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Lincoln's Melancholy

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Anonymous:
Lincoln's Melancholy:
How Depression Challenged a President and Fueled His Greatness

by: Joshua Wolf Shenk

The year is 1860. In a makeshift meeting hall, the Illinois delegation to the approaching Republican Convention is meeting to consider which of their own to back as a favorite son for the Presidential nomination. There is no clear-cut favorite. Moreover, it?s widely acknowledged the choice will be an empty gesture. The nomination is virtually a done deal. William Seward of New York, the party?s leading light, has nearly all the delegates he needs for a first ballot victory.

But then something completely unexpected happens. Abraham Lincoln is introduced. A distant relation enters carrying two split log rails. From them hangs a banner:

Abraham Lincoln
The Rail Candidate

The crowd goes wild. The hall shakes so much that the canvass roof flies off the building. The image of a humble rail-splitter is all this group of delegates needs to give Lincoln its enthusiastic backing. The dynamics of the nomination has completely changed. Illinois? freshly-minted favorite son is on his way to becoming a serious contender.

The meeting breaks up the next day. In the nearly empty hall, a man sits alone, elbows bent, hands pressed to his face. He confides to someone who approaches him, "I?m not feeling too well." The man is Abraham Lincoln. He is battling a crushing depression.

The event is recounted in Joshua Shenk?s outstanding new book, "Lincoln?s Melancholy: How Depression Challenged a President and Fueled His Greatness." Writes Mr Shenk:

"Lincoln?s look at that moment ? the classic image of gloom ? was familiar to everyone who knew him well. ? He often wept in public and cited maudlin poetry. He told jokes and stories at odd times ? he needed the laughs, he said, for his survival. As a young man he talked of suicide, and as he grew older, he said he saw the world as hard and grim, made that way by fates and forces of God. ?No element of Mr Lincoln?s character,? declared his colleague Henry Whitney, ?was so marked, obvious and ingrained as his mysterious and profound melancholy.? His law partner, William Herndon said, ?His melancholy dripped from him as he walked.?"

Mr Shenk relates that depression was a constant throughout Lincoln?s adult life. He never overcame it. He never rose above it. His life was one long unceasing litany of sorrow. At times, he completely gave in to his condition. He would fail to get out of bed. He would behave very strangely. He would alarm his friends and associates.

"I am now the most miserable man living," the 31-year-old Lincoln confessed. "Whether I shall ever be better I can not tell; I awfully forebode I shall not; To remain as I am is impossible; I must die or be better."

But other forces were also at work, Mr Shenk contends. Depression turned him into a hard-headed realist, untainted by the pitfalls of misguided optimism. His uncanny melancholic third eye allowed him to think like a visionary. And even though he was a religious skeptic, his tribulations would imbue him with a higher wisdom and deeper humanity, so much so that he occupies a unique place in history as an American saint.

It is easy to fall into the trap of romanticizing Lincoln, but the facts speak for themselves. As his life unfolds, one cannot help but have the impression of being in a higher presence. It?s almost a religious experience. Mr Shenk makes the experience all the more moving by allowing us to view the great man through the eyes of our illness. The result is both inspirational and heartbreaking. To begin ?.

The Early Years

Abraham Lincoln was different from day one. A voracious reader, intellectually curious, and a sensitive individual in a rural environment that only saw merit in physical labor, the young Lincoln was regarded as lazy and in need of discipline.

There was much cause for sadness in Lincoln?s life. His only brother died in infancy. His mother and aunt and uncle succumbed to an epidemic when he was age nine. Ten years later his sister died giving birth to a still-born infant. His father and mother were disposed to melancholy, and one side of the family "was thick with mental disease."

Despite this, young Lincoln made it into adulthood showing few signs of depression. His first major episode coincided with the death of Anne Rutledge in 1835 when he was 26. Lincoln had long since left the family farm to seek his fortune in the one-horse town of New Salem, Illinois. Many historians contend that there must have been a love interest between Rutledge and Lincoln, but Mr Shenk says there is no evidence.

