Pathologizing Life
by Gary Null
Copyright 2002
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There is a crisis in the United States today. Forty million of its
citizens are diagnosed as having depression. An increasing number of
these are children, the elderly, and African-Americans. But this
statistic occurs in a society that in the past decade has witnessed
unparalleled growth in the wealth of services, information, and
consumer choices, especially in the realm of health One just has to
think of the number of pharmacies that have sprung up in your
neighborhood, whether it's in a large city or small town. One would
suppose that our health is being properly serviced. So why are we
losing the battle for people's general well being as shown by recent
data?
Looking back, the United States experienced many depressing events in
the past century: the Depression, two world wars, and many smaller
wars that directly affected the well being and mental health of its
citizenry. But somehow they were able to cope without being
labeled "ill". They may have experienced many painful emotions, but
these didn't require medications or therapies, in general. Today, in
a time of unprecedented prosperity, however, more and more people are
being classified as incapable of coping with their daily routines and
circumstances, and, therefore, requiring treatment, usually in the
form of pharmaceuticals.
Now into this contemporary situation is dropped an informational
bomb. On June 13, 2002, ABCNews.com announced that recent studies
show that placebos (sugar pills) can often be just as effective at
improving mood, and even brain chemistry, as some of the most widely
advertised and prescribed drugs in the country. The report stressed
that placebos have been underestimated as a form of treatment for
depression. But we think the more relevant insight to be gotten from
these results is that the patients aren't really sick, ill,
or "depressed", in the first place. These studies, if interpreted in
this light, then reveal a very disturbing pattern: we are
pathologizing life. In this section we will show, by examining trends
in medication for children, African-Americans, and the elderly, that
our claim is not hysterical, but it is the professional functionaries
in sociology, psychology, psychiatry, and medicine that can be
accused of overreacting and consequently over prescribing for normal
moods, feelings, and sensations - in other words, the average
spectrum of reactions to being alive. For example, as we navigate our
way into the 21st century, there is an ominous trend that, strangely,
doesn't seem to concern people as much as it should: millions of
children are now taking psychotropic drugs. And they're not doing it
illegally, but by prescription. In fact, the medical and educational
establishments are conducting a skyrocketing campaign to get kids,
and their parents, to "just say yes" to brain-altering
pharmaceuticals, with the drug of choice being Ritalin.
I. The Children
In 1970, when approximately 150,000 students were on Ritalin, America
was alarmed enough to get the Drug Enforcement Agency to classify
Ritalin and other amphetamine-type drugs as Class II substances, a
category that includes cocaine and one that indicates significant
risk of abuse. Despite this apparent safeguard, the number of
children taking psychiatric stimulants today has risen over 40-fold;
current estimates are that between 6 and 7 million children are
taking them. (1) The American Academy of Pediatrics estimates that as
many as 3.8 million school children, mostly boys, are currently
diagnosed with attention deficit hyperactivity disorder, and that at
least a million children take Ritalin, a figure that many regard as a
gross underestimate. And it is not just schoolchildren who are being
dosed with psychotropics: Even preschoolers-those aged 2 to 4-
experienced a tripling of such prescriptions in a recent five-year
period. (2) Exactly why is all this juvenile pill-popping a problem?
Well, for one thing, Ritalin is a drug that has as potent effect on
the brain as cocaine. (3) And we're supposed to be a country that
eschews the use of such mind-altering substances, certainly for
children. For another, Ritalin's side effects can range from
unwelcome personality changes to cardiovascular problems to death.
Plus there's the very real issue of whether the "diseases" for which
this powerful medicine is prescribed are in fact real diseases at all.
The problem becomes further complicated when you consider that, in
addition to the Ritalin explosion, increasing numbers of children are
also being prescribed antidepressants, and that these are drugs
originally designed and tested for adults. (A fact not generally
publicized is that it's legal to prescribe drugs "off label," that
is, for conditions or populations that they weren't originally
designed for.) So in 1996, over 700,000 children and adolescents were
taking Prozac and similar antidepressants in the SSRI group, an 80-
percent increase from just two years earlier. It's not that the
SSRI's have been proven effective in battling childhood and
adolescent depression. They haven't. (4) Nevertheless, today, the
number of these prescriptions has surpassed one million.
Psychiatrist Peter Breggin estimates that, each year, 10 percent of
the school-age population will take one or more psychiatric drugs.
(5) Some children are prescribed several at once. And the phenomenon
continues to grow despite disturbing evidence of severe drug-induced
personality changes, manic reactions, and psychotic behavior.
Medication advocates would argue that those children who are
prescribed psychotropic drugs do in fact need them. Children with
affective disturbances or attention deficits can focus better, and
thus learn better when medicated, they say. Opponents protest that
the efficacy and safety of these drugs have not been proven, and
some, further, believe that many psychiatric "conditions" exist only
as labels in the minds of psychologists. Whether or not these
conditions are real, one must agree that the exceedingly high numbers
of prescriptions written for children in recent years are a cause for
grave concern. And they're of concern not just to the children and
parents directly touched by individual diagnoses, but to society at
large.
Consider the Columbine massacre and the rash of other school
shootings that have rocked this country recently. As the Washington
Times Insight Magazine reports, "the common link in the high school
shootings may be psychotropic drugs like Ritalin and Prozac." For
example, in 1998, 14-year-old Kip Kinkle killed his parents and then
went on a shooting spree at his Springfield, Oregon, high school,
killing two and injuring 22. He was being treated with Ritalin and
Prozac.
Then there was the15-year-old taking Ritalin who in 1999 wounded six
classmates in Heritage High School in Georgia, and the 18-year-old
who raped and murdered a 7-year-old girl in 1997, one week after
starting to take Dexedrine. One can't help but ask whether
psychotropic drugs are dangerous not just to those taking them, but
also, in some cases, to "innocent bystanders." And there are some
other basic questions people are beginning to ask as well: Do all
these children need to be taking all these drugs? Are they really
sick?
By far, the overwhelming majority of psychotropic prescriptions for
children are given for attention deficit disorder (ADD) or attention
deficit hyperactivity disorder (ADHD). In some instances, taking
medicine is a prerequisite for attending school, with refusal to
comply considered grounds for dismissal, or worse, removal of the
child from the home by the state.
This outrages Dr. Fred Baughman, a board-certified child neurologist
trained at New York University and Mount Sinai, and a fellow of the
American Academy of Neurology. Baughman feels that it's one thing for
a court to intervene and take over as legal guardian in a case where
a child's life is truly at risk, but quite another thing when
psychotropic drugs are forced on children who don't fit into the
mold. For instance, Baughman says, for religious reasons parents may
refuse a needed blood transfusion for a child, or they may refuse to
allow treatment of diabetes-a real disease-with insulin, a real
treatment. The courts may have to intervene in such cases. But courts
should have no place in mandating that behavioral problems in
children be treated with drugs. "There are no physical or chemical
abnormalities in these children," Baughman states. "The idea that
there is a false belief spouted by psychiatry.. For courts to
intervene and to mandate such treatment, as though these were
legitimate diseases or legitimate medical emergencies, is leading to
tyranny over parents of normal children..When we're talking about.so-
called psychiatric disorders, none of them are actual diseases due to
physical abnormalities within the child," states Baughman. (6)
An important argument against the thesis that ADHD and ADD are actual
conditions is that the epidemic appears to be confined to North
America. The use of Ritalin and similar prescriptions is
overwhelmingly concentrated in the United States and Canada. In fact,
these two countries account for 96 percent of their use throughout
the world, and children in the U.S. have been estimated to be from 10
to 50 times more likely to be labeled as having ADD than their
counterparts in Britain or France. (7) In American public schools,
about 10 percent of all children in grades K-12 carries an ADHD
diagnosis. Europe, by contrast, has a fraction of one percent so
labeled. Could the United States and Canada really be so unique in
the recent drastic upsurge of this malady?
Many in the health field are calling for more research in this area.
For instance, Thomas Moore, senior fellow in health policy at George
Washington University Medical Center, who feels that brain damage
from Ritalin is more common than has been admitted, often questions
the rationale of giving Ritalin to children, stating that the
chemical imbalance theory has not been established by any scientific
evidence. And while the public is given information by the National
Institutes of Mental Health that ADHD is neurobiological in nature,
NIMH psychiatrist Peter Jensen stated in 1996, "The National
Institutes of Mental Health does not have an official position on
whether ADHD is a neurobiological disorder." In other words, this
agency is talking out of both sides of its mouth-not that this is an
uncommon phenomenon in Washington.
Psychologist Diane McGuiness summed up the situation in 1991 by
saying, "We have invented a disease, given it medical sanction, and
now must disown it. The major question is, how do we go about
destroying the monster we've created? It is not easy to do this and
still save face."
Psychologist Daniel Elkind, in his 1981 classic The Hurried Child,
discussed the increasing "industrialization" of our schools, with
their regimented schedules, even at the elementary level, and their
focus on turning out quality-controlled products, i.e., students. (8)
Today, with administrators under the gun to have their students
perform well on standardized tests, and with more troubled children
in the schools, the atmosphere has not gotten any more relaxed. The
inescapable fact is that schools have an interest in keeping order,
in keeping children quiet and calm so they can get on with the
business of teaching and learning. And psychiatric medicines do help
keep schoolchildren under control. So, in the words of developmental
pediatrician Dr. Joseph Keeley, "We sometimes use medications to make
kids fit into schools rather than schools to fit the kids." (9)
Of course there are better ways to make schools work, such as
appropriate therapy for troubled youngsters, custom-tailored
education plans, and small classes. But these approaches are more
difficult-and more expensive. Thus, the school district may have a
vested interest in medication as a quick, less costly, fix, although
this may not be what's best for a particular child. Says Dr. David
Stein, "The drugs blunt their behavior. They don't act out in class,
and they sit there quietly..The difficulty is that children learn
nothing from a drug." (10)
Schools justify the need for medications by saying that children on
Ritalin learn better because the drug allows them to focus, but that
claim has never been proven. According to Stein, so-called ADD
children can learn when they want to; it's just that schools expect
too much of students and do not engage them. "This country has
started teaching second- and third-grade material in kindergarten,
and children begin to get burnt out by the time they're in the second
grade. They wind up hating schoolwork. And that's the key. These
children can play very complex video games, and they can read the
instructions, because they enjoy doing it." (11)
The situation in American schools today was chillingly illustrated
for me by a teacher I talked with recently. She works for a state-
funded organization that sends teachers, social workers,
psychologists, and speech therapists to disadvantaged schools for
support. Once a week, she explained, there are meetings with the
principal, other staff, and sometimes parents to discuss specific
problem children. "Although we are given no specific training in how
to advise or function as a team," she said, "we are looked at as
experts, and our advice is highly regarded. In my experience, the
meetings are merely attempts to find quick-fix solutions, and since
the psychologist dominates, the answer to a great many childhood
problems is an ADHD or ADD diagnosis for which medication is
considered the logical solution."
