The Dangers of Psychiatry – An Opinion
CW/TW: mention of violence, medication, self-harm, suicidality
It is close to the end of Mental Health Awareness month. This month is focused on spreading information about the importance of mental health and to fight the stigma around mental illness. I think that especially in these Covid-19 times, many people are talking about reaching out, talking with each other and the pain of loneliness. Those things are important to take up because for many, this is the first time they are actually struggling with their mental health. And let’s be honest, there is nothing scarier than the first ever panic attack, nothing more overwhelming than the first anxiety-induced sleepless night or the first bout of restless loneliness. I don’t want to minimize the pain that many are experiencing. But I rather want to talk about something else, something that might be helpful to those who have mental illness: the dangers of psychiatry.
Mental Illness and Assumptions
Talking negatively about something that many put their last hope in when they are struggling, might seem counterproductive. So let me start by saying that I write this post with the intention to empower people to take control of their recovery or management of their mental illness, to do research and to be actively involved in their own treatment. I want others to be able to avoid the sort of experiences I have been through. I want to say: There is help out there, but not everyone in psychiatry is helpful, so it is important to be your own advocate.
The sort of psychiatric treatment and help that I am talking about is for mental illness. I don’t mean counselling because you feel it would be helpful to talk to someone. Those sort of issues are important too, but I want to focus on mental illness, instead of mental health struggles that need a few weeks of counselling to get through a crisis. I believe that those with mental illness are in a position without power where they are being infantilized, controlled and dismissed. They don’t have a voice because they are not being taken seriously, as mental illness is still seen as synonymous with an inability to think rationally or speak for yourself.
The first time I got in touch with psychiatry, I was desperate. I had been diagnosed with depression a few years prior and had seen a counselor a couple of times. But when I had told that woman a little bit about my childhood, she had said that it didn’t sound so bad and I should learn to move on. Looking back, I think she sort of put a stop for me to dig deeper, and took away my opportunity to stop crashing the way that I did. I eventually got out of that depression (because that is how bipolar disorder works. Eventually, for no apparent reason, your depression goes away again) and didn’t think much about my mental health.
But when I my crash happened, I was desperate. I had never seen a psychiatrist. And I had never had therapy or tried any medication. I was 29 at the time, and I thought there was help out there. That what I was experiencing (the panic attacks, the anxiety, the depression, the suicidality) were temporary. I didn’t believe there would be any quick fixes. But I believed that there was proper help, if only I tried.
My first contact with psychiatry was on the phone. I told them that I got referred from my GP because they suspected I had panic attacks and anxiety, and needed help. But the person answering the call tried to tell me that I am not struggling badly enough to get registered with them, so referred me somewhere else. That was the start of being referred and changing providers dozens of times, without ever getting any long-term, constant and stable support. But I was desperate, so I did as I was told.
What could I have done differently? Oh, I could have spoken up for myself. I could have said no, sorry, but I need your help, so please do your job. But I was struggling
I made a mistake. The biggest mistake anyone being in touch with psychiatry could make. I just swallowed their pills. After an evaluation, and a night spent at a psychiatric emergency room, a psychiatrist prescribed antidepressants to me: Prozac. I didn’t read up on the side-effects, I did not understand that no one really knows why antidepressants work, as they can’t target just one area in the brain. They basically bathe the whole brain in chemicals.
I got worse. Much much worse. I couldn’t sleep anymore, I lost weight, I got more suicidal, I was more anxious. I had a burning feeling all over my scalp, it felt like I had poison in my veins. And what was the answer? More meds, sedatives and sleeping medication: Oxazepam and Zopiclone. But I got worse, until I eventually ended up in the hospital after a suicide attempt.
And more …
And then? Well, more meds! They doubled my dosage of Prozac, gave me Mitrazepam two nights. I got psychotic from that one so they stopped giving it to me. They added Propavan for sleep, and Lamotrigine for mood stabililisation. At that point, I didn’t even have a proper diagnosis. I was always sleepy, always anxious, I stopped talking, I stopped eating. I had to have suicide watch (a nurse being with you at all times).
Once back home, I stopped the Prozac by myself. After three months on it, I was done. It didn’t help me. At that point, I started reading up on things, and realized that meds make you worse before it gets better. I had waited the recommended six weeks though, even longer. So instead, they put me on Zoloft. I got a terrible rash all over my body for ten days, which only got better with extra-meds for that reaction. But that was not the worst side-effect. For the first time in my life, I developed self-harm urges and started self-harming. Later, I found out that that is a common side-effect on Zoloft.
