International Center for the Study of Psychiatry and Psychology | Summer 2004 | Depression, Presentation, Drugs, Children,

Summer 2004

ICSPP Newsletter

International Center for the Study of Psychiatry and Psychology

Special Summer 2004 Issue

The Eighth Annual International Center for the Study of Psychiatry and Psychology Conference, entitled Critiquing Disease Models of Psychosocial Distress and Developing and Implementing Effective Psychosocial Theories and Interventions will take place on October 8^th, 9^th, and 10,^th2004, in the Sheraton LaGuardia East, Flushing, Queens, New York. Outstanding, invited speakers include: George Albee, Ph.D., past president of the American Psychological Association; Mary Boyle, Ph.D. author of Schizophrenia: A Scientific Delusion?; Peter Breggin, M.D., founder and director emeritus of ICSPP, author of Toxic Psychiatry; Celia Brown, president of Mindfreedom.org; Joseph Glenmullen, M.D. author of Prozac Backlash; David Healy, M.D, internationally recognized researcher and author of Let Them Eat Prozac.; Bertram Karon, Ph.D., Researcher, Psychoanalyst and author of Psychotherapy with Schizophrenia: Treatment of Choice; Diane Lambert, Ph.D. Researcher, author and educator; Vera Sharav, founder and president of AHRP: and Robert Whitaker, author of Mad in America. In addition, over forty outstanding scholars and practitioners will by presenting a wide variety pf workshops and papers. (See pps. 21-27 for the full conference program.)

DUES

Many members of ICSPP are in arrear of their dues which for 2003 was $25.00. Dues for 2004 are $50.00 and are now payable. Our important organization cannot continue to function unless members keep it financially solvent. The costs of producing the newsletter keep escalating as do all others involved in maintaining the organization. Therefore, this will be the final newsletter for those in arrears. Please do not allow this to happen and deprive you and us from maintaining the vital link of communication that the newsletter represents. Important: Any individuals who cannot afford the full dues can send whatever portion they feel their budgets will allow

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Editorial ? The Importance of ICSPP and Our Conference

I have just finished reading about one hundred pages of process notes written by psychiatrists, social workers, nurses, and other professionals involved with the ?treatment? of an elderly female patient at a large state-run mental ?hospital? here in New York City. (I read this document as part of my role as expert witness to defend the woman against further forced ?treatment? with neuroleptic drugs. I will write more about this when the case is over and finally adjudicated.) What is so depressing and painfully evident in these handwritten pages is the total dehumanization of the ?patient? by all of her so-called caretakers as they perceive her as a disease in need of cure rather than as a complex, thinking, feeling, motivated and symbolically motivated human being. (p. 15.)

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About the International Center for the Study of Psychiatry and Psychology. The International Center for the Study of Psychiatry and Psychology (ICSPP) is a nonprofit, 501C research and educational network of professionals and lay persons who are concerned with the impact of mental health theory and practice upon individual?s well-being, personal freedom, families, and communities. For over three decades ICSPP has been informing professionals, the media, and the public about the potential dangers of drugs, electroshock, psychosurgery, and the biological theories of psychiatry.

ICSPP is supported by donations and contributions. Officers receive no salary or other remuneration.

Help us continue our work by sending a donation to ICSPP today.

Notes from the Desk of a Family Therapist

Norbert A. Wetzel

Conversations with parents regarding the use of psychiatric drugs for their children and adolescents are often dramatic enactments of the context within which we talk with each other, with our clients and with colleagues. Our language, our thought patterns, our associations to words like depression, anxiety, anger, obsession are pre-determined by the societal culture we live in.

J. Habermas? groundbreaking work, ?Knowledge and Human Interests? (1972) is as enlightening now as when it was first published. The economic, social, professional, cultural and political interests dominating our society pre-organize and pre-define what we think and, worse, how we can think. They are shaping outcome and process of our professional discourse and our conversations with parents and families.

As we are engaged with our clients in professional relationships aimed at giving meaning to their experiences and at transforming their lives we are surrounded by billion dollar advertising campaigns, by societal institutions constructing and perpetuating particular ?scientific? truths, and by myths deeply ingrained in the popular culture (?We all should and can be happy?; ?There is a pharmaceutical remedy for every ill?). The ghosts representing the various societal power structures are sitting right there in the room with us. Conversations with clients or professional exchanges with our psychiatrist colleagues about psychiatric drugs are never deliberations between partners of equal status. Nor do they take place within an unconstrained context, i.e. they are not ?domination free communications? (Habermas, 1972).

From where do we gather the authority and courage to ?make use of our own mind? (Kant, 1784) and to protest against the ruling powers in the face of overwhelming odds?

In my view, it takes a reassertion of our common humanity, i.e. a decision to remember the humanistic tradition of our profession and to recall the core of our commitment: to attend to the other?s suffering and to honor her or his inviting us into a relationship with them. From this point of departure beyond our individual selves we may be able to summon the strength to stand up and step away from the capitalistic definition of our therapeutic or professional conversations.