This teacher told me she will never forget an experience she had when
she was fairly new to team meetings. "After another teacher had
expressed concern about an active second grader, the psychologist and
psychology intern reported their findings to the parents at a team
meeting. They said that the boy fit the ADHD profile because he had
gotten out of his seat so many times in class and couldn't sit still
without fidgeting. They suggested that he should be taken to a doctor
for follow-up.
"The mother initially asked an intelligent question: 'Will the doctor
perform a special kind of test to determine that my son has a medical
disorder?' The team could not answer that question in the affirmative
since no such test is performed. The doctor merely observes the
child's behavior, looks at the behavior checklist filled out by the
parent and teacher, and then fills out a prescription. What the
psychologist and intern did instead was talk about CHADD and what a
great support it would be to these parents.
"While the mother appeared immediately receptive to persuasion, the
quiet father wore an expression of concern in his eyes. The principal
asked what was wrong, and the father responded in one
word: 'Ritalin.' The team then turned their attention to soothing the
father, saying that medication would be in the boy's best interest
because once he was calm he would be able to pay attention to his
schoolwork and succeed in his studies."
When the meeting ended, the teacher said, she pulled the father aside
and told him that she understood his concerns. "I told him that many
parents were opposed to medicating their children and that
alternative approaches did exist. Then I handed him a brochure on
alternative approaches." She felt she had to take a discreet approach
because she'd learned, from past meetings, that it was useless to
speak up. The psychologists are so married to their ideology that
they're quick to shoot down the opposition. "Even though I attempted
to be confidential," she reported, "the room was small, and I could
feel the psychologist's eyes glaring at me, as if she was going to
use the information to report me to the thought-control police."
Once the parents left, the teacher went on to relate, the red-faced
principal exclaimed, "That burns me up! Here we are trying so hard to
help their son, and the father gives us a hard time." Obviously, the
principal did not understand why the idea of medicating a young
child, possibly every single day for the rest of his life, should
concern parents.
Soon after that, the parents complied. The next time this teacher saw
the second-grader in her math group, he was already on Ritalin, so
she was able to see a before-and-after contrast in personality. The
child had been a bit antsy before, calling out or even getting out of
his seat from time to time, but his behavior seemed normal. Now the
child seemed severely depressed. He would cry for the smallest
slight, losing a turn in a board game, for example, and even crawl
under the table to cry. He had never acted that way before. On one
occasion he told the teacher that he wanted to kill himself. She
reported that to the psychologist, who seemed annoyed at the trouble.
Soon the psychologist reported back to the teacher that the parents
didn't notice any difference in behavior. He would continue as before.
This teacher went on to make the point that biological "treatments"
for childhood social disorders are not discriminatory; i.e., she has
seen the same arrogance and insensitivity in an affluent school
district on the other side of town. In the high school where she
worked as a reading specialist, teachers confronted with children
they deem problematic routinely say to peers and parents, "He [or
she] should be on meds." The students' perceived problems can range
from inability to focus to acting out to just not being able to read.
At one meeting, highly educated parents of a very bright young lady
with reading difficulties were looking for a specific diagnosis to
work with and were told by the psychologist to consider seeing a
doctor about her daughter's possible ADD-attention deficit disorder
without the hyperactivity component. To the teacher's relief, the
parents glanced at each other, snickering to themselves, as if to
say, "I can't believe you would say such a thing."
If only more parents would laugh in the face of this absurdity. Some
parents do seem aware of the ADD controversy, but overall there is
blind acceptance of ADD as a true medical condition and of medication
as a requirement.
It should be noted that it's not just elementary and high schools
that seem to need a drug to help them run smoothly, but preschools
and day care centers also. As writer Robyn Suriano recently pointed
out in the Orlando Sentinel, (12) "The drug [Ritalin] reached its
heyday in the 1990s, after more children started attending day care.
In a preschool, kids must follow instructions and behave just like
older children in classrooms. Rambunctious ones are not easily
tolerated in these surroundings, where workers must watch many
children." This is not to say that day care centers are necessarily
bad, but there are a lot of inadequately staffed and equipped ones.
These trap preschoolers in confining, boring situations for 10 hours
a day and then complain when they act like the active, inquisitive,
and needy young creatures that children just barely out of babyhood
normally are. That drugs are used to remedy this situation is
unconscionable, especially considering that Ritalin's label warns
that the drug is only for those aged 6 and over.
But "off-label" prescription is legal, and it's happening. As a Wall
Street Journal article reported, (13) the use of prescription drugs
to control toddlers' behavior has increased dramatically in the past
decade.
The Journal article did give voice to a couple of dissenting
professionals concerning this trend. Psychiatrist Joseph Coyle,
chairman of the Department of Psychiatry at Harvard Medical School,
was one. The brains of young children are developing rapidly, he
pointed out, and drugs can alter the process. Coyle also cited the
financial interests of managed care in creating a system in which
doctors are too busy to do much more than prescribe. And Dr. Julie
Zito, an associate professor at the University of Maryland's School
of Pharmacy, was especially skeptical of the use of Ritalin to combat
attention-deficit disorder in two-year-olds. "What is abnormally
inattentive in a two-year-old?" she asked.
It was Dr. Zito who, along with colleagues from the University of
Maryland, Johns Hopkins, and Kaiser Permanente's Center for Health
Research, authored a study on "Trends in the Prescribing of
Psychotropic Medications to Preschoolers." (14) Published in the
Journal of the American Medical Association, the study contained some
unsettling findings concerning very young children and psychotropic
drugs. The researchers found that poor-and particularly black-
children are being prescribed Ritalin at younger and younger ages. A
300-percent increase in prescriptions to the very young between 1991
and 1995 was cited. The study also mentioned Prozac being given to
children younger than one year of age, to the tune of some 3000
prescriptions in 1994.
Before ADD and ADHD came into vogue, amphetamines were seldom
prescribed. Ritalin was given for narcolepsy, a rare neurological
disorder that causes people to fall asleep unexpectedly despite
adequate sleep, but sales were minuscule. Now, thanks to the
popularity of ADD and ADHD, Ritalin sales are significantly
healthier. Moreover, the psychiatric establishment has seemingly
discovered several other childhood disorders, including pediatric
depression, for which medications are routinely prescribed. By the
way, most of the people prescribing psychiatric drugs are not
psychiatrists, but primary-care physicians, who have not received the
kind of sophisticated mental-health training needed to understand
what's involved in prescribing these life-altering substances. Our
managed-care system of health care bears at least some of the blame
for this trend. As a recent article in Parents magazine point
out, "Here, as with almost everything else in the tangled world of
health care, economics plays a decisive role. Drugs have become the
treatment of first resort when kids exhibit behavioral problems,
partly because most managed-care plans readily cover the cost of
medication but often won't pay for long-term alternative treatments,
such as talk or behavioral therapy." (15)
The people who manage managed care are not particularly interested in
getting to the source of patients' problems, focused as they are on
the bottom line and the quick fix. Psychiatrist Dr. David Kaiser
elaborates: "When I talk to a managed care representative about the
care of one of my patients, they invariably want to know about
medications I am using and little else, and there is often an
implication that I am not medicating aggressively enough. There is
now a growing cottage industry within psychiatry in advocating ways
to work with managed care, despite the obvious fact that managed care
has little interest in quality care and realistic approaches to real
patients. This financial pressure by managed care contributes added
pressure for psychiatry to go down a biological road and to avoid
more realistic treatment approaches." (16)
The boom in psychiatric drug sales has been helped along by a
vigorous marketing campaign. Psychiatrist Loren Mosher reports that
at meetings of the American Psychiatric Association, drug
companies "basically lease 90 percent of the exhibition space and
spend huge sums in giveaway items. They have nearly completely
squeezed out the little guys, and the symposiums that once were
dedicated to scientific reports now have been replaced by the
pharmaceutical-industry-sponsored speakers." (17) And pitches for
drugs are made not just to medical practitioners, but also to
teachers and parents. In the early 1990s, pharmaceutical companies
distributed pamphlets to schools nationwide on how to diagnose ADHD
and ADD, conditions for which medication was presented as the
solution. During this time America saw a dramatic rise in Ritalin
consumption, close to a 700-percent increase.
Ritalin's manufacturer also funded CHADD to encourage parents to
support the drug solution and to keep public confidence levels high.
Today, drug companies continue to spend hundreds of thousands of
advertising dollars in psychiatric journals.
They've also started advertising in popular magazines. Recently, some
stimulant manufacturers have gone against standard international
practice and begun marketing directly to parents. Here's how The New
York Times describes this appalling trend: (18)
"In the back-to-school section of this month's [Aug. 2001] Ladies'
Home Journal, tucked among the ads for Life cereal, bologna and Jell-
O pudding, are three full-page advertisements for the A.D.H.D.
treatments. "The ads evoke a sense of Rockwellian calm. Children chat
happily next to a school bus. A child's hand gently touches the hand
of an adult. In one, for the new drug Metadate CD, an approving
mother embraces her beaming son as the drug itself is named and
promoted.
"This is a first. Metadate CD, like Ritalin, Adderall and similar
drugs, are what are known as Schedule II controlled substances, the
most addictive substances that are still legal. (Schedule I drugs
like heroin and LSD are illegal.)
