication Connection to Psychosis and Cardiovascular Events
www.schizophrenia.com/sznews/archives/004802.html

[27] Does the light from a phone or computer make it hard to sleep?

https://kidshealth.org/en/teens/blue-light.html  

[28] Sleep and mental health ~ https://jigsaw.ie/sleep-and-mental-health/

[29] Healthy Food, Healthy Gut, Happy Child: The Real Dirt on Raising Healthy Kids in a Processed World, Dr Maya Shetreat-Klein, 2012 ~
www.amazon.com/Healthy-Food-Gut-Happy-Child/dp/1509816100 

[30] Trauma-proofing Your Kids: A Parents’ Guide for Instilling Joy, Confidence, and Resilience, Dr Peter Levine & Maggie Kline, 2008 ~
www.amazon.co.uk/dp/1556436998?tag=duc08-21&linkCode=osi&th=1&psc=1

[31] Dr Peter Levine on helping children who experience trauma ~
www.youtube.com/watch?v=cmsyNxag6fc

[32] The Body Keeps the Score by Dr Bessel van der Kolk, 2015 ~
www.amazon.co.uk/Body-Keeps-Score-Transformation-Trauma/dp/0141978619/

[33] The Tragic Consequences of Prescription Pills & children/teenagers: Natalie Gehrki ~
www.youtube.com/watch?v=1haYwZGcSRY

Other Relevant Information

* A WRAP workbook for kids ~
www.wrapandrecoverybooks.com/store/wrapkids.html

An easy to read workbook style book that guides kids aged 7-14 through creating their own Wellness Recovery Action Plan

* Irish childhood bereavement network ~ www.childhoodbereavement.ie/

* What are the benefits of Music therapy ~
https://positivepsychology.com/music-therapy-benefits/

* The Teenage Guide to Stress, Nicola Morgan, 2014 ~
www.nicolamorgan.com/product/the-teenage-guide-to-stress/

* The Big Picture : Young and Troubled, 2018 ~
www.rte.ie/news/player/2018/0426/10873228-the-big-picture-young-and-troubled/ 

* The Big Picture: Youth Mental Health, all this week on RTE, 2018 ~www.hotpress.com/The-Big-Picture-Youth-Mental-Health-all-this-week-on-RTE/22048411.html

* I share therefore I am: a narrative inquiry of young adults experience of personal disclosure on Facebook ~ Colman Nortor, 2017 ~ www.doras.dcu.ie/21824/

* Parenting courses ~ https://helpme2parent.ie/

* Barnardos Resources on bullying  ~
www.barnardos.ie/resources/bullying 

* ”BeLonG To Youth Services is the national organisation supporting lesbian, gay, bisexual, transgender, and intersex (LGBTI+) young people in Ireland” ~ http://belongto.org/

* Spun Out ~ Ireland’s Youth information website ~
https://spunout.ie/

* Young People’s mental health ~ www.jigsaw.ie/

* One Good Adult (Jigsaw YMH) ~ https://vimeo.com/97326672

* Mental Health Ireland ~ www.mentalhealthireland.ie/
* Self-harm distraction techniques ~
https://spunout.ie/mental-health/self-harm/self-harm-distraction

* Self harm ~ www.3ts.ie/need-help/self-harm/

* Self harm – a self-help guide ~ www.selfhelpguides.ntw.nhs.uk/3ts/leaflets/selfhelp/Self%20Harm.pdf

* Alcohol and You ~
www.selfhelpguides.ntw.nhs.uk/3ts/leaflets/selfhelp/Alcohol%20and%20You.pdf

* Drugs ~ https://spunout.ie/category/health/drugs

* Controlling anger ~
www.selfhelpguides.ntw.nhs.uk/3ts/leaflets/selfhelp/Controlling%20Anger.pdf