Depression is not as simple as cause and effect, Mr Shenk reminds us, citing a number of psychiatric sources, especially in someone predisposed to the illness. Any number of apparently innocuous occurrences can set off an episode, including several converging at once. According to one account, Lincoln bore up to Anne?s death fairly well. Then came heavy rains that seemed to unnerve him. He took to walking the woods alone with a gun and talking of suicide. Everyone in the village became aware of his strange behavior, and one concerned couple took him in for a week or two.

Finding His Way in the World

By Lincoln?s late twenties, friends and colleagues regarded him as "melancholic." The condition was virtually indistinguishable from the modern conception of depression, but did not carry the same stigma. Back in those days, despite an individual feeling "unmanned" by his affliction, there was considerable leeway for males to express their feelings in public, especially with the Romantic movement entering full flower.

In Lincoln?s case, his sorrowful demeanor induced people to come to his aid.

Nowhere was this more apparent than when the young man turned up to practice law in Springfield, Illinois with all his worldly possessions in two saddlebags. A store proprietor, Joshua Speed, urged his forlorn customer to take the bags upstairs to his room and the two became fast friends.

In an age when contact with the opposite sex was severely circumscribed, young men were encouraged "to pair off and form a special bond" as part of their grooming for greater responsibilities. Lincoln and Speed even shared the same bed for four years, but this was fairly common practice not to be mistaken for homosexuality. Nevertheless, gender roles were defined quite differently. It was acceptable for young men to display their affection for one another. This kind of intimacy encouraged the _expression of one?s innermost thoughts and feelings, including depression.

Mr Shenk points to a number of forces at work when Lincoln was coming of age. On one hand, it was an age of hope. The new economy for the first time gave ambitious young white men like Lincoln the opportunity to realize the dreams of the Founding Fathers. Steam power and the telegraph effectively shrunk the world and created a whole new mobile labor force. Advances in medical science instilled the belief that God was not punishing an individual, which effectively destigmatized illness. This spawned a whole new movement in self-improvement.

At the same time, thanks to a new religious revival, a loving redemptive God replaced the harsh vengeful God of John Calvin. Rather than predestination to hellfire and brimstone, men and women had the power to make moral choices and find their way to God?s favor.

For the first time in history, the individual did not have to subsume his needs to the needs of the tribe or community. But with this new freedom came new fears and anxieties. Gone was the communal security blanket. Ever present was the specter of failure, with full responsibility borne by the exposed individual. America, the land of opportunity, led the world in mental illness.

It was in this heady atmosphere of hope and insecurity that young Lincoln, now a hotshot lawyer and rising star in the state legislature, was to become badly unhinged.

Lincoln?s Breakdown

Many historians attribute Lincoln?s depressive episode of the winter of 1840-41 to his breaking off his engagement with Mary Todd. But much more was happening in Lincoln?s life, Mr Shenk points out.

In the legislature, Lincoln had hitched his political wagon to ambitious public works projects designed to open up the hinterlands to economic development. This included an elaborate network of rails, canals, and roads.

Then came the economic depression of 1837. Revenues dried up and the debt exploded. Lincoln used up all his political capital urging the legislature to stay the course, which proved a disaster. By the end of 1840, the state was teetering on the brink of bankruptcy, forcing the abandonment of Lincoln?s beloved projects. The rival Democrats rode into power on the aftermath of the debacle, and Lincoln was cast as one of the scapegoats. He barely held onto his seat in the legislature, his political career virtually finished.

At the same time, he was laboring under a heavy workload as a lawyer, with nine cases before the state supreme court.

As for Mary Todd, the exact time of the break-up is unknown, obviating a simple cause and effect. Another woman had turned him down, and he may have had an interest in yet another. On top of this, his dear friend Joshua Speed was making plans to move back to Kentucky. Then the weather turned bitterly cold.

In January 1841, Lincoln was confined to his bed, and his condition was the talk of the town. He put himself in the care of a physician, which likely made him much worse. Standard medical treatment involved purging the body by aggressively drawing blood, ingesting mercury and other poisons, inducing vomiting, starving the patient, and plunging him in cold water.

