 Good day mate 40 here so Why why does America have an epidemic of mental illness, right? Well in large part because it's the new welfare so Many low-income families find that applying for SSI supplemental security income payments on the basis of a mental disability That's the only way that they get to survive because it's more generous than welfare it unlocks Medicaid and other benefits and Essentially claiming mental disability is the new welfare So hospitals and state welfare agencies Have all these incentives to encourage uninsured families to apply for SSI payments Because then hospitals will get paid and states will save money because they get to shift their welfare costs to the federal government so all these poor people if they want to make it they have all these incentives to go on social supplemental security income SSI and What do you need though to qualify to qualify You and your kids you all have to be taking psychoactive drugs So yeah comes comes with a bit of a price You want to get that that juicy SSI income with with the Medicaid and all the other benefits You have to be on psychiatric drugs So you want to get say $1,500 a month for your family? Well, say $2,000 a month $2,500 a month with benefits. Oh You have to You have to take psycho Psycho drugs you have to take psych drugs To get that juicy juicy money all that free money pouring in and government benefits And welfare and being taken care of by the government. Yeah, just just this price to pay you have to take psych drugs Does that seem like a healthy situation? There's just this amazing two-part series by Marsha angle in The New York review of books and I just subscribed to the to the New York review of books So for $10 a year and it gives you access to the entire archive So about 20,000 articles, so it's just for $10. So who is Marsha angle? She just the editor-in-chief former editor-in-chief of the New England Journal of Medicine the most prestigious Journal of Medicine she was the editor-in-chief for about 10 years Okay, so highly prestigious highly accomplished woman and These two articles on America's epidemic of mental illness are just unbelievable so Why and The tally of those who are so disabled by mental illness that they qualify for SSI or social security disability insurance SSDI is increased to a Two and a half times between 1987 and 2007 so from 1 in 184 Americans to 1 in 76 And it's kept increasing ever since so now it's about 150 Americans qualify for Government welfare social security disability insurance or supplemental security income on the basis of a mental disorder and To get this sweet sweet government money. They have to take psychiatric drugs. That's the price So for children there's been a 35 forward increase In the part in those two decades So mental illness is now the leading cause of disability in children now. I remember mental illness Overwhelmingly has no objective criteria. There's no MRI scan. There's no CT scan There's no blood tests that diagnosis mental illness Right. This is highly subjective Mental illness is diagnosed according to the DSM the Diagnostic and what was it diagnostic DSM diagnostic and statistical manual of mental disorders It's now in its fifth edition now sounds really scientific, right? The diagnostic and statistical manual of mental disorders. Well This is a move by psychiatrists to make money That's what the the DSM is all about. There's no objective scientific Very little objective or scientific Basis for mental illness diagnosis. They just lay out. Okay, if someone's got at least five of the following 10 symptoms then you can diagnose them with this mental illness, but it's subjective and Psychiatrists have less training in doing psychotherapy than psychotherapists and psychologists and social workers So their advantage is that they because they're medical doctors they get to write prescriptions But they are the least respected medical doctors other medical doctors do not regard psychiatrists as you know, really real doctors because the scientific basis for psych psychiatry is really weak Okay, the biological objective basis for psychiatry The psychiatry has been trying to base itself on biological facts for over 120 years and it's like, oh, we're almost there. We're almost there. No Like psychiatry has been searching for 120 years to ground its basis in objective biological facts and it's still empty in that regard so How do you get a diagnostic and statistical manual of mental disorders? You get a psychiatrist who gathers together with his like-minded peers most of whom get enormous funding from Pharmaceutical companies All right, including all the people who write the entries on say mood disorders and anxiety disorders Right all of them are funded by the pharmaceutical companies And so they come up with these These tests where oh if your patient's got three of the five following symptoms, then you prescribe them xyz But in the diagnostic and statistical manual of mental disorders, there are no sightings of scientific studies like providing a basis for the content in this work All right, it's just completely unparalleled in in medicine All right, they come up with this diagnostic book But they don't include scientific studies to validate these diagnoses Okay Why do we have in short? Why do we have an epidemic of mental illness in america because psychiatrists And pharmaceutical