As we reclaim our tradition, it makes sense to understand what is commonly called psychotherapy as a ?complex responsive process of relating? (Stacey, 2003) between human beings that affects all participants, including the therapist. The core of our protest is directed toward therapy regarded as a question and answer interview to discover an objective diagnosis with the purpose of establishing the right medication. From an interpersonal process view a psychiatric diagnosis is a dyadic interaction frozen in time and manipulated to assert power and economic gain.

Advocates of psychotherapy as a relational process protesting against corruption, medical malpractice, fraud, exploitation, shoddy research and ignorance overlook frequently in their discourse with medical representatives of bio-psychiatry that both sides come from radically diverse epistemologies. We are speaking different languages; no wonder the discourse does not go anywhere.

The medical sciences in general and psychiatry in particular are still stuck, epistemologically speaking, in Newton?s classic realism paradigm, even though the natural sciences, especially physics, have transcended this world view a century ago with the development of Einstein?s Theory of Relativity and Planck?s Quantum Mechanics, to name but a few developments that revolutionized our thinking about how we think. Our psychiatric colleagues remain dazzled by the technological and pharmaceutical breakthroughs of modern medicine that are owed to the classic realist view of the world as a giant collection of objects that we can accurately measure and research. Medical practitioners (including psychiatrists) continue to conceptualize the world of human relationships as if they were dealing with objects as part of a quantifiable reality. Hence psychiatry?s focus on the bio-physiological aspects of a person.

Rather than understanding psychotherapy according to the model of medical examination and cure, it is much more useful to conceptualize therapy as an encounter between people who are engaged in a particular form of conversation. As such, the therapeutic conversation fits into the model of the relational process paradigm that is rooted in the post-modern constructionist relational Epistemology.

At the core of our inner experience we find ourselves involved in a constant relational process with others that occurs prior to our own decision, is reciprocal and enormously complex. Our existence as related Beings logically precedes our cognition of others. We are always logically first participants, then observers. As participant observers our choice of perspective, i.e. scientific, empathic, artistic, investigative determines the kind of ?reality? we can ?see?. The ?world?, therefore, is a project constructed jointly in the minds of the observing participants in a complex reciprocal process. Our mind?s project of the ?world? and of the people around us is not a mere phantasm because the project rests on the ongoing relational process in which the ?observer? is part of the ?observed? and as such profoundly defined by the other. The other remains, however, while accessible within the complex relational process, at the same time forever beyond the comprehension of the observing partner, i.e. the other is not a comprehensible object.

Adopting the above outlined post-modern relational Epistemology for our field is crucial for our work, our conversations with clients and our discourse with our colleagues.

One may adopt the classic realism paradigm for many aspects of daily life, for the construction of all sorts of great machines, yet for the human world it is woefully inadequate and often destructive, not only in terms of the medical field, but in general. It blocks out the relational aspects of reality, purports to enunciate ?the truth?, is blind to the uniqueness of others, and fails to provide a basis for the joint creation of meaning.

The rigorous application of the constructionist relational paradigm to clinical practice gets us out of the medical, i.e. classic realist model of thinking and puts the emphasis on the interpersonal language and collaborative process between the people involved. Change occurs not when an expert diagnoses and repairs the (psychic or bio-physiological) inside of a patient. Rather, clinical transformation refers to the collaborative responsive process between people who create new, more livable, less destructive levels of connection. Therapists will be effective if they are involved in the process and are able to learn.

Espousing the constructionist relational Epistemology opens up multiple perspectives both for clinical work as well as for professional dialogue. Most importantly, it allows us to choose the perspective with which we want to construct a specific relational context and process.

Most human phenomena that we subsume under the heading ?symptoms? manifest themselves on a social level, i.e. become manifest as part of interactions and communications between people. So it seems pragmatically plausible to look for and understand these phenomena on the interpersonal level first. Yet it may be equally useful for a therapist working with individuals to study a person?s intra-psychic life or for a psychiatrist to look for genetic or bio-physiological ?causes? precipitating a certain behavior. A sociologist may look at the socio-economic and cultural context to understand an individual?s actions. As long as I do not claim to have found the truth i.e. as long as I do not claim the paradigm of the classic realism, this ?kaleidoscope of perspectives? (Wetzel & Winawer, 2002) will enrich the picture and contribute to understanding.

It is immediately obvious how the relational Epistemology supports cross disciplinary discourse between talk therapists and bio-psychiatrists. Not only become the diverse views of the different professions equally legitimate and contributory to the understanding of complex human attitudes and behavior patterns, subject only to the evolving professional debate and research. We can also begin to recognize the complex correlations and interfaces between the various levels of understanding, i.e. societal, familial, individual, bio-physiological, and genetic. Productive and satisfactory marital relationships may be found to impact the brain physiology or the genetic makeup of a person, a healthier bio-physiological organism in turn may support the creativity of an individual or the well being of an entire family.