A concerned Joshua Speed told Lincoln that if he did not rally he would die. Lincoln replied he was not afraid to die. Yet, ironically, his perceived failures may have stoked his will to live. He confessed to his friend an "irrepressible desire" to accomplish something before he died that would "redound to the interest of his fellow man."

Some 20 years later, Lincoln would remind his friend of that conversation.

Finding Himself

In late 1842, Lincoln bit the bullet and married Mary Todd. His way of dealing with his depression was by throwing himself into his family and his work, but it wasn?t until he reached his mid-forties that he found a cause that animated him. The Missouri Compromise of 1820 had regulated the extension of slavery in the western territories. In practice, it operated as a containment policy that implicitly recognized slavery?s wrong. Lincoln foresaw slavery?s eventual end, but it was not a process, he believed, that could be speeded up.

That all changed in 1854 with the passage of the Kansas-Nebraska Act. Suddenly the northern territories were in play. Three years later, the Supreme Court?s infamous Dred Scott decision held out the prospect of legalized slavery in the northern states, as well. Slavery was no longer a wrong. It was about to become a universally recognized right. Passions on both sides were awakened, but the situation clearly favored the south.

Lincoln?s melancholia allowed him to see events with preternatural second sight. Southerners with a vested interest in the outcome stood a clear chance of having their way over largely indifferent northerners. It was the thin edge of the wedge that could put an end to free labor markets everywhere and dash the dreams of the Founding Fathers. The clock was being rewound back to the Dark Ages, and Lincoln was not confident of his ability to put a stop to it. Nevertheless, he felt compelled to speak out against the madness, even at the risk of his career.

Paradoxically, his political career took off, though true to melancholic form he saw every slight setback as a major failure. The new political reality spelled the end of Lincoln?s Whig party. In its place stood the newly-formed Republican party. In 1858, Lincoln found himself in the national spotlight in his series of debates with the author of the Kansas-Nebraska Act, Stephen Douglas. Both were contesting the same Senate seat.

The Senate was Lincoln?s lifelong dream. In an era of lackluster Presidents, this was the forum of his heroes such as Daniel Webster and Henry Clay. But Lincoln was prepared to sacrifice his ambitions for the cause. His antislavery position ran ahead of public opinion, but he strongly felt the greater interest was better served by enlightening the voters.

Lincoln also saw ahead to 1860, when Douglas was likely to be the Democratic standard-bearer in the Presidential election. In the debates, he forced his rival to expose himself as too moderate for his southern backers. The next Republican candidate for President, he knew ? certainly not he ? would benefit.

Lest we mistake Lincoln as morally flawless, he neither viewed African-Americans as biologically equal to whites nor did he envision the two races living together in harmony. The world was a stupid place back then, arguably only slightly more stupid than it is today.

In early 1860, Lincoln traveled to New York to deliver an address to the Cooper Institute. He brilliantly succeeded in linking the dreams of the Founding Fathers to the anti-slavery position, and threw down the gauntlet on right versus wrong. He brought down the house, and achieved rave notices everywhere. No one was quite ready to seriously consider him as Presidential timber. Yet ?

Improbably, on the strength of his new-found image as the rail-splitter, Lincoln won his party?s nomination on the third ballot. The election was a shoo-in. Thanks in part to the Lincoln-Douglas debates, an irreparable schism had formed in the pro-slavery ranks. The Democratic party splintered three ways, allowing Lincoln to win with just 40 percent of the popular vote.

Even more improbable, Lincoln?s well-known melancholia was not seen as a character flaw. Today, the immensity of a Lincoln-sized depression would disqualify a candidate from virtually any elected office save dog-catcher. Back in Lincoln?s time, living successfully with a mental illness was viewed in the same context of his rags to riches story, as evidence of a character virtue. Maybe they weren?t all that stupid back then, after all..

