Scan barcode
thepurplebookwyrm's review against another edition
2.0
Having been diagnosed bipolar II myself a few years ago (not that I really care about psychiatric diagnostics anymore) and having been in the "psychiatric system" since I was 12 years old, I was hoping to find an interesting, perhaps helpful, memoir of someone living with the loosely defined condition. With some actual, scientific data thrown in, about healthier living strategies for example. A more holistic approach, shall we say.
I was not only disappointed, but actively angered at times to be served the same rehashed praise for the Almighty Magic of Psychiatric Drugs! Not only that, I found the author to be profoundly condescending towards those of us who dare question contemporary, conventional psychiatry. Writing us off as crazy (ironic) "anti-psychiatry" nuts and conspiracy theorists. Well sorry, no. You can in fact exercise your critical thinking skills and ask legitimate questions regarding available treatments, where they come from, and still hope for a new and improved field of medicine. It's perfectly reasonable!
Believing she's being funded by "Big Pharma", now that would be paranoid; but I'll admit it crossed the mind of my baser self, as her opinion of medications was woefully biased, and completely befuddling as she herself states repeatedly, throughout the book, that they keep failing her. That she always ends up developing a tolerance... But oh no, it's not the same thing as substance dependency. Even the word withdrawal is used but, nope, still not addicted. Calling a spade, a spade, would be more honest. At least then people could make more informed decisions. Although I'll admit she does concede that benzodiazepines are highly addictive. So, kudos for that I guess?
These drugs are, simply put, not to be trifled with. There are NO long-term studies on their potentially irreversible side-effects. A lot of the available data at hand has confounded and/or manipulated by interested parties. This isn't being a conspiracy theorist, it's following the money, as well as the science. There are just not enough independent, evidence-based studies out there. Science is being squashed in the name of financial interests (and, mind you, this isn't unique to psycho-pharmaceutical research). Quoting the FDA or the DSM-V doesn't mean the science is sound, or unburdened by financial concerns. ESPECIALLY since it has been shown that more or less half of the DSM-V's board members have financial ties to the pharmaceutical industry*.
*To be honest, this review came out in 2012-2013. Which objectively is not that long ago, but it is possible things might have changed since then. However, without evidence to the contrary, I'll remain skeptical.
In any case, a lot of ethically-minded psychiatrists also question the validity of the DSM (though perhaps less so in the States), which keeps adding new items to its list of "pathological behaviors". Now, if this book were only taken as a compendium of guidelines, it wouldn't be such a problem. But it's considered by some to be a bible, an instruction manual, when it is well-known there is NO standardized, objective test to diagnose mental illnesses. It's largely a guessing game (exceptions might include acute psychoses I suppose). There is simply not enough data, not enough understanding about the human brain and/or the concept of mind. If these drugs were so great and awesome, then why are long-term results still so unpromising?
Yes, they can and do save lives, on the short, maybe medium-term. They treat symptoms (sometimes exchanging them for others, mind you, especially in the case of anti-psychotics), which I agree is better than nothing. For some, it's more than enough. But not all of us. It doesn't make us anti-psychiatry. It makes us disappointed. Hopeless. Angry. Suspicious. By us I mean patients, patients' families, doctors, researchers, etc... and yes, even qualified, respected psychiatrists. This field of medicine has been stagnant for years. This does not mean it should not exist at all. Absolutely not, but it needs to change.
The current "chemical imbalances in the brain" model has never been proven, and always appeared overly simplistic to me anyway. It's outdated. It's lazy. We should expect more scientific enquiry. We have a right to get better treatment options, ones that don't potentially damage our brains. The author writes in the book that anti-depressants and their ilk "fix the brain". Really? Based on what evidence, exactly? Where are your citations (no really, there was an abysmal scarcity of research citations)? If your aim is to promote informed consent (or perhaps it wasn't, now that I think about it), then you take it seriously. Anti-psychotics in fact probably encourage brain shrinkage, which is pretty bad considering people with mood disorders can have a measure of atrophy in certain regions of the brain... I say this is unacceptable. Anti-psychotics should not be doled out like candies. Or for any and all mental illnesses. There is such a thing as a chemical lobotomy. I mean, sure, you won't feel any crushing sadness, anxiety, or anger. In fact, you won't feel anything at all! If that is fixing you brain, then fine. But admit that surgical lobotomies could have been said to do the same thing then!