companies can make money from that Psychiatrists have incentives to keep increasing the number of mental illness diagnoses Because then they'll have more patients. So psychiatrists are fighting for patients with social workers psychologists and psychotherapists And the only advantage that psychiatrists have over those other people is that they can write prescriptions psychiatrists have less training in therapy than all those other professions, so Psychiatrists have developed this rig game along with the FDA and the pharmaceutical companies And just to be blunt and to boil things down the evidence for ssri's and other pharmacological Treatments for for depression the evidence that there's any benefit beyond a placebo effect is quite muddled And quite modest So there's just as much evidence that people get benefit from exercise For their mental illness as there is for pharmacological drugs There's just as much evidence that people benefit from psychotherapy as for drugs But there's no giant industry that makes money when you get people to exercise There's no giant industry Right that That uh, you know makes money from people going for a walk or going for a jog So That's the the shorthand reason for why we have this this absolute epidemic of mental illness so The National Institute of Mental Health So this is essentially a lobbying organization for people making money from the mental health industry They've now established that half of americans have mental illness At least at one point in their life They might have anxiety disorders phobias post traumatic stress disorder. There's no ptsd Prior to american Medical diagnoses like how come other countries don't have ptsd mood disorders major depression bipolar disorders impulse control disorders attention deficit hyperactivity Disorder ADHD substance use disorder All right, so according to the mental health industry, you know, half of americans have suffered from mental illness And treatment by medical doctors It virtually always means psychoactive drugs. So drugs that affect your mental state And while the benefits of these drugs are modest the harms that these drugs can do are quite substantial like they they shrink Your prefrontal cortex Okay, they reduce your ability to think clearly With with long-term use So most psychiatrists they only treat with drugs Because they make more money that way than if they do talk therapy And then most psychiatrists refer patients to psychologists or social workers if they believe psychotherapy is warranted So prozac came to market in 1987 as being intensely promoted as a corrective for a so-called deficiency of serotonin in the brain In the next 10 years the number of people treated for depression tripled So 10 of americans over age six now take antidepressants and the evidence that these drugs work is modest So why do we have this epidemic of mental illness? It's not because americans are more crazy, but it's because of incentives Psychiatrists make money pharmaceutical companies make money And people who are struggling to get by they get to tap into government welfare if they can claim a mental disability But to prove to sustain that they have to take all these psychological drugs So there's two-part series by Marsha Angle remember for 10 years she was the editor in chief of the new england german medicine Very prestigious title So she's reviewing here oving kersh who's a Harvard psychologist He wrote the emperor's new drugs exploding the anti-depressant myth and kersh makes the the argument the point that there's no There's no strong evidence that anti-depressants and ssri's Deliver any more benefits than the placebo effect. See depression All right. Depression means you feel hopeless Just offering if I offer you a pill say this helps many people with depression. You now have a way out, right? You now have hope So with depression you're hopeless with the pill you have hope So you will immediately get a placebo benefit Then another book here by Robert Whitaker anatomy of an epidemic magic bullet psychiatric drugs and the astonishing rise of mental illness in america Then the third book unhinge the trouble with psychiatry The doctor's revelations about a profession in crisis by daniel carlott. So daniel is a psychiatrist So kersh is at harvard university. He was interviewed in 2011 I believe by 60 minutes making the point that anti-depressants basically only have a placebo effect And he argues that psychoactive drugs create worse problems than they solve And daniel carlott the psychiatrist says that his profession essentially being corrupted by the pharmaceutical industry Now all three books agree on the disturbing extent to which the pharmaceutical companies sell psychoactive drugs And they have come to determine what constitutes mental illness how the Disorder should be diagnosed and treated. There are no objective standards for these Diagnoses and treatments, right? It's Psychiatrists generally making a lot of money from the pharmaceutical companies coming up with these subjective Diagnoses that uh That everyone in the mental illness industry particularly psychiatrists and pharmaceutical companies can then make money from Okay, it I still hear people who believe this ludicrous notion that That anti-depressants and SSRIs they they correct chemical imbalances in the brain. Have you heard that one? It's it's bunk There's