The Presidency

By the time Lincoln was sworn in, seven southern states had bolted from the Union. Facing the Republic?s gravest crisis, he assumed office with no executive experience, forced to govern from an untenable position. One slight overstep, and the border states would join the South, ending all hope of reunification. When hostilities broke out, the North lost far more battles than it won, forcing all and sundry to second-guess his leadership. As the terrible carnage mounted, much of the population lost its resolve, leaving Lincoln with a very weak bargaining hand. When he pressed his position harder, rebellion threatened to erupt on the home front. Few believed there would be a successful conclusion to the war. No one thought he could be reelected.

Of all things, a lifetime of living with depression admirably prepared him for the task. He possessed both the intestinal fortitude and the moral will. And the insights he had acquired from a lifetime of sorrow seemed to connect him to a higher power. As Joshua Shenk explains, over the course of his adulthood, Lincoln passed from fear to engagement to transcendence.

In other words, having decided that he WOULD live, he then decided HOW to live. When faced with the challenge of a lifetime, he proved more than ready.

But first came more personal tragedy. During his term of office, two of his sons died. Of his four sons, only one would live to adulthood. On learning of the death of Willie, his favorite, he wept convulsively.

In 1862, Lincoln deviated from a previously-held position by proposing to his cabinet the emancipation of slaves from all union-held southern territory. The move risked alienating the border states, but would serve to give the war a higher moral purpose. Lincoln entertained no delusions about whose side God was on. Death had visited far too many northern households for him to believe that the Almighty was playing favorites. "My greatest concern is to be on God's side," he advised a colleague.

The Emancipation Proclamation would be the first step toward universal freedom and enfranchisement. Soon after, Joshua Speed would pay a visit, and Lincoln would remind him of their conversation some twenty years earlier, when only his desire to accomplish something great gave him the will to live.

"I believe in this measure my fondest hopes will be realized," he confided to his friend.

Sainthood

On assuming his second term of office, Lincoln spoke the finest words ever uttered in the English tongue:

"With malice toward none, with charity for all, with firmness in the right, as God gives us to see the right, let us strive on to finish the work we are in, to bind up the nation's wounds."

He had six weeks to live, his last days filled with a transcendent lightness of being. It was as if, his mission on earth accomplished, he were ready to be taken up into heaven. On April 14, 1865, a man with a gun obliged. Now he belonged to the ages.

Final Words

In Lincoln?s depressions, we see the illness in its full destructive horror, one that nearly succeeded in cutting short the life of a promising young man and made the rest of his existence miserable. This is the side of depression with which we can all unfortunately identify. But we also see an aspect to his depressions that equally resonates with us ? how our suffering can strengthen us, ennoble us, and embolden us, often to achieve the impossible.

Our sense of achievement need not be the same as Lincoln?s, nor for that matter what our families may expect of us. It is simply enough that we survive from day to day with the kind of grace that is used to define courage. Believe me, if Lincoln were to visit you right now, he might admonish you to make your bed, but he would do it in the way of a funny story. And he would let you know how proud is of you. No doubt about it. Take heart. Lincoln lives in us all. Walk tall.

Book:
http://www.amazon.com/exec/obidos/tg/de ... s&n=507846

Audio CD:
http://www.amazon.com/exec/obidos/tg/de ... s&n=507846

Anonymous:
Did medications and psychiatrist cause Lincoln's depression?

Antigen:
Did medications and shrinks cure Lincoln's depression? I remember reading somewhere years ago that he had been advised by a doctor to try eating raisins.

Point is, despite prevailing opinion, mankind has been dealing w/ a range of issues from depression to substance addiction for thousands of years now. Modern psychiatry is just not the end all, be all. Much like other modern technology, it has been received as a miracle of science, but there are some down sides. Who knew that the noxious smoke and waste water coming off of various factories could actually kill a river? Read up on the Donora Fog for early 20th century thinking about that. Same w/ psyche drugs. For all the early perceived benefits, there are down sides. It's foolish to pretend otherwise.
Penalties against possession of a drug should not be more damaging to an individual than the use of the drug itself
--Jimmy Carter
--- End quote ---

Deborah:
Psychiatric Drugs: An Assault on the Human Condition
Street Spirit Interview with Robert Whitaker
Interview by Terry Messman
http://thestreetspirit.org/August2005/interview.htm

Excerpt:
Street Spirit: Your new line of research indicates that there has been an enormous rise in the incidence of mental illness in the United States, despite the seeming advances in a new generation of psychiatric drugs. Why do you refer to this increase as an epidemic?