"In keeping with a 1971 international treaty, such controlled
substances have never been marketed directly to consumers, only to
doctors. There is, however, no federal law to prevent drug companies
from doing it..The new magazine advertisement by Celltech
Pharmaceuticals, the British maker of Metadate CD,
states, 'Introducing Metadate capsules. One dose covers his A.D.H.D.
for the whole school day.'"
According to The Times, in the year 2000 close to 20 million
prescriptions were written for ADD medicines, with sales bringing in
about $758 million. It is true that a lot of this profit goes into
research that tests drugs' safety and efficacy. The obvious down side
to this, though, is that with companies funding their own testing,
results can be biased, as it is not in a company's best interest to
get negative results that discourage business. This conflict-of-
interest situation raises ethical issues that are especially
troublesome when you consider that it is children who are being
targeted by these drug companies. Furthermore, today it's not just
the classic "problem child" who is being targeted for stimulant
consumption. As Peter Breggin points out in Talking Back to Ritalin,
(19) there is a wide range of children being given stimulants, from
the truly hyperactive child who can't sit still for a second to the
child without severe behavior problems who is simply dreamy or
inattentive. As is the case with other psychotropics, the net of this
drug's reach seems to have widened. Many children taking Ritalin will
develop involuntary muscle contractions and limb movements known as
tics, or dyskinesia. A study published in the Archives of Pediatric
and Adolescent Medicine(20) showed that this can happen to up to 9
percent of children taking stimulants. Other studies in the peer-
reviewed medical literature bear out this association, (21,22,23) as
well as the Ritalin-psychosis connection. Also, Ritalin has also been
shown to have an adverse effect on heart tissue and has been linked
to cancer. In the mid-90s, the FDA forced Ritalin's maker to send
letters to 100,000 doctors, warning them of a possible link between
the drug and liver cancer. Researchers reported to the FDA that their
studies show "clear evidence" that link the drug to cancer. The FDA
changed the warning to "some evidence," a change that was protested
by one of the main researchers. A formal proposal to keep the
wording "clear evidence" was presented to an FDA panel, but this was
defeated by a vote of 4 to 3. "Clear evidence" became "some
evidence," and ultimately the FDA publicly announced that there
was "a weak link" between Ritalin and cancer and that doctors should
not be concerned about continuing to prescribe the drug.
A problem that some children and teenagers experience with Ritalin is
called rebound. When the drug is metabolized and the level in the
bloodstream goes down, these children seem to go back to a
hyperactive state "and then some." They may get excitable or
impulsive, or develop insomnia. (24) In fact, as many as half the so-
called ADHD children on medications report some presleep agitation,
called P-A. (25) Physicians try to handle this problem by decreasing
the last dose of the day, or, alternatively, adding another dose, so
that the child sleeps with a new supply of Ritalin in his blood.
Sometimes this works, but one has to wonder about the advisability of
children taking a sleep-pattern-altering drug over the long term.
Yet another Ritalin side effect is the stunting of growth that occurs
in some children taking moderate to high stimulant dosages over a
period of years. This happens not just because stimulants can
diminish appetite, but also because they may alter the body's natural
balance of growth hormones. (26) The growth-stunting phenomenon
doesn't seem to have alarmed the medical establishment as much as it
should.
Consider the advice given by clinical psychologist Dr. John Taylor in
his book Helping Your Hyperactive/Attention Deficit Child. (27) The
author notes, first, that some physicians recommend taking the child
off medication during vacation periods, so that he can catch up in
height and weight. Then Taylor counsels: "The crucial question is
whether your child's behavior can be tolerated if he or she is
unmedicated (or undermedicated) during the summer months. Several
adjustments are available. Your child can play outdoors more, attend
camps, participate in athletic programs or other vigorous play
activities, or even be sent to live with a relative. There is little
or no requirement for intense academic pursuits, there is no need to
sit still for hours as is required in school, and summer
entertainments can take advantage of your child's interests to
prevent boredom..Among those who are not given any medication-free
periods and who experience the stunting effect, the average amount is
less than two inches. If stunting occurs and becomes an important
psychological issue, choice of hair style and footwear can
compensate."
At least three questions arise. First, if it's possible to give a
child a stimulating and active life in the summer, at camp or with
relatives, why can't this be done in the winter, in school and with
the nuclear family? Surely arranging for more outdoor playtime, and
more interesting activities, is preferable to putting a child on
drugs. Second, do parents and doctors have the right to stunt a
child's growth for any reason other than, perhaps, to save his life?
And third, even if "choice of hair style and footwear can
compensate," for decreased height, how is the child going to feel
about this later, when he understands what's been done to him?
In addition to all the potentially damaging effects of Ritalin one
has to factor in the reality that it doesn't work. Yes, it does make
some children better behaved at certain times. But there are no
studies showing improved academic performance or social behavior over
the long term. (28) What has been shown over the long term is that
the side effects can become quite serious.
Most people assume that drugs are proven safe before they are
marketed. But this is not always the case, especially when you
consider the long-term picture. Science knows very little about the
long-term effects of medicating children. In effect, children have
been guinea pigs. The results of this grand experiment are only now
becoming evident, and sometimes the consequences are deadly.
Consider the case of Stephanie Hall, a first grader placed on Ritalin
because her teacher felt she was "just a little bit too antsy,"
according to her mother. "[The teacher] suggested that Stephanie go
for testing, so we went the route of a neurologist who said she could
throw a ball and read a book and a psychologist who said she had
average intelligence but, yes, she was a little easily distracted. So
now she qualifies to be medicated." When she turned 12, the
prescription was increased; that very day, Stephanie died from
cardiac arrest in her sleep. Says her mom, "Her death was caused by
cardiac arrhythmia with no family history of any type of heart
problem whatsoever, and she died a day after her medicine had been
increased. It kind of adds up." (29)
A double tragedy struck the Hall family when Stephanie's sister
Jenny, also a long-term Ritalin user, started to have seizures.
Subsequent medical tests revealed a brain tumor. Mrs. Hall believes
that Jenny was misdiagnosed; as a result proper medical attention was
delayed. She states, "There's Jenny's ADHD, it's a brain tumor. I'm
not saying everyone that is labeled ADHD has a brain tumor..But
there's the possibility that a child could have an underlying
neurological disease that really needs treatment." Mrs. Hall also
wonders whether the medication could have precipitated or exacerbated
Jenny's condition: "It probably made her condition worse because
prior to being on medication she never had seizures. I later read
that if you have a low threshold to seizures you should never take
Ritalin to begin with." (30) She and her husband are suing Novartis,
the maker of Ritalin, for producing a defective product and
concealing adverse reactions and deaths related to its use. (31)
The once trusting mother advises parents to learn from her
mistakes: "Don't trust your doctor. Question him over and over. If
you are not happy with what he says, if you have an intuitive feeling
that something doesn't seem right, it's not. Get second and third
opinions. It may not seem reasonable to have to go to that extent,
but if it's at the price of your child, it is. I hope others can
learn from my tragedy and realize that a doctor's word is not God's
law." (32)
In a more publicized story, Matthew Smith, a 14-year-old from
Michigan, had also, like Stephanie Hall, been taking Ritalin from the
time he was in first grade. After eight years of ingesting the drug
daily, Matthew suddenly became pulseless and died while riding his
scooter. An autopsy performed by the county medical examiner, a Dr.
Dragovic, found that Matthew's heart muscle was diffusely replaced
with scar tissue, as were the muscular walls of the coronary vessels.
Much to the displeasure of the psychiatric and pharmaceutical
industry, the doctor publicly stated that Matthew's death was
undoubtedly due to heart damage akin to that regularly seen in deaths
among amphetamine addicts, and that his death was clearly due to the
Ritalin. Yet another incident occurred in a psychiatric facility near
San Antonio, Texas, where young Randy Steele was being restrained
when he suddenly died. Randy was on several psychiatric drugs at the
time. But his first psychiatric diagnosis, his entry into a life of
psychiatry, had been ADHD, and his first drug was Dexedrine or
dextroamphetamine. At death he had an enlarged heart.
It should surprise no one to learn that Ritalin and other
amphetamines can lead to death. The dangers are well known to doctors
who study the adverse effects of these substances as medical
students. Dr. Dragovic explains: "Methylphenidate-that's [Ritalin's]
chemical name-is classified as an adrenergic agonist. This is a type
of drug that boosts the adrenergic system. It affects everything that
has as its chemical pathway adrenalin, noradrenaline, dopamine, those
types of mediators and transmitters. Drugs in the category of
stimulants also include Ritalin's cousins--amphetamines,
methamphetamines, and even cocaine. If they are repetitively used,
these drugs stimulate the adrenergic system in the human body. Over a
period of time.many months to many years-the enhancement of the
adrenergic system will produce changes in small blood vessels. Some
cells will be lost, and in an attempt to repair the area there will
be scarring..The blood vessels will narrow. The changes that we're
seeing in kids who have been on Ritalin for about eight years are
basically the same as the changes in someone that has been abusing
cocaine regularly over a period of years." (33) Dragovic adds that
irreversible damage to the vascular system could also result in
cardiovascular problems down the road, including high blood pressure.
By medicating vast numbers of children today, we could be creating an
army of future patients with other conditions that need to be
treated. "Do we need that?" asks Dr. Dragovic. His answer is
certainly no, but as he explains, "That's the peril of chronic
Ritalin use, or of any stimulant for that matter. It's paying the due
to long-term use." (34)
There are few if any statistics on how many people experience adverse
effects. What we do know is that, according to FDA adverse reaction
reports-which are notoriously incomplete-there were 160 Ritalin-
related deaths between 1990 and 1997, most of them cardiovascular-
related. We know that Ritalin is a vasoactive (blood-vessel-altering)
substance that decreases cerebral blood flow. (35) And we know that
children's brains are undergoing dramatic development through the
teen years, not just in early childhood, as had been previously
thought. (36) We also know that Ritalin can have persistent,
cumulative effects on the myocardium, the muscle cells that form most
of the heart wall. (37) With all these facts in mind, one has to
wonder about the implications for the millions of American children
being dosed over the long term with stimulants. As Dr. Fred Baughman
points out, "There is no way of knowing the actual frequency of. any
medical side effects of these drugs, because there is no required
reporting system. There is only a voluntary system whereby physicians
would call the FDA, and, needless to say, they don't often report
their own complications." (38) Ritalin's vast growth-its legal and
illegal use--could mean that a multitude of tragedies are on the
horizon.