absolutely no evidence for it All right, but I still hear people in 2021 citing it. It's like You'll find chiropractors who will make the case for chiropractic by saying well It's like when you've got a hose and it's kink the water doesn't flow through But you unkink the hose and then the water flows and that's what happens with with chiropractic We we unkink your your spine and then, you know, the vitality just flows just absolutely no scientific Evidentiary basis for this. It's it's completely bogus the evidence that That chiropractic works or anything more than temporary relief is virtually nil Right. It's just a scam industry so Yeah, there's if you encounter this notion that that Anti-depressants correct chemical imbalances in the brain just just know there's no evidence for this So we had all these drugs in the 1950s that would not That would not Develop to deal with mental illness, but they found to have side effects that help with mental illness such as Thorzene It seemed to calm down psychotic patients then you had tranquilizers so You had these three categories psychosis anxiety depression and the face of psychiatry was then completely completely Transformed because these drugs would blunt the disturbing mental symptoms So it's possible that these drugs affect neurotransmitter levels in the brain But it's not at all clear that these neurotransmitters have anything to do with the illness in the first place Now by the same logic, you can argue the cause of all pain conditions is a deficiency of opiates Why aren't you on opiates, dude? Why aren't you essentially on heroin, dude? because You know narcotic pain medications and heroin they take away pain So anyone with pain, dude, your problem is that you're not on heroin. You're not on opiates I mean you could similarly argue that all fevers are caused by two little aspirin neurotransmitter functions They're normal in people with mental illness before treatment So prior to treatment patients diagnosed with schizophrenia depression other psychiatric disorders do not suffer from any known objective empirical testable chemical imbalance But once you put a person on psychiatric medication Then you change the way the brain functions So Irving Kirsch has studied this exhaustively And his work is backed up by a major study in the british medical journal one of the three most prestigious One of the top five top three most prestigious medical journals so they searched very scientific libraries for every instance of the terms depression and antidepressants And they compared all the studies trying to see how effective they are Okay, so the studies show that antidepressants have a statistically significant effect on depressive symptoms But the size of the effect is minimal So the benefits of antidepressant seem to be Minimal possibly without any importance to the average patient with a major depressive disorder And it's not at all clear that the side effects are Exceeded by the benefits So i'm going to post links to these studies and these articles so Irving Kirsch at Harvard university Harvard psychologist finds that placebo's were 75 percent as effective as antidepressants Now when drug companies seek approval from the FDA to market a new drug They have to submit the FDA or clinical trials that they have sponsored And the trials are usually double blind and placebo controlled So patients don't know whether they're getting the real drug or a placebo But patients will experience side effects if they're giving the real drug So when they experience side effects, they think ah, i'm getting the real drug So it's not at all clear that there's any benefit beyond placebo Now drug companies make sure the positive results positive studies are published in medical journals and doctors know about them But the studies that don't show any beneficial result. They don't have to make those public those get hidden So the FDA regards these these studies as proprietary and confidential So you only ever get to hear about studies that show that the drug is effective above a placebo level So Irving Kirsch and his colleagues used the freedom of information act to obtain FDA reviews of all placebo controlled clinical trials for prozac paxil zoloxycelexa sozone and effectsor And then he found placebo's were 82 percent as effective as the drugs So the difference between the drug and the placebo was only 1.8 points But essentially clinically meaningless difference So all six of these drugs Scientifically empirically unimpressive in their results But because all the positive studies are extensively publicized the negative ones were hidden So the public of the medical profession came to believe that these drugs were just highly effective anti depressants Now all sorts of treatments that were not anti depressants such as synthetic thyroid hormone opiates sedative stimulants herbal remedies They were just as effective as anti depressants in alleviating symptoms of depression So when they were administered as anti depressants They relieved depression to the same extent as prozac and and all the other SSRIs and famous anti depressants Now what effective drugs all had in common was that they produced side effects So if a patient Is experiencing side effects, then he knows that he's getting the real drug So kersh looked at trials that employed active placebo's instead of a note one So an active