Robert Whitaker: Even people like the psychiatrist E. Fuller Torrey wrote a book recently in which he said it looks like we're having an epidemic of mental illness. When the National Institute of Mental Health publishes its figures on the incidence of mental illness, you see these rising numbers of mentally ill people. Some recent reports even say that 20 percent of Americans now are mentally ill.

So what I wanted to do was two-fold. I wanted to look into exactly how dramatic is this increase in mental illness, and particularly severe mental illness. Part of this rise in the number of people said to be mentally ill is just definitional. We draw a big wide boundary today and we throw all sorts of people into that category of mentally ill. So children who are not sitting neatly enough in their school rooms are said to have attention deficit hyperactivity disorder (ADHD), and we created a new disorder called social anxiety disorder.

SS: So what used to be called simply shyness or anxiety in relating to people is now labeled a mental disorder and you supposedly need an antidepressant like Paxil for social anxiety disorder.
RW: Exactly. And you need a stimulant like Ritalin for ADHD.

SS: This increases psychiatry's clients, but doesn't it also increase the number of people that giant pharmaceutical companies can sell their psychiatric drugs to?
RW: Absolutely. So part of what we're seeing is nothing more than the creation of a larger market for drugs. If you think about it, as long as we draw as big a circle as possible, and expand the boundaries of mental illness, psychiatry can have more clients and sell more drugs. So there's a built-in economic incentive to define mental illness in as broad terms as possible, and to find ordinary, distressing emotions or behaviors that some people may not like and label them as mental illness.

SS: Your research also shows that there is a real increase in people who have a severe mental disorder. Now, this seems counterintuitive, but is it true that you believe much of this increase is caused by the overuse of some of the new generations of psychiatric drugs?
RW: Yes, exactly. I looked at the number of the so-called severely disabled mentally ill -- people who aren't working or who are somehow dysfunctional because of mental illness. So I wanted to chart through history the percentage of the population who are considered the disabled mentally ill.

Now, by 1903, we see that roughly 1 out of every 500 people in the United States is hospitalized for mental illness. By 1955, at the start of the modern era of psychiatric drugs, roughly one out of every 300 people was disabled by mental illness. Now, let's go to 1987, the end of the first generation of antipsychotic drugs; and from 1987 forward we get the modern psychiatric drugs. From 1955 to 1987, during this first era of psychiatric drugs -- the antipsychotic drugs Thorazine and Haldol and the tricyclic antidepressants (such as Elavil and Anafranil) -- we saw the number of disabled mentally ill increase four-fold, to the point where roughly one out of every 75 persons are deemed disabled mentally ill.

Now, there was a shift in how we cared for the disabled mentally ill between 1955 and 1987. In 1955, we were hospitalizing them. Then, by 1987, we had gone through social change, and we were now placing people in shelters, nursing homes, and some sort of community care, and gave them either SSI or SSDI payments for mental disability. In 1987, we started getting these supposedly better, second-generation psychiatric drugs like Prozac and the other selective serotonin re-uptake inhibitor (SSRI) antidepressants. Shortly after that, we get the new, atypical antipsychotic drugs like Zyprexa (olanzapine), Clozaril and Risperdal.

What's happened since 1987? Well, the disability rate has continued to increase until it's now one in every 50 Americans. Think about that: One in every 50 Americans disabled by mental illness today. And it's still increasing. The number of mentally disabled people in the United States has been increasing at the rate of 150,000 people per year since 1987. That's an increase every day over the last 17 years of 410 people per day newly disabled by mental illness.

SS: So that leads to the obvious question. If psychiatry has introduced these so-called wonder drugs like Prozac and Zoloft and Zyprexa, why is the incidence of mental illness going up dramatically?
RW: That's exactly it. This is a scientific question. We have a form of care where we're using these drugs in an ever more expansive manner, and supposedly we have better drugs and they're the cornerstone of our care, so we should see decreasing disability rates. That's what your expectation would be.