And more …
Well, I stopped that med too. And was taken off the sedatives as well, because I met a psychiatrist who didn’t believe in Benzodiazepine. Instead, I got strong anthistamines: Atarax and Theralene. They made me sleepy, weak and unable to get out of bed. Theralene made me so hungover, that I threw up every morning. It was terrible! I stopped the Lamotrigine because it didn’t make a difference.
At that point I should have just said stop and not taken any medication anymore. But I was so desperate, and I wanted to believe what psychiatrists told me. To make this short, the next years were terrible mostly because of the medication that I tried out. There was Effexor (antidepressant which gave me such horrible brain zaps, they took me to the ER; worried I had had a stroke), Wellburtin (I have never felt so restless and anxious in my whole life), Zyprexa (made me unable to speak, gave me restless legs and made me gain 30 kg in a bit over 3 months), Abilify (gave me caged tiger syndrome), Valium (made me too sedated) and many more!
None of them helped me. Not one of them made me feel better. The worst combination I was on was Seroquel (Quietapine) and Propavan. They gave me long term neurological issues and dealing with those took almost two years away from my life. No one believed me either, because I hadn’t been on astronomical doses either And I still have those issues. They have improved though. The only medication that short-term had a good effect on me are Oxazepam and Zopiclone. But they are despised by psychiatrists and it is difficult to get them prescribed. And not only that. If you ever find yourself in the position where you run out of them, expect the worst withdrawal you can imagine. Months and months of my life were marked by feeling utter shit because of it.
Don’t let despair lead you, make informed decisions
I have seen people get better with medication, short-term. Until the side-effects get too much. I believe, and will continue to believe, that psychiatric medication is too dangerous. They don’t know what they are doing yet, they don’t understand how things work. Do not take psychiatric medication unless you really need to (if you have bipolar disorder type 1, or schizophrenia). They are not a quick fix, and they will affect your body long-term. Educate yourself on what you are taking, and make informed decisions. Someone as fucked up as I am with my four major mental illnesses can survive without medication. As long as you are not in crisis (suicidal etc), medication can make things worse. It is up to you to decide what you swallow, don’t let any doctor make you feel like you have to do what they tell you to do.
I don’t want to and can’t generalize about a whole group of people. But I also don’t want to say something like there are bad apples in every bunch. No, I want to make people understand that it is scary how many bad and invalidating psychiatrists are out there. I have run into so many sadistic, misogynistic and narcissistic psychiatrists with a Godcomplex, that it can’t be just a fluke. And the sad thing is that when you are struggling badly, you need help, so you blindly follow what they tell you because they are all you got.
The “wise old men”
The ones that have hurt me the most were older men. They were from the old garde, meaning that they sort of still very much believed in that women emotionally overreact. They are quick to judge and if you question them, they threaten you. I have realized that psychiatrists are largely overpaid because all they do is prescribe meds and diagnose you. Funny enough, not one doctor ever did an evaluation with me. Nurses did the evaluations with me, they were the ones going through the questionnaires with me. And sometimes, psychiatrists just look at you for a second and they think they got you figured out. Only two out of the dozens of psychiatrists I have met, had read my medical journal. Everyone else assumed stuff, wanted to get me quickly out of their office again, and did not in any way listen to me.
You might think I am exaggerating, but I am not. Let me give you a few examples. I met a doctor who took one look at me, asked me a couple of questions, and decided that I have Borderline Personality Disorder and that I am an addict. That diagnosis haunted me for a long time because it was the one that was first mentioned in my medical journal. He said that someone who looked like me, was female, had anxiety, depression, self-harms and dissociates, was loud and obviously wanted attention, could have no other diagnosis.
When he made me leave bloodtests and urine tests every day to prove that I am not a drug addict, he really humiliated me. At one point, he was so rude to me, that my boyfriend at the time who was sitting in the meeting with me, yelled at him to defend to me and security had to be called because both men were yelling and insulting each other.
I have talked about this incident before. I had a psychiatrist say to my face that he doesn’t like me, that I am a very unsympathetic person and that I don’t have a personality at all. To my face. While I was staying at the hospital. He later denied that ever happened, although me and the nurses in the meeting reminded him of that that was what had happened.