placebo is one that itself produces side effects So when they use an active placebo The trial show there's absolutely no difference between the anti depressant and the active placebo But every everything that you're given has a side effect. Everyone reports the same level of improvement Another odd thing about clinical trials of anti depressants. There is no dose response curve So there's no evidence that higher doses work better than lower doses Which is extremely unlikely if these drugs are actually effective So the relatively small difference between drugs and placebo's might not be a real drug effect at all It's probably an enhanced placebo effect Produced by the fact that some patients have broken the blind They've come to realize whether they've been given the drug or the placebo So there's probably no real anti depressant drug effect at all So if you prescribe anti depressants or if you take them you should know from clinical experience There's no strong clinical empirical evidence that these drugs work Now there are lots of anecdotes But you can find anecdotes talking about the healing powers of leeches or leitreal or megadotes as a vitamin c or All sorts of other popular treatments. There's simply no evidence So we've had this explosion in the number of disabled mentally ill americans since 1955 And it's basically our drug-based paradigm of care is fueling this modern-day plague of disabling mental illness There used to be conditions such as schizophrenia and depression were limited and episodic Now these conditions are chronic and lifelong Because drugs even those that relieve symptoms in the short term they cause long-term mental harm that continues after the underlying illness would have naturally resolved There used to be schizophrenia depression These things will last at most six months But when she'd start taking drugs Those nasty side effects can go on and on and on that's where you have so many americans on Getting disability for mental illness So when you take a psycho psycho drug The brain tries to nullify the drugs effect And with the long-term use of psychoactive drugs There is substantial long-lasting alterations in the way that your brain works in your neural functioning both qualitatively and quantitatively You begin to function different from your normal state So after several weeks on psychoactive drugs the brain's compensatory efforts begin to fail side effects emerge So ssri's often cause episodes of mania because of the excess of serotonin Antipsychotics cause side effects that resemble Parkinson's disease Because of the depletion of dopamine So these side effects emerge and build up and then treat it with other drugs So I remember I was I was dating a woman who eventually got on six different psycho active drugs So episodes of mania caused by antidepressants Lead to new diagnoses of things like bipolar disorder and you get treated with a mood stabilizers such as depicote One of the newer antipsychotic drugs and on and on and on so many patients take as many as six psychoactive drugs daily And these drugs shrink the brain and shrinking the brain is not a good thing And how much they shrink the brain is determined by the dosage and duration of treatment So the prefrontal cortex doesn't get the input it needs when you're on these drugs So it's slowly being shut down by the drugs that reduces the psychotic symptoms But it also causes the prefrontal cortex, which is your decision maker to slowly atrophy Getting off these drugs is exceedingly difficult So when selexa for example is withdrawn serotonin levels for precipitously When antipsychotics are withdrawn dopamine levels may skyrocket. So the symptoms produced by withdrawing from psychoactive drugs Often lead to relapses which lead psychiatrists to resume the drug treatment perhaps at even higher doses So we have an epidemic of brain dysfunction In part caused by the prescription of all these psychoactive drugs So imagine that a virus suddenly appears in our society that makes people sleep 12 hours a day And those infected with it move about slowly. They seem emotionally disengaged They gain huge amounts of weight their blood sugar levels soar their cholesterol levels Soar They're struck by mysterious illnesses. They become diabetic Federal government gives hundreds of millions of dollars to scientists at the best universities to decipher the inner workings of this virus The research shows that the Neural pathways in the brain have been severely compromised by this virus MRI studies find that over a period of years the virus shrinks the cerebral cortex Your decision maker And this shrinkage leads to cognitive decline Right there. It would be a terrified public clamoring for a cure Now such an illness has in fact hit millions of american children and adults We're just describing the side effects of Eli Lilly's best-selling anti psychotic zeprexa The psychoactive drugs probably worse than useless So why are they so widely prescribed if they're worse than useless? All right, you have to look at the incentives so In the late 1970s the psychiatric profession Was getting outcompeted by psychologists social workers psychotherapists And so they wanted to medicalize psychiatry, which means make the the primary answer to mental problems drugs So Psycho psychiatrists or mds. They're doctors. So they have the legal authority to write prescriptions