Instead, from 1987 until the present, we saw an increase in the number of mentally disabled people from 3.3 million people to 5.7 million people in the United States. In that time, our spending on psychiatric drugs increased to an amazing degree. Combined spending on antipsychotic drugs and antidepressants jumped from around $500 million in 1986 to nearly $20 billion in 2004. So we raise the question: Is the use of these drugs somehow actually fueling this increase in the number of the disabled mentally ill?

When you look at the research literature, you find a clear pattern of outcomes with all these drugs -- you see it with the antipsychotics, the antidepressants, the anti-anxiety drugs and the stimulants like Ritalin used to treat ADHD. All these drugs may curb a target symptom slightly more effectively than a placebo does for a short period of time, say six weeks. An antidepressant may ameliorate the symptoms of depression better than a placebo over the short term.

What you find with every class of these psychiatric drugs is a worsening of the target symptom of depression or psychosis or anxiety over the long term, compared to placebo-treated patients. So even on the target symptoms, there's greater chronicity and greater severity of symptoms. And you see a fairly significant percentage of patients where new and more severe psychiatric symptoms are triggered by the drug itself.

SS: New psychiatric symptoms created by the very drugs people are told will help them recover?
RW: Absolutely. The most obvious case is with the antidepressants. A certain percentage of people placed on the SSRIs because they have some form of depression will suffer either a manic or psychotic attack -- drug-induced. This is well recognized. So now, instead of just dealing with depression, they're dealing with mania or psychotic symptoms. And once they have a drug-induced manic episode, what happens? They go to an emergency room, and at that point they're newly diagnosed. They're now said to be bipolar and they're given an antipsychotic to go along with the antidepressant; and, at that point, they're moving down the path to chronic disability.

SS: Modern psychiatry claims that these psychiatric drugs correct pathological brain chemistry. Is there any evidence to back up their claim that abnormal brain chemistry is the culprit in schizophrenia and depression?
RW: This is the key thing everyone needs to understand. It really is the answer that unlocks this mystery of why the drugs would have this long-term problematic effect. Start with schizophrenia. They hypothesize that these drugs work by correcting an imbalance of the neurotransmitter dopamine in the brain.

The theory was that people with schizophrenia had overactive dopamine systems; and these drugs, by blocking dopamine in the brain, fixed that chemical imbalance. Therefore, you get the metaphor that they're like insulin is for diabetes; they're fixing an abnormality. With the antidepressants, the theory was that people with depression had too low levels of serotonin; the drugs upped the levels of serotonin in the brain and therefore they're balancing the brain chemistry.

First of all, those theories never arose from investigations into what was actually happening to people. Rather, they would find out that antipsychotics blocked dopamine and so they theorized that people had overactive dopamine systems. Same with the antidepressants. They found that antidepressants upped the levels of serotonin; therefore, they theorized that people with depression must have low levels of serotonin.

But here is the thing that one wishes all of America would know and wishes psychiatry would come clean on: They've never been able to find that people with schizophrenia have overactive dopamine systems. They've never been able to find that people with depression have underactive serotonin systems. They've never found consistently that any of these disorders are associated with any chemical imbalance in the brain. The story that people with mental disorders have known chemical imbalances -- that's a lie. We don't know that at all. It's just something that they say to help sell the drugs and help sell the biological model of mental disorders.

But the kicker is this. We do know, in fact, that these drugs perturb how these chemical messengers work in the brain. The real paradigm is: People diagnosed with mental disorders have no known problem with their neurotransmitter systems; and these drugs perturb the normal function of neurotransmitters.

SS: So rather than fixing a chemical imbalance, these widely prescribed drugs distort the brain chemistry and make it pathological.
RW: Absolutely. Stephen Hyman, a well-known neuroscientist and the former director of the National Institute of Mental Health, wrote a paper in 1996 that looked at how psychiatric drugs affect the brain. He wrote that all these drugs create perturbations in neurotransmitter functions. And he notes that the brain, in response to this drug from the outside, alters its normal functions and goes through a series of compensatory adaptations.