* Eating disorders association of Ireland ~ www.bodywhys.ie/

* The voices in my head, Eleanor Longden TED talk, 2013 ~
www.ted.com/talks/eleanor_longden_the_voices_in_my_head

* Sandra Escher: Children and Young People who Hear Voices Part 2 ~
www.youtube.com/watch?v=9QJhY9ns0Uw

* Children Hearing Voices, Sandra Escher, 2010 ~
www.amazon.com/Children-Hearing-Voices-Sandra-Escher/dp/1906254354

* Launch of the Hearing Voices Network in Ireland (2015) ~
 www.iimhn.ie/launch-of-a-hearing-voices-network-in-ireland/

* Irish Society for Prevention of Cruelty to Children ~ www.ispcc.ie

* Your Child Does Not Have Bipolar Disorder: How Bad Science and Good Public Relations Created the Diagnosis, Stewart L. Caplan MD, 2011 ~
www.amazon.com/Your-Child-Does-Bipolar-Disorder/dp/0313381348

* Padraig Bannon ~ My Problem with Gambling ~
www.youtube.com/watch?time_continue=136&v=q3FVpazHGus  

* 7 Ways to Help Students Who Struggle with Anxiety ~
www.weareteachers.com/7-ways-to-help-students-who-struggle-with-anxiety/

* An inquest into the death of Thomas Oliver McGowan at Southmead Hospital revealed the medication “most likely” led to brain swelling (distressing video) ~
www.bristolpost.co.uk/news/bristol-news/heartbreaking-video-oliver-mcgowan-medication-1468148

* “If You Tolerate This Your Children Will Be Next” Manic Street Preachers ~
www.youtube.com/watch?v=cX8szNPgrEs

Anti-depressants and Pregnancy

There is a free course on antidepressants in Pregnancy, available online, presented by Dr Adam Urato [1]. The aim of the course is to give women information about anti-depressants. This is not fear mongering but instead about informed consent. Some women may decide to stay on these drugs if already on them. Others may decide to withdraw from the drug but need to do that slowly under the supervision of an expert.

As over 10% of the population are on antidepressants (in places like the UK, US and Ireland) all women of childbearing age should be educated about these drugs. Dr Urato points out that at least 50% of pregnancies are unplanned so women need to know the risks upfront, as opposed to during the pregnancy.

While these drugs are promoted by some as safe during pregnancy one of the key messages that Dr Urato tries to get across is that “chemicals have consequences”, especially during pregnancy. The course discusses the many changes a woman goes through during pregnancy, both physically and emotionally. This can make pregnancy a more difficult time to withdraw and come off these drugs.

The “low serotonin” theory of Depression has never been proven and is mainly a marketing myth. Serotonin comes from tryptophan which is an amino acid. Dr Urato lists natural sources of tryptophan e.g. Cottage cheese, sunflower and sesame seeds, hummus, oats, chocolate etc

He explains that a baby’s developing brain is fed by the placenta, which makes serotonin in early development. SSRI antidepressants (Selective Serotonin Reuptake Inhibitors) cross the placenta from mother to baby and disrupt the serotonin system. The drugs can cause miscarriage, preeclampsia, preterm birth, heart problems, increase risk of brain malformation, smaller foetal head size and pulmonary hypertension [2]. Some studies showed increased rates of autism [3]. Some babies are born with newborn behavioural syndrome. These drugs also affect male sperm.

Harvard Professor Irving Kirsch found that the difference between using SSRIs and a placebo to be small [4]. Non-chemical approaches to Depression should be prioritised [5].

There is a Panorama documentary called The Truth About Pills and Pregnancy, researched and presented by Shelley Jofre [6].

Postnatal Depression (PND)

After childbirth progesterone and other hormone levels drop, the woman has been through the shock and/or elation of childbirth and sleep may be lacking when there is a new baby to look after. Some women get postnatal depression which can last for weeks or months. Support groups can help where a person gets to meet other mothers who may be able to empathise with them. There are other approaches to addressing PND/Depression [7].

