Interesting mainstream article on "mental health"

Have you seen this week's New Yorker?

SEATTLE, Washington - It's nice to see some swipes being taken at the mental health industries in a mainstream publication. The New Yorker is the mainstream, an opinion maker, right? Are there actually cocktail parties where everyone stands around, the guys with a drink in one hand and the other hand in their pants pocket, which crumples up the bottom of their blazer under their forearm, as they discuss what's popped up in The New Yorker? I mean, does this happen outside of movies set in Manhattan.

The chattering class can now chew on Louis Menand's article on psychiatry. The article cites many books both past and present on the topic and plucks out many nuggets regarding the shifting and dubious nature of the alleged nature and causes of "mental illness", the current decades-long push of chemical explanations and solutions, and the pathologizing of everyday thoughts and emotions.

Some clips:

There is little agreement about what causes depression and no consensus about what cures it. Virtually no scientist subscribes to the man-in-the-waiting-room theory, which is that depression is caused by a lack of serotonin, but many people report that they feel better when they take drugs that affect serotonin and other brain chemicals. [I'd swear I saw an ad the other day about how low serotonin levels cause depression - jeff]
..
..
As a branch of medicine, depression seems to be a mess. Business, however, is extremely good... By 2005, one out of every ten Americans had a prescription for an antidepressant. [I never cease to be shocked by these massive ratios - jeff]
..
..
The National Institute of Mental Health estimates that more than fourteen million Americans suffer from major depression every year, and more than three million suffer from minor depression (whose symptoms are milder but last longer than two years). [author Gary] Greenberg thinks that numbers like these are ridiculous—not because people aren’t depressed but because, in most cases, their depression is not a mental illness. It’s a sane response to a crazy world.

Greenberg basically regards the pathologizing of melancholy and despair, and the invention of pills designed to relieve people of those feelings, as a vast capitalist conspiracy to paste a big smiley face over a world that we have good reason to feel sick about. The aim of the conspiracy is to convince us that it’s all in our heads, or, specifically, in our brains—that our unhappiness is a chemical problem, not an existential one.
..
..
It has been claimed, for example, that up to 18.7 per cent of Americans suffer from social-anxiety disorder. In “Shyness” (2007), Christopher Lane, a professor of English at Northwestern, argues that this is a blatant pathologization of a common personality trait for the financial benefit of the psychiatric profession and the pharmaceutical industry... Turning shyness into a mental disorder has many downstream consequences... Centers are established (there is now a Shyness Research Institute, at Indiana University Southeast) and scientists get funding to, for example, find “the gene for shyness”—even though there was never any evidence that the condition has an organic basis. A juggernaut effect is built into the system.

But after recounting all the dubious history Menand rolls back to a pro-psychiatric-drug position, which is pointed out by Robin Hanson with what his colleagues would call a Hansonian explanation.

Powerful drug offered at Cupcake Royale

SEATTLE, Washington - Cupcake Royale has placed a large, well-labeled shaker of nutmeg on their condiment bar. Do they not know that nutmeg is a powerful psychoactive drug? Maybe they do know and that's why it's there.

William S. Burroughs discussed nutmeg in a letter to The British Journal of Addiction in the 1950s, a letter that was reproduced in some editions of Naked Lunch:

Convicts and sailors sometimes have recourse to nutmeg. About a tablespoon is swallowed with water. Results are vaguely similar to marijuana with side effects of headache and nausea. Death would probably supervene before addiction if such addiction is possible. I have only taken nutmeg once.

There are a number of narcotics of the nutmeg family in use among the Indians of South America.

Wikipedia also has some information on the *power* of nutmeg:

Large doses can be dangerous (potentially inducing convulsions, palpitations, nausea, eventual dehydration, and generalized body pain). In large amounts it is reputed to be a strong deliriant. Users report both negative and positive experiences, involving strong open-eye-visuals (hallucinations), and in some cases quite severe anxiety. Users may feel a sensation of blood rush to the head, or a strong euphoria and dissociation.