I was looking forward to encountering new, evidence-based information about a more holistic approach to the treatment of mental illness. I was also curious to learn more about ECT, as it is based on a slightly different medical model of mental illness than are psychiatric drugs. Or TMS, which is barely mentioned in passing. I can somewhat understand her dismissal of therapy, although to be comprehensive and helpful to others she should have given it more space than just a couple of pages in an appendix (especially when you compare that to the two, four pages each, appendixes dedicated to drug therapy recommendations - I was horrified at some of the combinations). Nothing whatsoever about the current research into psychedelic therapy either, which has a lot more preliminary evidence to back it up than a lot of the available drugs currently on the market...
The only positive thing I am taking away from this book is the recommendation for an interesting mood-tracking app.
The writing style was a little poor, but that's a minor quibble at this point. Really, it's the innumerable contradictions above all that really got on my nerves. To be fair, she did give a warning about this at the end of her book (putting it at the beginning would've made more sense though). But still, it reached truly ridiculous proportions. As I've already mentioned, the biggest being her stance on the glory of drugs when they keep failing her. The other big one was her mention of ECT as being more effective for depression than any drug, without her ever having gone through it herself (not that you have to go through something you recommend to others, I suppose).
The nail in the coffin, however, was her pseudo-philosophical ramblings about the mind/brain split, which didn't serve any real purpose. In any case, it's not an original thought, and it's beyond the scope of a book supposedly dedicated (or not? Again, this was never made clear!) to medical science. I will agree with the idea that the mind and brain are distinct "entities" (the good old software/hardware metaphor), but how can you prove they are separate, exactly? When the mind is clearly housed in the body? We are not separate from our flesh and blood animal selves. We live in them, we experience life on Earth through them. We shouldn't be unduly constrained by them, sure, but they are important nonetheless. Otherwise, why bother with living at all? Doesn't make any sense coming from someone encouraging people not to commit suicide, and to live this life. The mind/body split is a big part of the failings of modern allopathic medicine. Encouraging it, backing it up with a dualism worthy of pseudo-religious thought isn't going to help anyone.
I mean, would you tell people with eating disorders the body doesn't matter? How about all the horrible side-effects from anti-psychotics? Sexual dysfunction, diabetes type II, metabolic syndrome, horrific weight gain (I speak from personal experience - those 20 kg were a bitch to lose)? Those don't matter? Feeling good in your body doesn't matter?! Doctors and pharmaceutical companies make light of these serious side-effects, the author, as a fellow patient, shouldn't. I understand there are people who feel there lives have been saved by these drugs. More power to them. But it doesn't negate the fact some of us have been damaged by these same substances, either. We have a right to critique what we perceive to be a flawed, or a generally failing, system. Being dismissed as idiots and freaks for doing so by a fellow sufferer is just mind-boggling, even pathetic if I'm being completely honest.
The author does give advice for those who wish to quit their medication, which is really ironic given the tone found throughout the rest of her book - but it's better than nothing. I do think, however, people should receive higher quality, and most importantly unbiased, information. In order to weigh the pros and cons for themselves. This book, in my opinion, will not help you with that. At all. And, like I said, for a book claiming to be about "evidence", it doesn't even bother to provide a decent, well-researched bibliography...
This also points to another problem: it seems to me this book couldn't really make its mind as to whether it was supposed to be about personal experience or medical advice. It can of course be about both of those things (which I was sort of expecting?), but since each aspect was so poorly done, I'm left wondering if the decision wasn't made mid-redaction!
In any case, this book negates, erases, experiences like mine, my best friend's, and many other people we know who suffer from serious mental illness. I have studied biology, I believe in the scientific method, in independent, uninterested scientific inquiry, and it disturbs me deeply when I read on a medication notice that no one knows why it "works" for the condition it's meant to treat. It's unacceptable to be playing with the brain like that!
This book was overall little more than a mix of the DSM-V, pharmaceutical pamphlets, some personal history, and sprinkles of rudimentary wellness tips. It just goes to show that, just because you have a blog, doesn't mean you should necessarily make a book out of it!
N.B. Lest I be accused of being anti-psychiatry (again) despite my explanations, I'll just mention that I recently bothered to write a very similar critique on an openly anti-psychiatry website, pointing out the flaws in their own perception of mental illness (the perception being that they don't even exist). Interestingly, both critiques, one of anti-psychiatry, the other of this book which I see as being "pro-conventional-psychiatry", are incredibly similar! If anything, I see myself not as anti-psychiatry, but as psychiatry-critical. Make of that what you will.