There are those who believe that what we perceive as ADHD is simply
children's natural reaction to the sped-up quality of much of
American life today. One of these people is psychologist Dr. Richard
DeGrandpre, fellow of the National Institute on Drug Abuse and author
of Ritalin Nation. (39) "As society goes faster, so do the rhythms of
our own consciousness," DeGrandpre writes in this insightful book.
(40) "This is especially true for children, who grow up in concert
with the latest speed." DeGrandpre points out that young people who
have known nothing but a hurried, perpetually wired environment, will
tend to get restless when the stimulation level lags-in a classroom,
for instance. And he says that Ritalin, being itself a stimulant,
does not so much erase the need for excitement but rather fulfill it,
in a prosthetic way. Indeed, he coins the phrase "prosthetic
pharmacology" to refer to the way modern psychiatry uses drugs as
crutches, rather than cures. And while a real crutch may help a
person's injured leg heal, psychiatric crutches often mask underlying
problems, resulting in no effort being made to deal with them.
A noteworthy point made by DeGrandpre is that, while years ago, the
condition then known as hyperactivity tended to disappear when
childhood ended, today's ADHD seems to linger into adolescence and
adulthood for a lot of its "victims." But why would a bona fide
disorder suddenly afflict a whole new age group? There has to be a
cultural component at play.
We don't seem to want to face any cultural concerns, though. We'd
rather diagnose a large segment of the population as mentally
impaired, thereby shifting responsibility for our mental well-being
away from society and toward the medical profession. When people are
identified as "sick," their issues are seen as the result of a
diseased mind, rather than as a reaction to an unhealthy family
dynamic or social environment. But one need only compare the world of
today to that of 50 years ago to appreciate the magnitude of the
additional stresses in contemporary times that could result in
maladaptive behavior. Many children practically grow up in day care
centers, for example, their parents being too busy and hassled to
raise them, and dinner is usually eaten in front of the TV. Family
members don't interact with each other. School demands more academic
work from children at an earlier age. The extended family is
practically nonexistent, with grandparents, aunts, and uncles living
many states away. As a result, values are not taught to children. The
divorce rate is approaching 67 percent, and 50 percent of children
are being raised by single parents. These statements about modern
life are almost cliché, but the fact remains that the environment
they describe does have an impact on children.
I believe you have to look deeply at the values of a society to
really understand what ails its people. In today's America, it seldom
occurs to anyone that it's okay to just be by being. In our society
we hate the idea of being without purpose. Baby boomers, in
particular, feel that we're always supposed to have a purpose, a
goal, a motivation to get there, discipline to keep the motivation
going, and passion to fuel it all. We're supposed to have a higher
ideal, and to value success and competition. But in the process of
doing all that we frequently lose our sense of identity. We have to
consider that when today's kids take a careful look at their parents,
they may not want to duplicate what they see. They-or at least some
of them-may be turned off by the high stress levels, the judgmental
attitudes, the lack of quality of life, the lack of unconditional
love, the absence of peace of mind, and the inability to feel
comfortable with what is. So kids may say, "I'm just going to kind of
hang out in the moment." And we think, "No, you can't. You've got to
get in there. You've got to achieve. You've got to prove yourself.
You're up against competition. There's a shortage of everything." And
then we put them in a situation where they can't win and can only be
labeled as having some kind of deficit.
An alien observer looking at the current drug situation in the United
States would certainly be confused. On the one hand we're preaching
drug avoidance to our youth. On the other, we're dosing a lot of them
with mind-altering drugs, which, as we've just seen, can sometimes be
tragically behavior altering as well.
One of the results of our eagerness to fix problems with drugs is the
widespread abuse of drugs that have been legally prescribed to
children. According to the DEA, Ritalin and other stimulants are
among the most frequently stolen prescription medicines, (41) with
the pills often crushed and snorted for an immediate high. Ritalin is
now a prime choice among the drugs abused on college campuses across
the country. High school students use it recreationally as well. A
1997 Indiana University survey reported that nearly 7 percent of high
school students had engaged in this practice. (42)
It's time to reassess what we want for our children. Do we want to
bring them up in a drug culture or not? Do we want to mold them into
the confines of our educational system, or do we want to fashion an
education that will respond to their needs? What are our criteria for
a successful child? And will we continue to label those who don't
meet these criteria as psychologically abnormal? We're sticking this
label onto an awful lot of kids lately.
An important point was made in Contemporary Directions in
Psychopathology, a textbook used to train psychiatrists. (43) It was
stated that there was "evidence that the current psychiatric
diagnosis system is a reflection of social, cultural developments
rather than scientific data." The editor of this book, Gerald
Clerman, also edited The Archives of General Psychiatry, and sat on
the American Psychiatric Association's task force for its diagnostic
and statistical manual of mental disorders, the "psychiatrist's
bible" of diagnostic labels. So basically, in a
totally "establishment" textbook, we have an admission that social
and cultural expectations, rather than objective science, form the
basis for the way we evaluate who is mentally abnormal.
II. The Elderly
We would do well to remember this-and then to rethink our penchant
for labeling-before we prescribe any more brain-altering drugs to
children. 2) In light of our theme that the mental-health industry is
pathologizing life - a very broad category, then we would have to
look at the other end of its spectrum, the elderly, to see if our
argument applies. A woman in her 70 copes with recurring bouts of
depression after the death of her beloved husband. She consults a
psychiatrist who tells her all she needs to bring her out of the dark
is ECT, electroconvulsive therapy. What he fails to consider is that
his patient has a weak heart, and the consent form she signs mentions
nothing of this risk. The woman allows herself to undergo treatment
and, days later, dies.
This particular scenario is made up, but variations on it happen all
too frequently. Consider that from 100,000 to 300,000 Americans being
shocked each year are senior citizens. Now consider records from
Texas, the only state required to track complications within two
weeks of ECT administration. These records document a death rate from
ECT of 1 in 200 recipients of the treatment. Statistics also reveal
that the typical candidate for ECT is a depressed middle- or upper-
middle-class woman in her 70s who checks herself into a private
hospital. The targeted population has shifted since the 1950s and
60s, when schizophrenic men in their 40s were the primary group
subjected to ECT, and the reason is economics. Insurance no longer
supports long hospital stays, but Medicare, the government's medical
insurance program for people 65 and older, will generously reimburse
psychiatrists who administer ECT. This incentive is apparent once
again in Texas records, which show 65-year-olds receiving 360 percent
more shock therapy than 64-year-olds. (44)
But paralleling the growth of ECT is the growing number of critics of
the treatment, both within and outside of the psychiatric
establishment. Shock is not just ineffective, the opposition claims,
it often leaves recipients in a worsened condition than before
treatment. Depression and suicidal ideation soon return, complicated
by ECT-induced brain damage and memory loss. Plus new conditions,
such as epilepsy and heart arrhythmias, can develop. Moreover,
signing the permission form for this treatment may be signing your
life away, as the risk of death during or soon after the procedure is
great, far higher than ECT proponents admit, in part due to the
targeting of fragile elderly populations. ECT's most ardent
challengers, often former patients themselves, wonder how healing
professionals could have forgotten their Hippocratic oath to do no
harm. They assert that ECT is a barbaric procedure that must be
banned.
But why has ECT had a revival? Consider that sixty years ago, once
ECT was adopted in the U.S., abuse of this modality became common.
This is not to say that the treatment is not in and of itself an
abuse, but from the 1940s to the 70s, shock treatments were often
given in psychiatric hospitals not just as treatment, but to quiet or
punish patients. Notes one woman I interviewed, of her experience in
the early 70s: "I wasn't depressed; I wasn't suicidal....They were
shocking everyone on the ward-the young, the really old,
everyone...What were they shocking us for?... Ward control?" Medical
historian David J. Rothman of Columbia University points out that ECT
stands practically alone among medical/surgical interventions in its
role as a patient control mechanism used for the benefit of the
hospital staff." (45)
Economic factors of the 1980s brought ECT into the limelight once
again, particularly insurance policies that refused to pay for
lengthy therapies but readily reimbursed short-term hospital
procedures like ECT. Since then, electroshock has received glowing
endorsements from numerous organizations, including the National
Institutes of Health, the National Alliance for the Mentally Ill, the
National Depressive and Manic Depressive Association, and the
American Psychological Association. This last organization takes an
active role in ECT advocacy. This includes fighting attempts to
restrict the procedure, and working to relax current standards so
that shock therapy will become an initial, rather than last-resort,
treatment for the depressed. (46)
Although present-day modifications can help in certain ways by
reducing a patient's fear and stopping flailing movements that can
cause bone fractures, the treatment itself-the zapping of the brain
with an electrical current-is the same as it has been, and inevitably
results in brain damage. According to the National Head Injury
Foundation, each treatment equals one moderate-to-severe head injury.
(47) And as a series of shocks are prescribed-eight to fifteen on
average and as many as one per month on an indefinite basis-the
wounding intensifies. In 1983, Dr. Sydney Samant described what
happens in the following way: "As a neurologist and
electroencephalographer, I have seen many patients after ECT, and I
have no doubt that ECT produces effects identical to those of a head
injury. After multiple sessions of ECT, a patient has symptoms
identical to those of a retired, punch-drunk boxer....After a few
sessions of ECT the symptoms are those of moderate cerebral
contusion, and further enthusiastic use of ECT may result in the
patient functioning at a subhuman level. Electroconvulsive therapy,
in effect, may be defined as a controlled type of brain damage
produced by electrical means." (48)
The scientific literature is replete with research confirming memory
damage from ECT as the rule rather than the exception. For example,
in Freeman and Kendell's 1986 study, 74 percent of patients
mentioned "memory impairment" as a continuing problem, and "a
striking 30 percent felt that their memory had been permanently
affected." The authors mentioned that these symptoms were probably
under-reported because the patients were interviewed by the same
doctors who treated them. (49) An interesting note: The 1990 APA task
force cites Freeman and Kendell-these same authors-as indicating, "a
small minority of patients, however, report persistent deficits."