Our discourse with biologically oriented psychiatrists requires epistemological reflections and an ongoing critique about how we think and what the philosophical assumptions underlying our clinical practices are. The discourse also leaves no doubt that we need to do more clinical research and produce more replicable studies to support our contention that talk therapy can bring about long lasting transformation of a person or a couple or family without medication. Psychotherapists rooted in post-modern Epistemology pay attention to the relational field within which they work, be it the relational process constructed by the therapeutic setting (as in individual therapy) or be it the couple or family unit as the focus of treatment. As we learn to direct our clinical focus, ethnic culture, socio-economic class, gender, sexual orientation and the societal context ?beyond the therapy room? (Wetzel, 1994) come into view.

This is particularly important whenever children or adolescents are the ?identified patients?. State of the art psychotherapy will make it unnecessary and superfluous in most cases to search for other levels of understanding or therapeutic focus, such as intra-psychic consequences of childhood trauma or deficiencies at the bio-physiological or genetic levels of a person?s biological composition. In any case, the process of clinical inquiry rooted in a rigorous application of relational Epistemology proceeds from the broadest most encompassing level of clinical consideration to more narrowly defined levels, if necessary. It does not start the other way around, i.e. from a reduced focus on brain functions that seduces us to mistake the part for the whole.

Family therapy is not the only clinical modality that can gain from making the underlying relational Epistemology explicit. If rigorously and competently practiced, relationship focused and context sensitive therapeutic models of psychotherapy will continue to be effective without reliance on pharmacological interventions. A specific model of working with adolescents and their families is described in Wetzel & Winawer, 2002.

Norbert A. Wetzel is director of Princeton Family Institute (www.princetonfamily.com), Princeton, NJ

References:

Habermas, J. (1972). Knowledge and Human Interests. Boston: Beacon Press.

Kant, I. (1784; 1990). Foundations of the metaphysics of morals and, What is enlightenment. Translated, with an introduction by Lewis White Beck. (2^nd ed., rev.) New York: Macmillan.

Stacey, R. (2003). Complexity and group processes. A radically social understanding of individuals. New York: Brunner-Routledge.

Wetzel, N.A. (1994) Beyond the Therapy Room. Therapy and Politics in the Nuclear Age. In: Berger-Gould, B. and Hilleboe DeMuth, D. (eds.), The Global Family Therapist. Integrating the Personal, Professional, and Political. Needham, MA: Allyn and Bacon; pp. 22 - 40.

Wetzel, N.A. & Winawer, H. (2002). School-Based Community Family Therapy for Adolescents at Risk. In: Kaslow, F.W., Massey, R.F., Massey, S.D. (eds.) Comprehensive Handbook of Psychotherapy. Vol. 3. New York: John Wiley & Sons; pp. 205 ? 230.

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Alternative Ways of Supporting Individuals Struggling with Depression

By Thomas Johnson

Over the last 25 to 30 years there has been a dramatic increase in the number of people reporting significant levels of depression. The National Institute of Mental Health conducted a study of some 20,000 Americans in the early 1980?s and found that 3.7% of the adults in the preceding year had experienced a major depressive episode. Over 6% indicated that they had experienced a major depressive episode at some point during their lives. Those numbers almost tripled 10 years later with over 10% reporting a major depressive episode in the preceding year and over 17% indicated that they had experienced major depression at some point in their lives (Thayer, 2001). Garbarino (1999) estimates that approximately 2% of children in the United States in the early 1960?s had experienced some level of depression and that increased to almost 25% in the late 1990?s. More recently, Garland ( 2004) reports that about 20% of all children will experience an episode of major depressive disorder before reaching the age of 18.

Drugs, Food & Depression

Many Americans turn to drugs or food as ways of trying to feel better and to alleviate their feelings of depression. It is well known that alcohol, nicotine, and caffeine are widely used by Americans to alter their mood states. Some people also turn to foods that have high concentrations of saturated fats and trans fats (such as cheeseburgers and fries) to feel better and alleviate depression. These foods can function as addictive drugs such as nicotine, heroin and some prescription drugs do (e.g. see Burgers are as Addictive as Heroin. See www.nypost.com/cgi-bin. Also, see Neal Barnard?s Breaking the Food Seduction, 2003.). Additionally, increasing numbers of Americans are turning to their physicians who prescribe antianxiety and/or antidepressant drugs. Glenmullen reported in 2000 that approximately 28 million Americans or 1 in every 10 had taken one of the SSRI antidepressants such as Paxil, Prozac and/or Zoloft (Glenmullen, 2000). More than eleven million children in the U.S. are prescribed the SSRI and SNRI anti-depressants each year (Garland, 2004). In some states, the number of people taking antidepressants is as high as 14 to 16%. According to the company that puts together a yearly medication trend report, Express Scripts, Utah has the highest rate of antidepressant use (16%) and Maine has the second highest rate of use (14.4%). (www.sltribune.com/2003/Sep/09052003/utah/89826.asp).