When you get admitted to a psychiatric ward against you will (or sectioned, as it is called in the UK), you basically lose all your rights. It is a scary thing, because you are totally at the will of the head psychiatrist. And I once met one that was absolutely scary. He wanted to give me Lithium and I didn’t want to take it because I was worried about side effects. I didn’t want to be at the psych ward in the first place.
Anyway, I thought we were having a discussion about the dangers of Lithium and what it can do to the body, but he started threatening me. He said if I wouldn’t try the meds by next week, he would give me ECT (Electro Shock Treatment). I said I definitely wouldn’t want that, to which he replied that I have no say and he could just strap me down and force it on me. Wonderful, eh?
The Fight to get the Right Diagnosis
But I think the best representation of how clueless psychiatrists are is the list of diagnosis that they have given me through the years: Borderline Personality Disorder, Depressive Personality Disorder, Avoidant Personality Disorder, ADHD, Asperger’s, Panic Disorder, Social Anxiety, Anorexia, Bulimia, Schizo-affective disorder, PTSD, and so forth. It is now standing at Bipolar Disorder type 2, Complex Post-Traumatic Stress Disorder, Dissociative Identity Disorder and Generalized Anxiety Disorder. And for once, it feels like they have gotten it right. It took me ten years to get to a place where psychiatrists might have figured out what is really wrong with me.
Not all psychiatrists are utterly useless. I have met three who were kind, supportive, tried to understand me, didn’t judge me and didn’t just throw prescriptions at me. They didn’t diagnose me right away, but tried to get to know me. They read some of my medical files but also asked a lot of questions. So as I said in the beginning, not all psychiatrists are bad.
Be Vigilant and Never Alone
You need to be vigilant. I know that it is really difficult to stand up for yourself when you are not doing well. That is why I suggest that you do not go to psychiatrist appointments on your own. Take a loved one with you, someone who you trust, so they can speak up if something goes south. And remember: you are in control, they are offering a service and they are not Gods. You can look for a new psychiatrist, you can ask for a second opinion, you can report them if they mistreat you. Know your rights, read up, ask questions and don’t be alone with them. And there are good psychiatrists out there, it might just take a while to find one.
Being admitted to a psychiatric ward should be your very last resort. A lot of people assume that it is a place to breathe out, to do some self-care, to do some therapy. Well, no, they are not. Most psych wards do not offer therapy at all, they might offer groups to share in, or a priest that comes over once a week, or maybe some physical exercise. But nope. psych wards are there for when you have emergency needs, not when you are just doing a bit unwell. In Sweden, there are only two reasons why you’d be admitted to a psychiatric ward: you are actively suicidal, or you are in psychosis. And it isn’t important what you tell them about how you are doing, it is all about what the result of your assessment is.
I once came into the psychiatric ER after my ex had called the cops on me when I was going through a flashback and couldn’t stop screaming and shaking. He was worried that people would think he is abusing me, so in his warped mind, he thought it would be better to get proactive. Anyway, police brought me to the ER, I got assessed and sent back home again.
Another time, I was not telling them much at all, because I didn’t want to get admitted to the hospital. I wasn’t feeling well, and I knew I was suicidal. But I didn’t tell them. I was evasive with my answers, I lied, I made promises. But they didn’t believe me, so I got sectioned because I had said I didn’t want to be admitted. So yeah, from my experience, only when you are really really unwell, do they admit you to the hospital. The reason is mostly that they don’t have enough beds. The wards that I have been in, we shared a one bed room with three people, six people in a room for two. It was cramped. And not safe.
Psych wards are places of torture. Yes, I just said that. It is like prison, and the crime you have committed is mental illness. I might sound overly dramatic here. But the things that I have seen, and that I have experienced, are horrendous. I have seen people who killed themselves. My one roomate suffocated herself in the bathroom and I found her. And I have seen someone stand in the corridor of a psych ward and slash her whole arm open with a piece of glass, blood everywhere.
I have seen people being jumped on by nurses and doctors, literally pushed to the floor and sat on, while screaming and begging for their lives. And I have seen people have convulsions and seizures from medication. I have heard women scream in agony as they were forced fed, begging not to be hurt. Every night, people scream of nightmares. Every day you see people cut themselves, pass out after they ODed, scream out loud that they want to die. It is a horror show, really.