Cardiovascular complications arising out of ECT are commonly seen in
the scientific literature. For instance, the Journal of Clinical
Psychiatry reported that 28 percent of a group of 42 patients
undergoing ECT suffered cardiovascular problems following treatment.
Of the patients who already had a history or indication of cardiac
disease, 70 percent developed cardiac complications."(50) The Journal
of Humanistic Psychology reported on a 57-year-old man who died of
heart rupture after receiving several shock
treatments." (51) From that same article: "Physicians from Tulane
University Medical School reported on a 69-year-old woman who
developed brain hemorrhage during ECT. She was also left with
epilepsy afterward. This was, as expected, associated with further
deterioration in her mental status from her baseline depression. They
conclude that the fragile vessels of the elderly may make some
patients a particularly high risk for ECT."
Psychiatrists hail electroshock as the best method for curing
affective disorders and stopping suicides. One of its most zealous
proponents, Dr. Max Fink, a professor of psychiatry at the State
University of New York at Stony Brook and the editor-in-chief of
Convulsive Therapy, goes so far as to proclaim ECT "God's gift to
man" and has stated that "[it should be given to] all patients whose
condition is severe enough to require hospitalization." (52,53) A
closer look, however, casts doubt on psychiatry's enthusiasm. To
begin, one needs to ask what psychiatrists actually mean when they
call electroshock effective. For how long do patients show
improvement from depression? What do studies conclude about ECT and
suicide prevention? And what do psychiatrists actually consider
patient improvement?
What an ECT fact sheet fails to tell patients is that improvements
are temporary. Studies have never concluded that patients remain
depression-free for longer than a month. (54) Initially, ECT
recipients score higher on the Hamilton depression scale, a test used
to measure depression, but weeks later their scores drop again. This
is why psychiatrists recommend follow-up treatments with
antidepressants or more electroshock every few weeks. Maintenance
with antidepressants, however, does not guarantee success, according
to one study published in the New England Journal of Medicine. The
study reported a 59-percent return to depression two months following
ECT. (55)
Electroconvulsive therapy is to psychiatry what open-heart surgery
and hysterectomy are to other branches of medicine-a lucrative income
booster. Charges of several hundreds of dollars per treatment add up
quickly, so that physicians shocking patients three times a week, for
instance, can increase their salary by over $27,000 a year, (56) and
more ambitious doctors may receive a $200,000 bonus. (57) With the
electroshock industry grossing two to three billion dollars a year,
and psychiatric groups lobbying for relaxed restrictions, doctors
have ample opportunity for financial gain. (58) Since most insurance
policies permit month-long hospital stays, a course of ECT may be
begun right away. Or it may start a month later when Major Medical
insurance kicks in for "major" treatment protocols, of which ECT is
one. This second option is the best deal for private psychiatric
facilities (where the bulk of ECT takes place), as beds remain filled
longer for a charge of several thousand dollars per patient.
Afterwards, insurance will reimburse patients for outpatient follow-
up procedures, in which people are drugged, shocked, wheeled into the
recovery room while in a coma, and sent home in a stupor the very
same day. The importance of insurance in influencing who gets
treatment was noted by one psychiatrist, who stated, "Finding that
the patient has insurance seemed like the most common indication for
giving electroshock." (59)
The fact is that anyone speaking to a psychiatrist is at risk of
being perceived as psychopathological. All a psychiatrist need do is
pick one or more conditions that seem to fit from the
psychiatric "bible," the DSM manual, where hundreds of so-
called "diagnosable conditions" are listed-everything from insomnia,
worry, and caffeinism, to being shy. Very few of the "disorders" are
organic; the majority are socially based. In its rush to diagnose and
treat, what psychiatry forgets is that mental symptoms can be caused
by poor physical health. An example of misdiagnosis is the case of
Ruth Reed Price, whose nervous breakdown resulted in a diagnosis of
schizophrenia when the real problem, discovered later, was a thyroid
imbalance. In her 1995 testimony on banning electric shock in Austin,
Texas, Price talked of the damage to her memory and nervous system
that made returning to work a nightmare. "Instead of trying to really
discover what was wrong," she says, "the Austin State Hospital staff
made a wrong assumption and preceded to damage my brain and impair my
memory with their violent electric shock therapy."
So, one of the effects of the new pathologizing of life itself today
is that older technologies, even disgraced ones like ECT, are
retrieved as the arsenal for this panicked invasion of our bodies
must be expanded since newer alternative modalities that do not
stigmatize normal life experiences must be avoided.
III. African Americans
The present misguided and exploitative policies in health care
regarding depression and schizophrenia also have the dispiriting
effect of continuing anti-social traditions like racism. The irony is
that long-standing social pathologies of past cultures and social
groupings have a renewed "life" because they become ad hoc
justifications within the larger agenda of pathologizing life. For
example, what we see happening in the African American community
today has, in the minds of many, been created: blacks-against-blacks
violence, suicide and drug abuse at an all time high, children who
cannot read or write and a very high level of unemployment.
Psychiatrists involuntarily commit African Americans three to five
times as often as they do whites. Psychiatrists diagnose African
American men in public and private mental hospitals as having
schizophrenia at a rate of up to 1,500 percent higher than white men.
African Americans are given significantly higher doses of psychiatric
drugs, major tranquilizers, and neuroleptics than are whites. More
than twice as many African Americans as whites are classified as
mentally retarded. Psychiatry -- heavily financed by the National
Institutes of Mental Health along with this Community Mental Health
Centers Program, which began in 1963 -- has been, in the minds of
many, destructive in the oppression of the African Americans.
Community health centers have provided numerous frontline sales
outlets operating within the fabric of society, entrapping greater
numbers of unwitting victims. The growth of this network parallels
the declining statistics among African Americans.
William, a young African American, provokes a stark example of the
psychiatric approach to mental health. William lost his job and was
worried about how he was going to support himself. He could not
write. He could not read. He visited a local community mental health
center to talk to someone about it. Instead of listening to him, the
psychiatrist asked stereotypical questions about whether he abused
his girlfriend and if he felt angry. Well this frustrated him. He
raised his voice. Within minutes, the psychiatrist had called in two
men to involuntarily admit William to a psychiatric institution. He
was held for three days against his will, and was forcibly injected
with major tranquilizers. For the first two days the main question
asked of William was do you have any insurance. He was told that if
he wanted help he would need to pay for it. William had no money. Two
hours later psychiatrists interviewed him and suddenly found he was
fit to be released. Before being discharged, William was told to sign
a paper that he could not read. He was later told that this form
indemnified the hospital. It said that he had been fully informed
about the drugs prescribed to him and he had been willingly able to
take them. This is not an isolated case. It is typical of how easy it
has been for psychiatrists using diagnostic procedures and repressive
mental health laws to incarcerate African Americans.
One of the most respected institutions in the United States, Columbia
University and its affiliation with the New York State Psychiatric
Institute, supported a rabid Nazi who was responsible for
legitimizing what would be the death of millions of Jews and who had
caused the death of over 350,000 mental patients in Germany prior to
the Jewish holocaust. He was considered one of the shining lights of
American psychiatry clear up until his death. Now Calmun's study
published simultaneously in the United States and in Nazi Germany in
1938 was used by the Nazi T-4 Eugenics Unit, which launched the
scientific justification for the mass murder of all the individuals
that they could find who fit the criteria. That was over 350,000 in
one fell swoop, mental patients in Germany in their mental
institutions. In fact, I've seen film footage of psychiatrists and
nurses and staff celebrating with champagne the numbers reached at
how many of the feeble-minded or the schizophrenics they were able to
euthanize or kill to rid the world of these unnecessary burdens. It
is from these roots that the systematic diagnosing and psychiatric
imprisonment of African Americans evolved.
After the war, the National Institutes of Mental Health was formed
and most of the US psychiatric research had been carried out since
1948 has been funded by The National Institutes of Mental Health.
This has included LSD studies being carried out on African American
inmates. The 1970's Violence Initiative was planned to isolate
African American leaders among inner city youth, and give them
psychosurgery or lobotomies to curb "violent behavior." In the
1992, "Violence Initiative" was planned to find "violence causing
genes in African American children which can be controlled by
powerful psychotropic mind-altering drugs."
In 1992 The National Institutes of Mental Health launched a lucrative
plan under the bogus title of Violence Initiative to
identify "problem black children." In reality it was to be an
experiment on minority races using psychiatric drugs. It was to cost
$50 million of taxpayers' money until stopped by groups such as The
National Committee Against Federal Violence Initiative. At the time
the director of the agency over The National Institutes of Mental
Health, psychiatrist Frederick Goodwin, became infamous because of
his racist reasoning behind the proposed research that inner city
youth are like violent "oversexed Rhesus monkeys in the jungle." When
I was researching this I wanted to see surely the Black Caucus and
surely some of the black legislator and surely some of the liberal
involvement in 1992 would have stopped this. No. To the contrary. The
White House fully supported it. The President supported it. The
President's wife supported it. I always find it of interest when
people go saying they care about you. They suffer for you. They feel
for you. You trust that. Then they are part of the group that are
behind the idea that you are like a bunch of oversexed Rhesus monkeys
that need psychiatric drugs to keep in line. Connect the dots and see
if it changes perspective.
What we have is Big Brother as a biological psychiatrist. Even more
outlandish possibilities for social and political applications are
raised in The Tribune series. For example, monkey research allegedly
demonstrated that the more dictatorial leaders have low serotonin
while more democratic monkeys had high normal serotonin. Subordinate
monkeys supposedly become friendly democratic leaders after being
given Prozac. The leap to drugs as a solution for widespread social
problems raised the specter of Big Brother as a biological
psychiatrist. The recent Chicago Tribune series and The Los Angeles
Times series as well as [others] and Earl Research Project aimed at
thousands of children in Chicago and The National Institutes of
Mental Health studies of thousands of Chicano children, and The
National Institutes of Mental Health of thousands more through the
University of Illinois confirm our predictions as well as our worse
fears about the Federal Violence Initiative. The threat to human
rights through biomedical social control continues to mount.