Antidepressants Are No More Effective than Sugar Pills

The use of antidepressants has increased dramatically in spite of the fact that scientists have found that these drugs generally are no more effective for depression than placebos (sugar pills). The American Psychological Association has published a series of articles listed on their website under the title, ?New Study Finds Little Difference Between Effects of Antidepressants and Placebo.? This website highlights the research of Dr. Irving Kirsch as follows: ?Psychologist Irving Kirsch and his co-authors analyzed all the data submitted to the U.S. Food and Drug Administration for approval of the six most widely prescribed antidepressants between 1987 and 1999. They found that approximately 80% of the response to the medication were duplicated in placebo control groups. They believe the difference between the patients? response to medication and to placebo was small enough to be considered clinically meaningless? (www.apa.org/releases/antidepressants.html). (Also, see Breggin, 2001)

Most SSRIs Banned for Children in the UK

The UK Committee on Medicines and Healthcare Products Regulatory Agency (MHRA) recently issued bans on virtually all of the most popular SSRIs for children and teenagers. On December 9, 2003 the MHRA issued a directive to physicians in England to stop prescribing these selective serotonin reuptake inhibitors (SSRIs). This action was taken after an independent committee of specialists reviewed the raw data from controlled drug trials sponsored by the drugs? manufacturers. Contrary to the claims made by the drug manufacturers, they found that the SSRIs are neither effective against depression in children nor are they safe enough to continue to be prescribed. The MHRA granted an exception to Prozac but warned that, at best, it helps only one child in ten. Nine days later on December 18, 2003, the manufacturer of Prozac, Eli Lilly, sent out a document to all UK physicians indicating that ?Prozac is not recommended for children? for any condition (see www.ahrp.org). The MHRA was pressured into reviewing the research that lead to this ruling by patients, patient advocacy groups and a number of medical scientists, such as Psychopharmacologist David Healy, MD.

The FDA Hearings on Antidepressants

As a result of the UK?s ban on the use of SSRIs with children and adolescents, pressure developed for America?s Food and Drug Administration to either ban or curtail the use of antidepressants. On February 2, 2004, the FDA held public hearings to review the decision by the MHRA in order to determine if the FDA should also ban the SSRIs with children or if warnings should be issued. Because there was a large number of people that wanted to speak at this hearing, everyone was limited to only two minutes of testimony. Of approximately forty personal witnesses, only two parents spoke of the value of these medications. These two parents were representatives of the National Alliance for the Mentally Ill (NAMI) which reportedly has very close ties to the pharmaceutical industry and the psychiatric establishment. As the author of Should I Medicate My Child?, Dr. Lawrence Diller put it: ?Speaker after speaker shared harrowing tragic stories of children suddenly becoming suicidal and taking their own lives or going berserk, killing someone and spending their next twenty years in jail?The stories were compelling and relentless, almost overwhelming?By the end of the day, the medical panel consisting of pediatricians, not psychiatrists, were insistent the FDA issue some temporary warning to physicians and patients-that these drugs meant to treat depression could also cause agitation, restlessness and increased suicidality especially in the first days and weeks of treatment. If depressive symptoms worsen or new symptoms appear, rather than raising the dose or adding another drug (which is a common practice now), first stopping all medication may be the most prudent choice? (Diller, 2004).

After the February 2, 2004 hearings were held, the FDA?s Psychopharmacologic Drugs Advisory Committee indicated that warnings are needed to ?elevate the level of concern and attention that practitioners use in prescribing? anti-depressant medications. The committee wants physicians to take these medications more seriously and strengthen warnings about the risk of suicide ideation and attempts. Additionally, the advisory committee said that the FDA, patients, parents and health care providers should not only look at suicidal behavior ?but also evidence of ?activation? in patients on the drugs. Indications of activation could include increased agitation, aggression, akathesia (uncontrollable limb and body movements), confusion and violence toward others?

(See www.fdaadvisorycommittee.com).

Dr. Jane Garland

Dr. Jane Garland is a Clinical Professor of Psychiatry at the University of British Columbia and Clinical Head of the Mood and Anxiety Disorders Clinic at British Columbia?s Children?s Hospital. She is recognized as a leading authority on the treatment of depression and she has received research funding from Pfizer and GlaxoSmithKline for her research. In the February 17, 2004 issue of the Canadian Medical Association Journal, she reports that approximately 20% of children under the age of eighteen will experience an episode of major depressive disorder. She reports that many physicians and psychiatrists have become very confused and unsettled by reports that the drugs they are using to treat depression are ineffective and are actually harmful with a significant number of depressed patients. She states: ?The disappointing reality is that antidepressant medications have minimal to no effectiveness in childhood depression beyond a placebo effect?The physician treating a child or adolescent with recent onset of depression is advised to begin with education regarding sleep hygiene,

exercise, practical coping skills and family intervention, and to provide the frequent, supportive contact typical of clinical trials? (Garland, 2004, p. 490). Dr.Garland has recently been named to a panel of experts by the Canadian government to advise Health Canada on whether antidepressants are safe and effective when taken by children and teenagers.

