Ironically, the first time Maddie Jones ever felt truly crazy was the time she took an anti-psychotic medicine. Last
summer, Jones (not her real name) didn’t have a job and went to bed
each night, terrified that she might lose her Leelanau County home. Jones
was taking 300 milligrams of Effexor for depression — a high dose, but
she still felt incredibly down. So she started seeing a renowned
Traverse City psychiatrist. “He started prescribing all these
drugs, willy-nilly,” Jones said. “He’d say, ‘That didn’t work, so try
taking two. Hmm, that didn’t work. Let’s try taking that other one.’
“Then came the week from hell. I was really bonkers. I felt I had to
flee my own house. I wasn’t sleeping. I wasn’t eating. I was talking
really fast all the time. I was way out of it. I actually took photos
of all the drugs because I thought I was losing my mind.” Jones
asked another doctor to help wean her off from one of the two
antidepressants, one of the two sleeping pills, and the antipsychotic,
Seroquel. Now she’s on one anti-depressant and only one “sleeper.” She
feels much better. “I think there are psychiatrists who are legal drug pushers, and he’s one of them.”
IT’S PERSONAL Ben
Hansen, a passionate anti-drug activist, knows of stories like Maddie
Jones all too well. Last week, he was on the phone with a foster care
caseworker who suspected a boy died from a drug overdose. The child had
developed a neck twitch — possibly due to psychiatric medications he
was taking — and his doctor prescribed an ADHD medicine. Days later,
the boy died. When the caseworker learned a reporter had been apprised,
he quickly emailed that the cause of death was still unknown. Hansen
has spent the past eight years trying to sound the alarm over the
nation’s deepening addiction to mind-altering medication. For
Hansen, the issue is personal. His quest began in 1999 after an
involuntary confinement at Munson Medical Center’s psychiatric unit
after he had admittedly lost touch with reality. Hansen’s brush
with the psychiatric world began with a no-sleep vigil at his dying
father’s bedside over an intensely emotional three days. He reconciled
with his father and experienced a profound, spiritual connection with
God. Hansen was elated and went home to rest. Hours later, he was
called with news of his father’s death. As soon as he placed the phone
on the receiver, another call came in with tragic news: a coworker had
committed suicide. Hansen didn’t sleep, and the next day, he heard
voices and caused a disturbance on Front Street. He pushed his minister
(who was trying to help him), and was taken to Munson’s Center One,
given a shot, and diagnosed with bipolar disorder while he lay
sleeping, despite no previous history of mental illness. Hansen
managed to leave Center One 39 days later without the requisite
agreement to take prescription drugs for the remainder of his life. But
it involved a bitter fight. The experience radicalized him, and he is
now part of a national network of activists who challenge the culture
of pharmaceutical drugs. He also sits on the state’s Recipient
Rights Advisory Committee, which is linked to the Michigan Department
of Community Health. The committee’s mission is to help people
receiving mental health services who have had their rights violated.
DRUG ESCALATOR Hansen
has launched a satiric website, bonkersinstitute.org, and reaches out
to the media with his writing and research. But obviously his lone
voice is lost in an ocean of money. Drug companies spend $15 billion
on marketing and rake in $200 billion in sales a year in this county.
Pharma is our country’s most profitable industry. Drug companies and
company officials gave at least $17 million to federal candidates in
the 2004 election. They also spent $158 million that year to lobby
federal legislators and $7.3 million to support political party
conventions, according to a USA Today article. Thanks to
advertising, the public at large has swallowed the Kool-Aid, and
commonly pressure their doctors to prescribe a specific pill — “If you
don’t give it to me, I’ll go to somebody who will,” Hansen said. Taking
an anti-depressant is how many folks first get on the prescription drug
escalator. An anti-depressant often saps the sex drive. So you take
something for that — maybe Viagra for an on-call erection. But then you
can’t go to sleep. You take a sleeping pill. Problem solved. But now
you’re in a bit of a fog and have problems focusing at work. You go
online and diagnose yourself with adult attention deficit disorder. So
you take Ritalin a couple of times a day. Voila, you are an official drug addict.
PHONY FRONTS Ads
and political influence are pharma’s most obvious strategy, but its
messages are also promoted by what appear to be good-hearted patient
support groups, which are, in fact, supported and/or created by
pharmaceutical companies (wemove.org, adultadd.com, nami.org and
chadd.org are just a few of them). The Traverse City Record-Eagle
ran a forum piece last month by Mark Reinstein of the Mental Health
Association in Michigan. Reinstein argued in favor of parity in health
insurance — essentially requiring insurance companies to cover doctor
visits and drugs that are related to mental health problems. Most
people see that as a positive change for the patients, but it’s also
good for pharma. Health insurance is the quickest way to make people
forget about their pocketbook. Hansen later discovered that
Reinstein’s nonprofit received $35,000 in the first quarter of 2007
from pharmaceutical giant Eli Lilly for its “education and advocacy
initiative to promote mental health insurance parity in Michigan.”
These are the invisible ways that pharma influences our thinking, he
said. Hansen, on the other hand, said he submitted three letters
and forums to the Record-Eagle, only one of which was published in
2000. “It was easier for me to express my opinion in the New York Times
than the Record-Eagle,” he quipped. He was referring to the
front-page story about Eli Lilly setting up prescription Medicaid
oversight programs in two dozen states, including Michigan (see story
on page10).