African American adolescents between the ages of 13 and 17 are far
more likely to be coerced through a mental health center than whites.
Forty-six percent of African American adolescents referred to these
centers are between 16 and 17. African Americans are twice as likely
as whites to enter community mental health centers through a referral
agency. From a social agency, 90 percent of the adolescents entering
the community mental health system are poor. An August 1998 study on
arrest rates of patients at a community mental health center
indicates that people attending these centers are nearly two times
more likely to be arrested than the general population. Studies show
that 55 percent of outpatients visiting a community mental
health center receive a psychiatric drug.
Summary: as Dr. Thomas Oz says, "The engine that drives the
psychiatric industry today is a combination of federal and state
funds, government mandated insurance coverage, commitment laws, and
the threat of involuntary mental hospitalization together with false
claims about effectiveness of neuroleptic drugs."
The forces that actually propelled the change were economic and
legal. It was specifically the transfer of funding from psychiatric
services from the states to the federal government, and the shift in
legal psychiatric fashions from long term drugging. No one in
authority challenged the assumptions on which this alleged reform
rested.
No one asked if it was true that mental illness is like any other
illness or if psychiatric drugs made the patient mentally healthier
and economically more self-sufficient. On the contrary, careers in
politics, psychiatric academia, and the media are made by not asking
such questions. Pretending instead that we knew the answers and were
there with a resounding yes.
The familiar psychiatric code words -- such as mental illness,
hospital treatment, and schizophrenia -- thus remained intact and
were fortified with a set of fresh code words, such as dopamine,
serotonin, anti-psychotic drugs and pharmacology. Black patients were
consistently diagnosed with more severe mental illnesses than whites
subjecting them to heavier doses of drugs and longer hospital stays.
In South Carolina, for example, a third of all hospitalized blacks
were diagnosed with schizophrenia. A figure that's 300 times higher
than it is for whites. National studies indicate that this pattern of
discrimination is not confined to the south.
According to one survey of selected psychiatric hospitals by the
National Institute of Mental Health, blacks were 2.8 times more
likely than whites to be involuntarily committed to mental hospitals.
Out of shame or sloppiness most states try to keep their
discrimination a secret. No southern state keeps account of the
number of blacks they commit to mental hospitals each year. Many of
the figures in our survey had to be compiled on a hospital-by-
hospital basis. Hospitals in four states Alabama, Arkansas, Kentucky,
and West Virginia refused to provide any racial breakdown of their
admissions. "We're never asked to break them down that way," said
Janet Jenkins, Director of Admissions at Central State Hospital in
Louisville, Kentucky. "We break them down by sex, but not by the
race." With the number of voluntary admissions to state hospitals
declining in many states the racial disparities appear to be
worsening. In both Texas and North Carolina, the only two states with
consistent records, the number of black patients remained relatively
steady between 1975 and '85, but the number of white patients dropped
by 21 percent and 53 percent in North Carolina. The primary reason
why blacks are committed to mental hospitals more frequently than
whites is that they are easy targets for an arbitrary commitment
system. A system the US Supreme Court has condemned as "massive
curtailment of liberty." A full commitment hearing is usually held
before a probate judge, although Louisiana allows a local coroner to
have the final say in committing people to mental hospitals. The
maximum legal length of commitment ranges from 45 days in Arkansas to
unlimited terms in Alabama, Mississippi, and South Carolina, which
are the only three states in the nation that allow a person to be
involuntarily committed and locked up for the rest of their life with
no review ever. Yes. That is still in practice.
IV: Labels
I'd like to examine now the labeling of mental illness,
schizophrenia, and other so-called disorders. People do suffer
problems in life, and do look for what is causing them. In their
desperation for a solution, they are diagnosed as mentally ill by
psychiatrists. If you simply take a look at psychiatry's so-called
textbook on mental illness, "The Diagnostic Statistical Manual" (The
DSM), you'll find that any normal behavior can be diagnosed as mental
illness, and any adverse reactions to environmental influence, peer
pressure and social unrest has earned a psychiatric label. If you
don't wake up on time, if you sleep poorly, if you drink coffee or
smoke cigarettes, or if you give up these things, if you stutter, if
a child fidgets or loses things or can't wait their turn in a game,
if you've ever been intoxicated, if you've had trouble with
arithmetic or with grammar or with punctuation or writing
expressively - all of these are now considered mental illnesses
according to psychiatrists. Even teenagers who argue with their
parents are, according to the DSM IV, suffering a mental disorder
called "oppositional defiance disorder."
Much of the current basis of psychiatric diagnosis is rhetoric about
genes and IQ creating educationally and mentally defective people.
The IQ scam shows how easy it is today to diagnose anyone as
schizophrenic. In the first edition of DSM in 1952 only two pages
were devoted to nine different stages of schizophrenia. In 1968 the
number was three pages, but the different types increased to 16. In
1980, the Insurance Guide To Schizophrenia was released in DSM III.
Deregulation of the private psychiatric hospital industry began and
with it, insurance companies required a formalized guide to what
illnesses could be claimed against. The third edition dedicated six
pages, while its revised edition in 1987 11 pages to schizophrenia.
As to the point that genetic link to so-called schizophrenia was
introduced with psychiatrists involved in the Germany Eugenics
Movement cited as experts. In fact one of the psychiatrists cited,
Carl Schneider, was a key player in the men behind Hitler and was
instrumental in planning and experimenting on mental patients with
drugs and then exterminating them under Nazi Operation T4. Schneider
committed suicide before he could be tried at Nuremberg War Crimes
Trials. This didn't stop the American Psychiatric Association from
quoting his works in this prestigious diagnostic manual where terms
like "familial pattern" were introduced, and we saw that biological
relatives were at risk of catching this "disorder."
As schizophrenia became the cash cow for psychiatrists, the DSM IV
was released last year with 24 pages devoted to schizophrenia.
Statistics studies show that psychiatrists diagnose African American
males as having schizophrenia up to 1,500 percent more than they do
whites. One study carried out in both 1984 and 1990 in Tennessee
found that although African Americans represented only 16 percent of
the Tennessee population, 48 percent of the almost 3,000 involuntary
committed patients and 37 percent of the 2,100 outpatients were
African American for the primary diagnosis of schizophrenia. Since
1963 the number of psychologists in schools has increased seven fold
from 3,000 to 22,000. Simultaneously, SAT scores for math and verbal
have plummeted. The suicidal rate among African American males
between the ages of 15 and 19 has increased 125 percent since 1965.
African Americans special education statistics -- also a
disproportionate amount of black schoolchildren are routed into
special education programs compared with white school children.
Let me give you that number again. Listen carefully. Four of the five
million special education students in our schools have no mental or
physical disabilities. Then my question is, why would they be there?
In 1930, 80 percent of blacks over age 14 could read. In 1990 56
percent of blacks over age 14 could read. This frightening increase
in illiteracy may explain why the enrollment and appropriations for
both these remedial programs have ballooned, but the number of
students in public schools has shrunk by several millions since the
crowd of baby boomer years of the 1960s and '70s. The enrollment in
Chapter One has tripled from 2.2 to 6 million and special education
enrollment has climbed by 30 percent to five million. The federal
appropriations have tripled also to seven billion dollars. For
special education from the state and from federal and local taxes, 23
billion. Last year 11 million of the nation's 42 million public
school students were doing primary lessons outside regular classrooms
in one of these programs. A glance at expenditures for 570,000
Oklahoma public school students shows how impoverishing these
programs can be. Oklahoma's total education budget was 1.7 billion;
per capita funding for regular students in a standard curriculum,
$22,200 per 65,000 students; and $4,000 for special education
students. A major difference between American straight A private
schools and her C-D-F public schools is that most private schools
never stop teaching beginners to sound each syllable whereas most
public schools started teaching or trying to teach children to sight
whole words. In the US 26 percent of public school's students are in
special classes. In other countries, it's one percent. Understandably
many informed black parents fight to keep their children out of these
classes, but sadly over half of the five million black public school
students are in one of these two dead end programs.
Black patients were consistently diagnosed with more severe mental
illnesses than whites subjecting them to heavier doses of drugs and
longer hospital stays. In South Carolina, for example, a third of all
blacks were diagnosed with schizophrenia. A figure that's 300 times
higher than it is for whites. National studies indicate that this
pattern of discrimination is not confined to the south. According to
one survey of selected psychiatric hospitals by the National
Institute of Mental Health, blacks were 2.8 times more likely than
whites to be involuntarily committed to mental hospitals. Out of
shame or sloppiness most states try to keep their discrimination a
secret. No southern state keeps account of the number of blacks they
commit to mental hospitals each year. Many of the figures in our
survey had to be compiled on a hospital-by-hospital basis. Hospitals
in four states Alabama, Arkansas, Kentucky, and West Virginia refused
to provide any racial breakdown of their admissions. "We're never
asked to break them down that way," said Janet Jenkins, Director of
Admissions at Central State Hospital in Louisville, Kentucky. "We
break them down by sex, but not by the race."
With the number of voluntary admissions to state hospitals declining
in many states the racial disparities appear to be worsening. In both
Texas and North Carolina, the only two states with consistent
records, the number of black patients remained relatively steady
between 1975 and '85, but the number of white patients dropped by 21
percent and 53 percent in North Carolina. The primary reason why
blacks are committed to mental hospitals more frequently than whites
is that they are easy targets for an arbitrary commitment system. A
system the US Supreme Court has condemned as "massive curtailment of
liberty." A full commitment hearing is usually held before a probate
judge, although Louisiana allows a local coroner to have the final
say in committing people to mental hospitals. The maximum legal
length of commitment ranges from 45 days in Arkansas to unlimited
terms in Alabama, Mississippi, and South Carolina, which are the only
three states in the nation that allow a person to be involuntarily
committed and locked up for the rest of their life with no review
ever. Yes. That is still in practice.