Dr. David Healy

Dr. David Healy is an internationally recognized psychopharmacologist who currently serves as Professor of Psychiatry in the Mood and Anxiety Disorders Programme at the Center for Addiction and Mental Health at the University of Toronto. In his recent books, The Creation of Psychopharmacology and Let Them Eat Prozac, he documents the suicide and SSRI connection along with the research implicating SSRIs with addiction. He maintains that SSRI dependence may actually be more common and serious than benzodiazepine (e.g. Valium and Librium) dependence. Unlike insulin or thyroid hormone, which are replacements for a deficiency, the SSRIs are alien chemicals and act as brain stressors. Many psychiatrists assume that our serotonin levels decrease when we feel depressed and SSRIs are suppose to make up for decreases or deficiencies. However, Healy argues that there is no evidence for this and no abnormality of serotonin metabolism and depression has ever been demonstrated.

Dr. Peter Breggin

Dr. Peter Breggin is the founder of the International Center for the Study of Psychiatry and Psychology, a reform-oriented research and educational network. He is also the founder of Ethical Human Sciences and Services. He has been on the faculty of the Counseling Departments of the University of Maryland and John Hopkins University. Unlike Drs. Garland and Healy, he is a psychologically oriented psychiatrist rather than a psychopharmacologist. He does have a subspecialty in the adverse effects of psychotropic drugs and has written extensively about the dark sides of these drugs. In The Anti-Depressant Fact Book, he makes it clear that all of the discussion ?about biochemical imbalances is sheer speculation aimed at promoting psychiatric drugs? (Breggin, 2001, p. 21). He goes on to state that: ?The very idea of turning to pills instead of people can add to the feelings of despair and hopelessness. In short, it is depressing to believe that an improved life is best achieved by taking a pill?Depression is, above all else, a signal that our lives are not going well. Emotional pain should direct our attention to the source of the suffering and motivate us to face the conflicts and stresses in our lives?? (p. 25).

A Quick Fix?

The increase in the use of antidepressants does not appear to be as a result of scientific research documenting their effectiveness. The increase appears to be related to the aggressive advertising and marketing to consumers and healthcare professionals (See Antonuccio et. al. 2002). Also, health insurance companies appear to cover these drugs in more generous ways than they have been willing to cover comprehensive assessments and counseling approaches, which look at identifying the causes of the depression (Glasser, 2003).

In many respects, we live in a ?quick fix? society where people are often looking for a magic pill as a solution to complex problems that are often life style and stress related. Physicians at the Harvard Medical School have estimated that between 60 and 90% of all doctors visits are for stress related problems. Harvard has released new guidelines on stress control and they caution patients to avoid ?taking prescription or over the counter drugs that promise some form of relief, such as sleeping pills, muscle relaxants or antianxiety pills? (Harvard Medical School, 2002, p.10).

Effective Alternatives to Antidepressants in the Alleviation of Depression

If antidepressants and/or other drugs are not the best solutions to most people?s depression then the question must be raised as to what people suffering from depression should turn to. I would propose that anyone wanting to deal with the causes of their distress should start with comprehensive self-assessments. Many depressed people will also need the guidance of empathic, knowledgeable and well-trained practitioners who can help them look at the possible causes and sources of their depression such as: sleep disturbances, nutritional deficiencies, environmental toxins, medical problems, insufficient exercise and/or stressors that the individual has found overwhelming.

Improve Sleep. Sleep disturbances are frequently associated with depression. Clinicians are expected to ask depressed patients whether or not they have difficulty going to sleep or staying asleep. Sleep disturbances are often seen as symptoms of depression. However, sleep medicine researcher/clinicians like University of Rochester?s Professor of Psychiatry, Michel Perlis, argue that sleep disturbances should not simply be seen as symptoms-as insomnia is ?the single best predictor of depression.? Perlis ?has found that two or more weeks of sleeplessness increase the risk of a first episode of depression by 400%-even for someone who has never been depressed. For those who have struggled with depression before, insomnia often heralds a recurrence?insomnia is actually ?an unleashing factor? for depression. His longitudinal studies show that insomnia often precedes episodes of depression by about five weeks? ( Marano), 2003). It naturally follows that clinicians working with people who are struggling with depression should be knowledgeable of this recent research in sleep medicine and be able to utilize these findings in the counseling process.

Improve Nutrition. There is a growing body of research that shows that food choices can profoundly influence moods. As reported earlier, the use of junk food such as French fries and hamburgers can be used in the short-term to alleviate depression but in the long-term contributes to ill health in general. In some ways the use of junk food functions in the same way that drugs like nicotine and caffeine in providing symptomatic relief. Nutritional scientists who specialize in this area of research have found that depression tends to occur in middle-age people who have high animal-protein-based diets such as the Atkins Diet. Of course, researchers have also found that high animal protein consumption is associated with ?osteoporosis, kidney disease, cancer, decreased serotonin production and heightened levels of aggression and violence? (Hatherill, 2003). In contrast, Hatherill reports that ?complex carbohydrate intake coupled with low protein intake has been shown to enhance serotonin production.? He also notes that ?researchers discovered that a high-carbohydrate meal improved the mood of women with premenstrual syndrome, anger, confusion, depression and tension lessened or resolved after high-carbohydrate intake? (Hatherill, p. 119).