THE GOODNESS OF DRUGS There are two sides to every story, and the treatment of the mentally ill has about 30 times that many. For
those whose lives have been transformed with anti-depressants, Ritalin
or an anti-psychotic drug, Hansen’s message can rub them the wrong way.
Who is he to make a judgment call on someone’s personal decision to
take a drug that makes life bearable and even joyful? Jones said
that despite her bad experience, she believes that they are useful when
responsibly administered. “I started taking an anti-depressant 10 years
ago, after my daughter was sexually assaulted. I was just crying all
the time. I started taking Zoloft and found I could cope.” Hansen is
mostly unmoved when people tell them their success stories — how a new
mom, for example, was able to cope with terrible post-partum depression
or how one Traverse City man, who switched from Haldol ($14 per month),
is now able to hold a job and easily converse with people thanks to his
prescription for Zyprexa ($300 per month). He doesn’t buy that
millions of people have a “chemical imbalance” in their brains: “If
there’s a chemical imbalance, then why is the list of side effects a
mile long?”
MATTER OF CONTROVERSY Traverse City clinical
psychologist Greg Holmes confirmed that there is no known biological
test for depression. “What chemical imbalances exist, and whether they
are a cause or effect of depression is a matter of controversy.” The rating scale that physicians use to diagnose depression is also controversial, he said. “Many
studies indicate there is little or no difference in response between
depressed patients given an antidepressant, and those who receive a
placebo. Interestingly, people who are depressed have also responded to
many substances not classified as antidepressants, such as
neuroleptics, barbiturates and benzodiazepines.” Much of the
research of antidepressants and their use in treating depression is
also in dispute, in part, because pharmaceutical companies have funded
the research themselves and are suspected of putting a spin on the
findings, Holmes said.
THE NO-DRUG ROUTE Holmes said that
studies show that psychotherapy is as effective as medicine in the
short-term, and has longer lasting benefits after treatment ends.
Holmes is also a big proponent of exercise. “It has very powerful,
mind-elevating effects.” Studies also show that Omega 3 fish fatty
acids, or fish oils that you can take in a gel cap are also “huge” in
helping with depression, said Greg Chappell, doctor of chiropractic. “And they’re also using mega-doses with schizophrenia and bipolar disease,” said Chappell. Research
shows that subjects who simply anticipate that they will receive
antidepressants for their depression exhibit changes in their brain.
“What all this leads me to conclude is that hope, offered in any form,
is what many depressed patients actually respond to,” Holmes said.
OUT OF KILTER Hansen
rejects the “disease” theory of depression, attention deficit disorder,
postpartum depression, and the myriad of other mental disorders. Our
society is so out of kilter, that we call obesity a disease, instead of
what it used to be—a “condition” that leads to certain diseases, Hansen
said. “If you consume 5,000 calories per day and your only exercise
is walking from the sofa to the refrigerator, it’s perfectly natural to
gain weight. But if you fail to gain weight, then I’d say, perhaps, you
have some kind of disease.” Hansen points to the “rodent test” that
measures the efficacy of anti-depressants. Without any drugs, the
rodent will swim around in circles until a certain point, and then
stop. A rodent that has been administered an anti-depressant is more
optimistic and will keep swimming around and around until it’s
exhausted and drowns. “Now who has a better grip on reality — those who are realistic or those who are artificially optimistic?”
THE ROLE OF SPIRITUALITY
Hansen
believes people are really suffering from spiritual emptiness or
profound stress from the hardballs that life throws, such as divorce or
financial problems. In fact, a new analysis shows that drug
treatment may be inappropriate for people who are simply experiencing
painful episodes. Counseling would be the most effective for these
cases. The study said that the percentage of those diagnosed as
clinically depressed might be inflated by as much as 25%, according to
a study appearing last month in The Archives of General Psychiatry. To
be considered clinically depressed, you need only report five symptoms
out of a constellation of symptoms for at least two weeks—tired,
hopeless, or suffering from insomnia, for example. But you don’t
even have to do that with some doctors. One elderly woman went to an
area doctor for a sinus infection. Knowing her husband had recently
died, the doctor offered her an anti-depressant out of the blue. She
never opened it, Hansen said. If someone is told they are
“depressed” instead of “sad,” or “anxious” instead of “scared,” they
now think they have a medical condition, Holmes said. “Instead we
need to treat people with love and compassion, encouraging them to
develop new coping strategies for the difficulties of life,” he said. There
is a sense that the tide of public opinion might be turning against
chemical solutions. A reporter recently wrote in the New York Times
Magazine about his odyssey to get off an anti-depressant — a very
painful withdrawal that came with “brain shivers” (a side effect which
the drug companies have not acknowledged) and insomnia. His pay-off — a
sense of clarity and a depth of emotions, both of joy and grief, that
he hadn’t felt in three years. Hansen believes people mistake
depression for a general malaise about their lives. “They tell
themselves, ‘I have my perfect house, my perfect car, enough closet
space.’ It doesn’t occur to them that they might be depressed because
their life has absolutely no meaning. “Psyche means ‘spirit.’ Our
lives have a deeper meaning than to just acquire material possessions.
We are spiritual beings with a soul, but the pharmaceutical industry
would have us believe we’re nothing more than machines to be tinkered
with by adjusting chemicals in the brain. “Emotional and spiritual
problems cannot be solved by popping a pill. We need to stop
labeling every unpleasant emotion and every unwanted behavior a
disease. Instead, we need to start listening to each other’s
stories. That would be a good start.”