So they wanted to push all their competitors off to the side And identify themselves as the scientific discipline Along with the rest of the medical profession for dealing with mental illness And so by emphasizing drug treatment They became the darlings of the pharmaceutical industry which made its gratitude very tangible lots of money In fancy vacations So the third diagnostic and statistical manual the the dsm Was overseen by robert spitzer a professor of psychiatry at columbia university He just got together with all these friends all those who'd go along with what he wanted So it was published in 1980. It contained 265 diagnoses of mental illness So the more diagnoses of mental illness you can make the more americans You can convince have mental illness and need your Your therapy meaning your drugs. So they come to see you you give them drugs Psychiatrists and the pharmaceutical industry makes money. So they it's in their Interests they are incentivized to keep expanding What is mental illness? so The main goal of the dsm 3 was to bring consistency To psychiatric diagnosis So that psychiatrists saw the same patient would agree on the same diagnosis that didn't really happen But remember there's no connection between Consistency and reliability. So if you've persuaded or your peers to consistently diagnose something that Provides zero evidence that what you're diagnosing is real So it was more consistent. It was more reliable But there's no such connection between reliable and validity. So reliability just means consistency validity refers to correctness or soundness So if all physicians agreed that freckles were a sign of cancer the diagnosis would be reliable, but it would not be valid So the dsm all it does is reflect the opinions of its writers And so the people who organize each dsm they pick people that they like or they are on the same page with so One professor of psychiatry Wrote a 1984 article the disadvantages of dsm 3 outweigh its advantages He wrote the dsm 3 represented a bold series of choices based on guess taste prejudice hope So the dsm then became the bible of psychiatry But you know in the dsm There are no citations of scientific studies to support the decisions. All right, just absolutely astonishing emission because In virtually all medical publications where the journal articles or textbooks Statements of fact are always expected to be supported by citations of public scientific studies But the dsm does not do that And they sell over a million copies and the latest one has like over what 400 diagnoses of mental illness So drug companies saw hey, it's in our interest to ally with psychiatrist So they begin to lavish attention and largesse on psychiatrists individually and collectively They shower them with gifts free samples. They hire them as consultants. They hire them as speakers. They buy the meals They pay for them to attend conferences. They supply them with educational materials So the writers of the dsm most of them are on the payroll of pharmaceutical companies So drug companies are particularly eager to win over faculty psychiatrists at prestigious academic medical centers called key opinion leaders ko ls Okay, these are the people who's writing and teaching influence how mental illness is diagnosed and treated So the 170 contributors to the dsm for 95 had financial ties to drug companies including all of the contributors to the sections on mood disorders and schizophrenia So psychiatrists consistently lead the pack in all medical specialties When it comes to taking money from drug companies So overall psychiatrists make less money than all other medical doctors and have less prestige and less scientific and evidentiary basis for their work There are no objective signs or tests for mental illness. There's no lab data. There are no MRI findings Okay, the boundaries between what is normal and abnormal is not clear So that makes it possible for shrinks to just keep expanding diagnostic boundaries or to create new diagnoses In ways that'd be impossible in a field like cardiology. That's marcia angle And drug companies have every interest in encouraging psychiatrists to do just that so You've got this powerful Quartet of voices coming together To inform the public that mental disorders were brain diseases that could be cured by drugs So pharmaceutical companies provide the financial muscle the american psychological association and psychiatrists at top medical school Confer the intellectual legitimacy on the enterprise the national institute of mental health Puts the government stamp of approval on the story So daniel car lad who writes one of the books here He sees three patients an hour for psychopharmacology And so he earns about 180 an hour if he saw only one patient an hour for talk therapy Most insurers would pay him half that So patients tend to view psychiatrists as wizards of neurotransmitters Who can choose just the right medication for whatever chemical imbalance is at play This is a completely exaggerated distorted conception of psychiatric capabilities But it's one that's encouraged by drug companies and by psychiatrists and by patients hope for a cure so When psychiatrists bring in a patient and ask them questions They're trying to match them out with diagnoses in the dsm But what you're doing is assigning patients labels And patients will often meet criteria for