Those are the things i have seen. But I have also experienced some terrible stuff. I have been jumped on and strapped down to a bed, so I couldn’t move anymore, because I had a flashback and I told people not to touch me. And I have been injected with strong antipsychotic medication against my will. I have been sexually abused at a psych ward while being strapped down. I have been forced to take medication, I have been ridiculed, ignored and humiliated. But the worst of it all is that you can’t just leave. There were double doors, locked. You were imprisoned.
Not once did I find a stay at a psych ward to be a safe experience. And I wasn’t even at the ward for the most aggressive patients. So my only goal was always to get out of there. It was never: they can help me get better. It was always: fuck, I need to get out of here. You were totally helpless and powerless, the doctor was the God, and although it was the nurses and health workers that spoke to you and were around you all day, they had no say in anything. It was such a skewed power balance.
Stay away from psych wards, if you can. They are traumatizing places. Unless you are scared of yourself and are actively suicidal. But even then, I’d first call a suicide hotline and see what they suggest. Maybe talking it out will help, maybe having someone around that you trust will help. And if you are threatened with being admitted, go in voluntarily. That way not all your rights are being stripped off of you. And you might have a better chance to get out the next day. Or maybe you are lucky, and the head psychiatrist is helpful and after a week you are feeling better and can go home. There is always that possibility too. But I feel it is best to be prepared for the worst, and hold on to the little power you have over your own existence.
There is no one approach fits all when it comes to therapy. But unfortunately, the system seems to suggest that. There are milder forms of depression and anxiety disorders that can be treated with Cognitive Behavioural Therapy (CBT) but most serious mental illness will not get better with it. The reason is that that the underlying issues are being ignored. All you do is try to change your behaviour in the now, without ever processing what has happened in the past.
I have done CBT, DBT (Dialectic Behavioural Therapy) and psychodynamic therapy. None of them were particularly helpful for me. The therapists were all quite at loss as to how to help me, and I basically never opened up because it felt unsafe. Mindfulness exercises trigger me into panic attacks, when someone gets too close to my feelings, I divert the conversation. I was often called unwilling, but the issue was not that. The issue was that I didn’t feel safe and whatever tools they tried to give me, didn’t help.
I don’t think therapy has done me as much damage as medication, psychiatrists and psych wards have done. I just never met a therapist that I felt safe enough to talk about myself with. And I had a weird effect on them too, so some of them got really unprofessional (like calling me in the middle of the night, crying and telling me they are worried about me). I had two therapist terminate therapy with me because they felt like they couldn’t help me. Which is fair enough, but also made me feel very hopeless.
In retrospect, I realize that there are not enough trauma-informed psychologists out there. I don’t mean counselors, but psychologists that have a degree in the theories just as much as the practical therapy approaches. And there just isn’t a lot of trauma related stuff taught at universities. My guess is that the focus has long been on veterans and all trauma-approaches are a bit old-fashioned that way.
There are trauma centers. There is trauma based therapy. But it can take ages to get accepted, and it takes many many years to work through complex trauma. And don’t even get me started with the harmful idea of integration therapy with Dissociative Identity Disorder.
I am wary when it comes to professionals at this point. So if I ever were to give the idea of therapy another thought, I would do a lot of research. I would look up different clinics, different therapists, their approaches and their focus. I think that therapy is safer than medication, hospitals and being in touch with psychiatrists. Therapists are meant to create a safe space so the risk for harm is not as great. Just be mindful about who you reach out to, and also be aware of that this is definitely not a quick fix and you will have to put a lot of work into it.
My Story is a Warning
I know that my experiences are my own and do not reflect how psychiatry works everywhere, how hospitals operate or how medication affects all human beings. My story is my story. But I wouldn’t want anyone to have to go through what I went through. I feel like I have lost many years of my life in the claws of psychiatry, my body got ruined in the process and I am stuck with new trauma.
I want my story to be a warning about the dangers of psychiatry. The conclusion shouldn’t be that you should avoid psychiatry at all costs, or that all medication is bad or that hospitals are warzones. Instead, I want to make sure that people are aware of that they are not going into a safe space, but that they need to be vigilant. Always bring someone with you, always research things yourself, always read up on medication. Walk the safe path: call a suicide hotline before going to a ER, ask for therapy before taking medication, ask for another doctor if a psychiatrist is treating you badly. It is about your health, your mind. So you should be the one making the decisions.