A Look At . . .
Coping With Mental Illness
We've Been Misled by the Drug
Industry
By Daniel B. Fisher
Sunday, August 19, 2001; Page
B03
I have recovered from schizophrenia. If that statement
surprises you -- if you think schizophrenia is a lifelong brain
diseasethat cannot be escaped -- you have been misled by a cultural
misapprehension that needlessly imprisons millionsunder the label of
mental illness.
In the last 20 years, the pharmaceutical industry has
become the major force behind the belief that mental illness is a
brain disorder and that its victims need to take medications for the
rest of their lives. It's a clever sales strategy: If people believe
mental illness is purely biological, they will only treat it with a
pill.
Drug companies have virtually bought the psychiatric
profession. Their profits fund the research, the journals and the
departments of psychiatry. Not surprisingly, many researchers have
concluded that medication alone is best for the treatment for mental
illness. Despite recent convincing research showing the usefulness
of psychotherapy in treating schizophrenia, psychiatric trainees are
still told "you can't talk to a disease." This is why psychiatrists
today spend more time prescribing drugs than getting to know the
people taking them.
I, too, used to believe in the biological model of mental
illness. Thirty-one years ago, asa Ph.D biochemist with the National
Institute of Mental Health, I researched and wrote papers on
neurotransmitters such as serotonin and dopamine. Then I was
diagnosed with schizophrenia -- and my experience taught me that our
feelings and dreams cannot be analyzed under a microscope.
Despite what many people assume when they hear about my
recovery, that original diagnosis was no mistake: It was confirmed
by a board of six Navy psychiatrists after my four-month inpatient
stay at Bethesda Naval Hospital. I was devastated by being branded a
schizophrenic. My life seemed over. Six years later, however, I had
defied everyone's expectations and recovered. The most important
elements in my recovery were a therapist who believed in me, the
support of my family, steadfast friends and meaningful work. And I
had a new goal: I wanted to become a psychiatrist. My therapist
validated that dream, saying, "I will go to your graduation." (When
I received mydegree from George Washington University Medical School
in 1976, he was there.) Drugs were a tool I used during crises, but
I have been completely off medication for 25 years.
I am not an anomaly. Thousands of others have recovered,
but are afraid to disclose their past due to the stigma of mental
illness. The definitive Vermont Longitudinal Study, led by Courtenay
Harding, followed 269 patients diagnosed in the late 1950s with
severe schizophrenia. Three decades later, Harding found that
two-thirds of them were living and functioning independently; and of
those, half were completely recovered and medication-free.
The Swiss psychiatrist Manfred Bleuler -- whose father,
Eugen, coined the term schizophrenia in1908 -- obtained similar
results. His father had mistakenly concluded that people did not
recover from schizophrenia -- because he rarely saw his patients
after discharge. Our own research at the National Empowerment Center
(NEC), funded by the federal Center for Mental Health Services,
shows that the most important factor in recovery from mental illness
is people who believe in patients and give them hope: Medications
are a less important factor.
But that is not how psychiatrists are being taught;
recently I was reminded of how tightlytraining is controlled. I
contacted a colleague at a major West Coast medical school to see if
he could get me an invitation to conduct one of their teaching
rounds. He apologetically told me that he couldn't: Since he had
published a critique of the biological model of mental illness,
demonstrating that people could recover from schizophrenia without
medication, he himself was no longer allowed to speak to the
residents in training -- even though he was on the faculty.
The pharmaceutical industry also controlsthe public's
education. Who can avoid the TVimage of the phobic man who needs
Paxil to socialize?Industry-funded research and experts have a huge
impact on media coverage. Finally, the drug companies have taken
advantage of well-intentioned advocacy groups who support the
biological model of mental illness -- and they give those groups
much-needed financial support.
Schizophrenia is more often due to a loss of dreams than a
loss of dopamine. At the NEC, we try to reach out across the chasm
of chaos. I know there are many people who feel they have done all
they can, have struggled against mental illness to no avail, and we
understand their pain. Yet we believe that recovery is eventually
possible for everyone -- although it can take a long time to undo
the negative messages of past treatments. We can offer hope from
first-hand experience.
Addressing the needs of people with mental illness will
require a large-scaleretraining of mental health workers,
decision-makers, families and the public. There will need to be more
research into the ways that people recover. There will need to be
more jobs, housing, peer support and self-help, for these are the
pathways to self-determination and independence. And there needs to
be a cultural shift toward people rather than pills to alleviate
this form of human suffering.
Daniel Fisher is co-director of the National Empowerment
Center, a nonprofit organization run by people who have recovered
from mental illness that seeks to help others recover.
© 2001 The Washington Post
Company
|