Perhaps the best example of the change that has been taking place in
the complexion of the juvenile custody population can be seen in the
nation's response to youths involved with drugs. Analysis shows that
though murder and robbery make for bigger headlines, drug crimes are
responsible for vastly higher numbers of juvenile arrests and
incarcerations. In just one 15 year period the per capita arrest rate
for black juveniles has increased tremendously and the total number
of white juveniles brought into court on drug charges is now
substantially behind that of blacks, even though blacks only make up
12 percent of the population. The disparity is even greater for
violent crimes. In one year, 32,200 more white juveniles than blacks
were arrested for crimes such as murder, forcible rape, robbery,
assault and aggravated assault. Despite that difference, 300 more
blacks than whites were placed into custody, and 2,100 more blacks
than whites were transferred out of juvenile court so they could be
tried in more punitive adult courts. Again, racism. Listen carefully,
so you understand the meaning of this. You had 32,200 more white
juveniles than blacks arrested for crimes of rape, murder, robbery,
and aggravated assault. Despite that there were 300 more blacks than
whites placed into custody and 2,100 more blacks than whites were
transferred out of juvenile court into adult court. Across the nation
this disparity is played out in almost every category of offense.
Now here's a question for you. When was the last time you heard about
black women being raped? When was the last time you heard about black
families being victimized and robbed? We had a white woman jogger in
New York that was raped and brutalized. It was a terrible offense.
That made news for weeks. I decided to do a little homework. During
that same identical period of time that she was making headlines
daily, more dozens of black women and Latino women had been raped or
brutalized. Not one single mention in the media of any of them. Who
then do we value more? Who's life do we feel is more sacred? I think
the media speaks for a lot of people, and yet no one in the media
writing the story would present themselves as racist.
Goodwin joined as a Clinical Associate in 1965. Between 1981 and '88
Goodwin was the Director of the National Institutes of Mental Health
Intramural Research Program. Listen carefully to what I'm going to
share with you now. From 1988 to 1992 he was the Director of the now
defunct Alcohol, Drug Abuse, and Mental Health Administration. His
infamous February 1992 racist speech drew so much fire from black
groups including the NAACP and the Black Congressional Caucus that
the funding for the proposed Violence Initiative was never made. In
1992 Goodwin stepped down from Director of the one drug rehab group
to become the Director of The National Institute of Mental Health. He
remained the Director until his resignation in 1994. Mind you that
his term was under two separate administrations. Republicans and
Democrats had this man. This is what this man said in a speech given
before the National Health Advisory Council on February 11, 1992.
Goodwin then head of the US Department of Health and Human Services
Alcohol, Drug Abuse, and Mental Health Administration likened inner
city blacks to "hyper sexual monkeys." Let me give you the full
context of this speech.
"If you look for example at male monkeys, especially in the wild,
roughly half of them survive to adulthood. The other half die by
violence. That is the natural way of life for males to knock each
other off and, in fact, there are some interesting evolutionary
implications of that because the same hyper aggression monkeys who
kill each other are also hypersexual. So they copulate more and
therefore they reproduce more to offset the fact that half of them
are dying. Now one could say that if some of the loss of the social
structure in the society, and particularly within the high impact
inner city areas, has removed some of the civilized evolutionary
things that we have built up and that maybe it isn't just the
careless use of the word when people call certain areas of certain
cities 'jungles.' That we may have gone back to what might be more
natural without all the social controls that we have imposed upon
ourselves as a civilization over thousands of years in our own
evolution."
During the same speech, Goodwin revealed plans for a national
violence initiative. The initiative involved principally a biomedical
approach that would use "100,000 inner city children, mainly blacks
and minorities, to focus mainly on brain neurotransmitter chemicals
such as serotonin and their alleged role in violence. Researchers
planned on using genetic and biochemical markers to "identify"
potentially violent minority children as young as five years old for
biological and behavioral "interventions," including drug therapy and
possibly psychosurgery-- all supposedly aimed at preventing violence
later in adulthood. According to Goodwin, the Violence Initiative was
scheduled to be the number one funded priority of the National
Institutes of Mental Health. Subsequent to his February 1992 speech,
public outcry prevented the initiative from being funded, but it had
been up for funding. This comes from the Science Magazine, September
11, 1992, page 1474. "Her concerns haven't stopped Sullivan who
insists there are 'no plans whatsoever to scrap the initiative even
as he concedes he hasn't done a very good public relations job
selling it.'" Well the idea was you got something that you feel that
you need to put in to effect make sure you have a good PR campaign
around it. So what it came down to was this. They believed, and he
specifically believed, that black children were the same as monkeys--
uncontrollable sexual urges and violent. They were worth only to
society within their own groups their capacity to copulate and to
kill. We had better protect society as a whole by identifying these
children young in life, and that there were biomarkers that could
determine a person's capacity for sexual violence and any other
violence. That's why it was called the Violence Initiative.
The Eugenicists were going to be able to identify the gene. Sound
familiar? Identifying the gene for cancer? Women hastily cutting off
their non-cancerous breasts and happy to do so. Identifying the gene
for colon cancer. Cutting out the colon. Being happy. So even though
they were healthy. No. Cancer free colons. Cancer free breasts.
Everything was as long as we can identify the gene we can give a
diagnosis and give a preventative treatment. No one challenged it.
Now think of it this way. The Black Caucus and the NAACP were right
in challenging the racist comments, but they would have supported it
had it not been for his use of the terms. If it had been just we
believe we have a capacity to do gene testing to determine high rates
of violence and prevent those, they would have passed. That's the
unfortunate part. That the only way someone will stop is because they
went so far over the top, but what if they hadn't have made those
statements. Right now all across America millions upon millions of
black youth would be given tranquilizers because of their biochemical
potential for causing violence, and that would have been in a file.
Those files would have been in registries in every insurance company,
in every employment agency, in every high school and college. They
would have the knowledge that, gee whiz, we have a kid here who's
taking drugs because he is a sex violator and a criminal violator
POTENTIALLY. The only way he's not creating the crime is because he's
on a drug. Who's going to hire that person? Who's going to want to
give him a mortgage? Who's going to want to have a relationship with
that person? Yet it was just a five-year-old kid. Did they want to do
this in the suburbs? No. Did they want to take 100,000 children five
years old from executives within the United States and do it? That
wouldn't be tolerated. Isn't it interesting what we will not tolerate
among ourselves and we're only too happy to see it happen in other
groups? So that's just to give you an idea of what's going on.
V. The Medical Model
The medical evaluation field is another way they play this game. They
look at the medical causes to psychiatric symptoms. Nearly two out of
every five patients, that's 39 percent, had an active important
physical disease. The mental health system had failed to detect these
diseases in nearly half of the affected patients. Of all the patients
examined, one in six, that's ONE IN SIX had a physical disease that
was related to their mental disorder. It was either causing or
exacerbating this disorder. The mental health system had failed to
detect one in six physical diseases that were causing the patient's
mental disorder. The mental health system had failed to detect more
than half of the physical diseases that were exacerbating the
patient's mental disorder. These are just some of the cases from
different areas. What they were doing is, if you went in to a mental
hospital with a mental disease and if you were black, whatever
physical conditions you had were considered immaterial.
They just weren't treated or minimally so because anything you would
have said-- if you said, "My back hurts"-- they would have said well
that's just part of your delusional psychosis. If you said, "I'm in
terrible pain," they would have said "delusional psychosis." If you
would have said, "I've got arthritis"-- delusional psychosis. But
later, when people did examine them, they found they had real
physical problems that had not been treated. There is an article that
was written called Psychological Symptoms of Physical Origin by
Richard Hall and Michael Pompkin.
"One of the most difficult problems encountered by the practicing
physician is that of distinguishing emotional from organic symptoms.
Organically based symptoms that mimics psychiatric disorders are
numerous and many diseases produce them. In women, endocrine and
metabolic disorders are the most frequent causes of psychiatric
symptoms. Early identification and appropriate treatment can avert
many emotional, physical, and even legal problems for our patients.
Any condition that disrupts the brain or alters its subtle balance of
stimulation and inhibition can produce psychiatric symptoms. Often
these symptoms are the first and only signs of an underlying physical
disorder." What this means in lay language is this... We can have a
person going to a doctor and suggesting they have a physical symptom
and that it's causing such physical problems that it's manifesting in
some alteration of their emotions. If the doctor doesn't recognize
that, then they'll classify the person as mentally disturbed, but
without trying to fix the physical condition that may have caused the
emotions. I know people who have been diagnosed, put into mental
institutions, given electro convulsive therapy for depression. When I
worked with them, I found out they merely had an under-active
thyroid. Corrected the thyroid; the person is normal. They never had
depression. Hence they were maltreated, mistreated, misdiagnosed.
Because they were black and they were poor, they had virtually no
recourse within the current system. No lawyer wanted to take on their
case and no one wanted to hear their problem.
When all you have is a hammer, everything looks like a nail. When all
you have to treat illness are pharmaceutical drugs, then you look for
symptom clusters of an illness in order to use these drugs. Vitamin
and mineral deficiencies, hypoglycemia, hormone imbalance, and organ
pathology can all mimic depression. Allopathic medicine is not geared
toward treating nutritional imbalance and instead looks at the
resulting symptoms these imbalances create. Then it tries to suppress
these symptoms with drugs.
The mind-body split has never been greater than in today's medicine.
Medicine itself is split into so many specialties, each one trying to
maintain its status and mystique. That means the individual is split
as well. There is no one in charge of the whole person. So, when an
Internist fails to "cure" a patient with fatigue, body rash, and
itching, who also has anger and irritability, instead of recognizing
a "toxic liver", the doctor sends his failure to a psychiatrist,
saying that the patient's symptoms are "all in his head." Menopausal
women who go through hormonal shifts are given synthetic hormones and
antidepressant medication to treat a normal life change. Women with
premenstrual tension are treated with Serafem, which looks like a new
drug but it's just Prozac with a new name. Kids who can't stand being
confined in a classroom after exploring the whole world via TV or the
internet, are "calmed down" with Ritalin.