more than one diagnosis because there's usually overlapping symptoms so Psychiatrists target discrete symptoms with treatment And then they add in other drugs to pile on top to treat the side effects of the initial medications So a typical patient might get selexa for depression Ativan for anxiety Ambien for insomnia Provigil, which is midaphanel for fatigue and then viagra for impotence So they're only a handful of umbrella categories for psychotropic drugs And in these categories the drugs are not very different from each other So the choice of medications is largely subjective even random So guided generally speaking psychiatrists are guided by symptoms and are guided by any objective laboratory findings and just try different drugs have no real conception of what they're trying to fix or how the drugs are working And you know, it's I'm perpetually astonished that we are so effective for so many patients But what they may very well be responding to is hope You're giving people hope and appeal And then we've got all these multiplying of diagnoses always expanding The the The definition of one is mentally ill to encourage more and more people to see psychiatrists and get medicated So we've got diagnostic boundaries broadened to include psychosis risk syndrome or mild cognitive impairment Got obsessive compulsive disorder spectrum Autism spectrum disorder hypersexual disorder restless leg syndrome binge eating So the DSM is essentially a bonanza for the pharmaceutical industry But at a huge cost to the new false positive patients caught in the excessively wide DSM net so In primary care about half of patients seen will have prominent mental health symptoms that can be diagnosed by the DSM So it's becoming harder and harder to be normal And the people arrange these DSMs They're usually on advisory boards for Eli Lilly forest pharmaceuticals Johnson and Johnson So the pharmaceutical industry influences psychiatrists to Prescribe psychoactive drugs for categories of patients in whom the drugs have not been found to be safe and effective And we've got an astonishing rise in the diagnosis and treatment of mental illness in children Sometimes as young as two years old They're treated with drugs never approved by the FDA for use in this age group and drugs that have serious side effects so prevalence of juvenile bipolar disorder jumped 40 forward between 1993 and 2004 autism Increased over five times in the same decade 10 percent of 10 year old boys now take daily medication for ADHD 500 000 american children take antipsychotic drugs And These prescriptions just go in the lines of fads. All right. We have fashions in diagnosis. We had ADHD And then it became bipolar juvenile bipolar disorder Then we've got tempered dysregulation disorder with dysphoria Right. So someone who's irritable right your child's irritable. Ah get him on meds So whether children are labeled as having a mental disorder treated with prescription drugs depends on who they are And the pressures their parents face. So This low-income parents Experience growing economic hardship many find that applying for supplemental security income payments On the basis of mental disability is the only way to survive. It's the new welfare hospitals state welfare agencies encourage uninsured families To apply for ssi because then the hospitals will get paid and the welfare agencies will get paid You've got all these growing numbers of for-profit firms specializing in helping poor families apply for ssi But to get on ssi you almost always have to for mental disability You and all your kids have to take psychoactive drugs So children from poor families are four times as likely as privately insured children to receive antipsychotic medicines 2006 a four-year-old child named rebecca riley died in a small town near boston from a combination of clonidine and depico Which had been prescribed along with cerakwell to treat adhd and bipolar disorder diagnoses she received When she was two years old She got these diagnoses at two years old Okay, none of these drugs were approved to treat adhd or for long-term use in bipolar disorder none was approved for Children her age Her two older siblings were given the same diagnoses. They were each taking three psycho active drugs Parents got ssi benefits for the siblings and for themselves And we're applying for benefits. We thought rebecca when she died Family's total income from ssi when she died in 2006 was 30 000 a year So the FDA approved drugs only for specified uses It's illegal for companies to market them for other purposes off label But physicians do it all the time for any reason they want And despite these drug companies paying hundreds of millions of dollars in fines. They've come out financially well ahead because psychiatric diagnoses are incredibly subjective And diagnostic boundaries can just be almost endlessly expanded So we've had a frenzy of mental illness diagnosis frenzy in prescribing Drugs for which the evidence that they work is at best modest Also, all these drugs come with the loss of brain tissue And diminished cognitive functioning So psychotherapy exercise Are at least as effective as drugs for depression But they don't come with the horrible side effects But there's no industry to push these alternatives And americans have been Taught to believe that the psychoactive pills are just much more potent