Examining the intake of macronutrients (carbohydrates, fats and protein) is only one aspect of the process of assessing nutrition and depression links. It is also important to look at the intake of micronutrients such as vitamins and minerals. Bleak moods may result from a simple nutritional deficiency. If a person suffers from depression, the first course of action should be to investigate the nutritional balance of one?s diet. Changing a person?s diet has far fewer side effects than taking antidepressant drugs. ?A number of studies show that a diet poor in folic acid can lead not only to depression, but-if the deficiency is severe-also to dementia and schizophrenia.? When folic acids levels were corrected in the studies, so was most of the depression. Good whole-food sources of folic acids include dark-green leafy vegetables like spinach; lentils; soy beans; nuts; beans; fresh fruits and vegetables; and yeast?Selenium is another micronutrient associated with positive moods. Studies have shown that people consuming low amounts of selenium in their diet are more apt to suffer from gloomy moods. Good food sources of selenium are whole grains such as oats and wheat, and Brazil nuts and sunflower seeds (Hatherill, p. 113).

Reduce Environmental Toxins. Environmental toxicologists have been able to identify over six-hundred different chemicals in people from industrialized countries and most of these were not known or present in humans before the 20^th century. Wide spread use of some of these chemicals increases the likelihood of depression. The most powerful neurotoxic foods include over-processed foods, especially those with hydrogenated oils (trans-fatty acids); fish, especially shark, sword fish, tuna, trout and shell fish; dairy (cow?s milk and cheese); and animal flesh. Environmental toxicologist Robert Hatherill Ph.D. makes a strong case for consuming a whole foods plant-based diet because: ?Our meat, poultry, fish and dairy products are now responsible for about 60-80% of the pesticide and organochlorine chemical residues in the American diet? (Hatherill, p. 40). These pesticides can contribute to feelings of depression as well as impede concentration skills and decrease memory.

Increase Exercise. Psychiatric researchers in the Department of Psychiatry and Behavioral Sciences at Duke University compared the use of exercise verses Zoloft in order to determine the relative effectiveness or ineffectiveness of each approach plus a combined approach in patients diagnosed with major depression. In the initial Duke study, which lasted for just four months, one-hundred and fifty-six patients diagnosed with major depression were randomly assigned to one of three interventions: exercise, the antidepressant Zoloft or both. After four months, patients in all groups showed improvement. However, six months later, those in the exercise group had significantly lower relapse rate (p. equals .01) than those in the medication group and those in the exercise plus medication group. Depressive symptoms had returned in only 8% of the exercise-only patients whose symptoms had initially disappeared. This compares with 38% in the drug group and 31% in the exercise-plus-drug group. This finding was surprising to the Duke researchers and they commented, ?This was an unexpected finding because it was assumed that combining exercise with medication would have, if anything, an additive effect? (Babyak et.al., 2000, p. 636).

The American Psychological Association website references additional studies showing the therapeutic benefits of regular exercise in an article entitled, ?Exercise Helps Keep Your Psyche Fit? (www.apa.org/releases/exercise.html). The APA authors point out that recent reviews of psychological research shows that exercise is an effective but underused treatment for mild to moderate depression.

Stress Control. Researchers and clinicians at the Harvard Medical School have found that high levels of stress can cause or exacerbate depression. An empathic, knowledgeable and skillful psychologist or other healthcare professional can help a client to identify sources of stress in their clients? lives. The Harvard clinicians stress the importance of well-balanced plant-based nutrition, regular moderate exercise, regular practice of the relaxation response (or some other meditative practice), opportunities to openly express thoughts and feelings associated with conflict and distress in a nonthreatening, helping relationship and cognitive restructuring exercises such as is offered by cognitively oriented psychotherapists.

Researchers at Monash University in Melbourne, Australia, recently compared relaxation training and other cognitive strategies with antidepressant medication in treating depressed adolescents. The university researchers studied the reactions of a number of depressed adolescents aged between twelve and eighteen and offered different depression treatments. The teenagers were divided into three groups and were treated with antidepressant medication, cognitive behavior therapy and a combination of both. Those in the cognitive behavior therapy group were taught relaxation strategies, social skills and helpful ways of thinking and reacting to situations. The depressed teenagers in that group did much better than those taking the antidepressant and even than those taking the antidepressant and participating in the cognitive therapy. The lead researcher, Glenn Melvin, reported that: ?We expected the combined treatment would be superior, but found the cognitive behavioural therapy alone leads to a more rapid treatment response. (www.theage.com.au/articles/2003/06/03/1054406176511.html)

Summary & Conclusion

In summary, I?ve attempted to discuss the increased incidence of depression that has occurred in recent years. With the increase in the incidence of depression has come a dramatic increase in the use of pharmaceutical drugs to help people feel better and alleviate their feelings of depression. The increase in the prescription of these drugs has not been as a result of scientific discoveries but rather as the result of effective advertising and marketing. Recent studies have documented that these drugs are generally no more effective in alleviating depression than placebos. In fact, there are significant numbers of patients who have been harmed to the point of becoming suicidal and/or homicidal from the drugs. Highly responsible and ethical advocacy groups like the Alliance for Human Research Protection (www.ahrp.org) and researcher/clinicians such as Antonuccio, Breggin, Garland and Healy have tried to make drug regulators and policy makers more aware of the many dark sides of these drugs. It is far more responsible and helpful to support people suffering from depression to assist them in looking at what factors are causing and/or exacerbating their feelings of depression than to simply experiment with them by having them use antidepressant drugs. I have cited research studies documenting the importance of looking at sleep patterns, nutritional practices, stress control and other life style practices as they relate to the assessment and treatment of depression. Gaining insight and learning these skills through empathic and nurturing counseling relationships will likely result in more effective decision-making, problem solving and the alleviation of depression.