I was not only disappointed, but actively angered at times to be served the same rehashed praise for the Almighty Magic of Psychiatric Drugs! Not only that, I found the author to be profoundly condescending towards those of us who dare question contemporary, conventional psychiatry. Writing us off as crazy (ironic) "anti-psychiatry" nuts and conspiracy theorists. Well sorry, no. You can in fact exercise your critical thinking skills and ask legitimate questions regarding available treatments, where they come from, and still hope for a new and improved field of medicine. It's perfectly reasonable!
Believing she's being funded by "Big Pharma", now that would be paranoid; but I'll admit it crossed the mind of my baser self, as her opinion of medications was woefully biased, and completely befuddling as she herself states repeatedly, throughout the book, that they keep failing her. That she always ends up developing a tolerance... But oh no, it's not the same thing as substance dependency. Even the word withdrawal is used but, nope, still not addicted. Calling a spade, a spade, would be more honest. At least then people could make more informed decisions. Although I'll admit she does concede that benzodiazepines are highly addictive. So, kudos for that I guess?
These drugs are, simply put, not to be trifled with. There are NO long-term studies on their potentially irreversible side-effects. A lot of the available data at hand has confounded and/or manipulated by interested parties. This isn't being a conspiracy theorist, it's following the money, as well as the science. There are just not enough independent, evidence-based studies out there. Science is being squashed in the name of financial interests (and, mind you, this isn't unique to psycho-pharmaceutical research). Quoting the FDA or the DSM-V doesn't mean the science is sound, or unburdened by financial concerns. ESPECIALLY since it has been shown that more or less half of the DSM-V's board members have financial ties to the pharmaceutical industry*.
*To be honest, this review came out in 2012-2013. Which objectively is not that long ago, but it is possible things might have changed since then. However, without evidence to the contrary, I'll remain skeptical.
In any case, a lot of ethically-minded psychiatrists also question the validity of the DSM (though perhaps less so in the States), which keeps adding new items to its list of "pathological behaviors". Now, if this book were only taken as a compendium of guidelines, it wouldn't be such a problem. But it's considered by some to be a bible, an instruction manual, when it is well-known there is NO standardized, objective test to diagnose mental illnesses. It's largely a guessing game (exceptions might include acute psychoses I suppose). There is simply not enough data, not enough understanding about the human brain and/or the concept of mind. If these drugs were so great and awesome, then why are long-term results still so unpromising?
Yes, they can and do save lives, on the short, maybe medium-term. They treat symptoms (sometimes exchanging them for others, mind you, especially in the case of anti-psychotics), which I agree is better than nothing. For some, it's more than enough. But not all of us. It doesn't make us anti-psychiatry. It makes us disappointed. Hopeless. Angry. Suspicious. By us I mean patients, patients' families, doctors, researchers, etc... and yes, even qualified, respected psychiatrists. This field of medicine has been stagnant for years. This does not mean it should not exist at all. Absolutely not, but it needs to change.
The current "chemical imbalances in the brain" model has never been proven, and always appeared overly simplistic to me anyway. It's outdated. It's lazy. We should expect more scientific enquiry. We have a right to get better treatment options, ones that don't potentially damage our brains. The author writes in the book that anti-depressants and their ilk "fix the brain". Really? Based on what evidence, exactly? Where are your citations (no really, there was an abysmal scarcity of research citations)? If your aim is to promote informed consent (or perhaps it wasn't, now that I think about it), then you take it seriously. Anti-psychotics in fact probably encourage brain shrinkage, which is pretty bad considering people with mood disorders can have a measure of atrophy in certain regions of the brain... I say this is unacceptable. Anti-psychotics should not be doled out like candies. Or for any and all mental illnesses. There is such a thing as a chemical lobotomy. I mean, sure, you won't feel any crushing sadness, anxiety, or anger. In fact, you won't feel anything at all! If that is fixing you brain, then fine. But admit that surgical lobotomies could have been said to do the same thing then!