{ Important Do not stop or change prescribed psychoactive drugs without consulting your prescriber, due to the dangers of withdrawal. This is not medical advice } 

References

[1] Antidepressants & Pregnancy: The risks & potential harm to normal fetal development ~ Free Course ~  https://education.madinamerica.com/p/antidepressants-pregnancy

[2] Prenatal exposure to antidepressants and persistent pulmonary hypertension of the newborn: systematic review and meta-analysis ~ www.bmj.com/content/348/bmj.f6932

[3] Exposure to selective serotonin reuptake inhibitors during pregnancy and risk of autism spectrum disorder in children: a systematic review and meta-analysis of observational studies ~

www.ncbi.nlm.nih.gov/pubmed/25498856

[4] Antidepressants and the Placebo Effect: The Emperor’s New Drugs by Irving Kirsch ~ www.youtube.com/watch?v=LQ_EixhrFaw

[5] How Should We Treat Depression in Pregnancy? Adam Urato, 2018 ~
www.madinamerica.com/2018/04/how-treat-depression-pregnancy/

[6] Panorama – The Truth About Pills And Pregnancy (15 mins in) ~

www.youtube.com/watch?v=BMAEJ1exKPU (researcher Shelley Jofre, 2013)

[7] The Postpartum Experience and Women’s Health with Dr. Maggie Ney :

https://drhyman.com/blog/2019/01/03/bb-ep36/

Other relevant information

* Antidepressants and Pregnancy: Who Says They Are Safe? by Dr Urato (2014) ~

www.madinamerica.com/2014/12/antidepressants-pregnancy-says-safe/

* A New Epidemic: Antidepressants During Pregnancy, 2012 ~
https://davidhealy.org/a-new-epidemic/

* Antidepressant Birth Defects Warnings and Alerts ~
www.baumhedlundlaw.com/prescription-drugs/antidepressant-birth-defects/warnings-and-alerts/
“The FDA uses a pregnancy category system to classify potential risk to a fetus when medication is taken during pregnancy. The FDA has declared the majority of SSRI antidepressants, a pregnancy “Category C” drug. This pregnancy category means that animal reproduction studies have shown an adverse effect on the fetus … “

* Citalopram (Celexa) Birth Defects ~ www.baumhedlundlaw.com/prescription-drugs/antidepressant-birth-defects/celexa-information/

* The effects of maternal depression and maternal selective serotonin reuptake inhibitor exposure on offspring (Pawluski, 2013) ~
www.ncbi.nlm.nih.gov/pmc/articles/PMC3659337/

* Open verdict at inquest into death of Anna Byrne, 2012 ~
www.independent.ie/irish-news/courts/open-verdict-at-inquest-into-death-of-anna-byrne-28903356.html

* Taking antidepressants in pregnancy may raise risk of an autistic child, study suggests :
www.telegraph.co.uk/science/2017/07/19/taking-antidepressants-pregnancy-may-raise-risk-autistic-child/

* Antidepressant use during pregnancy and the risk of major congenital malformations in a cohort of depressed pregnant women: an updated analysis of the Quebec Pregnancy Cohort ~ http://bmjopen.bmj.com/content/7/1/e013372

* Worse than the Disease: The Pitfalls of Medical Progress by Diana Dutton et al, 1988 ~
www.amazon.com/Worse-than-Disease-Pitfalls-Progress/dp/0521395577

“DES, a synthetic estrogen prescribed to millions of women to prevent miscarriages, which produced devastating side effects”

* Antidepressant use during pregnancy and the risk of gestational diabetes mellitus: a nested case–control study ~
https://bmjopen.bmj.com/content/9/9/e025908

* Post-Natal Depression and Antidepressants ~ http://antidepaware.co.uk/antidepressants-and-post-natal-depression/

* Medicating Post-Natal Depression ~
http://antidepaware.co.uk/medicating-post-natal-depression/