References

Antonuccio, D., Burns, D., Danton, W. (7/15/02). Antidepressants, A Triumph of Marketing Over Science? Prevention & Treatment, 5 (25).

Babyak, M. et al. (2000). Exercise Treatment for Major Depression, Maintenance of Therapeutic Benefits at Ten Months. Psychosomatic Medicine 62:633-638.

Barnard, N. (2003). Breaking the Food Seduction. New York: St. Martin?s Press.

Breggin, P. (2001). The Anti-Depressant Fact Book (Cambridge: Persus Publishers).

Diller, L. (2004). The FDA Conference on Children and Anti-Depressant Medication. www.docdiller.com.

Garbarino, J. (1999). Lost Boys. New York: The Free Press.

Garland, J. (Feb. 17, 2004). Facing the Evidence: Antidepressant Treatment in Children and Adolescents. Canadian Medical Association Journal. 170 (4).

Glasser, W. (2003). Warning: Psychiatry Can Be Dangerous to Your Health. New York: HarperCollins Publishers

Glenmullen, J. (2000). Prozac Backlash: Overcoming the Dangers of Prozac, Zoloft, Paxil and Other Antidepressants with Safe, Effective Alternatives. New York: Simon & Schuster.

Harvard Medical School (2002). Stress Control: Techniques for Preventing and Easing Stress. Cambridge, MA: Harvard Health Publications.

Hatherill, J. (2003). The Brain Gate. Washington D.C.: LifeLine Press.

Healy, D. (2003) Let Them Eat Prozac. Toronto: James Lorimer & Ltd.

Johnson, T. (2003) A Look at Depression and Current Trends in Treatment. Communiqu?.. 32 (2).

Johnson, T. (2004) Most SSRI Antidepressant Drugs for Children Banned in the UK. Communiqu?. 32 (5).

Marano, H. (2003) Night Life. Psychology Today. 36 (6).

Sharav, V. (Sept. 21, 2003) UK Issues Ban on Second SSRI Antidepressant for Children, www.ahrp.org.

Thayer, R. (2001). Calm Energy: How People Regulate Mood with Food and Exercise. New York: Oxford University Press.

Dr. Thomas Johnson completed his graduate studies at Brown, Harvard, UC Berkeley and Duke. He provides comprehensive psychological services to individuals, families, schools and universities in his health, family and school psychology practice located at 2 Goff Street in Auburn, Maine 04210. He has served as Contributing Editor for the National Association of School Psychologists? Communiqu? since 1996 and has focused on alternative and complementary approaches to health and learning.

The Angels Valley project ?

Advocacy for children?s right to heal

By Filip Marceron, Founder

When I finished my psychoanalysis in Paris in 1983, as I was amazed how well and deep it had worked, I wanted in turn have others benefit from such valuable help, but I did not feel like being myself a psychoanalyst as I would have most likely to live in a big city, as I feel a strong need to live in the countryside with space, trees, birds to hear, sky to see, fresh air to breathe, and ease to start new activities without concern for cramped and high cost space. Plus from my readings of Bruno Bettelheim?s books on milieu therapy with children I felt children can heal much faster than adults.

I thus tried to find a similar place in France in which I could participate . Surprisingly I found none, and not even in Europe, though Bettelheim?s books translated into French sold well and were even republished in the 1990?s.

Well, I had to take my sense of duty to help those who suffer to the word : I had to create the place. Not so easy, I soon discovered, I had no money to buy a home in the countryside, and there rentals were scarce, except for vacation. I placed ads and got a few not so workable offers, of which a very nice 50-room chateau, too big for me to handle. A number of child psychiatrists in charge of county children?s mental health services were interested by my project, but those in charge of licensing homes for children were not, probably because they did not like the non-directive approach. This was an other big block on the road, and anyway no help was offered.

As I had been impressed by the US culture and felt grateful to them for having been the liberators of Western Europe in 1944 at the cost of many of their lives, I decided to probe there, Bettelheim?s Orthogenic School happened to be created there, and there too was made the movie ?Sybil?, truly showing what a psychoanalysis could be, it had been a vital help to me. I thus sent letters to US officials and organizations, coast to coast, describing the project I wanted to create, and I got a good number of positive answers and invitations to visit. Quite encouraging to pursue, though my knowledge of English as a foreign language was quite limited especially when spoken. Once I saved enough money to travel and visit as much of them as I could I set off, year 1990. Surely the visits confirmed the interest, though hardly nowhere in the US these days milieu therapy was to be found. When Bettelheim retired in 1973, though results from his practice were better than any other methods, the name of the place was changed and it shifted to medications and behavior modification. Sure enough, he had raised hell in stating that parents of autistic children caused their child?s condition and he proved right when many autistic children at his School were truly cured thru psychotherapy only. But then again I fell short of money and could not start in the US as no financial help nor no home for free was offered for my project.