This probably isn't much of an issue at the West Seattle location, because there aren't enough people around with either the knowledge or the desire to dip into the nutmeg. But, Cupcake Royale is opening a Capitol Hill location later this month, and I'm pretty sure the Capitol Hill hipster/indigent population will blast right through the nutmeg supply. May want to keep the nutmeg behind the counter there, just like how Twice Sold Tales in the U-District can't leave Kerouac books sitting around on the bookshelves where poor students will take them and shove them into their pants.

Notes on recently read books

SEATTLE, Washington -

Appointment in Samarra, by John O'Hara: Nice to see that an American was writing in the 1920s and 1930s while not living in Paris. This novel takes place in Gibbsville, a fictionalized Pottsville, PA, circa 1930. It's a decent enough novel about the type of people that would inhabit such a place at such a time. (spoiler alert) I didn't think the guy's life was bad enough for him to kill himself (end spoiler) but I didn't write the thing.

I didn't know much about O'Hara upon finishing this book, and I assume this was the definitive word about Gibbsville/Pottsville. But, while poking around the we're-moving sale at Twice Sold Tales I saw a big book of Gibbsville essays authored by O'Hara. On top of that he set five of his novels there. He just kept writing and writing and writing about Gibbsville/Pottsville - maybe he should have spent more time in Paris.

Stork Club : America's Most Famous Nightspot and the Lost World of Café Society, by Ralph Blumenthal: I felt mildly let down by this book. It may just be that the Stork Club's owner, Sherman Billingsley, was not a very compelling figure. It seemed to have a fine-grained focus on Billingley's various battles over the years (mobsters, unions, Josephine Baker, sticky-fingered employees) without giving much insight on either the man or the broader "café society" in which the Stork Club operated. At least he spent a few years banging Ethel Merman.

Blaming the Brain: The Truth About Drugs and Mental Health, by Elliot Valenstein: This book was written in the late 1980s and heavily updated in 1997, but some facts are eternal: the Mental Health professions continue not to have much of a clue about the etiology of many of the things that they call "mental illnesses", but they pretend that they do.

A good hunk of the book is history, covering the evolution of thought about mental disorders and the history of treatments for said disorders. He gets into what is currently in vogue (chemical explanations for "mental illness") and what some of the alternatives are (e.g. physical brain structure issues). Chemical explanations are obviously popular with pharmaceutical companies, and Valenstein is quite hard on them, blaming them for distorting research and giving detailed coverage of the speculations, crumbs of knowledge, and outright bullshit that pharmaceutical companies have peddled as established scientific fact over the years (e.g. "low serotonin levels cause depression").

Valenstein doesn't think we should abandon psychoactive drugs, he agrees that they help some people some of the time, but he thinks we should honestly acknowledge that we don't have a very good idea why they have the effects that they have or what the drugs say about the underlying etiology of "mental illness".

(all "mental illness" scare quotes are mine, not Valenstein's)

Barney Frank, Ron Paul, marijuana - what could possibly go wrong?

SEATTLE, Washington - I'm sure if I combed over Barney Frank's overall record, I could find quite a bit of garbage, but I like to give credit when credit is due. Last year I mentioned Frank's criticism of state and federal efforts to restrict online gambling. Now Frank has turned his attention to the herb: He and Ron Paul have gotten together to introduce H.R. 5843, which would (among other provisions) eliminate all federal penalties for possession of up to 100 grams of marijuana for personal use.

I figured that someone or other introduced legislation like this on a regular basis, even as only a symbolic gesture, but this is in fact the first decriminalization legislation introduced in 24 years.

I'm sure if Thomas Jefferson was around today he would include the marijuana plant in "tree of liberty" discussions.

What do papayas, hopscotch, and Ouija boards have in common?

NEW YORK CITY, New York - Answer: they're all just about as effective as multi-billion dollar antidepressant drugs in treating "depression".

The BBC is reporting on a meta-study by the University of Hull, where they dug around and acquired both published and unpublished trial data, instead of only the published data (which is apparently cherry-picked to put the greatest possible light on the "antidepressant" drugs). To summarize, the swanky, patent-encrusted SSRI drugs were deemed to be no better than a placebo for all but the most "severely depressed" patients.