We continue to treat normal life events with drugs and it appears as
if there is an overabundance of drugs just waiting to be slotted into
people's lives. Insurance companies and HMO's are only too willing to
promote drug therapy. It's far less expensive and far less time-
consuming for a doctor to identify a few key symptoms and prescribe a
drug. Everybody has stress, everybody is burdened with worry. These
are normal aspects of everyday living. But when these normal
individuals are constantly bombarded with advertising for mood-
altering medications and told they have the right to permanent
happiness, then their emotions have become pathologized. They have
gone through a process where the disease has been created, in their
perception of themselves, and the cure is immediately offered. And
they go to their doctor and ask for the cure.
The elderly are prescribed a vast amount of drugs and are now being
treated with electroshock when the drugs fail. Politicians say they
are very concerned that the elderly can't afford their drugs. Instead
of arguing to make medicine less expensive or instead of finding less
expensive medicine or medicine that has fewer side effects, there is
a debate about giving the elderly free access to drugs. It's a poor
choice. This type of medical welfare is not looking after the welfare
of the whole person by leaving out diet, nutrition, and lifestyle
intervention in favor of drugs alone.
Where is medicine headed? The Genome Project put everyone's attention
on our genetic makeup and the possibility that with genetic screening
we can identify diseases and the predisposition to disease at birth.
Genetic screening has taken a huge chunk out of the American research
budget. The stakes are high to find the locks and the keys to the
body through our genes. We often hear about the various disease
genes, the breast cancer gene and even the depression gene. We create
the notion of a diseased gene and offer the cure of inserting a
healthy gene. Or perhaps we'll soon hear about a vaccine against
depression. Replacing depression genes or using vaccines for
depression may never be possible but it's just a continuation of
defining depression where it does not exist and pathologizing life.
What does this mean for the average person who is on a bad diet with
lots of sugar, artificial sweeteners like aspartame, packaged and
processed foods with lots of additives and preservatives? Chances are
your liver is toxic. Your liver is responsible for processing any
chemicals that come into the body. And chances are you are feeling
bloated, fatigued, constipated and irritable with a toxic liver. If
you take those vague physical symptoms and obvious emotional symptoms
to a doctor you will be diagnosed as anxious or depressed during a
three-minute HMO appointment. You will then be given a prescription
for a drug that will overload your liver even more with daily amounts
of a synthetic chemical drug. And you will have side effects and feel
more fatigued, bloated and irritable. But the mood-altering
properties of the drug may make you feel better while the liver
struggles to break down the drug.
NOTES
1. The Hoax of Learning and Behavior Disorders, Citizens Commission
on Human Rights (pamphlet), Los Angeles, 2001.
2. Zito, Julie Magno, "Trends in the Prescribing of Psychotropic
Medications to Preschoolers," Journal of the American Medical
Association, Feb. 23, 2000, Vol. 283, No. 8, pp. 1025-30.
3. West, Jean, "Children's drug is more potent than cocaine," The
Observer, London, Sept. 9, 2001.
4. Graham, J.E., et al., "A double-blind, randomized, placebo-
controlled trial of fluoxetine in children and adolescents with
depression." Arch. Gen. Psychiatry, 1997; 54:1031-37.
5. Breggin, Peter R., "Today's Kids Suffer Legal Drug Abuse,"
Newsday, Sept. 23, 1999, p. A53.
6. Gary Null interview with Dr. Fred Baughman, Feb. 12, 2001.
7. DeGrandpre, Richard, Ritalin Nation, W.W. Norton & Co., New York,
1999, p. 160.
8. Elkind, David, The Hurried Child, Addison-Wesley, New York, 1981.
9. Suriano, Robyn, "As kids get put on pills, critics fret," Orlando
Sentinel, Nov. 26, 2001.
10. Gary Null interview with Dr. David Stein, Feb. 13, 2001.
11. Ibid.
12. Suriano, op. cit.
13. Harris, Gardiner, "Use of Mood-Altering Drugs to Control
Toddlers' Behavior Jumped in the '90s," Wall Street Journal, Fed. 23,
2000.
14. Zito, Julie Magno, "Trends in the Prescribing of Psychotropic
Medications to Preschoolers," Journal of the American Medical
Association, Feb. 23, 2000, Vol. 283, No. 8, pp. 1025-30.
15. Robinson, Holly, "Generation Rx," Parents, Nov. 2001, p. 82.
16. Kaiser, David, "Commentary: Against Biologic Psychiatry,"
Psychiatric Times, CME Inc.,
webmaster@mhsource.com
<mailto:webmaster@mhsource.com>.
17. O'Meara, Kelly Patricia, "Writing May Be on Wall for Ritalin,"
Insight, Oct. 16, 2000,
omeara@insightmag.com.
18. Zernike, Kate, and Melody Peterson, "Schools' Backing of Behavior
Drugs Comes Under Fire," The New York Times, Aug. 19, 2001.
19. Breggin, Peter R., Talking Back to Ritalin: What Doctors Aren't
Telling You About Stimulants for Children, Common Courage Press,
Monroe, ME, 1998, p. 5.
20. Lipkin, P.H., et al., "Tics and dyskinesias associated with
stimulant treatment in attention-deficit hyperactivity disorder,"
Arch. Pediatr. Adolesc. Med., Aug. 1994, 148(8):859-61.
21. Gerlach, J., et al., "Methylphenidate, apomorphine, THIP, and
diazepam in monkeys.dopamine-GABA behavior related to psychoses and
tardive dyskinesia," Psychopharmacology (Berl.), 1984, 82(1-2): 131-4.
22. Young, J.G., "Methylphenidate-induced hallucinosis: case
histories and possible mechanisms of action," J. Dev. Behav.
Pediatr., June 1981, 2(2):35-8.
23. Weiner, W.J., et al., "Methylphenidate-induced chorea: case
report and pharmacological implications," Neurology, Oct. 1978, 28
(10): 1041-4.
24. Silver, Larry B., Dr. Larry Silver's Advice to Parents on
Attention-Deficit Hyperactivity Disorder, American Psychiatric Press,
Washington, D.C., 1993, p. 189.
25. Taylor, John F., Helping Your Hyperactive/Attention Deficit
Child, Prima Publishing, Rocklin, CA, 1994, p. 87.
26. Sears, William, and Lynda Thompson, The A.D.D. Book: New
Understandings, New Approaches to Parenting Your Child, Little, Brown
and Co., New York, 1998, p. 235.
27. Taylor, John F., Helping Your Hyperactive/Attention Deficit
Child, Prima Publishing, Rocklin, CA, 1994, p. 91.
28. Swanson, J.S., et al., "Stimulant medication and the treatment of
children with attention deficit disorder: A Review of Reviews,"
Exceptional Children, 1993, Vol. 60, pp. 154-61.
29. Gary Null interview with Janet Hall, Feb.13, 2001.
30. Ibid.
31. Associated Press, "Ritalin Maker Sued Over Girl's Death," The
Record (New Jersey), Jan. 9, 2000, p. A-3.
32. Gary Null interview with Janet Hall, Feb.13, 2001.
33. Gary Null interview with Dr. Dragovic, Feb.13, 2001.
34. Ibid.
35. Wang, G.J., et al., "Methylphenidate decreases regional cerebral
blood flow in normal human subjects," Life Sci., 1994, 54(9): PL143-6.
36. Suplee, Curt, "Brain not finished developing by age 6, scientists
now say," The Philadelphia Inquirer, Mar. 9, 2000.
37. Henderson, T.A., and Fischer, V.W., "Effects of methylphenidate
(Ritalin) on mammalian myocardial ultrastructure," American Journal
of Cardiovascular Pathology, 1995, 5(1): 68-78.
38. Gary Null interview with Dr. Fred Baughman, Feb. 12, 2001.
39. DeGrandpre, op. cit.
40. Ibid., p. 19.
41. Zernike, Kate, and Melody Peterson, "Schools' Backing of Behavior
Drugs Comes Under Fire," The New York Times, Aug. 19, 2001.
42. Ziegler, Nicole, "Recreational Ritalin," The Associated Press,
abcNEWS.com, May 5, 2000.
43. Clerman, G., ed., Contemporary Directions in Psychopathology,
1986.
44. Cauchon, Dennis, "Patients often aren't informed of full danger,"
USA Today, Dec. 6, 1995.
45. Boodman, Sandra G., "Shock Therapy...It's Back," The Washington
Post, Sept. 24, 1996, p. Z14.
46. Boodman, op. cit.
47. Electroshock as Head Injury: Report for the National Head Injury
Foundation, Sept. 1991.
48. Samant, Sydney, Clinical Psychiatry News, Mar. 1983.
49. Freeman, C., and Kendell, R., "Patients' experience of and
attitudes to electroconvulsive therapy," Annals of the New York
Academy of Sciences, 462 (1986), 341-52.
50. Gerring, Joan P., and Shields, Helen M., "The identification and
management of patients with a high risk for cardiac arrhythmias
during modified ECT," J. Clin. Psychiatry, 43-4.
51. Appendix to Breeding, John, "Electroshock." Based on an article
in the J. of Humanistic Psychology, Winter 2000, Vol. 40, No. 1, pp.
65-69, citing Ali, P.B., and Tidmarsh,, M.D., Cardiac Rupture During
Electroconvulsive Therapy Anesthesia 1997; 52: 884-895.
52. Boodman, op. cit.
53. Edelson, E., "ECT elicits controversy--and results," Houston
Chronicle, Dec. 28, 1988, p.3, as reported in "Electroshock: Death,
Brain Damage, Memory Loss, and Brainwashing," op. cit., p.493.
54. Opton, E.M., Jr., Letter to the members of the panel, National
Institute of Health Consensus Development Conference on
Electroconvulsive Therapy, June 4, 1985, as cited in Frank,
L.R., "Electroshock: death, brain damage, memory loss, and
brainwashing," op. cit., p. 497.
55. Boodman, S.G., "Shock therapy...it's back," op cit.
56. Cauchon, Dennis, "Patients often aren't informed of full danger,"
op. cit.
57. Frank, L.R., "Electroshock: death, brain damage, memory loss, and
brainwashing," op. cit., p.494.
58. Ibid.
59. Viscott, D., The Making of a Psychiatrist. Greenwich, CT,
Faucett, 1972, in Leonard Roy Frank, "Electroshock: Death..." op.
cit., p.494