In other words, it tries to adapt to the fact that an antipsychotic drug is blocking normal dopamine functions. Or in the case of antidepressants, it tries to compensate for the fact that you're blocking a normal reuptake of serotonin. The way it does this is to adapt in the opposite way. So, if you're blocking dopamine in the brain, the brain tries to put out more dopamine and it actually increases the number of dopamine receptors. So a person placed on antipsychotic drugs will end up with an abnormally high number of dopamine receptors in the brain.

If you give someone an antidepressant, and that tries to keep serotonin levels too high in the brain, it does exactly the opposite. It stops producing as much serotonin as it normally does and it reduces the number of serotonin receptors in the brain. So someone who is on an antidepressant, after a time ends up with an abnormally low level of serotonin receptors in the brain. And here's what Hyman concluded about this: After these changes happened, the patient's brain is functioning in a way that is "qualitatively as well as quantitatively different from the normal state." So what Stephen Hyman, former head of the NIMH, has done is present a paradigm for how these drugs affect the brain that shows that they're inducing a pathological state.

SS: So the paradox is there's no evidence for modern psychiatry's claim that there is any pathological biochemical imbalance in the brain that causes mental illness, but if you treat people with these new wonder drugs, that is what creates a pathological imbalance?
RW: Yes, these drugs disrupt normal brain chemistry. That's the real paradox here. And the real tragedy is, that even as we peddle these drugs as chemical balancers, chemical fixers, in truth we're doing precisely the opposite. We're taking a brain that has no known abnormal brain chemistry, and by placing people on the drugs, we're perturbing that normal chemistry. Here's how Barry Jacobs, a Princeton neuroscientist, describes what happens to a person given an SSRI antidepressant. "These drugs," he said, "alter the level of synaptic transmission beyond the physiologic range achieved under normal environmental biological conditions. Thus, any behavioral or physiologic change produced under these conditions might more appropriately be considered pathologic rather than reflective of the normal biological role of serotonin."

Read the entire and very lengthy interview at the link above.

Anonymous:
Comparing Schizophrenia Drugs
THE NEW YORK TIMES
http://www.nytimes.com/2005/09/21/opini ... ?th&emc=th

Published: September 21, 2005
A government-financed study has provided the strongest evidence yet that the system for approving and promoting drugs is badly out of whack. The study compared five drugs used to treat schizophrenia and found that most of the newest, most heavily prescribed drugs were no better than an older drug that is far cheaper. The nation is wasting billions of dollars on heavily marketed drugs that have never proved themselves in head-to-head competition against cheaper competitors.

The whole class of antipsychotic drugs has had undeniable value in blunting the symptoms of schizophrenia, enabling many patients to leave mental hospitals and move into the community. But the first generation of these drugs fell into disfavor because they often caused neurological side effects, like tremors and other involuntary movements.

That spurred the development of a new generation of drugs known as atypical antipsychotics, which now dominate the market and rake in some $10 billion in annual sales. The trouble is that these new drugs were approved largely on the basis of short-term clinical trials that compared them primarily with placebos, so there was little if any evidence that they were any better than many of the older drugs.

That gap has been filled by an 18-month clinical trial involving more than 1,400 adults around the nation. The study, sponsored by the National Institute of Mental Health, measured how long patients were able to keep taking their assigned drugs before deciding to change, usually because a drug wasn't working or had intolerable side effects. Three-fourths of the patients, a shocking number, stopped taking the drug they had been given, suggesting that there is a clear need for better treatments.

The study found that the oldest drug, perphenazine, was as effective and caused no worse side effects than three of the newer drugs. Zyprexa, a new drug made by Eli Lilly, helped patients control symptoms slightly better than the others, but at the cost of serious side effects.

Doctors should find a trove of useful data in the study to help them decide which drug might be best for a particular patient. But Congress and the Bush administration ought to pay attention as well. Surely it would make sense to force manufacturers to test their drugs not just against placebos, but against existing drugs that they are seeking to displace. And surely it would be cost-effective for the government to sponsor large studies comparing a slew of expensive drugs with their cheaper alternatives.

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