The BBC article notes that new armies of therapists are being trained to provide "talking therapies", and a Financial Times article on the same study notes that "outdoor exercise" can be used to combat "depression."

If talking to someone "cures" them, then there was nothing medically wrong with them to begin with. If a bit of outdoor prancing "cures" someone, then they were not medically ill.

I hate to sound like a Scientologist on this, but even a crazy, blind Scientologist squirrel can stumble upon a nut.

Another note on Thomas de Quincey

SEATTLE, Washington - de Quincey and Todd Solondz - separated at birth?

Couldn't have said it better myself

SEATTLE, Washington - The "War on Drugs" is riddled with hypocrisy and inconsistencies, but perhaps the central one is this: some psychoactive substances (alcohol, nicotine, etc.) are deemed acceptable for consumption, and others (marijuana, opiates, mescaline, etc.) are prohibited or doled out only in specific medical circumstances. Attempts have been made to justify why some substances are allowed and others are not, but upon close examination these categorizations are somewhat arbitrary and are strongly distorted by misinformation and special interests.

Many authors have made the case that adults should not be bound by these categorizations, and should be free consume whatever intoxicants they wish (one that I've read being Saying Yes by Jacob Sullum). While book-length assertions of this principle are great, it's tough to beat the succinct and elegant case made by Thomas de Quincey in Confessions of an English Opium-Eater.

I just started reading Confessions, and may or may not write a full review later. This book was first published in 1822, and an expanded version was published in 1856. Well-written English from the early 19th century has great style that simply cannot be matched by modern authors. The passage that caught my eye first appeared in the 1856 publication (italics and archaic spellings in the original):

If in early days I had fully understood the subtle powers lodged in this mighty drug (when judiciously regulated), (1) to tranquillise all irritations of the nervous system; (2) to stimulate the capacities for enjoyment; and (3) under any call for extraordinary exertion (such as all men meet at times), to sustain through twenty-four consecutive hours the else drooping animal energies - most certainly, knowing or suspecting all this, I should have inaugurated my opium career in the character of one seeking extra power and enjoyment, rather than of one shrinking from extra torment. And why not? If that argued any fault, is it not a fault that most of us commit every day with regard to alcohol? Are we entitled to use that only as a medicine? Is wine unlawful, except as an anodyne? I hope not: else I shall be obliged to counterfeit and to plead some anomalous tic in my little finger; and thus gradually, as in any Ovidian metamorphosis, I, that am at present a truth-loving man, shall change by daily inches into a dissembler. No: the whole race of man proclaim it lawful to drink wine without pleading a medical certificate as a qualification. That same license extends itself therefore to the use of opium; what a man may lawfully seek in wine surely he may lawfully find in opium; and much more so in many cases (of which mine happens to be one) where opium deranges the animal economy less by a great deal than an equivalent quantity of alcohol.

Don't trust the media to cover Marijuana - or "mental illness"

SEATTLE, Washington - An article at Huffington Post written by Maia Szalavitz discusses media coverage of a recent British study claiming causative link between marijuana use and schizophrenia and other psychotic illnesses. Szalavitz makes the case that the mainstream media have overstated the results of the study to stir up a bit of "reefer madness".

A cornerstone of Szalavitz's argument is that marijuana usage has increased dramatically in the last several decades, while the incidence rate of schizophrenia has remained fairly constant. Being immersed in Szaszian thought, I immediately thought, "so what?" Since a diagnosis of schizophrenia consists of little more than a psychiatrist coming to the opinion that you have schizophrenia, the so-called mental health professions could raise or lower the rate of diagnosis as they choose. When the appointment book at the office is light they can always gin up some new "Autism Spectrum Disorders" or maybe start bringing in the infants for psychotherapy.

And when the media are not busy refusing to ask fundamental questions about mental health, they're happily occupied not discussing the correlation of antidepressant drugs and violence, including a stunning correlation of these drugs with various massacres of recent years.

Come on, Huffington Post, let's see you dig up the real dirt!