In 2000 at last I had saved enough to buy cash a home in a remote and cheaper area of northern NY with enough money left to improve the place and try have project started. But since being in the US I realized not only the field of psychotherapy for children had fallen down with ever-increasing medication prescribing, but so did also the field of psychosomatics : in the 1970-80?s some practitioners cured people with cancer and other severe illnesses thru psychotherapy only. Now at the beginning of the 21 st century these advances were ignored : it seemed all illnesses and disturbances, mental or physical, had to be treated thru biochemical means or explained by genetics, as if a consensus emerged to deny as a whole the prime importance of feelings and emotions in our lives.

From my experiences in France, Denmark, Sweden and later in the US I found all statements Bruno Bettelheim made backed up by positive results with children originally suffering from severe conditions proved true, and so were the authors who claimed having cured physical illnesses thru psychotherapy only. Lately, a German M.D., Ryke Geerd Hamer, also proved the true cause of some cancers when cured just by reaching the emotional issue in the sufferer: this outstanding work in Europe was rewarded by persecution, as Galileo was when he dared stating the earth was not flat but round.

Anyone interested by my project can ask any question or receive by mail more data, it is based on psychoanalysis, psychosomatics and milieu therapy, working on the basic principle that repressed emotional issues in children can cause mental disabilities (autism, schizophrenia, mental retardation, epilepsy), or physical illnesses (cancer, obesity, migraines, diabetes, asthma), and thus can be cured thru psychotherapy without no risk of relapse when the help was successful.

Positions offered are without salary, as the purpose is to show feasibility of the best model ? a few children cared for in a family-like home ? for best results at lowest costs so to be duplicable anywhere else.

Filip Marceron ? Angels Valley

PO box 600

Harrisville NY 13648

Phone (315) 543-0025

e-mail : fillip_marceron2003@yahoo.com

web sites on Dr Hamer?s work :

www.hamernewmedicine.com

www.newmedicine.ca

www.curezone.org

(editorial continued from page 1.) Not once in these pages is there evidence that anyone sought to ask the patient what she thought or felt about anything. Never is there any evidence that any of the so-called professionals sought to ask about the possible meanings in the strange behaviors simply judged to be ?bizarre.? In grim, spare and humorless prose all of the document?s authors reveal a terrifying lack of imagination about the patient as a human being, her behavior, her past, the context in which both she and they work, and her future. She is to be cured of her ?symptoms? of ?negativism,? ?lack of cooperation,? ?argumentativeness? and ?delusional refusal to take her medication? even if she has to be held down and injected. There seems no insight or willingness to step ?outside the box? as it were and develop other perspectives. To quote R. D. Laing ?They cannot see how they see because of how they see.?

On this fine Sunday morning I have also just read the New York Times which today focuses of the nightmarish events in Iraq as hooded terrorists publicly behead a young American and other young Americans torture and humiliate young Iraqi?s. What strikes me in both the hospital case and the events in Iraq is the ease with which human beings can dehumanize their fellow human beings, hurt or destroy them, and then interpret their actions to represent the highest of moral activity. For some time now I have been suggesting that the key psychological question we must be asking concerns the psychological, social, political, economic and developmental factors that will allow human beings to believe they are acting on the highest of moral principles when they commit suicide as they murder other people?s children.

I see our struggles to humanize psychiatry as part and parcel of an overall struggle to understand and come to grips with the process of the human dehumanization of self and others. While neither our organization nor our Fall 2004 conference have an explicit political agenda, the underlying theme of our collective work is always illuminating psychiatry?s activities with truthful scientific evidence, humanizing our interventions into the lives of those who seek our help, and creating alternative directions and visions for our field. This year?s conference, coming as it does in this critical time of human history, is more important than ever. It is the largest conference we have ever mounted with ten illustrious, cutting edge invited speakers, as well as over forty scholars from all over the US, Canada, the UK and Europe, many themselves, deserving of being invited presenters. I urge you to come to the conference, support ICSPP, be a part of history and enjoy yourself as you do so. Please make your hotel reservations now if you haven?t already done so.

SEE YOU AT THE SHERATON LaGUARDIA EAST, OCTOBER 8, 9, 10 IN NEW YORK CITY ? LAURENCE SIMON, Ph.D.

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CONFERENCE PROGRAM AND REGISTRATION FORM FOR THE EIGHTH ANNUAL ICSPP CONFERENCE

2004 Conference Program

CRITIQUING DISEASE MODELS OF PSYCHOSOCIAL DISTRESS AND IMPLEMENTING PSYCHOSOCIAL THEORIES AND INTERVENTIONS

A THREE-DAY MULTI-DISCIPLINARY INTERNATIONAL CONFERENCE FOR PROFESSIONALS, STUDENTS, AND THE GENERAL PUBLIC