I was looking forward to encountering new, evidence-based information about a more holistic approach to the treatment of mental illness. I was also curious to learn more about ECT, as it is based on a slightly different medical model of mental illness than are psychiatric drugs. Or TMS, which is barely mentioned in passing. I can somewhat understand her dismissal of therapy, although to be comprehensive and helpful to others she should have given it more space than just a couple of pages in an appendix (especially when you compare that to the two, four pages each, appendixes dedicated to drug therapy recommendations - I was horrified at some of the combinations). Nothing whatsoever about the current research into psychedelic therapy either, which has a lot more preliminary evidence to back it up than a lot of the available drugs currently on the market...
The only positive thing I am taking away from this book is the recommendation for an interesting mood-tracking app.
The writing style was a little poor, but that's a minor quibble at this point. Really, it's the innumerable contradictions above all that really got on my nerves. To be fair, she did give a warning about this at the end of her book (putting it at the beginning would've made more sense though). But still, it reached truly ridiculous proportions. As I've already mentioned, the biggest being her stance on the glory of drugs when they keep failing her. The other big one was her mention of ECT as being more effective for depression than any drug, without her ever having gone through it herself (not that you have to go through something you recommend to others, I suppose).
The nail in the coffin, however, was her pseudo-philosophical ramblings about the mind/brain split, which didn't serve any real purpose. In any case, it's not an original thought, and it's beyond the scope of a book supposedly dedicated (or not? Again, this was never made clear!) to medical science. I will agree with the idea that the mind and brain are distinct "entities" (the good old software/hardware metaphor), but how can you prove they are separate, exactly? When the mind is clearly housed in the body? We are not separate from our flesh and blood animal selves. We live in them, we experience life on Earth through them. We shouldn't be unduly constrained by them, sure, but they are important nonetheless. Otherwise, why bother with living at all? Doesn't make any sense coming from someone encouraging people not to commit suicide, and to live this life. The mind/body split is a big part of the failings of modern allopathic medicine. Encouraging it, backing it up with a dualism worthy of pseudo-religious thought isn't going to help anyone.
I mean, would you tell people with eating disorders the body doesn't matter? How about all the horrible side-effects from anti-psychotics? Sexual dysfunction, diabetes type II, metabolic syndrome, horrific weight gain (I speak from personal experience - those 20 kg were a bitch to lose)? Those don't matter? Feeling good in your body doesn't matter?! Doctors and pharmaceutical companies make light of these serious side-effects, the author, as a fellow patient, shouldn't. I understand there are people who feel there lives have been saved by these drugs. More power to them. But it doesn't negate the fact some of us have been damaged by these same substances, either. We have a right to critique what we perceive to be a flawed, or a generally failing, system. Being dismissed as idiots and freaks for doing so by a fellow sufferer is just mind-boggling, even pathetic if I'm being completely honest.
The author does give advice for those who wish to quit their medication, which is really ironic given the tone found throughout the rest of her book - but it's better than nothing. I do think, however, people should receive higher quality, and most importantly unbiased, information. In order to weigh the pros and cons for themselves. This book, in my opinion, will not help you with that. At all. And, like I said, for a book claiming to be about "evidence", it doesn't even bother to provide a decent, well-researched bibliography...
This also points to another problem: it seems to me this book couldn't really make its mind as to whether it was supposed to be about personal experience or medical advice. It can of course be about both of those things (which I was sort of expecting?), but since each aspect was so poorly done, I'm left wondering if the decision wasn't made mid-redaction!
In any case, this book negates, erases, experiences like mine, my best friend's, and many other people we know who suffer from serious mental illness. I have studied biology, I believe in the scientific method, in independent, uninterested scientific inquiry, and it disturbs me deeply when I read on a medication notice that no one knows why it "works" for the condition it's meant to treat. It's unacceptable to be playing with the brain like that!
This book was overall little more than a mix of the DSM-V, pharmaceutical pamphlets, some personal history, and sprinkles of rudimentary wellness tips. It just goes to show that, just because you have a blog, doesn't mean you should necessarily make a book out of it!
N.B. Lest I be accused of being anti-psychiatry (again) despite my explanations, I'll just mention that I recently bothered to write a very similar critique on an openly anti-psychiatry website, pointing out the flaws in their own perception of mental illness (the perception being that they don't even exist). Interestingly, both critiques, one of anti-psychiatry, the other of this book which I see as being "pro-conventional-psychiatry", are incredibly similar! If anything, I see myself not as anti-psychiatry, but as psychiatry-critical. Make of that what you will.
More...